“Although quitting smoking is the most important preventive action in reducing lung cancer risk, consuming a mix of different types of fruit and vegetables may also reduce risk, independent of the amount, especially among smokers,” explained H. Bas Bueno-de-Mesquita, MD, MPH, PhD, senior scientist and project director of cancer epidemiology at The National Institute for Public Health and the Environment in the Netherlands.

The collaborative European Prospective Investigation into Cancer and Nutrition study found 1,613 out of 452,187 Europeans developed lung cancer during nearly nine years of follow-up.

The authors noted “Diet diversity scores (DDS) were used to quantify the variety in fruit and vegetable consumption. Multivariable proportional hazards models were used to assess the associations between DDS and lung cancer risk. All models were adjusted for smoking behavior and the total consumption of fruit and vegetables.”

“Variety in vegetable consumption was inversely associated with lung cancer risk among current smokers. Risk of squamous cell carcinomas was reduced with increasing variety in fruit and/or vegetable consumption, which was mainly driven by the effect in current smokers,” concluded the researchers.

Bueno-de-Mesquita added, “Fruits and vegetables contain many different bioactive compounds, and it makes sense to assume that it is important that you not only eat the recommended amounts, but also consume a rich mix of these bioactive compounds by consuming a large variety.”

However, Bueno-de-Mesquita told Relaxnews on August 30 that “Smoking is by far the most important, recognized avoidable, risk factor for lung cancer. But also high risk occupations such as those with exposure to industrial chemicals like arsenic, asbestos, chloromethyl methyl ether and/or bischloromethyl ether, coal-tar fumes, pollutants from iron and steel founding are known to increase lung cancer risk (WCRF/AICR report 2007).”

He added, “The WCRF/AICR [World Cancer Research Fund/American Institute for Cancer Research] report 2007 also found probable evidence for decreased lung cancer risk with increased consumption of fruits and foods containing beta-carotene.”

Should you plan to add a mix of beta-carotene-rich fruits and veggies to your daily diet, the nutrition and health info site HealthyGuidance.org recommends: carrots, sweet potatoes, watermelon, lettuce, spinach, cabbage, avocado, pumpkin, squash, tomatoes, asparagus and radish.

Full study, “Variety in Fruit and Vegetable Consumption and the Risk of Lung Cancer in the European Prospective Investigation into Cancer and Nutrition”: http://cebp.aacrjournals.org/content/early/2010/08/25/1055-9965.EPI-10-0489

WCRF/AICR’s Expert Report “Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective” online: http://www.dietandcancerreport.org/

In the September issue of Cancer Prevention Research, researchers report that metformin was associated with a substantial reduction (up to 73 percent) in the number of tumors mice developed when they were given a common carcinogen found in tobacco.

Despite the fact that there have been no randomized controlled trials on whether metformin really can prevent cancer, researchers expressed excitement both over this animal study and previous epidemiological evidence pointing to this possibility.

Metformin (originally marketed as Glucophage, though it is now available as an inexpensive generic) has been in use for more than two decades and is currently prescribed to 40 million Americans.

“This is a very safe agent and has been around for a while,” said Cancer Prevention Research editor-in-chief Dr. Scott Lippman, chair of thoracic head and neck medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston, at a Wednesday news conference.

“The evidence in diabetic humans is very convincing and very strong,” added Dr. Phillip Dennis, a senior investigator with the U.S. National Cancer Institute and senior author on the lung cancer paper. “Almost every epidemiological study I can think of found a decreased cancer incidence in diabetics taking metformin. The reduction is real and ranges from 30 to 70 percent.”

The researchers thought metformin’s possible cancer-lowering properties suggested the need for clinical trials to investigate whether the drug might help prevent tumors in smokers at high risk of developing cancer. Others believed that the finding might influence the choice of drugs in people with diabetes.

“All other things being equal, many diabetics face a choice of oral agents, and early evidence that metformin may have an effect on the oncology side may increasingly play a role in decision-making,” said Dr. Michael Pollack, professor of medicine and oncology at McGill University in Montreal. “We can’t ignore this, but we can’t say we have FDA [U.S. Food and Drug Administration] approval for metformin for cancer indications.”

Metformin was developed from the French lilac plant, known in the Middle Ages to control excess urination, a symptom of uncontrolled diabetes. The drug was approved by the FDA in the mid-1990s.

The study by Dennis and colleagues looked at mice that had been genetically engineered to be susceptible to lung tumors.

Mice taking metformin in their drinking water had 34 percent fewer tumors than those not taking metformin. And when the drug was administered by injection, the improvement seen was 73 percent.

Dennis stated that a likely mechanism of action resides in the liver “and specifically the hormones [including insulin] that are released.” Insulin may have a relationship with cancer.

“It’s most likely that metformin is working by reducing insulin and IGF1 [insulin-like growth factor] levels in the body,” said Lewis Cantley, director of the Cancer Center at Beth Israel Deaconess Medical Center in Boston, and co-author of an accompanying perspective piece.

It’s also possible, however, that metformin is working more directly on the tumor process, the researchers said.

A second study, this one a randomized controlled trial involving a very small number of humans (23), found that patients with an early form of colorectal cancer who were treated with metformin did see a decrease in possible cancer-related growth, compared with participants not taking the drug.

“These patients were not diabetic, so they didn’t necessarily have high insulin levels to begin with but lower insulin levels,” Cantley explained.

This adds credence to the idea that metformin’s value is in its ability to lower overall insulin levels in the body, Cantley said.

At this point, no one knows if metformin is safe in non-diabetic populations but some clinical trials are starting to look at the issue, Lippman said.

And, pointed out Dr. Lucas Wong, associate professor of internal medicine at Texas A&M Health Science Center College of Medicine and co-director of the Gastrointestinal Cancer Program at Scott & White in Temple, Texas, while the new research is “interesting and thought-provoking, what’s proven in humans is totally another level.”

More information

The U.S. National Library of Medicine has more on metformin.

SOURCES: Lucas Wong, M.D., associate professor of internal medicine, Texas A&M Health Science Center College of Medicine and co-director, Gastrointestinal Cancer Program, Scott & White, Temple, Texas; Sept. 1, 2010 teleconference with Scott Lippman, M.D., editor-in-chief, Cancer Prevention Research and professor and chair, department of thoracic head and neck medical oncology, University of Texas M.D. Anderson Cancer Center; Michael Pollack, M.D., professor of medicine and oncology, McGill University, Montreal; Phillip Dennis, M.D., Ph.D., senior investigator, U.S. National Cancer Institute; Lewis Cantley, Ph.D., director, Cancer Center, Beth Israel Deaconess Medical Center, Boston; September 2010, Cancer Prevention Research

But, the researchers stressed that quitting smoking will do far more to reduce risk than “an apple a day” or having a salad for lunch.

In the study, participants who ate a diet that contained a diverse mix of fruits and vegetables appeared to have a 27 percent lowered risk of a common type of lung cancer, the researchers reported.

“First and foremost, the best way to reduce one’s risk of lung cancer is to quit smoking. That is of paramount importance,” said principal investigator Dr. H. Bas Bueno-de-Mesquita, project director of cancer epidemiology at the National Institute for Public Health and the Environment in the Netherlands. “However, we realize that there are still millions worldwide who cannot and don’t want to quit smoking. To just ignore them would be somewhat of a pity. This study shows there is a possibility of reducing one’s risk even if one is a smoker.”

