19 April 2009

Tobacco, pot users at higher disease risk

Chances of serious lung disease about three times more likely than in non-smokers, study says

People who habitually smoke both tobacco and marijuana are about three times more likely than non-smokers to develop serious lung disease.

That affects a lot of people because nearly 20 per cent of Vancouverites over the age of 40 do or have done just that, according to a new study by a team from St. Paul's Hospital.

People who smoked only cigarettes were 2.7 times more likely than non-smokers to have chronic obstructive lung disease. Those who smoke or smoked both cigarettes and marijuana were 2.9 times more likely to have the disease.

The study, published today in the Canadian Medical Association Journal, included nearly 900 Vancouver residents recruited into the study by random telephone dialing.

It showed that 14 per cent of participants now smoke only pot and 14 per cent smoke tobacco. Only 38 of the 856 participants now smoke both marijuana and tobacco. But 160 participants (18 per cent) were either current or previous users of both.

Consistent with previous population surveys showing B.C. has the highest marijuana use in the country, 45.5 per cent of participants in the current study said they had used marijuana in the past.

The study was designed to estimate the prevalence of chronic obstructive lung disease (COPD) among adults over the age of 40 in the general population and the associations with smoking.

Researchers from iCapture Centre for Cardiovascular and Pulmonary Research, a department at St. Paul's, had expected 15 per cent would have lung disease, but the study found it was 19.3 per cent.

About half of the people with clinical signs of lung disease had not yet been diagnosed with it -- they found out when they did lung function tests for the purposes of the study.

Lead author and respirologist Dr. Wan C. Tan said those study participants were given the results of their tests so they could share them with their family doctors, get referred for specialist care or, ideally, "take smoking cessation more seriously."

COPD -- which includes chronic emphysema or chronic bronchitis -- is often indicated by a continuing cough with phlegm and wheezing or shortness of breath. Tan said COPD is a progressive disease and is the fourth leading killer in North America, behind cancer, heart disease and stroke.

In the study, researchers found that participants with COPD had a greater likelihood of other illnesses like asthma, heart disease and high blood pressure. They were more likely to have a history of hospital admission for respiratory problems.

Marijuana smoking alone did not appear to cause COPD.

Although marijuana-only users had a 1.6 times greater risk of COPD than non-smokers, Tan said researchers are not convinced of the statistical power of that odds ratio because there were too few study participants who used marijuana alone in the COPD group.

Experts have found one marijuana joint is equal to the effects (on lungs) of 2.5 to five cigarettes. But while there is well-established evidence of lung damage from cigarettes, research has shown conflicting results on marijuana use.

The current study does not appear to provide clear answers, except for users of either tobacco alone or users of both marijuana and tobacco.

Since the study will now be repeated in other Canadian cities, the larger data set should reveal a more convincing picture of marijuana's role in the development of lung disease, Tan said.

"Innately, it seems logical that marijuana would be a risk factor for COPD. The noxious fumes are identical except for the THC in marijuana and the nicotine in tobacco," said Tan, adding there is a synergistic effect between marijuana and tobacco smoking. Marijuana may sensitize the lungs and exacerbate the effects of tobacco on the airways.

Study authors said the findings should have implications for public policy and additional research. "Anti-smoking campaigns should include a reduction in marijuana use among their goals, aiming especially at those who regularly use both marijuana and tobacco," states the paper's conclusion.

The local research was funded through a $200,000 grant from pharmaceutical companies AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline and Pfizer Canada. Tan said the companies provided an unrestricted grant and had no role in the study design, data collection, analysis, interpretation or writing.

Sun Health Issues Reporter

pfayerman@vancouversun.com

See more health news at vancouversun.com/health

Risk of chronic obstructive pulmonary disease among current and former marijuana smokers

COPD defined by lung function testing, patient reports of symptoms or physician's diagnosis of chronic bronchitis or emphysema

Group Number Adjusted (n/N) odds ratio

COPD defined by spirometric testing

Tobacco* and marijuana** 25/160 2.90

Tobacco only* 79/286 2.74

Marijuana only** 4/54 1.66

Non-smokers 35/364 1.00

COPD defined by self-report

Tobacco* and marijuana** 98/160 2.39

Tobacco only* 174/286 1.50

Marijuana only** 14/54 0.62

Non-smokers 163/364 1.00

COPD defined by self-report of physician diagnosis

Tobacco* and marijuana** 13/160 1.53

Tobacco only* 32/286 2.07

Marijuana only** 1/54 0.67

Non-smokers 18/364 1.00

n= number with condition, N= number in category

*Participants who had smoked at least 365 tobacco cigarettes.

**Participants who had smoked at least 50 marijuana cigarettes.

Can. Medical Association Journal

How to Study Weird Things

As a science teacher in an interdisciplinary undergraduate program, I often encounter students who want to study topics that many of my colleagues would find nonacademic, and certainly unscientific, such as astrology, Reiki, channeling, Tarot, homeopathy, and ESP. What can an instructor, working within the western scientific tradition, do with such requests? One approach is to clearly explain to the student that these topics "aren't science," and they are not going to learn anything from researching them. I think that this gets a student nowhere, and it is just such an attitude that makes many afraid to pursue unconventional interests. This position also reinforces the students' mistrust of science, professors, and academia, an attitude that they will find no shortage of in the books written on the unconventional subjects of their choice.

