Prevention Matters

On Monday and Tuesday the National Forum for Heart Disease and Stroke Prevention held its 8th annual meeting in Washington DC. The meeting focused on developing the will to prevent heart disease and stroke in the public and private sectors, including drawing attention to the recently released Institute of Medicine (IOM) reports on hypertension and sodium reduction.

Dr. David Fleming, the chair of the IOM Committee on Strategies to Reduce Sodium Intake and a member of Partnership for Prevention’s National Commission on Prevention Priorities (NCPP), presented information about actions that can be taken by food manufacturers, the federal government, and public health professionals to reduce the sodium content in foods. The sodium plenary session was timely, occurring a few days after Partnership’s congressional briefing on reducing sodium consumption.

Another highlight from the meeting was a session on connecting traditional and emerging communication approaches to change behavior. Dr. Rob Gould, President and CEO of Partnership, spoke about behavior change and exciting new methods of communication. Other panelists hailed from the CDC, NIH, and Pew Research Center.

The National Forum on Heart Disease and Stroke Prevention works to provide leadership and facilitate collaboration among those committed to preventing heart disease and stroke. Partnership participated in last year’s Forum Symposium on the Health Economics of Cardiovascular Disease, and recently joined as a Forum member. Partnership’s work in cardiovascular disease prevention includes its Aspirin Task Force , a multidisciplinary group of medical professionals committed to promoting aspirin for primary prevention of heart disease and stroke, as well as projects in its priority areas of tobacco cessation and control, and poor nutrition and physical inactivity (obesity). For more information on the Forum and the Annual Meeting, please click here.

Rebecca Doigan
Program Associate
Partnership for Prevention

Due to the improper use of antibiotics, Gonnorrhea may become untreatable in the near future. The World Health Organziation reported yesterday that there is now "widespread resistance" to first-line antibiotics, which are cheaper than other options, to fight the bacterium that causes Gonnorrhea.

Some countries, such as Australia and Japan are now also reporting treatment failures with a class of antibiotics that is the last line of defense against the disease. The WHO and CDC have developed an action plan to begin identifying other treatments.

Left untreated, gonorrhea can result in infertility, pelvic inflammatory disease, ectopic pregnancy, and infections in newborn children. It also increases the likelihood of acquiring and transmitting HIV.

Christianne Johnson
Program Manager
Partnership for Prevention

There is growing awareness that transportation systems and policies can impact our health and indeed the quality of life in communities across America. Congress is currently hard at work developing a multi-year transportation authorization that will have a profound impact on air quality, traffic safety, the availability of walkable communities and affordable mass transit…the challenge is for this impact to be a positive one.

In a thoughtfully written 11 page report (“CDC Recommendations for Improving Health through Transportation Policy”) the Atlanta-based Centers for Disease Control and Prevention (CDC) offers federal, state and local policymakers a valuable framework to consider that will foster consideration of transportation policies and investments that have the greatest “positive impact on health.” The CDC recommendations have been under development since 2007 and have been informed by the work of the US Department of Transportation and key public health organizations like the American Public Health Association and the Convergence Partnership. CDC calls for adoption of “a balanced portfolio of transportation choices that supports health and reduces health care costs.” The goals of a balanced portfolio are straightforward and should enjoy broad support inside and outside of government.

• Reduce injuries associated with motor vehicle crashes
• Encourage healthy community design
• Promote safe and convenient opportunities for physical activity by supporting active transportation infrastructure
• Reduce human exposure to air pollution and adverse health impacts associated with these pollutants
• Ensure that all people have access to safe, healthy, convenient, and affordable transportation

The challenge for those of us committed to prevention is convincing transportation advocates that healthy transportation is in everyone’s interest. We need adoption of complete streets policies, expanded support for safe routes to school, greater attention to community design that promotes health and safety, support of public transportation that improves access for all people and a commitment to reduce human exposure to transportation-related air pollution.

Partnership for Prevention is working to support these efforts by partnering with the Transportation for America, APHA and other public health and prevention leaders to educate policymakers about the extensive body of research that supports the CDC recommendations.

Ripley Forbes
Director, Government Affairs
Partnership for Prevention

The Food and Drug Administration’s plans to gradually reduce the amount of salt consumed each day by Americans was named the “Best Prevention Idea of the Week,” while the rise in use of smokeless tobacco, chewing tobacco and snuff by teens in recent years was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

FDA poised to save lives by lowering sodium content … It’s about time!

In a page one story in the Washington Post entitled, “FDA plans to limit amount of salt allowed in processed foods for health reason," reporter Lyndsey Layton writes:

“The Food and Drug Administration is planning an unprecedented effort to gradually reduce the salt consumed each day by Americans, saying that less sodium in everything from soup to nuts would prevent thousands of deaths from hypertension and heart disease. The initiative, to be launched this year, would eventually lead to the first legal limits on the amount of salt allowed in food products.”

