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December 14th, 2012:

Tobacco linked to stroke

12/14/2012 02:44:00admin

By Jimmy Downs

Thursday Dec 13, 2012 ( — Tobacco use has been known to increase risk of lung cancer. A population-based case-control study in Tobacco Control suggests that tobacco smoking may also drastically increase risk of stroke.

The study led by Ruth Bonita, University Geriatric Unit, North Shore Hospital in Takapuna, Auckland, New Zealand and colleagues conducted the study and found active tobacco smoking were fourfold as likely as those who did not smoke to suffer stroke during a 10-year follow-up.

The study involved 521 patients with first acute stroke and 1851 community controls aged 35 to 74 years.

After adjustment for possible confounders including age, gender, history of hypertension, heart disease and diabetes mellitus, both passive tobacco smoking or second hand smoking and long-term smoking in the past were correlated with a 82 percent increased risk of stroke.

Men were more prone to the effect of tobacco smoking than women. Male smokers were twice as likely as those who did not smoke to suffer stroke while female smokers were 66 percent more likely to get hit by stroke compared to non-smokers.

Active tobacco smokers had a fourfold risk of stroke, compared with those never-smokers. The increase in the risk was increased by 533 percent in those active smokers, compared with those who had ever smoked or had quit smoking for more than 10 years and who were not ever exposed to any environmental tobacco smoke including second-hand smoke.

Division of Periodontology: Tobacco Use Cessation Program

FACT:  More than 1,324 people die from ETS/SHS inhalation in Hong Kong each year

Secondhand Smoke Facts

Secondhand smoke, also known as passive or environmental tobacco smoke (ETS), is a combination of:

Mainstream smoke: exhaled by smokers

Sidestream smoke: given off by the burning end of a cigarette, cigar, or pipe

Between 70% and 90% of non-smokers in the American population, children and adults, are regularly exposed to secondhand smoke. It is estimated that only 15% of cigarette smoke gets inhaled by the smoker. The remaining 85% lingers in the air for everyone to breathe. If a person spends more than two hours in a room where someone is smoking, the nonsmoker inhales the equivalent of four cigarettes.

Secondhand smoke is the third leading preventable cause of disability and early death (after active smoking and alcohol) in the United States. For every eight smokers who die from smoking, one innocent bystander dies from secondhand smoke.

Secondhand smoke contains over 4000 chemicals including more than 40 cancer causing agents and 200 known poisons.

Secondhand smoke has been classified by the EPA as a Class A carcinogen – a substance known to cause cancer in humans.

Secondhand smoke contains twice as much tar and nicotine per unit volume as does smoke inhaled from a cigarette. It contains 3X as much cancer-causing benzpyrene, 5X as much carbon monoxide, and 50X as much ammonia. Secondhand smoke from pipes and cigars is equally as harmful, if not more so (Mayo Clinic release, Aug 97).

Over the past two decades, medical research has shown that non-smokers suffer many of the diseases of active smoking when they breathe secondhand smoke.

Secondhand smoke causes lung cancer and contributes to the development of heart disease. Never smoking women who live with a smoker have a 91% greater risk of heart disease. They also have twice the risk of dying from lung cancer.

Never-smoking spouses who are exposed to secondhand smoke have about 20% higher death rates for both lung cancer and heart disease.

Secondhand smoke increases heart rate and shortens time to exhaustion. Repeated exposure causes thickening of the walls of the carotid arteries (accelerates atherosclerosis) and damages the lining of these arteries.

When a pregnant woman is exposed to secondhand smoke, the nicotine she ingests is passed on to her unborn baby.

Women who smoke or are exposed to secondhand smoke during pregnancy:

have a higher rate of miscarriges and stillbirths

have an increased risk of low birthweight infants

have children born with decreased lung function

have children with greater risk of sudden infant death syndrome (SIDS)

Children exposed to secondhand smoke are more likely to experience increased frequency of:

asthma, colds, bronchitis, pneumonia, and other lung diseases

middle ear infections

sinus infections

caries in deciduous teeth

Ventilation systems and designated smoking sections do not protect patrons from ETS.

Current estimates of how smoking increases the risk of various diseases are dramatically underestimated because the ill effects of secondhand smoke inhalation are not taken into account.

Nicotine vs heroin and cocaine addictiveness Inbox x

Nicotine Addiction

Nicotine combines with a number of neurotransmitters in the brain and may contribute to the following effects:

Dopamine: Pleasure, suppress appetite Norepinephrine: Arousal, suppress appetite
Acetylcholine: Arousal, cognitive enhancement Vasopressin: Memory improvement
Serotonin: Mood modulation, suppress appetite Beta-endorphin: Reduce anxiety / tension

Tobacco is as addictive as heroin (as a mood & behavior altering agent).