A few years ago I stopped fighting the New Age educational tide. I asked myself if there were ways that I could turn a student's curiosity to pedagogical advantage. These students were coming to me with enormous enthusiasm for study and research. How could I maneuver this interest into credible, academic work, which would also appear credible and academic to my colleagues? I realized that if I framed their scholastic approach creatively it would be an opportunity for these students to begin learning about science, the scientific method, and critical thinking.

Since then I have tried to help students take subjects that they are already interested in, regardless of how eccentric they may seem from the standpoint of traditional academia, and complicate them. I help them to fashion their interest into a traditional study by choosing an analytical approach we are both satisfied with. Sometimes this is easy, but sometimes it takes quite a bit of creativity. My first step is to ask the students if they want their studies to be credible. For many, this is a pivotal question, as they may be intending to eventually practice the discipline they want to study. For others, this work may be tied to deeply held beliefs. Typically, the question of credibility begins to encourage an openness towards broadening their work.

Is Studying Weird Subjects Credible?

Even though students may intensely want to research an unconventional topic, they are often unaware that it may not be possible to grant credit for studying these areas by reading the books and articles written by the field's practitioners and proponents. As defined and interpreted by the "believers," these are subjects that accrediting institutions and most faculty will not see as academically admissible.

One student asked me about this in regard to her topic, Polarity Therapy. I told her that although she can go to an institution like the American Polarity Therapy Association (APTA), and take legitimate and respected courses, they are only "legitimate and respected" within a narrow spectrum of schools. Accredited colleges and universities attempt to say something different from the APTA. They claim that what an individual is learning in their classrooms, although open to critique and correction, is reliable and broadly applicable. It is the best that the western analytical model has come up with through comprehensive research. If someone wants to investigate something unconventional, the challenge is to transform the study into work that is rigorous and scholarly. How can we accomplish this?

An initial approach is to look at the unorthodox subject through the lens of an established discipline, using the epistemological and methodological foundations and standards of that system. With this procedure, any subject can be examined and becomes credible by traditional academic standards. For instance, if we look at Polarity Therapy (PT) through the lens of history, sociology, or psychology, we can use these disciplines to lend their credibility to our studies, asking legitimate research questions such as: How and where did PT originate? Are there demographic differences in the patients who use PT? Do alternative medical modalities satisfy patients in ways that allopathic medicine does not? Students are often intrigued by scholastic questions closely tied to their unconventional pursuits.

This approach is useful in interdisciplinary programs, where students need credits in a variety of areas. In my work I primarily use the discipline of science studies to meet conventional criteria. In this case, the questions might be: Are the techniques of PT scientific? How does PT compare with scientifically established medical techniques? Even students who claim that they "do not agree with science" are eager to look at these questions in an attempt to justify their beliefs.

The basic idea is to provide the student with a method to examine their subject as an objective outsider, free of unavoidable misconceptions inherent in exploring a subject from too close a perspective.

Using a Book List in Reverse

After we have established an investigative discipline and an appropriate research question, I encourage students to read the skeptical literature on their subject. These are the books that can offer them a challenging perspective from which to examine unconventional topics, deepening their studies. It is helpful to have them read something that looks at a broad range of critical thinking as it applies to unconventional ideas (e.g., Gilovich 1991; Randi 1982; Schick and Vaughn 1995; Shermer 1997), although it is sometimes difficult for non-science-oriented students to completely work their way through one of these texts. Since my students are all working on independent studies, and not in a classroom, they do not have an instructor immediately available to help them through difficult intellectual terrain. In this case, specific articles on their topic taken out of anthologies (e.g., Frazier 1991) or journal reprints from skeptical journals are most helpful.

This material can often be a frontal assault on their beliefs, which is helpful only for some students. After all, most of them are interested in proving that their unconventional topic has research merit and ultimate validity. In this case, I alter the research approach, using an ancient rhetorical strategy for building an argument. I explain to them that, curiously, skeptical articles and books actually include potentially corroborative insights about unorthodox science and medicine. These skeptical resources are a good place to probe unconventional topics, by letting the debunkers do the background research.

Let us say that you are interested in channeling, and you read a number of the articles that Martin Gardner has written on this subject (e.g., Gardner 1996). Of course, the thrust of his rhetoric will be to challenge mediums and channelers; however, in order to do this effectively he will first tell you all about them, including the history of channeling, biographies of famous channelers and unexplained channeling sessions, why channelers themselves think channeling works, stories about exposed channeling frauds, former channelers who have exposed fraudulent channeling, magicians who have replicated the techniques of mediums and psychics, and (importantly) any celebrated (albeit controversial) results coming from conventional laboratories. All this will be followed by citations for books and articles where you can follow up on his sources.

If students are seriously interested in channeling, Gardner may have just saved them a frustrating day of basic library research. They can repeat this process for almost any unconventional topic. Even though these skeptical authors are frequently debunking this research, some of what they are challenging are findings by scientists in reputable university laboratories. Research results can be interpreted in a multitude of ways, and dubious methodology eventually verified or disputed. There is no reason why a student cannot find these articles and cite them in reverse of the skeptics.

Some educators may protest that these students are reading this material for the wrong reasons and missing the point. In my experience, however, students gradually change how they view their topics. An individual may not alter her fundamental beliefs in the efficacy of channeling, but she will learn that its truth value and applicability are not obvious, and that the phenomena may simply be due to natural, unrecognized determinants (e.g., an active imagination). This leads the student to further inquiry. Importantly, students using skeptical reports and analysis in reverse, and in support of their hypotheses, have engaged themselves in the research process.