Keep in mind that “wide variety” meant more than a banana with breakfast and a helping of peas and carrots with dinner. Think kale and spinach; berries and melons; cabbage, cauliflower and eggplant — some 40 different fruits and vegetables in all.

The researchers analyzed data on more than 450,000 adults from 10 European countries. Participants filled out questionnaires about dietary habits and lifestyle, including occupation, medical history, tobacco and alcohol use and physical activity.

Over the course of nine years, 1,613 of the people were diagnosed with lung cancer.

Vegetable consumption was divided into eight categories: leafy vegetables; fruiting vegetables; root vegetables; cabbages; mushrooms; grain and pod vegetables; onion and garlic; and stalk vegetables. Vegetables did not include legumes, potatoes and other tubers.

The 14 fruits tracked included fresh, dried and canned fruits but excluded nuts, seeds and olives.

Participants were then divided into four groups, or quartiles, based on the diversity of their diet. Those in the highest quartile ate between 23 and 40 different types of fruits and vegetables during the prior two weeks. Those in the lowest quartile ate less than 10 different types of fruits and vegetables.

Smokers who ate the greatest variety of fruits and veggies were 27 percent less likely to get squamous cell lung cancer, which accounts for about 25 percent to 30 percent of all lung cancers, than smokers who ate the least variety.

“It is important to realize the risk reduction one can achieve by eating a greater variety of fruits and vegetables will be minor in relation to quitting smoking,” Bueno-de-Mesquita stressed.

The study is published in the September issue of Cancer Epidemiology, Biomarkers & Prevention. It should be noted that the study relied on “self reports” — in which the participants described to the researchers their fruit and vegetable consumption. Such studies, while valuable, are not considered the “gold standard” of research — a double-blind, placebo-controlled study.

But what is it about fruits and vegetables that may ward off the changes in cells that cause tumors to grow?

There probably isn’t one “magic” compound in the fruits and vegetables, Bueno-de-Mesquita said, but instead many compounds that interact with each other and the body in ways that aren’t yet understood.

It can be dangerous to put too much stock in any one substance, he added. A study in Finland found smokers who took the antioxidant beta carotene and vitamin E supplements actually had an increased risk of lung cancer.

Previous research has also linked fruits and vegetables with lowered risk of cancer. A 2007 World Cancer Research Fund/American Institute for Cancer Research report concluded that fruits probably protect against lung cancer, but there was no evidence that vegetables did.

But other research has suggested eating a variety of vegetables can reduce the risk of other types of cancers, including colorectal, gastric, breast, oral and pharyngeal cancer and squamous cell esophageal cancer.

Marjorie McCullough, strategic director of nutritional epidemiology at the American Cancer Society, said fruits and vegetables may help to protect against lung cancer, but every smoker should be working on quitting.

“Quitting smoking is far and away the most important way to lower the risk of lung cancer, but eating a variety of fruits and vegetables may further help lower the risk of several cancers,” McCullough said.

Eating lots of fruits and vegetables can also help prevent obesity, which is a risk factor for certain cancers, she added.

More information

The U.S. National Cancer Institute has more on lung cancer.

SOURCES: H. Bas Bueno-de-Mesquita, M.D., M.P.H., Ph.D., project director, Cancer Epidemiology, National Institute for Public Health, Bilthoven, The Netherlands; Marjorie McCullough, Sc.D., strategic director, nutritional epidemiology, American Cancer Society, Atlanta; September 2010, Cancer Epidemiology, Biomarkers & Prevention

The American Legacy Foundation in Washington, which sponsors the anti-smoking “Truth” campaign, is joining forces with the MTV cable channel for an initiative called “The Real World: Zombieville.” The project is based on “The Real World,” the long-running reality series on MTV that brings together a group of young adults to live in a house in locales that have ranged from Brooklyn to Hawaii to Paris.

To strengthen the ties between “Zombieville” and “The Real World,” the “Zombieville” commercials are appearing during the current installment of the series, “The Real World: New Orleans,” on Wednesday nights on MTV, and can also be watched on a section of an MTV Web site.

And the “Zombieville” commercials are being produced in the vein of episodes of “The Real World,” echoing aspects like the diversity of cast members, the use of hand-held cameras and having the cast speak, confessional-style, to the audience.

In this instance, however, the cast is composed of actors, rather than real people, and they are cohabiting in a house surrounded by hungry zombies — is there any other kind? — who are picking them off one by one.

The “Zombieville” commercials, each a minute long, are replete with violent goings-on and drenched in fake blood — the better to liken the effects of smoking, and the marketing methods of the tobacco industry, to the relentless havoc wreaked by zombies in fiction.

The twist is, of course, that cigarettes are part of the real world, not the fevered imagination of the authors of books, screenplays or TV scripts.

“Zombieville” began with a teaser spot during the episode of “The Real World” that appeared on Aug. 18. Two commercials are running during each of the next three episodes, on Aug. 25, Sept. 1 and Sept. 8, for a total of six. Then there will be wrap-ups during the episode to be shown on Sept. 15.

“Zombieville” is the most recent example of a collaboration between the foundation and MTV, part of the MTV Networks unit of Viacom, that dates to 2006. As the foundation seeks to stretch its limited advertising budget, estimated at $30 million a year, it is working with media companies to develop ideas that go beyond traditional commercials.

“MTV has proven to be a great partner for us,” says Eric Asche, senior vice president for marketing at the foundation, which was created as part of the landmark 1998 settlement between the tobacco industry and attorneys general.

The “Truth” campaign, which seeks to turn the marketing tactics of cigarette makers against them, first appeared nationally a decade ago. It was based on a concept created by Crispin Porter & Bogusky for anti-smoking ads aimed at youths who lived in the state of Florida.

Crispin Porter and Arnold Worldwide, part of Havas, cooperated on the “Truth” creative assignment until 2007, when it was consolidated at Arnold. Among the fruits of their collaboration was a commercial that appeared during the Super Bowl in 2004 for a make-believe product named Shards O’Glass Freeze Pops — frozen treats studded with sharp pieces of glass.

The Shards O’Glass spot was intended to mock how tobacco marketers belatedly conceded the dangers of smoking by presenting the chief executive of the imaginary Shards O’Glass company who discusses the unhealthy aspects of his products.

“Exposing the tactics” of cigarette marketing “has been an incredibly powerful tool for us,” says Mr. Asche, whose name is pronounced, appropriately enough, “Ashy.”

“We will never be able to out-shout the industry because the industry spends more in a day than what I spend in an entire year,” he adds, so “when we tell the truth, that resonates with consumers, as much today as in the past.”

The original Shards O’Glass commercial returned on June 30, during the season premiere of “The Real World: New Orleans,” and two new ones are appearing during the run of this installment. In one, the chief executive character introduces another (fake) product as dangerous to the human throat as a zombie, Shards O’Glass Spheres.

MTV and the “Truth” campaign share “a similar esthetic in how we talk to the consumer,” Mr. Asche says, and executives at MTV have “shown a keen interest in our issue.”

