Tobacco could kill 1 billion by 2100
Fri, 08 Feb 2008 04:52:26 GMTBy EDITH M. LEDERER, Associated Press Writer
NEW YORK - The World Health Organization warned in a new report Thursday that the "tobacco epidemic" is growing and could claim 1 billion lives by the end of the century unless governments dramatically step up efforts to curb smoking.
In its first comprehensive report on tobacco use in 179 countries, the U.N.s health agency said governments around the world collect more than $200 billion in tobacco taxes every year but spend less than one-fifth of 1 percent of that revenue on tobacco control, it said.
"We hold in our hands the solution to the global tobacco epidemic that threatens the lives of 1 billion men, women and children during this century," WHO Director-General Dr. Margaret Chan said in an introduction to the report.
The WHO Report on the Global Tobacco Epidemic 2008 calls on all countries to dramatically increase efforts to prevent young people from beginning to smoke, help smokers quit and protect nonsmokers from exposure to second hand smoke.
It urges governments to adopt six "tobacco control policies" — raise taxes and prices of tobacco; ban tobacco advertising, promotion and sponsorship; protect people from second hand smoke; warn people about the dangers of tobacco; help those who want to quit smoking; and monitor tobacco use to understand and reverse the epidemic.
Chan announced the report Thursday at a news conference with New York Mayor Michael Bloomberg, whose foundation, Bloomberg Philanthropies, helped fund it with a $2 million grant. The report examines the tobacco policies of 179 countries for the first time, Bloomberg said.
According to the report, nearly two-thirds of the world's smokers live in 10 countries: China, which accounts for nearly 30 percent, India with about 10 percent, Indonesia, Russia, the United States, Japan, Brazil, Bangladesh, Germany and Turkey.
It forecast that more than 80 percent of tobacco-related deaths will be in low- and middle-income countries by 2030.
Dr. Douglas Bettcher, director of WHO's Tobacco Free Initiative, said WHO estimates 5.4 million smoking-related deaths a year, rising to more than 8 million a year by 2030 if nothing is done. That adds up to 175 million between 2005 and 2030. Beyond that, he said, deaths will continue to rise and statistical projections put the death toll at near 1 billion by the end of the century.
Tobacco use is growing fastest in low-income countries, the report said, "due to steady population growth coupled with tobacco industry targeting, ensuring that millions of people become fatally addicted each year."
It warned that "the shift of the tobacco epidemic to the developing world will lead to unprecedented levels of disease and early death in countries where population growth and the potential for increased tobacco use are highest and where health care services are least available."
According to the report, 74 countries still allow smoking in health care institutions and about the same number allow smoking in schools. More than half the countries, with two-thirds of the world's population, allow smoking in government offices and workplaces, and only 20 of 179 countries have complete bans on tobacco advertising, promotion and sponsorship.
"The tobacco epidemic is growing — it is shifting toward developing countries, with tobacco use growing fastest in low-income countries," Chan said.
For the tobacco industry to survive, and keep existing customers hooked and attract new customers, "it spends tens of billions of dollars a year on advertising, promotion and sponsorship," WHO said.
Michael Pfeil, vice president for communications for Lausanne, Switzerland-based Philip Morris International, said the company advocates "for tough, fair, cohesive regulation of the industry" and believes many countries need to do more. The company has operations in 160 countries.
He said regulations Philip Morris supports mirror some core provisions of the U.N. anti-smoking treaty that came into force last year. These include mandatory health warnings, restrictions on advertising including bans in some media, and minimum age laws for smoking, he said.
"We're going to continue to spend money," Pfeil said in a telephone interview. "I think we have a duty as a commercial entity to continue to grow our business, but ... our interest is in marketing to adult smokers who are smoking competitive products."
David Howard, spokesman for R.J. Reynolds, the second-largest cigarette manufacturer in the U.S., said the company is responsible in its advertising and warns consumers of the risk of smoking.
"The best course of action for any tobacco consumer concerned about their health is to quit," he said.