Once students begin their research it is important to move them beyond the opinions of the believers into scholarly references. Simply because information is in a book does not mean that you can quote the opinion or research and it will substantiate your position. For instance, students can quote the Bible to support a point they are making about the existence of God, and although this may have purchase with a minority of their readers, its value as evidence would be lost on most. Books that scholars do not find credible can be used as long as proper disclaimers and a critical review are added. This distinction between valid and invalid references can be discouraging to students who may feel they are on the right research track, only to discover their resources are of dubious distinction.

Sandy's Talking Goldfish

Sandy is a woman who is intensely interested in nature and animals. She works at a nature center where it is her job to take people on walks and introduce them to the local plants, animals, and ecology. She is also someone who believes fervently that people can communicate with animals and that animals have something interesting to tell us about ourselves. Her writing often includes anecdotes describing conversations with her goldfish.

When I asked Sandy if she wanted to appear credible, I could see her eyes light up. "Of course," she said. Since she already had experiences with the public, she knew how difficult it was to explain the ideas she sincerely believed in. It was not difficult encouraging her to read skeptical authors, so she would know "the other side of the story." I suggested that she read Schick and Vaughn's How to Think About Weird Things: Critical Thinking for a New Age.

At an informal discussion in the middle of the semester some students, all of whom were involved in unconventional studies, were sitting around discussing the books they had been reading. Suddenly, Sandy launched into an hysterical tirade against "Schick and Vaughn." She proudly told the others that she had finished the book and continued, "I was so frustrated. I wanted to tell them a thing or two. I'd be reading it in my living room and I'd say out loud, `Schick and Vaughn, do you believe in anything?' There were so many times I took my pen and underlined things and wrote in the margin: Yeah, Schick and Vaughn, I'd like to see you prove something!"

We all laughed at this harangue, but I was smiling contentedly inside. Sandy was irritated by the book, and probably had not gotten the full message that the authors intended her to receive, but she was intensely involved with the book and its ideas. It was an interactive workbook for her, and its lesson and cautions about examining fringe beliefs became subtle parts of her perspective, obvious in her essays and analyses.

"Why Do I Have to Address the Skeptics Anyway?"

This statement is the way one irritated student, who was working on Traditional Chinese Medicine, complained about looking into the skeptical viewpoint. I had two immediate responses. First, it indicates thorough research and scholarship about a subject to know its weaknesses, as well as the claims of the proponents. And second, it will help you to establish your credibility.

"To whom?" he asked, since he did not want to fight over concepts and energies that he believed were not measurable. I suggested to him that there were many possible situations in his future where knowing the science, criticism, and full spectrum of issues behind his unconventional subject would be of assistance. For example: 1) With clients who are trying to make a decision between an unconventional therapy and orthodox medicine; 2) At professional meetings where research is critiqued; 3) When writing papers, either popular or scholarly; 4) For protection, as some day someone in power may decide that the unconventional modality he is practicing is dangerous and declare that it is against the law. (I often use the examples of herbs and midwifery, both threatened by government control.); or, 5) To prepare himself for newspaper or radio interviews.

These are all forums where it helps students to have done their homework faithfully. They may not presently see themselves in these situations, but if they stay in an unconventional field the chances are high that they will find themselves there eventually.

Hard Evidence

I once had a student say that she was not interested in arguing with the skeptics, but that she wanted to find "hard evidence" for her beliefs, in this case astrology. I agreed with her that many people do not like to assume an adversarial posture. I pointed out that she did not need to be familiar with all the issues, claims, and counter-claims surrounding astrology so that she could debate with the skeptics. Critically reviewing unorthodox claims is not necessarily about argument, but about fully understanding what you are investigating so you can articulate it clearly and competently.

Students worry that including the skeptical viewpoint in an essay will weaken their position with the reader. In fact, it will have just the opposite effect. Including disparate views will indicate that their research has been thorough, and that they are not afraid of controversial or disconfirming data. In most essays, it is not necessary to completely refute skeptical hypotheses. Simply acknowledging them will often add strength to the student's argument.

I told the student who was interested in astrology that if she was really committed to looking for the "hard evidence" then she could not avoid examining skeptical perspectives. It is the skeptics who attempt to make unconventional evidence "soft." For instance, she wanted to cite an astrological researcher. I suggested she go ahead and quote his data, opinions, and findings, but to not take them completely at face value. Ask some probing questions: Is his work reputable? How do you know it is? What are reasons skeptics offer to question his results? If a student is looking for substantive evidence he or she cannot avoid these questions. It is the difference between deciding that something feels right, and knowing that it is right.

Looking into the skeptical side of things does not have to take away from the student's interests or primary work. Skeptical inquiry should not be something that redirects a student from his or her passion; instead it should enrich their work. Although sometimes scholarship demands us to look into things that seem to take us far afield, it is ultimately useful if this work and time help us to strengthen our analysis. When I suggest that a student look at the skeptical side of things I mean: 1) Reading an article about their subject written by a critical author; 2) Interviewing a researcher who does not agree with the student's approach; 3) Looking at some of the general objections to unorthodox modalities; or, 4) Reading a book that would help them think critically about unconventional topics. This is not a large commitment, it is simply a beginning.