The “Truth” creative team at Arnold helped with story lines for the “Zombieville” commercials, which are being produced by MTV to enhance their resemblance to “The Real World.”

“Kids are not sitting around waiting for the next prevention message with bated breath,” Mr. Asche says, and the people at MTV have “a knack for creating content that resonates with their audience,” particularly the viewers ages 12 to 17 who are the “bull’s eye” for the “Truth” campaign.

Still, the process was not easy, he acknowledges, because “it took a while to get comfortable with handing over our assets” to the MTV staff members “and letting go” as the commercials were made.

“They worked hard to tie back the carnage” created by the zombies “to the facts about how the industry is marketing to consumers, the danger of the product, the packaging of the product,” Mr. Asche says.

In the first commercial, a housemate named Dante meets a housemate named Piper and, as is so common on actual episodes of “The Real World,” they have what Dante calls “this instant connection,” and start to make out.

Suddenly, zombies emerge out of nowhere and attack them. Dante makes it into the house, but Piper does not. The housemates fend off the zombies and in the melee, a zombie leaves his arm behind.

There is a close-up of a label on the sleeve on the arm that reads “Warning: Zombies are known to attack and eat you.”

A housemate asks Dante, “Didn’t you see the warning label?” And another says, “Hey, Dante, welcome to ‘The Real World: Zombieville.’ ”

An announcer’s voice is heard at the end of the commercial as the remaining housemates mop up the mess. “Just like zombies, cigarettes kill over 50 people an hour despite having a warning label,” he says. “The only difference is cigarettes are real.”

The viewers then see superimposed on screen the “Truth” and MTV logos and the realworld.mtv.com Web address. (In addition to the commercials, the site also has information on the cast and behind-the-scenes footage.)

In the second commercial, a housemate named Garrett fixes breakfast as Dante and a third housemate, Trevor, are beating zombies at the front door with baseball bats.

“They call it ‘Zombie baseball,’” says a fourth housemate, J. Suddenly, a zombie gets past Dante and Trevor and enters the house, attacking Garrett and killing him.

J bemoans the loss because, he says into the camera, “Garrett made really good French toast.”

As Dante kills the zombie who killed Garrett, the announcer says: “Nearly 50,000 people in the U.S. die each year from second-hand smoke. Second-hand zombie attacks may not be real, but the dangers of second-hand smoke definitely are.”

The subsequent commercials are to cover subjects like smoking by teenagers and how the tobacco industry aims at segments of the consumer market like young women.

“Obviously, ‘The Real World’ provides a lot of fertile territory to explore,” says Amy Campbell, vice president for MTV on-air promotions in New York, like “the mix of characters in a house” and what happens when “a range of personalities comes together.”

Because “The Real World” is among “the staple shows” of the channel, she adds, “we’ve done a lot of things with it over the years, but nothing quite like this.”

MTV is describing the commercials as “a micro-series,” Ms. Campbell says, with “mini-episodes that play out like a series” each week.

The cast members of the spots are “young actors who we cast in the iconic, ‘Real World’ types of roles,” she adds, to invoke the kinds of teenagers and 20-somethings found on “The Real World,” among them “the more naïve persona and the more urban persona.” And the “isolated cabin in the woods” that is Zombieville, Ms. Campbell says, stands in for the cities in which “The Real World” has taken place, which have also included Boston, Chicago, Denver, Las Vegas, London, Los Angeles, Miami, Philadelphia, San Francisco and Washington.

The commercials were filmed over several days at a studio in New York, she adds.

Although Ms. Campbell and Mr. Asche are reluctant to give away too much of what will take place during the rest of “The Real World: Zombieville,” he will say that “there may be some repeat characters” — suggesting that killed-off housemates could return as zombies.

As for the violent tone of what occurs in Zombieville, Ms. Campbell says, it “made sense and didn’t feel like going too far” because it is “a fantastical sort of set-up.”

“Real zombies would have been too much,” she adds, laughing. “Those were not real zombies.”

I spoke with Dr. Wetter last week about what the research shows — and about how it could be used to ease the quitting process for smokers.

Talk about the smart phone data you collect from people trying to quit smoking.

We use smart phones to collect data during critical events that happen when people try to quit. For example, when they have a craving to smoke or when they actually smoke a cigarette, we’ll collect data. [We'll find out]: Who else is in the environment with them? What else is going on? Are cigarettes available? Are they drinking? Are they eating? Are they at work, at home, in the car? The smart phone will also beep at random times throughout the day and evening to collect the same kinds of information. We can compare that information across different situations. For example, when someone is craving we may find that they’re in situation characterized by negative emotions, like anxiety and stress, much more so than when you beep them at random times.

Why is getting the data via smart phone integral to this research?

There’s a voluminous amount of data showing that people can’t recall situations accurately. We all have these inherent biases in our recall. With the smart phones, we don’t have to ask them to remember anything. We just ask [them to] tell us what’s going on right now. A lot of our recall is a reconstruction rather than plucking out truths from memory. If you ask them to recall what was going on when they had a craving, they’ll very likely report being stressed. Most of us think that precipitates craving. When you compare those with real time, that is often not the case. The smart phones are integral for insuring we have accurate data. We use [the data] to develop their treatments and optimize them for each specific person.

What trends are appearing in your research?

The volatility of their emotions and the intensity of their craving is predictive of relapse. People who are having really strong cravings, and then not much, and then really strong cravings again will struggle to stay abstinent. We see the same thing when we look at negative emotions. People who are bouncing around [from really stressed to not stressed], this volatility really predicts relapse. Riding the roller coaster is tough. We wouldn’t have been able to [learn] that without using smart phones in real time, in the real world. We get a good picture of what their daily experience looks like.

You mentioned that many people assume a moment of stress comes right before a craving. Did you find truth in assumption?

Negative emotions are strongly related to cravings, just not as much as people believe they are. There is a wide variety of other things that precipitate craving as well: having alcohol, habitual situations such as a cigarette after a meal, a coffee break. People have this really strong belief about stress and negative emotions.

How will the data you’ve collected help you develop specific treatment options for patients?

We will ask them, when they’re right in the middle of a craving, “What would work for you right now? What would help you get through this situation without smoking?” We can provide a menu of coping strategies to help them get through that situation. They tell us which ones would work for them. The next time they’re in a similar situation, we can suggest they use those strategies. You’re really individualizing people’s treatment.

When the smart phone collects data [and] sees a lot of volatility, for example, it could fire off an application that makes suggestions on how to deal with craving. It could fire off a text message to a quit line and they could have a counselor call [the patient]. Or the smart phone could directly connect them to the quit line. We could make suggestions on increasing their pharmacotherapy: “We recommend that you chew some nicotine gum or use the nicotine nasal spray.”

It sounds like an evidence-based medical smart phone app.

We want to have some app you can download on your iPhone or Android that gives you the boost you need to help you quit smoking.

How could smart phone monitoring be used to study other health issues?

We know a lot about individuals trying to initiate a physical activity program. A lot of them are able to stick with it for awhile, but very quickly everything drops off. We don’t really know what specifically, other than people’s ideas and recall, causes them to drop off. We think you can use the smart phones to understand what makes some people successful and some not. They’re using it for diet now, too. You can provide people with guidance on what a serving size should look like. The technique is being used for a wide variety of risk behaviors.

