Monday, August 26, 2013

In the News: Office Visits Can Reduce Youth Smoking & More Benefits Found for Mediterranean Diet

Hot off the presses this morning are two important health-related releases from the US Preventive Services Task Force and the Cochrane Library.

From the USPSTF are updated recommendations that highlight effective approaches that primary care providers can use to prevent tobacco use in youth.  Because 90 percent of regular adult smokers begin smoking when they are under 18, targeting youth with effective prevention methods can have a significant impact on rates of adult smoking, and all the poor health outcomes that go with it.  The range of effective methods highlighted in the report range from minimal - a mailed packet of information or computer app, say - to much more involved face-to-face counseling.   Part of the importance of this updated reported is that it continues to keep a focus on tobacco.  While it can seem like the war on tobacco has been won - it hasn't.  Yes.  There have been great strides in lowering the rate of smoking in the US, but it's still quite prevalent and still a top contributor to death and ill health.  Stopping youth from taking it up is the best way to make sure they become and stay healthy and smoke-free adults.  

Next, from the always rigorous Cochrane Library is a new report on the health benefits of the Mediterranean Diet - the eating pattern inspired by traditional dishes in countries along the coast of the Mediterranean Sea, like Italy and Greece.  The focus is on healthy oils (like olive oil), fish, fruits, vegetables, legumes, and whole gains and lower amounts of red meat and dairy.  The report - one of Cochrane's systematic reviews - combined results from 11 different randomized controlled trials and found some modest but significant benefits to cholesterol levels (total and LDL "bad" cholesterol) and likely blood pressure.  No direct benefits were found in overall rates of heart disease.  Since the benefits of diet can be hard to assess in clinical trails - because subjects can have a hard time adhering to a regimented diet for long periods - these findings can be viewed as heartening - showing that diet alone - and one that is generally viewed as good tasting and sustainable - can have an important impact of key heart disease risk factors.  

Prevention of diseases like cancer and heart disease largely comes about by linking together small changes, which over time, can have a big impact on rates of disease and the burden they place on society.  These two releases can help us keep moving forward in that direction.

Thursday, August 1, 2013

Annals of Short-Sightedness: Washington State Cuts Off Tobacco Quitline Access to Uninsured

Yesterday, we wrote about new lung cancer screening guidelines and the overarching health benefits of smoking cessation.  In a strange twist, there is news today out of Washington state that uninsured Washingtonians will now have their access to the state's Tobacco Quitline drastically cut.

Quitlines (1-800-QUIT-NOW) offer valuable resources to smokers who want to quit or are thinking about quitting.  Washington state legislatures cut back access to the Quitline to help balance the budget.  So beginning August 1, most uninsured smokers will get only a single call to the service.  This is short-sighted for multiple reasons.

Most smokers take multiple tries to quit for good, so a single call is unlikely to provide the support smokers need to quit.   That the highest rates of smoking are in those who are economically disadvantaged and who have lower levels of education means that groups who are most likely to benefit from Quitline services are being cut-off from them.  And, even though there is a perception that smoking is a public health issue that's already been addressed, it remains a huge issue, and success with cessation programs are likely to provide economic productivity and health spending benefits well beyond any modest savings by cutting back Quitline services.

Economic and health disparities continue to climb in the United States, taking a toll not only on the economy but most importantly on the health of its citizens.  For a largely progressive state like Washington to cut back on an important health service to its underserved is a disturbing move that will broaden disparities rather than narrow them.

Quitting smoking at age 40 can add nearly 10 years to a smoker's life.  Quitting at 60 can add three years.  These are years spent with family, friends, and rewarding work that every smoker should have the chance to experience equally.