Mr. Whitewing: Openness to the Unconventional

I try to empathize with students attempting unconventional studies, and to treat their work like any conventional research project. By doing this I let them know that I realize the complexities of the world that we share. Occasionally, it is helpful to point out situations where you, as an instructor, are confronted by a mysterious world, and then suggest the ordinary explanations that you are considering. The following story helped one of my students, who was studying the intelligence of ravens, understand that I could relate to her ideas, and also form alternative explanations for seemingly inexplicable phenomena. I told her:

"I was sitting in the physics library reading. Actually, I was staring out the window watching two ravens hop around the parking lot. One of them turned sideways and I noticed that it had a conspicuous white patch of feathers at the top of its wing. When it turned, I noticed that it had a corresponding patch on the other wing. When this unusual bird flew off, its epaulets left a striking pattern of flashing white freckles.

Days later, I was in a different building, sitting in my office, reading your paper about intelligence in ravens. You claimed that, even without scientific evidence, you realized certain things about ravens by intuition. As I read, I marked the places where I thought you should have provided corroborative evidence. I muttered, `No, this won't do,' or `This isn't convincing,' writing my comments in the margins. Suddenly, I looked up and out my window, which overlooks some roof tops. There was Mr. Whitewing, unmistakably perched on the roof right outside, staring in the window at me! He hopped around for quite some time, as if not to let me forget about his presence too quickly."

My student was impressed by this extraordinary anecdote. However, as I told her later, I discovered that the ornithology department on campus was marking ravens in this way to keep track of them. It was not a natural coloration, and perhaps, not even the same Mr. Whitewing at my window. It is helpful to demonstrate that your intellect can be broad when thinking about the boundary between the real and the imaginary, but that the line between magic and science is not always impossible to distinguish.

There are some scholars, however, who believe that the demarcation between science and magic is completely ambiguous. In this view, science is a narrative, similar to any other cultural mythology. This critique of science is one approach for students with unconventional studies to use in their analyses. After all, if science itself is built on an insecure foundation, how can it make any epistemic demands on what it classifies as pseudoscience? Unfortunately, this provocative intellectual observation, besides being confusing for many students, can turn hopelessly relativistic, which is ultimately unhelpful for a student seeking credibility. It is necessary to guide students with care along the path of scientific deconstruction, so that all of western theory and expertise are not abandoned.

Pedagogical Kindness

For those of us who have happily worked with science and analytical thinking for years, it is difficult to realize how frustrating it may be for students to look at challenging ideas. Students can be resistant to opinions that have the potential to upset their worldview; even if they embrace the quest it can lead to upsetting realizations about themselves and their world. As educators, it is important to work with students in a process-oriented and developmental model. It does not help to be condescending or pejorative about their deeply held beliefs, even if these beliefs seem totally absurd. Anyone who has worked with students who hold unconventional views, or who believe in seemingly useless health modalities, knows how deeply these ideas are felt. It is important to realize that students who follow your suggestions, carefully reading critical books and thinking about the skeptical approach, can experience a minor existential crisis. Suddenly they will not know what to believe, and many things they have based their lives on may be insecure. It behooves you, at these moments, to be an ally.

Studying Things That Don't Exist

It is common for students to approach science educators with the intention to study phenomena that the instructor may not believe exists. Where does this leave you as their guide on this unconventional academic expedition? Remember to avoid the temptation of trying to talk students out of the things they believe in. The objective is to share a process of thinking and careful research. An instructor's questions and critique should be an attempt to strengthen the student's approach, not squelch their enthusiasm.

I once had a student who was interested in astrology tell me: "Those scientists and skeptics are so closed-minded. They'll never change their beliefs."

I said, "Do you think you are closed-minded?"

"Of course not. I'm not a scientist."

"So, you're willing to change your beliefs? Are you open to the idea that, perhaps, astrology is a lot of wishful thinking?"

She thought about this for a long moment and finally said, "Yeah, I guess that's real open-mindedness, isn't it?"

I pointed out that if she were truly open-minded she would read the skeptical objections to astrology, and try to come to an impartial decision about its merits. This is the fundamental intention of good science.

However, open-mindedness only works when it goes both ways. For most unconventional studies, completely clear and final solutions to the questions students want to answer do not exist. The best we can do as educators is to help them work on diligently thinking about their subjects, so when they are challenged by a skeptical inquiry they will have an educated response.

Believing vs. Knowing: Faith’s Role in the Evolution Debate

To this day, nearly six decades later, I have memories of my parish priest’s occasional visits to religion classes in the early grades of my school, St. Mary’s, in rural eastern Wisconsin. Those moments that I remember most vividly were when he came to warn us about a distinguished and supposedly all-knowing college professor someday attempting to convince us to accept the evil and atheistic idea that we had evolved from lower animals. As he predicted, I did go on to have many such encounters. Ironically and to my continuing amusement, as a geology professor (albeit not very distinguished and certainly not all-knowing), I am now the cause of such encounters.

Perhaps because I was raised in a strong faith-based environment, I possess a unique appreciation for the critical need to prevent turning the evolution-versus-creationism/intelligent design debate into one of anti-religion versus religion. It is a lose-lose argument for both sides and will simply widen the destructive wedge separating believers, nonbelievers and the agnostics in between. Belief in evolution does not preclude belief in God. But belief is the key word. Fully understanding the concept of belief is fundamental to arguments for keeping creationism and its clever smokescreen, intelligent design (as my father used to say, giving a slow horse a new name doesn’t make it run faster), out of the science classrooms of all of our schools, not just the public ones.

Believing something to be true because of faith and knowing that something is true because of empirical testing are fundamentally distinct. For many people, faith is a wonderful gift, permitting them to believe whatever they want about a natural phenomenon; it does not, however, permit them to know the phenomenon. For example, faith permits some people to believe that an almighty being — God — created them in his image. But faith cannot permit them to know, to empirically prove, that humans instead did not create God in their image, as those without faith often choose to believe. Not recognizing the difference between believing and knowing prevents constructive and intellectually honest debate over faith-based teaching in the science classroom.