The editorial, written by Gil Kerlikowske, John Walters, Barry McCaffrey, Lee Brown, Bob Martinez and William Bennett — that’s every United States “drug czar,” including the current one — was published in the Los Angeles Times Wednesday, and argues primarily that social costs incurred by legalizing marijuana would outweigh the potential revenue streams gained by taxing drug sales.

First and foremost, the high-profile anti-drug group contends, a potential marijuana legalization will lead to an upswing in use, particularly among minors:

Proponents of marijuana legalization often point to Amsterdam’s “coffee shop” marijuana sales, rarely mentioning that the Dutch have dramatically reduced what at one time were thousands of shops to only a few hundred — after being inundated with “drug tourists,” drug-related organized crime involvement and public nuisance problems. During the period of marijuana commercialization and expansion, there was a tripling of lifetime use rates and a more than doubling of past-month use among 18- to 20-year-olds, according to independent research.

This issue, they say, could also manifest itself dangerously by putting an increased number of high people on the roads.

While some argue that legalization could save money spent on law enforcement, the drug czars don’t buy this claim, saying instead that such a measure would instead create a complex and confusing set of priorities to police:

Law enforcement officers do not currently focus much effort on arresting adults whose only crime is possessing small amounts of marijuana. This proposition would burden them with new and complicated enforcement duties. The proposition would require officers to enforce laws against “ingesting or smoking marijuana while minors are present.” Would this apply in a private home? And is a minor “present” if they are 15 feet away, or 20? Perhaps California law enforcement officers will be required to carry tape measures next to their handcuffs.

Perhaps most interestingly, the narco-foes allege that the potential revenue that could be gained by taxing marijuana sales is overstated due to the fact that cannabis plants can be easily cultivated at home.

Regarding the supposed economic benefits of taxing marijuana, some comparison with two drugs that are already regulated and taxed — alcohol and tobacco — is worth considering. People don’t typically grow their own tobacco or distill their own spirits, so consumers accept high taxes on them as retail products. Marijuana, though, is easy and cheap to cultivate, indoors or out, and Proposition 19 would allow individuals to grow as much as 25 square feet of marijuana for “personal consumption.”

Yet its authors claim smoking still features in too many films and could be influencing young people to take it up.

“There’s a declining trend which is good to see,” said Ursula Bauer of the Center for Disease Control. “But we haven’t made nearly enough progress.”

The research is based on how many times tobacco use was shown in the biggest-grossing US films released between 1991 and 2009.
Continue reading the main story
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According to the study, there were 1,935 instances of smoking in all the films ranked in the US weekly box office Top 10 last year.

This compared with almost 4,000 instances in the biggest-grossing films of 2005.

The report recommends that movie ratings take into account smoking scenes and suggests that strong advertisements about the dangers of the habit precede such films.

Lead author Stan Glantz, of the University of California, said the report showed Hollywood was “perfectly capable of making movies without as much smoking and people still come see them”.

In a study of 20,000 Mexicans age 20 and older, researchers found that smoking and obesity were the most prevalent heart disease risk factors. One-third of men said they smoked, while half of women were found to have abdominal obesity (defined as having a waist size of about 35 inches for women, 40 inches for men).

High blood pressure was not far behind — affecting almost 30 percent of both men and women. Meanwhile, about 13 percent of adults had diabetes, and a similar percentage had high cholesterol.

Those figures are a far cry from the Mexico of 50 years ago, the researchers point out in the American Heart Journal.

In 1960, the nation’s rate of diabetes was less than 3 percent, before rising to 8 percent during the 1980s. Similarly, high blood pressure rose from a rate of about 10 percent, to 20 percent in the 1990s, to where it stands now.

Those patterns mirror the trend past studies have shown in Mexico’s rate of death from heart disease, which nearly doubled between 1970 and 2000. The current rate — about 56 heart disease deaths per 100,000 people — is still lower than that of the U.S., where the rate in 2006 was 135 per 100,000.

That gap, however, is somewhat misleading, as the U.S. population is older than Mexico’s. Moreover, the two nations’ heart disease trends are going in opposite directions.

Between 1970 and 2000, the U.S. and Canada showed a roughly 63 percent drop in their rates of deaths from heart disease, noted Dr. Jorge Escobedo, one of the researchers on the new study.

It’s believed, he told Reuters Health in an email, that this reduction resulted both from improved treatments for heart disease and from a decline in the number of people developing heart disease.

A number of factors likely help explain the trend seen in Mexico, according to Escobedo, who is with the Mexican Social Security Institute, which provides health care to 45 percent of the Mexican population. (The nation’s healthcare system involves a mix of public and private services.)

For one, the country is showing a pattern common to nations undergoing industrialization: Over the second half of the last century, fewer and fewer Mexicans were dying early of infectious disease; that meant that more and more were living long enough to develop major risk factors for heart disease, like type 2 diabetes, and of course heart disease itself.

In 1950, Escobedo pointed out, life expectancy in Mexico was only 47 years. Today it’s estimated to be 75 years.

However, Escobedo said, changes in lifestyle — less physical activity and a move away from traditional diets — are also likely involved.

Smoking has become a substantial problem in Mexico, especially among men. And the younger population has the highest rates: Escobedo’s team found that among men in their 20s, 38.5 percent said they smoked; that compared with 20 percent of men in their 60s.

According to the researchers, Mexico appears to be in between what are considered the second and third “stages” of the tobacco epidemic. The second stage is marked by an increase in a population’s number of female smokers, plus a 50 percent or greater increase in the number of male smokers. In the third stage, those rates plateau and a slow dip begins in the rate of smoking among men.

So Mexico’s smoking rates have yet to plateau.

According to Escobedo, public health efforts to prevent smoking, obesity and other heart risk factors among younger Mexicans are needed.

“The battle against smoking should be reinforced,” he said. “Actions to reduce obesity should be implemented.”

Moreover, Escobedo said, people who already have conditions like diabetes and high blood pressure need to get them under better control to lower their chances of developing heart disease.

Part of the problem in Mexico, he noted, is that many people, and even some health providers, are not aware of the importance of managing disorders like diabetes.

Access to treatment is another obstacle; Mexico’s patchwork of public and private insurance programs has meant unequal access to better-quality healthcare.

According to Escobedo, about 11 percent of the population remains uninsured, while 29 percent receive government-run care through a program called “popular health insurance” — which, Escobedo said, provides “quite limited” services.

No, she’s not looking for a job on the hit AMC drama, but…

Joosten, who plays Karen McCluskey on Housewives, thinks there should be a warning at the beginning of Mad Men episodes because of all the smoking the characters do—even if all that cigarette-puffing is historically accurate for the 1960s.

“I think they should at least have a disclaimer at the front of the show saying smoking is relevant to the time and place with the subject matter we’re dealing with and it is not recommended because it causes cancer,” Joosten, a two-time lung cancer survivor, told me yesterday at the Creative Arts Emmys. “They should at least do that.”

Joosten, 70, ended her 45-year smoking habit when she was first diagnosed with lung cancer in 2001. Eight years after beating the disease, she was once again told she had cancer. In January, doctors said she was cancer-free after undergoing surgery to remove the cancerous growth.