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Associated Press Writer Erin Gartner in Raleigh, N.C., contributed to this report
SAfrica questions circumcision advice
Fri, 08 Feb 2008 00:01:35 GMTBy CLARE NULLIS, Associated Press Writer
CAPE TOWN, South Africa - South Africa's health minister took another controversial foray into the AIDS debate Thursday by questioning international medical studies that say circumcision helps reduce HIV infections in men.
Manto Tshabalala-Msimang, who frequently clashes with foreign experts on how to deal with this nation's world-worst AIDS epidemic, said there wasn't "enough information" to justify the government running roughshod over some local communities whose traditions frown on circumcision.
Her comments were the latest in a string of positions that have earned Tshabalala-Msimang sharp criticism from AIDS activists, leading one expert to say the statement showed she is "addicted to folly."
Tshabalala-Msimang voiced doubts about the circumcision studies on the sidelines of a meeting of South African traditional leaders. Many of those leaders portrayed the advice on circumcision as a Western attempt to force foreign values and solutions on Africans.
South Africa has an estimated 5.4 million people infected with the AIDS virus — the most of any nation.
The United Nations says there is compelling evidence circumcision reduces the risk of men contracting the AIDS virus by up to 60 percent. The World Health Organization and UNAIDS last March endorsed male circumcision as an "additional important intervention."
The advice was issued following three extensive trials in South Africa, Kenya and Uganda that showed circumcision dramatically reduced men's susceptibility to HIV infection because the cells in the foreskin of the penis are especially vulnerable to the virus.
One study projected that in the next decade, male circumcision could prevent 2 million AIDS infections and 300,000 deaths.
Tshabalala-Msimang said she was not convinced, noting South Africa's Xhosa ethnic communities suffer high AIDS infection rates even though nearly all Xhosa men are circumcised. However, the infection rate is even higher for Zulus, for whom circumcision is taboo.
The health minister also said male circumcision offers no protection for women, who bear the brunt of the AIDS infections in sub-Saharan Africa.
"I can't say to people they must get circumcised when the process is ongoing," she said. "I can't go and say things to people which I can't guarantee."
Stephen Lewis, the former U.N. AIDS envoy for Africa and a strong critic of Tshabalala-Msimang, said the comments were typical of an official who has espoused garlic and lemon as a remedy for AIDS and openly mistrusts anti-retroviral medicines used to treat infections.
"She remains a minister who is addicted to folly," Lewis said in an interview from Canada. "There is overwhelming scientific evidence that male circumcision is one of the important ways of preventing transmission of the virus. This is proven beyond a shadow of a doubt."
Rwanda, Uganda, Zambia and Swaziland are among the African countries incorporating male circumcision as part of government AIDS prevention strategies. The United States and big donors like the Bill and Melinda Gates Foundation have said they are willing to fund such programs.
Swaziland, where an estimated one-third of the population is infected, has set up a circumcision task force even though Swazi culture is similar to that of Zulus, who fear circumcision will undermine their warrior traditions.
Twelve Swazi doctors, a tenth of the country's total, are being trained to perform the operation. The country's rate of circumcisions has increased from a couple a week to more than 10 a day, said Inon Schenker, head of an Israeli training mission in Swaziland.
"I meet almost everyone who comes into the operating room," Schenker said in a telephone interview. "I ask them, `Why did you come?' and 90-plus percent say, `This is going to allow us to be healthy.'"
He said every Swazi man who undergoes circumcision is counseled that the medical procedure alone does not offer complete protection against the AIDS virus and continued condom use is essential. They are also told they must wait until the wound heals before having sex.
Removing clot aids heart attack recovery
Fri, 08 Feb 2008 00:04:48 GMTBy STEPHANIE NANO, Associated Press Writer
NEW YORK - New research suggests that more people survive major heart attacks with fewer problems if doctors use a mini-vacuum to clear out an artery blockage instead of pushing it aside to restore blood flow.
The Dutch study is the largest to date to show that suctioning out the clot before implanting a stent has big benefits, and could lead to wider use in heart attack treatment. Previous smaller studies of various devices had mixed results.
"This study suggests that it is worth doing," said Dr. George Vetrovec, a heart disease expert at Virginia Commonwealth University in Richmond.