Scientific theories expressing what we think to be true at any given time about something as complex as evolution derive from the scientific method, a process in which testing is a fundamental ingredient; it has nothing to do with faith or reliance on some higher faith authority that tells us what to believe as truth. Believing instead of knowing something to be true can lead people to potentially dangerous acts, seemingly justified by their faith.

Religion and especially the concept of an almighty force or forces in nature appeal to many people because they supply easy-to-understand answers to questions that lack easy-to-provide testable answers — for example, how did it all begin and how will it all end? These questions have been around since humans first experienced volcanism, earthquakes and all sorts of other natural processes that were unexplainable within their existing framework of knowledge.

Scientists thrive on unanswered questions. Without puzzles to solve, they would have no careers. But those people who have not had a sound foundation in the process of scientific discovery cannot comfortably live with the unknown. These same individuals become dangerously disruptive to science education when they demand that their faith-based answers to these questions share equal status in science classrooms with empirically testable theories.

In spite of claims by the intelligent designers, no reputable scientist can call on the existence of an almighty guiding force to explain the incredible complexity and order of evolution just because of a lack of total understanding of this complexity and order right now. This notion is no different than creating a god of fire to explain volcanoes, as done millennia ago. Full and open pursuit of scientific truth abruptly ends in our schools when faith is invoked in this way.

For example, we do not now know all the details of genesis. Perhaps space/time is infinite with no boundaries, as Stephen Hawking suggests — we just don’t know, regardless of what those with faith in a creator would like for the faithless to believe. But scientists do not throw up their arms in despair and appeal to a higher being for an answer. (In their own lives, they may make a personal choice to use the beauty and complexity of something like evolution to strengthen their belief in an almighty being, which is perfectly acceptable, but should have nothing to do with their advancement of scientific knowledge in the minds of others.) Thousands of years of knowledge accumulation attest to the fact that with time, answers to even the most difficult questions about nature as we know them today may be discovered.

It seems that fundamentalists, and now more and more mainstream religious people, fear the teaching of evolution in the absence of creationism/intelligent design because they lack sufficient confidence and faith in the existence and power of their deity to be manifest without empirical proof. They believe that if their deity is taken out of the physical mechanism of genesis, belief in its existence among children in our schools will be threatened — how sad, selfish and shortsighted.

All people who feel that way should read Christianity and the Age of the Earth, written by geologist, evangelist and self-proclaimed “creationist” Davis A. Young. He presents cogent arguments that Christian evangelism will be significantly hindered by creationists’ attempts to defend their faith by falsely interpreting geologic evidence and thus arguing error on behalf of faith.

18 April 2009

Smokers Can't Blow Off Stress

Ask cigarette smokers why they light up and one answer you're likely to hear is that it relieves stress.1

But if that's the goal, it's not at all clear that cigarettes deliver the goods. Half (50%) of all smokers say they "frequently" experience stress in their daily lives, compared with just 35% of those who once smoked and have now quit and 31% of those who never smoked, according to a Pew Research Center Social & Demographic Trends survey conducted June 16-July16, 2008 among a nationally representative sample of 2,250 adults.

The finding raises as many questions as answers. Does it mean that the kinds of people who smoke are pre-disposed to stress? Does it mean that the stress relief smokers get while smoking doesn't last once they don't have a cigarette in hand? Or might it mean that the whole idea that smoking relieves stress is illusory?

Psychologists, physiologists and neuroscientists are better situated than public opinion researchers to supply answers. Nevertheless, the Pew Research survey sheds some new light on the subject by allowing for a range of comparisons among current smokers, former smokers and non-smokers on matters related to stress, happiness, health and life satisfaction.

The survey findings come at a time when the share of adults in the United States who smoke appears to have stabilized following a half-century decline. The most recent data from the Centers for Disease Control show that for the period of January through June 2008, the share of current smokers in the adult population was 20.8%, a bit higher than in 2007, when it was 19.7%.

Moreover, the one-in-five adults who smoke now have a new reason to feel stressed. On April 1, the U.S. government imposed its largest-ever tax increase on cigarettes; Uncle Sam's take on a pack of cigarettes shot up to $1.01 from 39 cents. (The Pew Research survey was taken well before these taxes went up.)

The Pew Research finding of a strong correlation between smoking and stress raises an obvious question: Is the stress a by-product of the smoking or of other unrelated factors?

One way to look for answers is by conducting a multivariate regression analysis.2 Ours finds that, even after controlling for the basic demographic characteristics of respondents -- including gender, age, race, education, income, marital status, and parental status -- current smokers are still more likely than non-smokers and quitters to report being frequently stressed.

However, our survey did not ask respondents about their psychological characteristics, so we were unable to weigh the impact of those traits on stress levels. Had we done so, it is possible we would have found that the independent effect of smoking on stress was weak or non-existent.

Happiness, Health, Life Satisfaction

The survey also finds that smokers are less happy and less healthy than both non-smokers and quitters.

About a quarter of current smokers say that they are very happy, compared with more than a third of quitters and almost four-in-ten non-smokers.

Consistent with what decades of public health research shows, smokers also report being in poorer health than non-smokers and quitters. Fewer than half of smokers (45%) say that their health is excellent or very good, compared with 63% of non-smokers and 55% of former smokers.