She also thinks Mad Men producers should provide annual chest x-rays “for any member of the cast and crew who wants one.”

Are you listening, Don Draper?

“Based on data that we have at the Philippine Cancer Society, lung cancer is the top cause of cancer-related death for males. And while breast cancer among females is most prevalent, the mortality rate for women caused by lung cancer is significant,” said PCS executive director Dr. Rachel Rosario.

“Tobacco use is the single most significant lifestyle choice that has increased the incidence of lung cancer. The mortality rate is alarming because more than 80 percent of women with lung cancer have succumbed to the disease. This dangerous habit affects not only the smoker, but also the people around them. Second-hand smoke is as lethal, and a new study has pointed out that 3rd hand smoke is also a possible cause of cancer” added Dr. Rosario. While first-hand smoke is inhaled directly by the smoker and second-hand is the smoke exhaled (and inhaled by others), third-hand smoke is the residue from second-hand smoke.

Some studies on third-hand smoke and its effects reveal that tobacco residue that lingers on surfaces can react with another chemicals in the air to form potent carcinogens — chemicals linked to various cancers. When someone smokes in a confined space, the scent lingers for an extended period of time. This indicates the presence of third-hand smoke. Nicotine can persist on those indoor surfaces, such as walls, floors, carpeting, drapes, and furniture for days, weeks, and even months.

International lung cancer death rates among women vary dramatically, which reflect the historical differences in the adoption of cigarette smoking by women in different countries. In 1990, lung cancer accounted for about 10 percent of all cancer deaths among women worldwide and more than 20 percent of cancer deaths among women in some developed countries.

In 1950, lung cancer accounted for only three percent of all cancer deaths among women. However, by 2000, it accounted for an estimated 25 percent of cancer deaths an estimated one of every four cancer deaths and nearly one of every eight newly diagnosed cancers among women.

Research has also shown that women are approximately 1.5 times more likely to develop lung cancer than men given the same conditions and the number of cigarettes smoked on a daily basis. Furthermore, the risk for dying of lung cancer is 20 times higher among women who smoke two or more packs of cigarettes per day than among women who do not smoke.

Scientists led by Dr. Ronald Crystal at Weill Cornell Medical College documented changes in genetic activity among nonsmokers triggered by exposure to secondhand cigarette smoke. Public-health bans on smoking have been fueled by strong population-based data that links exposure to secondhand cigarette smoke and a higher incidence of lung diseases such as emphysema and even lung cancer, but do not establish a biological cause for the correlation. Now, for the first time, researchers can point to one possible cause: the passive recipient’s genes are actually being affected.

Crystal’s team devised a study in which 121 volunteers — some of whom smoked and some of whom had never smoked — agreed to have samples of their airway cells studied for genetic activity. The subjects also provided urine so the researchers could measure the amount of nicotine and its metabolites, like cotinine, for an objective record of their exposure to cigarette smoke.

Airway cells that line the bronchus, from the trachea all the way to the tiny alveoli deep in the lungs, are the first cells that confront cigarette smoke, whether it is inhaled directly from a cigarette or secondhand from the environment. Crystal’s group hypothesized that any deterioration in lung function associated with cancer or chronic obstructive pulmonary disease, including emphysema and bronchitis, in which the lungs lose their ability to take in air, would begin with these cells.

And indeed, that’s what he and his team found. The researchers removed airway cells from the volunteers using a bronchoscope and tested all 25,000 identified human genes in them to determine which ones were active — either turned on or off — in response to cigarettes. They narrowed the search to 372 genes that were active among the smokers but not in the cells of the nonsmokers. Based on the level of nicotine in the urine, the scientists also divided the volunteers into three groups: smokers, who showed the highest level of the tobacco metabolites; nonsmokers, who showed none of these compounds and a low-exposure group who fell in between. Comparing the 372 genes among these three groups, they found that the low-exposure group shared 34% of the same active genes with nonsmokers and 11% of the same gene activity with smokers. The low-exposure group included both nonsmokers who have never lit up as well as those who admitted to smoking only occasionally.

The results suggest that the genetic changes among the low-exposure volunteers, some of whose exposure is exclusively secondhand, mimicked those of smokers and represent the first molecular steps toward later lung disease. The study did not follow the subjects long enough to document what effect the genetic changes may actually have on the lung tissue, but Crystal says those studies are forthcoming.

“What is interesting to me is how sensitive the lung cells are to any cigarette smoke,” he says. “It doesn’t matter if you are walking into a cocktail party where other people are smoking or if you smoke one cigarette a week. No matter what level of exposure you have, your lung cells know it and they are responding. It’s sort of like canaries in the coal mine — they are crying out and saying, ‘I’m changing here, I’m changing the genes that I turn on and off in response to this environmental stress.’”

It’s not clear how permanent these genetic changes are, but previous data suggests that, at least in smokers, some of the alterations may be irreversible. Smokers experience a decline in lung function that is accelerated compared with nonsmokers, and even if they kick the habit, they can never achieve the same level of function as those who never lit up. If the genetic results are confirmed, says Crystal, they may help doctors to identify those whose genetic makeup put them at higher risk of developing lung disease when exposed to cigarettes, and potentially steer them toward drugs that can help them suppress the dangerous effects of nicotine on their cells.

In the meantime, the latest findings should reinforce public-health messages about the dangers of cigarette smoke, even if it is secondhand, says Dr. Norman Edelman, chief medical officer of the American Lung Association. “When you look at the biology, there is no safe level of exposure to tobacco smoke,” he says. “This [study] adds an important piece of evidence that inhaling secondhand smoke is deleterious and does things to the airway that are not good.”

Cigarette smoking has been clearly linked to increased risks of a number of cancers, including cancers of the lungs, colon, pancreas and bladder. But studies have yielded conflicting results as to whether smoking may boost a woman’s odds of developing breast cancer.

The new study, published in the American Journal of Epidemiology, looked at the relationship between smoking and the risk of ductal carcinoma in-situ, or DCIS — abnormal cells in the milk ducts of the breast that can progress to cancer that invades the breast tissue.

If smokers have a higher risk of DCIS, the researchers reasoned, that could mean that tobacco exposure acts at the very early stages of breast cancer development.

However, the study found that among more than 63,000 postmenopausal women followed for eight years, smokers and former smokers were no more likely to be diagnosed with DCIS than women who had never smoked.

The findings “provide little support” for a relationship between smoking and the risk of DCIS after menopause, write the researchers, led by Dr. Geoffrey C. Kabat of the Albert Einstein College of Medicine in New York.

The results come from an analysis of more than 63,000 U.S. women ages 50 to 79 who took part in the government-sponsored Women’s Health Initiative clinical trial, begun in the 1990s.

Over eight years, 486 women were newly diagnosed with DCIS. Of women who developed the condition, 4.5 percent were current smokers; among women who remained free of DCIS, 7 percent were current smokers. In both groups, about 42 percent of women were former smokers.

Overall, Kabat’s team found no differences in the risk of developing DCIS among former, current and non-smokers, when other factors — like age, weight, education levels and self-reported exercise habits — were taken into account.