Most heart attacks occur when a buildup of plaque in a coronary artery ruptures, and a blood clot forms, blocking the flow of oxygen-rich blood to the heart. The preferred treatment is an angioplasty to quickly reopen the artery.
Doctors snake a tube through a blood vessel to the blocked artery and use a small balloon to compress the blockage and restore blood flow. A tiny metal-mesh stent is put in place to keep the artery open.
But sometimes the procedure causes bits of the clot or plaque to break off and plug the tinier vessels, restricting blood flow to the heart, said Dr. Felix Zijlstra, who led the study at University Medical Center Groningen in the Netherlands.
The artery is open "but still the blood doesn't go where you want it to go," he said.
They tried a different approach, suctioning the clot out before inserting the stent, and found that reduced debris and improved blood flow. The results are published in Thursday's New England Journal of Medicine.
For the study, doctors enrolled 1,071 patients who came to the hospital in 2005 or 2006 with a major heart attack and needed emergency angioplasty. Half received the conventional procedure; the other half had the blood clot suctioned out. Doctors threaded a small tube to the blockage and sucked out the clot with a syringe before putting in a stent.
"In daily practice, we say that we use the vacuum cleaner," said Zijlstra.
The heart attack was stopped in its tracks in 57 percent of the vacuum group and 44 percent of those getting regular care.
Using a dye, the researchers measured how much blood from the opened artery was saturating the heart tissue. In the conventional group, 26 percent of the patients had little or no blood reaching the heart tissue, compared to 17 percent of the patients who had the blockage removed.
Over the next 30 days, those with the poorest blood flow had higher death rates — 5 percent compared to 1 percent for the best flow group — and more serious complications.
Zijlstra said they are continuing to follow those patients, and the technique has been adopted at his hospital.
"I think there will be definitely others who will follow us very quickly. It's not very difficult to apply," he said.
The study was paid for by the Dutch medical center and Medtronic Inc., which makes the device used in the study. Other similar devices are available around the world.
Vetrovec, who wrote an accompanying editorial in the journal, said that the clot-removing technique is not routinely used in the U.S. It can take a bit longer to clear out the clot, he said, and guidelines recommend fast action on blocked arteries.
He said the study has "the potential to change practice," but noted that the heart attack death rate is already so low that this technique isn't likely to substantially change outcomes.
"We're sort of inching forward in terms of improvement," he said.
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On the Net:
New England Journal: http://www.nejm.org
House GOP opposes AIDS program changes
Fri, 08 Feb 2008 00:42:00 GMTBy JIM ABRAMS, Associated Press Writer
WASHINGTON - House Republican leader John Boehner and other Republicans warned on Thursday that a successful program to combat AIDS in Africa would be in jeopardy if Democrats move ahead with plans to make changes that he said would support abortions.
Boehner, R-Ohio, said the Democratic proposal to renew the five-year, $15 billion anti-AIDS effort "will undermine this valuable program as we know it, placing at risk the work it does on behalf of millions."
In what is shaping up to be a political and ideological showdown, House Foreign Affairs Committee Chairman Tom Lantos, D-Calif., replied that his Democratic proposal reaffirmed the compromise he worked out with the late Rep. Henry Hyde, R-Ill., in 2003. It is a shame, he said, that the GOP minority is "failing to honor this spirit of compromise and is willing to endanger a valuable U.S. foreign policy program addressing one of the most serious health care challenges that humanity faces today."
The program expires this year and President Bush, who travels to Africa this month, has urged Congress to double funding to $30 billion over the next five years. The President's Emergency Plan for AIDS Relief is now treating 1.4 million people, with the focus on 15 mostly sub-Saharan African nations.
Democrats, backed by AIDS groups, say that's still not enough to cope with the continuing HIV/AIDS crisis, and Lantos' committee next Thursday is to vote on a bill approving $50 billion in funds and making several changes that have enraged social conservatives.
The Lantos bill would eliminate a provision in the 2003 bill requiring that one-third of all prevention spending go to abstinence programs. That amounts to about 7 percent of all spending. Critics say that while they don't oppose abstinence programs, inflexible funding requirements are counterproductive.