  • Nicotine is:
    • 1000 X more potent than alcohol
    • 10-100 X more potent than barbiturates
    • 5-10 X more potent than cocaine or morphine
  • A 1-2 pack per day smoker takes 200-400 hits daily for years. This constant intake of a fast acting drug (which affects mood, concentration & performance).. eventually produces dependence.

Pressures to relapse are both behaviorally & pharmacologically triggered.

Comment: The wisdom of Scotland’s ‘smoke-free’ gamble

Sheila Duffy: 'Tobacco is a product sold on image and branding.'

Friday, 14 December 2012 11:20 AM

By Sheila Duffy

The Scottish government will publish a new, comprehensive tobacco strategy early next year and it could be set to commit to a smoke-free future – as Finland and New Zealand have already done.

Aiming for an adult smoking rate of five per cent or less in roughly a generation is an ambitious but an achievable target. It depends on effectively helping the 69% of adult smokers who say they want to be smoke-free to achieve their ambitions, and preventing children from becoming hooked on tobacco.

The tobacco industry remains a pervasive and malignant influence in our society. It works through lawyers, lobbyists and funded front groups like Forest in a perpetual game of smoke and mirrors. It seeks to throw the focus on its customers, smokers, and away from the lethal and addictive product it continues to peddle. A product which is unlike anything else that can be bought over the counter in that when used as the manufacturers intend, it will reliably kill one in two long-term consumers.

The tobacco industry makes grand gestures in the direction of its competition, and claims that effective public health measures will increase the illicit and counterfeit tobacco trade. It ignores the facts – that illicit tobacco has been in sustained decline for more than a decade, and that the claimed relationship with health measures like plain packs or tax hikes do not stand up to scrutiny.

Tobacco is a product sold on image and branding. In blind taste tests, most smokers can’t tell the difference between brands of cigarette. The industry is selling a dream, which for many becomes a solid nightmare.

Fiscally, tobacco remains a drain on economies as well as on household budgets. As well as the monetary costs in terms of NHS treatments, there are direct costs from fires, litter, costs to business from absence due to ill health and the costs of secondary damage to health from breathing tobacco smoke. In human terms, the costs of lives and families damaged by heart disease, strokes, cancer and lung disease are incalculable.

Tobacco is an epidemic – one that claims more than 13,000 lives every year in Scotland. I am proud of the Scottish government’s commitment to putting tobacco out of fashion and creating a future in which our children can breathe.

Sheila Duffy is chief executive of ASH Scotland.

The opinions in‘s Comment and Analysis section are those of the author and are no reflection of the views of the website or its owners.

Just a single cigarette a day linked to sudden death

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So About That ‘Glowing’ Cigarette…

So About That ‘Glowing’ Cigarette…

By the end of the 1920s, scientists already knew that tobacco smoke contained a small encyclopedia’s worth of risky chemical compounds: carbon monoxide and hydrogen cyanide, hydrogen sulfide and formaldehyde, ammonia and pyridine (a component in industrial solvents).

I discovered that list when I was researching my book about early 20th century toxicology, The Poisoner’s Handbook. And I remember being surprised because I had believed that it wasn’t until the mid-20th century, maybe a little before the famed 1964 U.S. Surgeon General report on the dangers of smoking – that we really knew anything about the health risks of smoking.

Of course, that 1920s list turns out to only be the bare start of the one we’ve assembled today. By some counts, there are a good 4,000 chemical compounds in cigarettes and, of those, the U.S. Food and Drug Administration classifies more than 100 as dangerous (from carcinogenic to addictive). Given the body of evidence, linking cigarette smoking to disease, it’s not necessarily a surprise to find that the smoke contains well-known bad actors ranging from arsenic to toluene.

Still, I’ll confess to being startled last week when I was researching the suspected radiation poisoning of Palestinian leader Yasser Arafat and discovered that one of the most common sources of radiation exposure is through smoking cigarettes. I wrote about that in the context of the recent exhumation of Arafat’s body and the toxicity texts underway in a post called “Yasser Arafat and the Radioactive Cigarette.”

And when I read the FDA list of hazardous compounds in cigarette smoke and found not only polonium-210 (the radioactive element suspected in Arafat’s death) but two well-known isotopes of uranium best associated with nuclear reactors (uranium-235 and uranium-238), I thought – wow, how did I miss that?

As it turns out, there’s a real case to be made that I – and really all of us – missed this because the tobacco companies hid the information, that cigarette makers flagged the problem internally by 1960s and studied it in secret. The best evidence for that comes from the companies’ confidential documents, which were released in the 1998 Tobacco Master Settlement Agreement between four major companies – Philip Morris, R.J. Reynolds, Brown & Williamson and Lorillard – and attorney generals from 46 states.

