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Study Tracks Yik Yak App To Learn More About College Drinking And Drug Use

The Yik Yak app, lower left, is seen on an iPhone on Nov. 11, 2015. (Ronald Lizik/AP)

The Yik Yak app, lower left, is seen on an iPhone on Nov. 11, 2015. (Ronald Lizik/AP)

Consider this message, most likely posted by a college student in or around Brandeis University near Boston: “I just remembered I have a 4loko in my minifridge. Guess who’s getting sloppy day drunk tomorrow!”

Good luck finding the Four Loko fanatic. The post is from Yik Yak, an anonymous, free social media platform popular on college campuses.

Even so, a recent study analyzing Yik Yak posts gathered from 120 campuses suggests that tracking these messages does have an upside: Public health experts say it may ultimately help them learn more about issues like alcohol and substance use.

Over the span of one month, researchers at Johns Hopkins University and the University of Colorado at Boulder found 2,047 health-related yaks — the term for posts on Yik Yak — dealing with themes like smoking, drinking and drug use.

“Because it’s anonymous, people disclose things about themselves that they might not publicly post, either on Twitter or even necessarily to their doctors,” said Michael Paul, an assistant professor and founder of the Information Science Department at UC Boulder,  in an interview.

While big data collected from social media has been used to study public health, such as influenza surveillance through Google search queries and Twitter, the field is relatively new and Paul’s study is the first to look at public health using Yik Yak. Continue reading

Study: Despite Weight Gain, Quitting Smoking Improves Heart Health For Mentally Ill After A Year

(kenji.aryan/flickr)

(kenji.aryan/Flickr)

The health profile for people with serious mental illness is pretty grim. In general, they have a lower life expectancy — 25 years less than the general population — which is largely due to cardiovascular disease related to high rates of obesity and smoking.

But a new study by researchers at Massachusetts General Hospital found that after one year, seriously mentally ill patients who quit smoking — even though they gained about 10 pounds — had a lower risk of developing heart disease compared to those who didn’t quit. That’s the good news part of the research, published online in The Journal of Clinical Psychiatry. The bad news is that if those people — who already have high rates of obesity — continue to gain weight, it’s fairly likely they will develop a slew of other health problems, including cardiovascular disease, said the study’s lead author, Dr. Anne Thorndike, an assistant professor at MGH and Harvard Medical School.

“Quitting smoking is the single most important behavior change that anyone, [including] people with serious mental illness, can do to reduce their risk of developing cardiovascular disease,” Thorndike said in an interview. “But the weight gain is a red flag. The story’s not over at one year … If they continue to gain weight, all the health factors will worsen and contribute to higher rates of cardiovascular disease.”

Continue reading

Mass. Lawmakers Unveil Bill To Raise Legal Age For Buying Cigarettes To 21

A statewide ban on the sale of cigarettes and other tobacco products to anyone under the age of 21 cleared a legislative committee on Thursday, and supporters said they were hopeful for final passage within months.

Boston recently raised the legal age for tobacco purchases from 18 to 21, joining dozens of communities around the state that have made the change in recent years and building momentum for a uniform statewide law.

Rep. Kate Hogan, a Stow Democrat and House chair of the Public Health Committee, said young people are particularly susceptible to nicotine addiction.

“With this legislation, [Massachusetts] has a real opportunity to intervene during the early formative years to prevent young people from using tobacco products and becoming addicted to nicotine, a habit that can last through their entire lives,” Hogan said.

The bill would not punish minors for smoking, only make it illegal to sell tobacco products, including e-cigarettes, to people under 21. Those already between 18 and 21 would be allowed to continue buying tobacco, but anyone not yet 18 at the date the proposed law became effective would have to wait until age 21.

Hogan said a statewide standard would eliminate confusion caused by the current patchwork of local rules.

The push to hike the minimum age has begun to gain traction nationally, as well.

Continue reading

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Bad Odors And Brain Fog: 5 Things Nobody Tells You About Quitting Cigarettes

On a break from his midday hosting duties, WBUR's Jack Lepiarz lights up outside the station. (Robin Lubbock/WBUR)

On a break from his hosting duties, WBUR’s Jack Lepiarz lights up outside the station. (Robin Lubbock/WBUR)

WBUR’s Jack Lepiarz is no wimp. He not only braves live air multiple times a day as the station’s midday anchor, he also performs around the country as a circus whip-master, and even recently attempted to break the Guinness world record for whip strokes per minute.