It also would remove a provision stating that all groups receiving money under the program must sign a pledge confirming that they do not support the legalization of prostitution or sex trafficking. The groups still may provide condoms or condom information to prostitutes. The provision, said its author, Rep. Chris Smith, R-N.J., was designed to "ensure that pimps and brothel owners don't become U.S. government partners."
Democrats said studies have shown that some groups will not or cannot make the pledge because of concerns it will alienate women they are trying to reach. Other groups say legalized and controlled prostitution could help slow the spread of HIV infection.
Third, Republicans claimed that the Democratic-written bill undoes carefully crafted rules that allow money to go to family planning groups for AIDS work as long as no money is spent on abortions. That change, Rep. Mike Pence, R-Ind., said at a news conference including anti-abortion groups, "would transform the program into a mega-funding pool for organizations with an abortion promotion agenda."
Lantos said the administration has endorsed a link between family planning and HIV/AIDS programs, and that his bill clarifies that additional contraceptive services may be provided under the law as long as these services are focused on stopping the transmission of HIV/AIDS.
His spokesman, Lynne Weil, said it is clear that funds are not available for abortion and it strengthens the "conscience clause" that allows faith-based groups to opt out of any program to which they have a moral objection.
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On the Net:
The President's Emergency Plan for AIDS Relief: http://www.pepfar.gov/
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Antiimpotence pill could boost high flying pilots
Thu, 07 Feb 2008 20:43:25 GMTJERUSALEM - A drug used to treat impotence could help Israeli fighter pilots operate at high altitude, the Israeli military's official magazine reported in its latest issue.
It said a retired general plans to present to the air force the results of a study he conducted on Mount Kilimanjaro in Tanzania where he found that tadalafil, the active ingredient in Cialis tablets, improved breathing in a thin atmosphere.
"The study's findings justify the continuation of tests with drugs of this type in low oxygen environments," an unnamed air force officer told Bamahaneh, the military's weekly magazine.
An army spokeswoman said that there were no plans to use any such drug and a statement said the phenomenon of chronic oxygen starvation experienced by mountaineers and the immediate oxygen starvation which pilots suffer at high altitude are different.
" there is no significance for medical treatment of any drug for pilots in the Israel Air Force ... and it has no intention of using any form of drug," the statement read.
(Writing by Joseph Nasr and Ori Lewis; Editing by Stephen Weeks)
Health Tip Protect Your Child From Flu
Fri, 08 Feb 2008 04:47:39 GMT- Children are in constant contact with germs, and can easily spread them to others. Flu is a particularly nasty nemesis, but it can be prevented.
Here are ways to help reduce your child's risk of getting the flu, courtesy of the Children's Hospital at the University of California, San Francisco:
- Flu vaccine is recommended for children aged 6 months to 23 months, and for children aged 2 and older who are at a high risk of contracting flu.
- Hand washing also is an easy way to help prevent flu. Your child should wash her hands thoroughly and frequently, with soap and warm water.
- Parents and caregivers should also should wash their hands often, and get a flu vaccine.
- Teach your child to cover her mouth when she coughs or sneezes, and to wash her hands afterward.
- Try to keep your child away from others who are sick. Keep her home from school if she has symptoms of a cold or the flu.
Health Tip Pain Isn39t a Normal Part of Aging
Fri, 08 Feb 2008 04:47:38 GMT- Some seniors accept chronic pain as part of getting older.
But AARP says pain and aging don't have to go hand in hand. The organization says it's important to see to your doctor to help figure out the cause of your pain, and to determine the best course of treatment.
AARP offers these general suggestions:
- Try to exercise regularly.
- Seek out counseling or support groups to help you deal with pain.
- Soothe pain with relaxation techniques, including meditation and massage.
- Rate your pain on a scale of one to 10 for your doctor, and keep a record of when you experience pain.
- Talk to your doctor about methods you use to control pain, including any medications and topical treatments.
- Pay attention to what makes your pain subside, and what seems to make pain worse.