An analysis of those documents by public health researchers at the University of California-Los Angeles was published last year in the journal, Nicotine and Tobacco Research. As that study (paywall) notes:

The documents show that the industry was well aware of the presence of a radioactive substance in tobacco as early as 1959. Furthermore, the industry was not only cognizant of the potential “cancerous growth” in the lungs of regular smokers but also did quantitative radiobiological calculations to estimate the long-term (25 years) lung radiation absorption dose (rad) of ionizing alpha particles emitted from the cigarette smoke.

<img title=”smoke” src=”×300.jpg” alt=”” width=”233″ height=”300″ />

1962 L&M advertisement using a “family theme” Photo: The Stanford School Of Medicine

This wasn’t the first study to note the corporate coverup; an earlier report in American Journal of Public Health reached the same conclusion. Still, let’s call the information an imperfectly kept secret (as so many are). In 1964, for instance, we find scientists from the Harvard School of Public Health reporting that they had discovered hot spots, fizzing with polonium-210, in the lungs of regular smokers. They published that finding in the highly visible New England Journal of Medicine in 1965, warning that “we believe 210Po may be an important factor in the initiation of bronchial carcinoma in humans”. It wasn’t, actually, that tobacco companies were entirely successful at hiding the radioactive nature of cigarettes; it was that the rest of us weren’t entirely successful at paying attention.

But, as the UCLA analysis points out, internal documents revealed something else. Not only did cigarette makers know about polonium-210 contamination of their product for decades – they knew how to fix it and chose not to. And to understand that, you need to know why tobacco plants become such little radiation factories.

The radioactive elements occur naturally in the Earth’s crust. So it’s not surprising to find them in soils where crops are grown. In the case of tobacco, this effect tends to be amplified because the most commonly used fertilizers for that plant are phosphate-rich mixtures based on the mineral apatite. And apatite is known to mix up with radioactive elements. Or as the U.S. Environmental Protection Agency puts it: “When phosphate fertilizer is spread on the tobacco fields year after year, the concentration of lead-210 and polonoium-210 in the soil rises.” When the soil is stirred up – by planting, plowing, wind, whatever – radioactive particles drift into the air, attach to dust and other particulates there. As these settle back down to the ground, they are often trapped by the naturally sticky leaves of the tobacco plant.

These radioactive residues can be removed by acid-washing the plants. But the documents obtained by the California researchers showed that manufacturers refused to do that for fears that the acid would alter the nicotine and decrease the chemical kick that helps make the products popular. The UCLA analysts went on to calculate the resulting radiation health risk from regular smoking, based in part on the industry’s own analysis. They set the cost of such alpha radiation in the lungs at 120-138 cancer deaths per 1,000 regular smokers.

As a story by British science writer Ed Yong points out, these are tricky numbers to set because the radiation dose comes in a smoke fog of treacherous chemistry. But as he also points there’s no disagreement that having p0olonium-210 delivered directly to the lungs is a very bad idea. This is a highly energetic element, with a half-life of only 138 days; it’s considered 5,000 times as radioactive as radium. Like radium, it primarily emits alpha particles which, although, not particularly dangerous outside body (they lose energy on impact and don’t penetrate skin) wreak havoc once inside.

But inside the body, alpha particles are capable of doing wide-spread harm. Polonium-210 lodges in cells of the lungs like little hissing balls of radiation. It travels easily elsewhere in the body, irradiating tissue as it goes. It settles into and destroys bone marrow, causing a host of blood-related disorders. At smoker-related exposure levels, health expects thus warn of diseases, such as cancer, that follow a kind of chronic, radiation-induced injury. At high levels, though, polonium-210 kills with relative speed.

The classic example is the 2006 death of former Russian spy Alexander Litvinenko, who was purportedly killed by KGB agents who slipped polonium-210 into his drink during a meeting in London. Litveninko died just three weeks after that November meeting. British police say there is enough evidence to charge two Russian agents with his death but Russia has refused to extradite them and – even today – angrily denies the accusations.

Which brings us back to the other possible assassination, the suspected poisoning of the Palestinian leader Yasser Arafat, who died in 2004. A months long investigation by Al Jazeera, which included testing of his clothes and even his famous checked kaffiyeh, found some unexpectedly high traces of polonium-210. The publication of those results in July led to calls for further testing and last month his body was exhumed and tissue and bone samples sent to three laboratories (one, ironically, in Russia). Results are not expected until early next year.