Nor could the researchers find a relationship between DCIS and the length of time a woman had smoked, how heavily she had smoked or the age at which she had started smoking.

Given the “myriad” cancer-promoting chemicals in cigarette smoke, the lack of an association between smoking and DCIS — and, in many studies, invasive breast cancer — seems counterintuitive, Kabat and his colleagues write.

However, they point out that cigarette smoke also has anti-estrogen effects, and estrogen can fuel the growth of breast tumors. That, the researchers note, makes the relationship between smoking and breast cancer more complex.

Whatever the effects of smoking on estrogen, however, the known risks of smoking — from various cancers to chronic lung disease to heart disease — far outweigh any potential benefit.

Since mammography screening came into widespread use in the 1980s, diagnoses of DCIS have been increasing. It’s been estimated that by 2020, 1 million U.S. women will be living with the diagnosis. Because of the chance that DCIS can progress to invasive cancer, most women receive treatment — usually with surgery to remove the abnormal cells, sometimes followed up with radiation.

In general, the risk factors for DCIS are the same as those for invasive breast cancer — such as older age; having a mother, sister or daughter who had breast cancer; and long-term use of hormone replacement therapy after menopause.

The NHS Information Centre said 373,964 had successfully given up, an 11% rise from the 337,054 who gave up in in 2008/09.

The figures are for people in England who successfully stopped when they were followed up after four-weeks.

A separate report from the centre shows around one in 20 hospital admissions for over-35s were linked to smoking.

It brought together data from a wide range of previously published material and said smoking accounted for 462,900 admissions.

Drug therapies

Record quit rates were seen three years ago after the introduction of the smoking ban in public places.
Continue reading the main story

“This just shows what you can do when you have a proper plan to help smokers quit”

The ban – introduced in England and Wales in 2007 – was seen as one of the key reasons why more people tried to stop smoking that year. A ban was introduced in Scotland in 2006.

About 65% of people trying to give up smoking used nicotine replacement therapy (NRT), and 47% of them were successful.

Almost a quarter used the controversial stop-smoking drug varenicline (Champix) last year, more than did so in 2008/09. Sixty per cent of them managed to quit using the drug.

Of those who did not use any kind of drug therapy, 49% were able to give up cigarettes.

Total spending on NHS stop smoking services was just under £83.9m last year, up £10m from 2008/09. The cost per quitter was £224, an increase of 3% from the previous year.

There was wide variation in quit rates across England.

The highest percentage of successful quitters was reported by Redbridge Primary Care Trust, with 70%. The lowest rates were seen in Lambeth PCT and Blackburn with Darwen PCT, where only 31% of smokers who tried were able to stop.

‘Resist the heavy mob’

NHS Information Centre chief executive Tim Straughan said: “NHS Stop Smoking Services are helping more people than ever before to quit, and… they are using a number of means of offering support.

“With smoking attributed to so many hospital admissions among those who are 35 and over, it is important that people get the support they need to quit in order to remain as healthy as possible.”

Health Secretary Andrew Lansley welcomed the findings, but said more could be done.

“Smoking is the biggest preventable cause of death in England.

“We are now reviewing how best to tackle this issue in the context of the new priority and focus on public health by the government and this department.”

Martin Dockrell, director of policy and research at the charity Action on Smoking and Health, said: “Of course this is the opposite of the ‘nanny state’. These are people who really want to quit but they know they stand a much better chance of making their choice stick if they get professional help from the NHS.”

But Simon Clark, director of the smokers’ lobby group Forest, said: “Total expenditure on NHS Stop Smoking Services during 2009/10 was more than £83 million, £10 million more than the previous year. People choose to smoke so I’m not sure that the taxpayer should pick up the bill when they choose to quit.”

Teens with all three of the negative lifestyle factors were 3.4 times more likely to have frequent headaches than those with none of the negative lifestyle factors. Of those with all three negative lifestyle factors, 55 percent had frequent headaches, compared to 25 percent of those with no negative lifestyle factors. Those with two negative factors were 1.8 times more likely to have frequent headaches.

Overweight teens were 40 percent more likely to have frequent headaches than those with no negative factors. Teens who smoked were 50 percent more likely to have frequent headaches, and teens who exercised less than twice a week were 20 percent more likely to have frequent headaches than those who exercised at least twice a week and had no other negative factors.

“These lifestyle factors have rarely been studied in teens,” said Andrew D. Hershey, MD, PhD, of the University of Cincinnati College of Medicine and a member of the American Academy of Neurology, who wrote an editorial accompanying the study. “This study is a vital step toward a better understanding of lifestyle factors and potential preventive measures that can be taken.”

As part of the Nord-Trøndelag Health Study, 5,847 students age 13 to 18 in Nord-Trøndelag county in Norway were interviewed by nurses about headaches and their weight and height measurements were taken. They also completed a questionnaire about physical activity and smoking. Out of the group, 36 percent of girls and 21 percent of boys reported having recurrent headaches within the last year.

A total of 16 percent of the students were overweight, 19 percent were smokers, and 31 percent exercised less than twice a week.

Study author John-Anker Zwart, MD, PhD, of the University of Oslo said the study suggests that the treatment and prevention of headaches in teens may need to include management of healthy habits such as regular exercise, healthy food choices and stopping smoking.

The Nord-Trøndelag Health Study is a collaboration of HUNT Research Centre, the Norwegian University of Science and Technology, Norwegian Institute of Public Health and the Nord-Trøndelag County Council.

The American Academy of Neurology, an association of more than 22,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer’s disease, narcolepsy and stroke.

For more information about the American Academy of Neurology, visit http://www.aan.com.

“Our study reveals that nicotine can react with ozone to form secondary organic aerosols that are less than 100 nanometers in diameter and become a source of thirdhand smoke,” says Mohamad Sleiman, a chemist with the Indoor Environment Department of Berkeley Lab’s Environmental Energy Technologies Division (EETD) who led this research.

“Because of their size and high surface area to volume ratio, ultrafine particles have the capacity to carry and deposit potentially harmful organic chemicals deep into the lower respiratory tract where they promote oxidative stress,” Sleiman says. “It’s been well established by others that the elderly and the very young are at greatest risk.”

Results of this study have been reported in the journal Atmospheric Environment in a paper titled “Secondary organic aerosol formation from ozone-initiated reactions with nicotine and secondhand tobacco smoke.” Co-authoring this paper with Sleiman were Hugo Destaillats and Lara Gundel, also with EETD’s Indoor Environment Department, and Jared Smith, Chen-Lin Liu, Musahid Ahmed and Kevin Wilson with the Chemical Dynamics Group of Berkeley Lab’s Chemical Sciences Division. The study was carried out under a grant from the University of California’s Tobacco-Related Disease Research Program.

The dangers of mainstream and secondhand tobacco smoke, which contain several thousand chemical toxins distributed as particles or gases, have been well documented. This past February, a study, also spearheaded by Sleiman, Destaillats and Gundel, revealed the potential health hazards posed by thirdhand tobacco smoke which was shown to react with nitrous acid, a common indoor air pollutant, to produce dangerous carcinogens. Until now, however, in terms of forming ultrafine particles, there have been no studies on the reaction of nicotine with ozone.

