Harm reduction has been an effective tool in relieving the plight of drug addicts who are at an increased risk of contracting severe infections especially hepatitis and HIV, but also drug-resistant bacteria such as MRSA as a result of using contaminated shared needles. Government-run clinics, such as Vancouver s Insite safe injection clinic, have demonstrated the beneficial effects of using this approach: Instead of reprimanding, cajoling, or even jailing heroin users, the clinic provides them with sterile needles to minimize the risks their addiction poses to the health and safety of themselves and others in the community. And such harm reduction tactics have paid off, resulting in markedly reduced rates of HIV and drug overdose cases in Vancouver.
Harm Reduction
Are hospitals really doing enough to help smokers quit the dangerous habit? The numbers seem impressive: The records show that they re providing advice on smoking cessation to 99 percent of heart attack patients, 97 percent of heart failure patients, and 95 percent of pneumonia patients. But a recent study in the Archives of Internal Medicine suggests that they re not doing an adequate job.
The clean nicotine delivery device known as the electronic cigarette has fared well in its first clinical trial. According to a new study that Italian researchers published in the journal BMC Public Health, the device may be more effective than traditional nicotine replacement therapies (NRT) as a means to help people quit smoking. And, even better, the results of the trial suggest that the e-cigarette may be effective at reducing smoking even in smokers who are not motivated to quit.
Lisa R. Lauve is the new sheriff at Christus St. Frances Cabrini Hospital in Alexandria, Louisiana, and her first order of business is to cut down on third-hand smoke. Starting July 1 of next year, the entire hospital campus will be subject to an anti-tobacco policy such that current staff members who smoke will have one year to make whatever adjustments they need in order to quit smoking or at least forgo the habit while at work. The idea is to prevent employees from even smelling of tobacco smoke.
North America s only safe-injection site for drug addicts will be allowed to continue its services, the Supreme Court of Canada ruled on Friday. The Court ruled unanimously that shutting down Vancouver s Insite clinic would threaten the health and lives of drug users, thus violating their human rights. This was a landmark legal decision in favor of the methods of harm reduction to address the health complications associated with illegal drug use without demanding abstinence from the addictive substance.
A lengthy article in this week s New England Journal of Medicine catalogues a variety of approaches to helping smokers quit within the healthcare setting, including counseling, smoking cessation medications such as bupropion and varenicline, as well as conventional nicotine replacement modalities like gum, inhalers, and patches. Unfortunately, the majority of these approaches have a success rate no higher than 9 percent a far cry from the 70 percent quit rates seen among smokeless tobacco users.
In keeping with the unimpressive success rate of conventional smoking cessation aids, cytosine, an anti-smoking drug first marketed in 1964, has only an 8.4 percent success rate among smokers, according to the first large modern study of the drug published in the New England Journal of Medicine. Researchers in Poland analyzed data from 740 volunteers who were accustomed to smoking 10 or more cigarettes a day.
Dr. Neal Benowitz, a professor in the Department of Medicine at the University of California, San Francisco, and a member of the Tobacco Products Scientific Advisory Committee, acknowledges that use of smokeless tobacco (ST) could reduce harm to smokers if they switched to the products entirely. He reviewed the literature and found, surprisingly, total agreement with our approach: ST is not a risk for cardiovascular disease and is only a minimal risk for pancreatic cancer (far less than smoking).
In a letter to the FDA on modified risk tobacco products (MRTP), a coalition of public health non-profits, including the American Cancer Society, The Campaign for Tobacco-Free Kids, and the American Heart Association, cites the tobacco industry s long history of misleading the public. As is now common knowledge, the industry hid the dangers of cigarette smoking, manipulated their products to enhance addictiveness, and marketed to young people. Now, these non-profits have used this history as a springboard to urge the FDA to establish stringent standards for the marketing of MRTP.
Just last week we reported that the smoking rate in New York City dropped to an all-time low of 14 percent down from 22 percent in 2002. The rate of smoking in the state as a whole has also declined. So we were surprised to read that the American Cancer Society (ACS) is criticizing the state for spending less than the recommended amount on tobacco control programs.
Upon initially reading the results of new research that found that nearly 30 percent of U.S. male smokers between the ages of 18 and 24 who were living in snus test market areas had tried the product, Dr. Ross thought the study was going to finally reveal the truth about snus and other smokeless tobacco products that they can help smokers get off deadly cigarettes. Unfortunately, however, Dr. Ross was gravely disappointed since the study led by the Center for Survey Research at the University of Massachusetts and Legacy, a national public health foundation arrived at an opposite conclusion.
Finally a bit of sound science and common sense seems to be percolating from an official governmental agency unfortunately, not in our country. The U.K.'s Cabinet level behavioral insight team, better known as the nudge unit, is encouraging the use of smokeless nicotine cigarettes to help addicted smokers quit, thus hoping to prevent tens of thousands of smoking-related deaths among Britons. Published on Thursday, the unit's first annual report states: If alternative and safe nicotine products can be developed which are attractive enough to substitute people away from traditional cigarettes, they could have the potential to save 10,000s of lives a year.