When asked whether they are satisfied with their family life, smokers are less likely than non-smokers and quitters to say that they are "very satisfied": About six-in-ten current smokers say they are very satisfied, compared with about seven-in-ten non-smokers and quitters. Smokers' satisfaction level with their job is also lower than that of non-smokers, and their satisfaction with their standard of living is lower than that of both quitters and non-smokers.

Who Smokes and Who Doesn't?

According to the Pew Research survey, more than half of adults (54%) have either never smoked or smoked fewer than 100 cigarettes in their lifetime. Another 22% are former smokers or "quitters," and 24% are currently smoking. (This 24% figure is slightly higher than the 2l% figure for 2008 reported by the CDC.3)

Women are more likely than men to be non-smokers (59% vs. 49%), the Pew survey finds. However, a quarter of men have quit smoking, compared with just 18% of women, which explains the nearly equal rates of current smoking within each gender.

Older adults are less likely than younger adults to be current smokers. Some 31% of 18-29 year olds are smokers, compared with just 11% of those ages 65 and older.

However, the younger age group also has a bigger share of people who never smoked. Six-in-ten adults under age 30 have never smoked or have not smoked more than 100 cigarettes in their lives. But among people who are ages 50 or older, only somewhere between four-in-ten and half never smoked.

Hispanics and blacks are both more likely than whites to be non-smokers. More than six-in-ten Hispanics and blacks have never smoked, compared with about half of whites.
High family income and high levels of education are associated with a low occurrence of smoking, and so is being married. Also, conservatives are more likely than liberals to be non-smokers (56% vs. 50%).

Region matters too. Compared with other regions of the country, the Midwest has the highest rate of smoking. Nearly three-in-ten (28%) Midwesterners are currently smoking, compared with only one in five Westerners.

Who Are the Quitters?

Nearly half of Americans have smoked at some time in their lives. But once a smoker, not always a smoker: Half of the men and 45% of women who have ever smoked have now quit.

Age is strongly related to whether a smoker continues or stops. At ages 18 to 29, about eight-in-ten smokers are still smoking. But the rate of current smoking goes down sharply as smokers grow older. By ages 65 and above, only about two-in-ten smokers are still smoking, which means that the rest have quit.

Whites are more likely to start smoking than are blacks or Hispanics. But among all smokers, whites are also more likely than blacks or Hispanics to quit. More than half of white smokers are no longer smoking, compared with about a quarter of black smokers and more than a third of Hispanics smokers.

Higher education and higher family income are related to a higher rate of quitting smoking. Married people also are more likely to quit than are those who are not married.

Liberals are more likely than conservatives to continue smoking once they become a smoker. About 63% of liberal smokers still smoke, compared with fewer than half of conservatives.

Among city dwellers, 57% of people who have ever smoked continue smoking, while only 48% of their suburban counterparts do so.

The findings about who is most likely to quit smoking are further confirmed by a multivariate regression analysis.4 Holding all other variables constant, men are more likely than women to quit smoking. Being older, married and a college graduate are also independently related to a higher probability of quitting cigarettes, as is being a conservative rather than a liberal.

More about Stress

Just as there are demographic differences in who smokes, there are demographic differences in who is more likely to feel stressed in their daily lives. In terms of age cohorts, the 30-to-49-year-olds are the most stressed: almost half report that they are "frequently" stressed. Nearly four-in-ten 50-to-64-year-olds say they are frequently stressed. Those over age 65 are the least stressed age group: only about one-in-five report being frequently stressed.

Apparently, money doesn't bring relief from stress, nor does higher education. Those with an annual family income of $100,000 or more are more likely to be frequently stressed (44%) than are adults with lower annual incomes. And compared with people with a high school education or less, college grads are less likely to report "rarely" or "never" experiencing stress.

The survey finds no linkage between marital status and daily stress. However, it does find a linkage between parenting status and daily stress. More than four-in-ten parents who have children under age 18 say they frequently experience stress in their daily life, compared with about one third of those who have no children or who only have adult children.

Men and women are equally likely to say they are frequently stressed. However, the share of women who say they never or rarely experience stress (22%) is smaller than the share of men who say the same thing (31%). Whites are more likely to report being frequently stressed than are blacks or Hispanics.

Finally, people's ideology (but not their party ID) is linked to stress. Liberals are more likely than conservatives or moderates to report being frequently stressed in daily life.

Background: Smoking in America

According to Center for Disease Control and Prevention (CDC), cigarette smoking has decreased substantially since the 1960s. However, the rate of current smoking among adults has stabilized since 2004, averaging about 20%-21%. The most recent CDC data show that for the period of January through June 2008, the percentage of current smokers is 20.8, a bit higher than in 2007, when 19.7% of adults smoked.

While the rate of current smoking is lower among women than men, this gender gap has narrowed over time. In 1965, 34% of adult women smoked, compared with 52% of adult men. This gap gradually narrowed until reaching about 5% in the mid-1980s; it has remained in that range ever since. It's not that women are smoking more: rates of smoking for both men and women have declined since the 1960s. The narrowing gender gap since 1965 is mainly due to the fact that smoking has declined at a faster rate among men than among women.


1. Parrott, Andy C. 1999. “Does Cigarette Smoking Cause Stress?” American Psychologist 54 (10): 817-820.
2. A multivariate regression analysis is a statistical technique that can be used to show the importance of each of a number of independent variables in predicting a phenomenon of interest – in this case, the likelihood that a respondent reports being frequently stressed or not. The independent variables in the model include smoking status, gender, age, race, education, income, marital status, parental status, and community type.
3. The CDC’s NHIS number for current smokers during January-June 2008 is 20.8% for all, 23.5% for men and 18.3% for women. The different estimates might be due to the different time periods of data collection and the different mode of surveys: the NHIS data are collected through a personal household interview, while the Pew data is through a telephone interview.
4. The explanatory variables in the model include gender, age, race/ethnicity, education, family income, marital status, having children under age 18, ideology, community type.