Released as a vapor by the burning of tobacco, nicotine is a strong and persistent adsorbent onto indoor surfaces that is released back to indoor air for a period of months after smoking ceased. Ozone is a common urban pollutant that infiltrates from outdoor air through ventilation that has been linked to health problems, including asthma and respiratory ailments.

Says co-author Gundel, “Not only did we find that nicotine from secondhand smoke reacts with ozone to make ultrafine particles – a new and stunning development – but we also found that several oxidized products of ozone and nicotine have higher values on the asthma hazard index than nicotine itself.”

Says co-author Destaillats, “In our previous study, we found that carcinogens were formed on indoor surfaces, which can lead to exposures that are likely to be dominated by dermal uptake and dust ingestion. This study suggests a different exposure pathway to aged secondhand or thirdhand smoke through the formation and inhalation of ultrafine particles. Also, our group had previously described the formation of secondary organic aerosols in reaction of indoor ozone with terpenoids, commonly present in household products. But this is the first time that nicotine has been tagged as a potential candidate to form ultrafine particles or aerosols through a reaction with ozone.”

To identify the products formed when nicotine in secondhand smoke is reacted with ozone, Sleiman and his co-authors utilized the unique capabilities of Berkeley Lab’s Advanced Light Source (ALS), a premier source of x-ray and ultraviolet light for scientific research. Working at ALS Beamline 9.0., which is optimized for the study of chemical dynamics using vacuum ultraviolet (VUV) light and features an aerosol chemistry experimental station, the researchers found new chemical compounds forming within one hour after the start of the reaction.

“The tunable VUV light of Beamline 9.0.2′s custom-built VUV aerosol mass spectrometer minimized the fragmentation of organic molecules and enabled us to chemically characterize the secondhand smoke and identify individual constituents of secondary organic aerosols,” says Sleiman. “The identification of multifunctional compounds, such as carbonyls and amines, present in the ultrafine particles, made it possible for us to estimate the Asthma Hazard Index for these compounds.”

While the findings in this study support recommendations from the California EPA and the Air Resources Board that discourage the use of ozone-generating “air purifiers,” which among other applications, have been used for the removal of tobacco odors, the Berkeley Lab researchers caution that the levels of both ozone and nicotine in their study were at the high end of typical indoor conditions.

Says Sleiman, “In addition, we need to do further investigations to verify that the formation of ultrafine particles occurs under a range of real world conditions. However, given the high levels of nicotine measured indoors when smoking takes place regularly and the significant yield of ultrafine particles formation in our study, our findings suggest new link between asthma and exposure to secondhand and thirdhand smoke.”

Provided by DOE/Lawrence Berkeley National Laboratory

The actor will undergo chemotherapy and radiation to treat the cancer.

“That combination is, unfortunately, a recipe for development of a throat cancer,” Dr. Kenneth Hu, co-director of the Head and Neck Institute at Beth Israel Medical Center in New York, told “Good Morning America” today. “I think the fact that he’s getting radiation means it’s curable.”

News of a tumor in Douglas’ throat was released Monday. People magazine is reporting that the star known for his gravelly voice will soon undergo eight weeks of chemotherapy and radiation.

“It tells you that it’s probably an intermediate stage cancer,” said Hu, who is not involved with Douglas’ treatment.

The two months of treatment, he said, will likely preserve Douglas’ voice box though he may be noticeably more hoarse by the end. More aggressive treatment, he said, such as surgery, carries a much more significant risk of permanently damaging the voice.

Hu said Douglas’ will have to stop smoking, if he hasn’t already, for the treatment to work properly.

“Smoking probably caused the cancer,” he said.”But smoking during the radiation makes the radiation less effective.”

Representatives for Douglas have confirmed to ABCNews.com that doctors discovered a tumor in the Oscar-winning actor’s throat, but declined further comment.

The Oscar-winning actor’s spokesperson told People magazine Monday that doctors expect him to “make a full recovery.”

“I am very optimistic,” Douglas said in a statement.

Douglas has openly struggled with his smoking habit in the past, but it has not been confirmed that his penchant for cigarettes is linked to his diagnosis.

Hu said tobacco infiltrates most of the body, causing tissue to inflame and repeated alcohol use serves to chronically irritate the area. Put together, the two drugs create a breeding ground for cancerous cells to develop.

“Michael Douglas, as recently as four years ago has admitted that he was struggling with his smoking situation,” People magazine staff writer Blaine Zuckerman said. “Smoking has been a part of his life.”

In 1996 Douglas told ABC News that the 20 years of abuse “needed to be corrected and checked.”

Michael Douglas Cancer Diagnosis Comes After Harrowing Year

Douglas’ diagnosis comes ahead of the premiere of his latest movie, “Wall Street: Money Never Sleeps,” due to open in theaters Sept. 24. It’s unclear whether his treatment will affect the promotion of the highly anticipated follow-up to 1987′s “Wall Street.”

The 65-year-old actor and husband of actress Catherine Zeta-Jones has had a harrowing year.

“I’ve had a rough year on the personal front,” he told the Chicago Sun-Times in June. “It’s been pretty well publicized.”‘

In April, his son, Cameron Douglas, was sentenced to five years in prison on drug charges. In a bid to keep Cameron from a long stint in jail, Douglas hand-wrote an impassioned, five-page letter to Manhattan federal judge Richard Berman, referring to his family’s history of drug abuse.

“Dear Judge Berman,” he wrote, “I don’t want to burden you with a litany of my son, Cameron’s rehab history, beginning at 13. He’s an adult and responsible for his own life. We do know, however, that genes, family, and peer pressure are all a strong influence on a substance abuser.”

Michael Douglas suggested that his family’s fame — he is the son of Kirk Douglas, one of Hollywood’s biggest stars in the 1950s and ’60s — could be to blame for his son’s dependence on drugs.

“I have some idea of the pressure of finding your own identity with a famous father,” he wrote. “I’m not sure I can comprehend it with two generations to deal with.”

Douglas told the Sun-Times that when he first became a father, the travel involved with making movies forced him to be away from Cameron. He said he doesn’t want to make the same mistake with his children with Zeta-Jones, Dylan, 10 and Carys, 7.

“My priorities have completely changed. My marriage and my families come certainly before my career,” he said.”I cherish the time with them. I’m picking a lot fewer projects now. It’s tough to get me out of the house.”

Maori could expect a five-year gain, while the life expectancy of non-Maori would be three years longer if sales ended by 2020 and the gains projected to 2040, researchers from Otago University, Wellington, say.

This was compared to life expectancy if smoking rates stayed the same as they were in the 2006 census.

“This is a win-win situation,” lead researcher Tony Blakely said.

“Making New Zealand free from tobacco sales not only improves everyone’s life expectancy, but it also substantially reduces health inequalities between Maori and non-Maori.”

Currently just under 50 percent of Maori smoke, and about 22 percent of the whole population, with 4500-5000 tobacco-related deaths annually.

Professor Blakely said there was growing momentum among the public and politicians that it was time to end the tobacco epidemic.

The Maori Affairs select committee was soon to report to Parliament with recommendations, following its inquiry into the effect of the tobacco industry on Maori.

“Phasing out the sale of tobacco by 2020 would be the single most important and feasible action to reduce Maori mortality and ethnic disparities in this country,” said Prof Blakely.