But Jack has yet to defeat the most insidious physical and psychological challenge many of us ever face: his smoking habit.

He has plenty of company: Almost 1 in 5 Americans smoke, the CDC says. He writes here about some of the unexpected obstacles involved, in hopes of helping other would-be quitters and their supporters. And he’ll document his fight periodically this year. Please stay tuned. — Carey

I’m about to try again. This weekend will mark my fourth attempt to quit smoking over the last 10 weeks or so. At age 27, I’ve been smoking for a little more than seven years, with multiple attempts to quit every year since three months after I started. When they tell you that nicotine is as addictive as heroin, they’re not kidding.

I’m at the point where I’ve started and stopped so many times that I know what I’m getting into, but every time, I seem to notice a new symptom or side effect of nicotine withdrawal. Almost always, I’m surprised. We hear about cigarette cravings, irritability and other symptoms of withdrawal — but the process of quitting also carries with it some other, lesser known symptoms.

1. The Mental Fog

By far my least favorite side effect, and one that I find the hardest to explain. You know that feeling you have right after you wake up? Half present, half in another world? This is your brain — not on drugs. I’ve described it as similar to going a day without coffee — except worse. (Believe me, I’ve tried.) Or being in a state of constantly having just had two beers. You can’t focus, you can’t sit still, you can’t formulate any thoughts that last in your brain for more than 30 seconds.

Except for how much you want a cigarette.

2. The Smell

This is one that sneaks up on you. Most people know that smoking dulls your sense of taste and smell, but it’s such a gradual process when you start smoking that you don’t notice it. For me, it rarely takes more than 36 hours to get those senses back strongly — and never in a good way.

The first time I really noticed it was last winter, when after a day of not smoking I drank a soda and nearly spat it out. I never knew it was that sweet.

The smell aspect hit me when I tried to quit on a hot, humid day in July. Long story short, we all need to wear more deodorant. Also brush our teeth more. Also, cities just smell awful in general. Also, yes, I recognize the irony of a smoker complaining about bad smells. You notice just how bad cigarettes smell, too.

3. The Constant Hunger Continue reading

How I Was Seduced By Cigarettes, And What Set Me Free

By David C. Holzman
Guest Contributor

More than half a century has passed since Luther Terry released the landmark U.S. surgeon general’s report on smoking and health.

Since then, smoking in the U.S. has declined dramatically. Nonetheless, roughly 50 million Americans still smoke.

Tobacco’s ‘Fantastic Voyage’

If anyone should have been immune to taking up smoking, it was me.

As a prepubescent child, I absorbed the lessons about the importance of living healthily that my parents instilled. At age 10, I got them to quit smoking after the first surgeon general report came out — although I’m sure they would have done it on their own, if not quite as quickly. Early on in my writing career, I wrote a “fantastic voyage” article about all the carcinogens in tobacco, where they went in the body, and what nefarious things they did when they got there. Little did I ever suspect I would become briefly but definitely addicted.

The germ of the habit occurred when I was medical writer for Insight Magazine. Dennis, the head copy editor, smoked like a chimney.

The author, smoking at his sister's wedding in June 1991 (Photo illustration courtesy of the author)

The author, smoking at his sister’s wedding in June 1991 (Photo illustration courtesy of the author)

“How’s that cigarette?” I’d tease him every morning when I arrived at work. “Not long enough!” he’d say. Or, “Not as good as the first one.” It became our way of bonding.

One day he said, “You want to try it?”

Curious, I took a puff. It gave a powerful kick, like a turbocharger. But it was not something I felt I needed.

But one Sunday, a few years later, I needed it. I’d gone to the car races at Summit Point, West Virginia, with my friend, Don, a former racer, and his wife Eva, who smoked. I’d slept little the week before, and D.C., where I lived at the time, was being its usual oppressively hot, humid summer self. By mid-afternoon I’d gotten so sleepy that I was getting ready to curl up in the back of my car and snooze. Then I remembered Dennis’ cigarette. I asked Eva if I could finish one of hers. A couple of puffs, and I was wide awake, once again enjoying being with my friends.

My FDA Cigarette

Around this time, I was working for daily biotech news publication, regularly covering meetings of the Advisory Committee to the head of the Food and Drug Administration. These meetings were boring. They took place in a windowless room of the incredibly ugly, mid-’50s institutional style Parklawn building. As soon as they started, off went the lights, and on went the Powerpoints.

At that point, no matter how much coffee I’d had, my head would start to sag.