17 April 2009

Happy Hour Harvest

The green movement meets the cocktail realm with organic, fruit-, veggie- and herb-infused spirits. Try these savory liquors naked, in a martini, or in creative tipples with fruit juices, mixers and bitters. With these spirits anyone can have a green thumb, all year round.

Square One Cucumber Vodka
“Spa water with a kick” is how Square One founder Allison Evanow describes her vodka, in which two kinds of cucumber essence (for both aroma and flavor) are added to organic rye vodka at the end of the distillation process. Its authentic taste is comparable to slices of the slender green veggie, and Evanow explains that the vodka’s charm lies in its cool and delicate flavor profile. Versatile in both savory and sweet cocktails, Square One Cucumber vodka is equally enjoyable in twists on the Martini or Mojito, as well as in creations like the Pimm’s-based Celery Cup #1, where it easily mingles with cilantro and celery.

Crop Organic Tomato Vodka
If you think you need to wait until late summer to capture that unbeatable garden tomato taste, think again. Take one sip of Crop Organic Tomato Vodka, and you’ll swear you are drinking tomato water squeezed from the ripest of fruits. Director of Marketing Connie Kam says their organic vodkas appeal not only to tomato lovers, but also to people interested in the eco-friendly products and farming practices used at Crop. It’s a natural choice for a kicked-up Bloody Mary, but the fresh tomato flavor shines through even better in a Martini. Increase the Vermouth, and garnish with a basil leaf and freshly cracked pepper, and you can pass on the Caprese salad appetizer.

Indio Spirits Lemongrass Lime Vodka
Citrusy, fresh and so aromatic, Indio Spirits’ Lemongrass Lime Vodka gets its zingy kick from lime zest and lemongrass steeped in the spirit for 36-48 hours. “All of our vodkas are 100% natural and 80 proof, which is a unique thing in this business,” explains Chairman and CEO John Ufford of the Oregon-based company. Indio’s version has a drier and earthier taste than most lemon or lime vodkas, and it adds an enticing Asian flair to a vodka and tonic or gimlet, mixing especially well with freshly made ginger ale in a variation on the Collins.

***Recipes***
Celery Cup #1
Courtesy of H. Joseph Ehrmann, Square One Brand Ambassador and Mixologist
1 ½ oz. Square One Cucumber Vodka
1-inch piece English cucumber
2-inch piece celery stalk (close to the center of the bunch)
Handful of cilantro
1 oz. fresh lemon juice
½ oz. Pimm’s
¾ oz. organic agave nector or simple syrup
Celery stalk for garnish
In a mixing glass, muddle the cucumber, celery, cilantro and lemon juice into a pulp. Add remaining ingredients, cover with ice and shake hard for 10 seconds. Strain into a tall glass over fresh ice and garnish with a celery stalk.

Organic Tomato Vodka Martini
Courtesy of Crop Organic Vodka
3 parts Crop Organic Tomato Vodka
1 part dry Vermouth
Fresh basil leaf
Add ingredients to a shaker half-filled with ice. Stir until chilled. Strain into a cocktail glass, and garnish with a fresh basil leaf, and freshly cracked pepper if desired.

Indio Ginger Collins
1.5 oz. Indio Spirits Lemongrass Lime Vodka
1 tsp. sugar
½ small lime
Ginger ale (freshly made if possible)
Muddle vodka, sugar and lime in the bottom of a Collins glass. Add ice, and top with ginger ale.

Kelly Magyarics is a wine and spirits writer, and wine educator, in the Washington, DC area. She can be reached through her website, www.trywine.net

15 April 2009

Passive smoking in cars linked to hayfever and wheezing in children

MedWire News: Children who are regularly exposed to second-hand tobacco smoke when travelling by car have significantly higher rates of hayfever and wheezing than those without such exposure, results of an Irish study show.

Previous research has shown that regular exposure to second-hand smoke is associated with an increased risk of respiratory diseases in adults.

Writing in the European Respiratory Journal, Professor Luke Clancy, from the Tobacco Free Research Institute in Dublin, and team explain: “Children may be more vulnerable to second-hand smoke-induced respiratory diseases due to smaller airways and greater oxygen demand, as well as a less-mature immune system.”

But they add that “there is no evidence quantifying second-hand smoke -induced respiratory health effects in children exposed to second-hand smoke in cars”.

To address this, the team studied 2809 children, aged 13–14 years, selected randomly from schools throughout Ireland.

All the children completed questionnaires detailing their exposure to second-hand smoke at home and in the car, and whether they themselves smoked.

They were also asked whether they had ever suffered from asthma, hayfever, wheezing and other respiratory health problems.

The team found that, overall, nearly 15% of the children surveyed were regularly exposed to tobacco smoke when travelling by car.

After accounting for tobacco smoke exposure at home and other factors, the researchers found that children exposed to second-hand tobacco smoke in cars were 35% more likely to suffer from wheezing and 30% more likely to have hayfever symptoms than those who were not exposed to second-hand smoke in cars.

However, the team found no significant association between exposure to second-hand smoke in cars and an increased prevalence of asthma among children.