Prof Richard Edwards, co-author and lead researcher on projects looking at how to end tobacco sales in New Zealand, said enough was known now about how to reduce smoking to start a 10-year countdown to zero tobacco sales.

“A ‘sinking lid’ in tobacco imports, accompanied by massive increases in tobacco cessation activity and other supportive measures to promote quitting amongst smokers and to stop children starting, will see New Zealand effectively tobacco-free by 2020,” he said.

A companion paper in the journal presents trends in survival and lifetables, necessary for projections of life expectancy to 2040.

Dr Kristie Carter, lead author of the paper, reported that the differences in life expectancy between current smokers and people who never smoked was about seven years during 1996-99 — the most recent period with the necessary data.

If nothing was done, and smoking persisted at current rates it would become an even greater constraint on life expectancy and reduction of health inequalities in future, Prof Blakely said.

The research arose from the New Zealand Census-Mortality Study, funded by the Health Research Council and the Ministry of Health.

Medicago, based in Quebec, plans to create 85 jobs paying $50,229 on average, not including benefits, over three years. The Medicago jobs would pay less than the Durham County average wage of $57,772.

Still, if it creates the jobs, the company will receive a $128,000 state grant as a financial incentive and a matching grant administered by Durham County.

Medicago specializes in producing vaccines by growing viruslike cultures on tobacco leaves, a process that reduces the time needed to create vaccines from six months to several weeks. In awarding its grant, the Defense Department cited the technology’s potential to manufacture high quantities of vaccine to rapidly respond to epidemics, bioterrorist attacks and other public health emergencies.

“This is really breakthrough science they’re working on,” said Sam Taylor, president of N.C. Biosciences Organization, an industry trade group.

Medicago CEO Andy Sheldon said that when the new facility is completed in 14 months, it will have the capacity to create 10 million doses of vaccine per month. The facility will include a greenhouse to cultivate 14,000 tobacco plants, labs to extract vaccines from the plants and administrative offices.

The 11-year-old development company, which employs 90 people in Canada, is several years away from selling its products on the market.

Sheldon said the company is working on three vaccines, but its technology could one day be used to create at least 40 kinds of proteins, viruses and enzymes for a wide variety of applications.

Sheldon said Medicago picked North Carolina over two other states in large part because of the high-tech work force available in Research Triangle Park. The state’s code name for its campaign to recruit Medicago was Project Flower.

“The Research Triangle Park’s reputation is known to people who don’t even know where it is,” Sheldon said.

Medicago’s facility will cost about $25 million to build, he said.

In addition, the company will invest $7.5 million in the plant, and Alexandria Real Estate Equities will invest $13.5 million. Alexandria is the nation’s largest landlord to the life sciences industry.

The U.S. government has been pushing for the development of an antidote to the swine flu in the wake of last year’s H1N1 pandemic. The outbreak turned out to be milder than some had feared, but the flu scare demonstrated that existing methods of vaccine production were too slow to respond in time to avert a major public health crisis.

Medicago will grow tobacco plants from seed and submerge 5-week-old plants in a chemical bath containing proteins that will be used to make vaccines. The proteins will grow on the tobacco leaves and will be extracted after five days. After the proteins are removed, the plants will be destroyed.

He said tobacco leaves act as sponges in absorbing the solution which penetrates the plant cellulose and “switches on the cell machinery.”

Sheldon noted that the plant used in vaccine production is not the same species of tobacco used to make cigarettes. He said that other companies have worked with this technology but either ran out of cash or ran out of time before they could commercialize their product.

Medicago hopes to have approval from the U.S. Food and Drug Administration by 2013 to make its tobacco-based vaccines, and hopes to be selling the product the following year.

1. Japanese smoking rate as of May 2010

2009 (%) / 2010 (%) / Change since last year

Men: 38.9 / 36.6 / -2.3 percentage points

Women: 11.9 / 12.1 / 0.2 percentage points

Total: 24.9 / 23.9 / -1.0 percentage points

2. Japanese smoking population as of May 2010 (estimate)

(Unit: millions)

2009 / 2010 / Change since last year

Men: 19.57 / 18.40 / -1.17

Women: 6.44 / 6.55 / 0.11

Total: 26.01 / 24.95 / -1.06

Note: The above figures were calculated based on the men and women adult population as of April 1, 2010, provided by the Statistics Bureau of the Ministry of Internal Affairs and Communications, which were 50.26 million and 54.14 million, respectively.

The company believes that total smoking rate in Japan has been slightly decreasing, continuing the trend of past years. The decrease may be due to various factors, including the aging of society, increasing health consciousness, more stringent smoking regulations, and amendment of retail prices of tobacco products in conjunction with the planned tobacco excise tax hike in October 2010.

JT will continue its efforts to realize a society in which smokers and non-smokers can co-exist in harmony.

[Outline of the 2010 Japan Smoking Rate Survey]

The survey was conducted in May 2010 using a stratified two-stage sampling method, by mailing questionnaires to 32,000 adult men and women nationwide. JT collected 20,631 (64 percent) valid responses from the total population surveyed.

For more information please visit http://www.jt.com/investors/media/press_releases/2010/0811_01/index.html

While most people are currently hiding in their air-conditioned homes, Errol Povah is running across the country to support his goal of a tobacco-free world.

Povah, 57, left Victoria May 31, which was the World Health Organization’s 23rd annual World No Tobacco Day and is walking toward Montreal and, if he has time and the resources, possibly onto New York.
Povah chose those two end-destinations because they are home to the head offices of some of the biggest cigarette producers in Canada and the United States respectively, he said.

While there is no one reason that spurred Povah into action, his family has been affected by tobacco usage.

“I did lose both an aunt and an uncle to lung cancer,” he said on the side of the Trans-Canada Highway just west of Portage la Prairie Monday.

Several years ago, Povah was inspired to form an anti-tobacco activist group with a woman from Nanaimo, who was just tired of breathing in second-hand smoke all the time.

That group is now defunct but Povah is currently president of the Airspace Action on Smoking and Health group.

The decision to run across the country came after some careful consideration for the former B.C. Ferries employee.

“It’s something I’ve been thinking about for a long time,” he said.

But it has not been as easy for him as, unlike many cross-country treks, Povah was unable to find sponsorship for his journey.

In fact, he doesn’t even have a support group following him. He has to park his van on the side of the highway and run up one side of it for a while and back down the other to his van so he can drive it ahead and do the circuit all over again, as he makes his way across the country walking 42 kilometres each day.

“I’m living in my Dodge Caravan mini van right now,” he said.

Adding to his woes is Manitoba’s lack of paved shoulders on the Trans-Canada Hwy. He prefers to walk on the pavement and that means having to walk directly on the side of the road, hoping drivers are kind enough to move over to the other lane.

If both lanes are full, Povah said, then he’ll walk on the gravel shoulder until he can get back on the pavement.

And, especially this week, Povah is having to fight through the heat armed with only a 500-millilitre bottle of warm water.

“I ration it,” he said.

While trekking across the country, Povah is also raising funds through his website www.tobaccofreeworld.ca. He aims to give part of the money he raises to charities in Vancouver and Toronto.