In my postlast week, I pointed out that a possible explanation for evidence of polonium-210 exposure could, in fact, be cigarette smoke. Arafat and his colleagues in the Ramallah compound were known to be heavy smokers. Of course, I also somewhat undermined that idea by also pointing out that Israel had been known to restrict Arafat’s access to tobacco as a form of petty punishment. In other words, it’s worth exploring all possibilities but keeping them ones that make most sense.

It might be, as I’ve suggested, that a smoky environment accounted for some of the polonium-210 traces in Arafat’s clothing. But there’s still no clear evidence that smoking killed him; no clear evidence that he was a victim of one of those polonium-201 induced lung cancers or similar illness. So, beyond the first stage of this investigation, if forensic work is able to show a lethal exposure then – as in the case of Litvinenko – we will indeed be talking about assassination and all its ugly and messy implications.

But while we wait, let me just emphasize my other point. Let me just quote you the closing line of that UCLA look at radiation in cigarettes: “The evidence of lung cancer risk caused by cigarette smoke radioactivity is compelling enough to warrant its removal.” After all these years, it would be gratifying to see that message get a little traction too. And that conclusion, we can safely call an understatement.

Europolitics mandatory health warnings and further restrictions



Tobacco directive: Details emerge

By Sophie Petitjean | Friday 14 December 2012

“Smoking kills – quit now” and “Tobacco smoke contains over 70 substances known to cause cancer”: these health warnings could soon become mandatory on each unit packet of tobacco for smoking, as proposed by the draft Directive on Tobacco Products, which Europolitics has seen. The text, which dates from before the interservice consultation, aims to make tobacco products less attractive in order to discourage people from picking up their first cigarette. It bans flavoured tobacco products, long cigarettes and overly-attractive packets. Moreover, it allows member states to maintain or introduce stricter measures for domestically manufactured or imported products on the basis of public interest, “provided that these measures are proportionate, do not constitute arbitrary discrimination and […] are accepted by the European Commission.”

The adoption of the proposal is on the agenda of the College of Commissioners on 19 December.


Firstly, the Commission has proposed regulating on cigarette packages and cigarettes themselves. A cigarette packet should be rectangular and include at least 20 cigarettes, and 75% of its surfaces, recto and verso, should be covered with health warnings (images and text). Furthermore, these health warnings, which should be a minimum of 64 millimetres long and 55 millimetres wide – should be positioned at the top edge of the unit packet. A unit packet of rolling tobacco should contain at least 40 grammes of tobacco. The proposed text specifies that member states should not increase the size of health warnings by introducing, for example, the obligation to surround health warnings with a border. The same logic applies to the form and content of cigarettes, which should in future meet precise criteria: the draft directive proposes imposing a right circular cylindrical form on cigarettes, and a diameter of between 7.5 mm and 8.5 mm. Member states should affix a single indentifier, and a bar code of at least one cm 2 on cigarette packets in order to avoid fraud, with a dispensation of five years for products other than cigarettes and rolling tobacco. Unlike Australian legislation, this directive does not regulate on colour and depth.


The Commission has also proposed regulating the ingredients of tobacco products. The proposed text establishes a maximum threshold per cigarette for tar (ten mg), nicotine (one mg) and carbon monoxide (ten mg). It forbids adding special flavourings and certain additives, such as vitamins, caffeine, taurine and other stimulating additives associated with energy and vitality. This ban also applies to the ingredients of tobacco products, such as filters, papers, packages, capsules and other elements that alter flavour and smoke. As for ingredients that will remain authorised, these will be subject to the obligation to provide information: producers and importers of tobacco products will have to draw up a list of all ingredients used in the manufacturing of products, justify the presence of these ingredients, and classify them according to their quantities.


These new rules will also apply to new products (those placed on the market after 1 January 2012). These will be subject to a notification obligation six months before they are placed on the market. The draft directive also covers products whose nicotine content surpasses a certain amount (two mg per unit, or a concentration of four mg per ml). Finally, it forbids tobacco for oral use (except that which is smoked or chewed) while maintaining Sweden’s dispensation for snus.


The draft text is only provisional, since the College of Commissioners has not yet adopted it. However, very few changes have been made during the interservice consultation. Some measures have disappeared since the summer, including a ban on all smokeless products. The same goes for the obligation for tobacconists to restrict their presentations to one packet per brand and per threshold, as well as those concerning the presence of 85% tobacco in products.

However, the proposal is not immune to further changes, since health advisers for each commissioner are due to give their opinions on the text on 14 December, and heads of cabinet on 17 December. Parliament and Council must then adopt the legislative proposal.

Copyright © 2012 Europolitics. Tous droits réservés.

Tobacco firms held quiet meetings with top EU officials

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