So the next time I had to cover one of these meetings, I bummed a cigarette. I took several puffs, and then tossed it. This time, I remained painlessly alert after the lights went out.

I took to bumming cigarettes while I waited for the FDA meetings to start, and ultimately I bought my own pack. Continue reading

50 Years Of American Health Choices: Smoking Gains Offset By Getting Fatter

(Lucia Sofo via Wikimedia Commons)

(Lucia Sofo via Wikimedia Commons)

Feeling optimistic? Then you may see the moral of this story as, “Yay, public health efforts! They can wield amazing power and save many lives.”

In more of a glass-half-empty mood? Then your takeaway may be, “If it’s not one thing, it’s another.” Or perhaps, that public health must play an eternal game of Whack-a-Mole.

The story itself: The National Bureau of Economic Research just sent over word of a new working paper that looks at American health behaviors and their effects over 50 years, from 1960 to 2010. It examined six behaviors: obesity, smoking, heavy drinking, unsafe driving, firearms, and poison or overdoses. What most struck me: Though we’re generally living longer, our health gains from shunning cigarettes and safer driving are all but erased by the rise in obesity and drug overdoses. Sigh. From the summary:

(Source: NBER working paper 20631, “The Contribution of Behavior Change and Public Health to Improved U.S. Population Health”)

(Source: NBER working paper 20631, “The Contribution of Behavior Change and Public Health to Improved U.S. Population Health”)

…The authors find that the gains associated with declines in smoking, motor vehicle fatalities, and heavy drinking are essentially offset by the losses arising from rising obesity and misuse of firearms and poisonous substances. Valued in dollar terms, there is a near zero net gain in health from public health and behavioral changes over the past fifty years. However, the analysis includes a mix of some risk factors that have been aggressively addressed through public health and behavioral changes over a long period (smoking, unsafe driving), and others that are in the earlier stages of being addressed and have proven challenging (obesity, prescription drug addiction).

The authors conclude “our study demonstrates the enormous benefits of public health and behavioral change in improving population health, underscoring the importance of continued advances in these areas of research and practice.”

I asked Harvard health economist David Cutler, who co-authored the report, what he’d want the public’s takeaway to be (and included a plea to help me beat down my own cynicism.) His e-mailed response:

There are some who see this as ‘glass mostly empty’ – i.e., if it’s not one thing, it’s another. But remember how hard these changes are. Quitting smoking is very difficult, and yet millions of people have done it. Reducing caloric intake is very difficult, though weights finally seem to be stabilizing. The difficulty of these interventions makes the successes particularly notable.

Readers, your own thoughts? Read the full paper here and the summary here.

E-Cigarette Debate: 7,000 Flavors Of Addiction, But What Health Risks?

I’m not young or edgy enough to hang out with anyone who smokes e-cigarettes, but I’ve been vaguely aware that they’re a big and growing thing, and the focus of a big and growing controversy. To wit: Do they end up a net positive, because they help people quit the classic “cancer sticks,” or a net negative, because they act as “gateway” cigarettes just when we’ve finally beaten our smoking rates down?

Answer: We don’t know yet. That’s my takeaway from a major multimedia project on electronic cigarettes on Boston University’s new research website. But it’s such an important question that it’s even a source of debate between prominent researchers on campus — though both strongly concur that more research is needed. From “Behind The Vapor:”

At Boston University, Avrum Spira, a pulmonary care physician and School of Medicine associate professor of pathology and laboratory medicine and bioinformatics who studies genomics and lung cancer, was one of the first scientists to receive funding from the FDA to investigate the health effects of e-cigarettes. “In theor y—- and how they’re marketed — e-cigarettes are a safer product because they don’t have tobacco, which has known carcinogens,” Spira says. “The question is: does safer mean safe?”

(From the Boston University video)

(From the Boston University video)

Across BU’s Medical Campus from Spira, Michael Siegel, a physician and professor of community health sciences at the School of Public Health, has emerged as perhaps the country’s most high-profile public health advocate for e-cigarettes. Siegel, who is not currently researching e-cigarettes, says he believes that the device could potentially help large numbers of smokers quit, or drastically decrease, a habit that is the leading cause of preventable deaths in the US. He points out that despite all the existing smoking cessation products on the market, only a small fraction of cigarette smokers manage to quit. Only 4 to 7 percent break the habit without some nicotine replacement or medication, according to the American Cancer Society. At the same time, Siegel says, more research is needed on the health effects of e-cigarettes as well as their effectiveness in helping people quit smoking.