Professor Clancy and team comment: “Despite this study showing a tendency towards an increased likelihood of respiratory and allergic symptoms in children when exposed to second-hand smoke in cars, comprehensive longitudinal studies across different population settings are imperative.”

However, the researchers add: “Assuming a causal relation, such adverse respiratory symptoms could have a knock-on effect on school absenteeism, and also on being at greater risk for future second-hand smoke related morbidity [illness] and mortality.”

They conclude: “These results add further support to efforts to push ahead with legislation supporting smoke-free cars in Ireland but needs to be adequately substantiated with further evidence from elsewhere.”

Malas dispel When Morning Build

If you are hard out of bed every morning to rise, is actually quite fair only. Try the following atasi strategy.
Remember that good things will happen today. Before bed, put a note in the log weker contain fun things in the next day. "During the sleep-endocrine changes. As a result, once awakened in the morning, most people feel ill-humored. Imagine the luck lunch with a friend or television call him later in the night, mood improves," said Dana Lightman PhD, psychologist, behavior in Abington, PA.
Forget snooze button. Snooze button on the hour weker. This function will stop the alarm button dipencet, but some time and then resumes. Persons that possibility in order to "bonus" to sleep a few minutes. But in fact this measure is not recommended. Once we turn off the alarm, the brain can "guess" when the alarm rings again. As a result, "bonus" time to sleep, we can not lalui quietly. Plus, if awakened, we feel tired. Best strategy: Alert after installing the desired hour, said Jodi Mindell PhD, Associate Director of the Sleep Disorder Center at Children's Hospital in Philadelphia. "Sleep without interruption at all, that we need more fresh and rileks."
Let the light. Seberkas sunlight makes us more "awake". To read the newspaper on the street near a window or outside the house, while drinking coffee. "Light of the sun, the biological signals to jam us to stop removing the melatonin, the hormone makes us sleepy," said James B. Maas PhD, Professor and former Head of the Department of Psychology at Cornell University, New York. Light also brain serotonin content, the chemical compound to improve the mood. , So that sunlight can sneak to the room in the morning, open the curtains to sleep the night before. So that the sunrise, the light in the bed slowly and give a sign to the body to awaken.
Massage of the building. "Rub your face and will facilitate the distribution of fish awakened us," said Maggy Dunphy, general manager at the Aria Spa and Club in Vail, CO. Start from the forehead, then on the chin. Clap slowly, and to vary the speed, intensity and location, the entire face. Bonusnya: This movement is the face we see not only healthy but also more luminous.
A glass of white water. Whitewater is very good to replace body fluids lost during sleep. Good again, the white water feed energy immediately. Summary bodies need water, "said Holly Andersen, MD, Assistant Professor in the area of treatment in the Weill Cornell Medical Center. "If there is not enough water, the body must work harder and also with fatigue." 2% lack of water, the body tired, physically and mentally. Series of the Institute of Medicine recommended is 11 glasses of water per day.
Intimate relationship. Physical activity is one of the best ways to dizziness. No, the morning is the level of some chemical substances in terms of endurance (testosteron), energy (dopamine) and rest (oksitosin), said Helen Fisher E PhD, a research professor in the department of anthropology at Rutgers University, New Jersey, USA. A very enjoyable day for the beautiful, is not it?
Cold water bath. Set mengguyur cold body of water is the punishment. However, cold water is "awakening" your body so that they no longer feel weak. It is not even in the cold air outside the house, because your body has to adjust. I remember when you are on the tour, where the cold valve, then exit the bathroom feeling the air is not so cold. After that you are ready beraktivitas!

10 April 2009

Urine test may determine if a smoker is at risk for lung cancer

DENVER – Researchers may have uncovered why lung cancer afflicts some smokers and not others, according to data presented at the American Association for Cancer Research 100th Annual Meeting 2009.

"A history of smoking has always been thought of as a predictor of lung cancer, but it is actually not very accurate," said Jian-Min Yuan, Ph.D., M.D., associate professor of public health at the University of Minnesota. "Smoking absolutely increases your risk, but why it does so in some people but not others is a big question."

Yuan and colleagues hypothesized that the presence of the metabolite NNAL in a patient's urine might predict risk of lung cancer. This metabolite has been shown to induce lung cancer in laboratory animals, but the effect in humans had not yet been studied.

Researchers collected data from 18,244 men enrolled in the Shanghai Cohort Study and 63,257 men and women from the Singapore Chinese Health Study. In addition to in-person interviews to assess levels of cigarette smoking, dietary and other lifestyle factors, researchers collected blood and urine samples from more than 50,000 patients.

To evaluate the impact of NNAL, researchers identified 246 current smokers who later developed lung cancer and 245 smokers who did not develop lung cancer during the 10-year period following initial interview and collection of urine samples.

Levels of NNAL in the urine were divided into three groups. Compared to those with the lowest levels, patients with a mid-range level of NNAL had a 43 percent increased risk of lung cancer, while those at the highest level had a more than two-fold increased risk of lung cancer after taking into account the effect of number of cigarettes per day, number of years of smoking, and urinary levels of cotinine on lung cancer risk.

Levels of nicotine in the urine were also calculated. Those with the highest levels of nicotine and NNAL had an 8.5-fold increase in the risk of lung cancer compared with smokers who had the lowest levels after accounting for smoking history.

"Smoking leads to lung cancer, but there are about 60 possible carcinogens in tobacco smoke, and the more accurately we can identify the culprit, the better we will become at predicting risk," said Yuan.

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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and nearly 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.