Check out the full project here, including the video above, “7,000 Flavors of Addiction.” And while you’re on the new website, a couple of other particularly grabby features: The Secret’s In The Spit (the gluten-saliva link — who knew?) and The Secret Life of Neutrinos.

Wave Of Praise For CVS Decision To Stop Selling Cigarettes; What’s Next?

(Twitter)

(Twitter)

From President Obama to the American Medical Association, praise is ringing through the land for CVS Caremark’s announcement today that it will stop selling tobacco products even though that will cost the company some $2 billion in revenue. USA Today reports here that CVS found tobacco sales incompatible with its goal of promoting wellness:

“Selling tobacco is very inconsistent with being in that business,” said Helena Foulkes, CVS’s president. “We really thought about this decision as it relates to the future as a health company — it’s good for customers and our company, in the long run.”

Just to highlight a couple of the positive responses:

The Harvard School of Public Health tweets: “CVS will quit selling tobacco–an important step in fighting smoking and improving health. Bravo!”

A statement from Dr. Ronald Dunlap, president of the Massachusetts Medical Society, reads in part:

The announcement that CVS Caremark will no longer sell tobacco products in its stores is a welcome and exciting step in the continuing campaign against the leading cause of preventable disease and premature death in the United States. Following on the heels of the U.S. Surgeon General’s 50th anniversary report on tobacco issued last month, this decision represents a milestone in tobacco prevention efforts by eliminating the availability of tobacco at more than 7,600 CVS/pharmacy locations nationwide.

It has long been the position of the Massachusetts Medical Society that the sale of such products in health care facilities is inconsistent and contradictory with health and well-being.

As a cardiologist for 34 years, I have seen the devastating effects of tobacco on too many patients for far too long. Heart and respiratory diseases, stroke, and other disorders related to smoking have taken a huge toll. Continue reading

Cigarette Study: Increased Nicotine ‘Yield’ May Make Quitting Even Harder

kenji.aryan/flickr

kenji.aryan/flickr

Fifty years after the U.S. Surgeon General issued the first report on the health hazards of smoking, cigarettes are potentially more addictive than ever, according to a new study that examines so-called “nicotine yields” — essentially the amount of nicotine delivered via smoke.

The study, led by the Massachusetts Department of Public Health and researchers at UMass Medical School, found that nicotine yield “increased sharply from 1998 to 2012 even as the total amount of nicotine in cigarettes has leveled off.”

Public health officials suggest that cigarette makers have cleverly changed the design of their product to increase the amount of nicotine smokers are taking in. (I asked whether the researchers had confronted the tobacco companies directly on these findings. Their response: No, tobacco companies were not directly questioned: “We use the data that they are required to provide to DPH annually,” a UMass Medical School spokesperson emailed.

Here’s more from the news release:

“This study indicates that cigarette manufacturers have recently altered the design of cigarettes. This can significantly increase the amount of nicotine a person receives while smoking,” said Thomas Land, PhD, director of the Office of Health Information Policy and Informatics for the Massachusetts Department of Public Health (MDPH) and principal investigator for the study.

“Cigarettes have a more efficient nicotine delivery system than ever before,” Dr. Land said. “Because smokers have no way of knowing that the level of nicotine they are receiving has increased, they can become more addicted more easily without knowing why.” Continue reading

Mass. Minors Buying E-Cigs? Maybe Not For Long.

(Wikimedia Commons)

(Wikimedia Commons)

I was shocked to find out that minors can buy electronic cigarettes in the state of Massachusetts.

But not for much longer, if a new piece of legislation has its way.

The bill, released today by state Rep. Jeffrey Sánchez, co-chair of the Joint Committee on Public Health, seeks to fix the loophole that allows the free sale of electronic cigarettes and other nicotine delivery products. Though cigarettes are tightly regulated under the Tobacco Control Act of 2009, the FDA and other federal organizations do not currently regulate the sale of alternative nicotine delivery products.

The current state of disarray is caused in part by the development of new tobacco products since the passage of the 2009 act. According to a press release and accompanying fact sheet, Sanchez’s bill would define existing and future tobacco and nicotine delivery products, such as e-cigarettes, ensuring that future products would also be subject to regulation. It would restrict sales of any of these products to minors under the age of 18. And it would prevent the use of electronic cigarettes everywhere that smoking is banned, including in the workplace.

Currently, 12 other states regulate the sale of e-cigarettes: Continue reading