The FDA’s involvement is welcome news. For years public health authorities have cautioned Americans to reduce sodium consumption in order to reduce the risk of heart disease and stroke; the nation’s first and third leading causes of death.

WORST

Smokeless tobacco use rising among teens

The use of smokeless tobacco, chewing tobacco and snuff, by teens has risen in recent years, reversing a trend toward declining use of all tobacco products by teens, Terry Pechacek of the Centers for Disease Control and Prevention told a U.S. congressional panel. He said data to be released in the next few months will show an increase mainly among white and Hispanic young males. Health experts say smokeless tobacco can cause cancers of the mouth, throat, esophagus and pancreas. Pechacek said the CDC is concerned that high school students perceive smokeless tobacco to be safer than cigarettes.

Mayor Michael R. Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs and Health Commissioner Dr. Thomas A. Farley announced the first 16 companies to formally commit to the National Salt Reduction Initiative – a public-private partnership created to reduce Americans’ salt consumption by 20% over five years. New York City began coordinating this voluntary effort two years ago. The National Salt Reduction Initiative partnership now includes 18 national health organizations; 29 cities, states and related entities; and some of the nation’s leading food companies, including: Au Bon Pain, Boar’s Head, FreshDirect, Goya, Hain Celestial, Heinz, Kraft, LiDestri, Mars Food, McCain Foods, Red Gold, Starbucks, Subway, Unilever, Uno Chicago Grill and White Rose.

According to Dr. Robert J. Gould, Partnership’s CEO, “I commend Mayor Bloomberg and the NYC Department of Health for their leadership on this vital public health issue. Over the past 30-40 years the consumption of sodium in the diet has increased to levels that have alarmed clinicians and the public health community. 77% of the sodium in our diets come from processed and restaurant foods. The commitment and national leadership of Mars Foods and other companies to promote public health by reducing the sodium levels of their products is a positive example that other food manufacturers should quickly follow.”

Americans consume roughly twice the recommended limit of salt each day. The sodium in salt is a major contributor to high blood pressure, which in turn causes heart attack and stroke, the nation’s leading causes of preventable death.

Last week, the Institute of Medicine released a report stressing the urgent need to reduce sodium intake in the United States. The report recommends that the U.S. Food and Drug Administration use its regulatory authority to reduce salt in the nation’s food supply, but it also notes that public-private partnerships can “achieve meaningful reductions in sodium intake prior to the implementation of mandatory standards.”

On April 22, Darwin Labarthe, MD, MPH, PhD, Director of the Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention, told a briefing of the Congressional Prevention Caucus that “the current level of sodium added to the food supply—by food manufacturers, foodservice operators, and restaurants—is simply too high to be “safe” for consumers. Reducing the sodium content of processed foods is a necessary and urgent public health strategy for reducing blood pressure and preventing hypertension, heart disease, stroke, and other cardiovascular diseases. The time is now.”

William Tatum
Director of Membership
Partnership for Prevention

The Centers for Disease Control and Prevention has released the report Tobacco Control State Highlights 2010, which provides tobacco control programs and decision-makers with state-specific data regarding proven, high-impact tobacco strategies. The report aims to address the public health impact of smoking and call attention to the urgent need to end the tobacco use epidemic.

Tobacco Control State Highlights 2010 provides state-specific data for a number of indicators including prevalence of tobacco use; Medicaid coverage for cessation counseling and medications; state retail environment tobacco licensure laws; and state funding for tobacco control. The indicators that were selected for this report are considered important and timely because they are closely aligned with high-impact program and policy recommendations from CDC’s Best Practices for Comprehensive Tobacco Control, 2007 and MPOWER, the World Health Organization’s framework for reducing tobacco use globally.

Key information provided by the report includes:

• There are currently 24 states and D.C. that have passed comprehensive smoke-free laws
• In 2007, seven states (Indiana, Massachusetts, Minnesota, New Mexico, Oklahoma, Oregon, and Pennsylvania) provided insurance coverage to Medicaid enrollees for all FDA-approved medicines and counseling to quit smoking.
• Six states (Alabama, Connecticut, Georgia, Missouri, Nebraska, and Tennessee) had no cessation coverage for their Medicaid population
• Combined interventions – increasing the price of cigarettes, implementing smoke-free policies, implementing mass media advertising campaigns, reducing tobacco advertising and promotion, controlling access to tobacco products, and promoting and assisting smokers to quit – are proven to significantly reduce smoking.

According to CDC Director Thomas R. Frieden, M.D., M.P.H. "Smokefree laws, hard-hitting ads, and higher cigarette prices are among our strongest weapons in this fight against tobacco use. We must redouble efforts to bring down smoking rates, prevent suffering and premature death, and cut health care costs by reducing smoking."

In the hopes of helping states take steps toward permanent change in coverage, access, and utilization of tobacco cessation treatments, Partnership for Prevention has awarded six ACTTION State Grants for the implementation of innovative strategies to increase access to treatment. Funds are to be used primarily for the development of state alliances and the creation of strategic plans. The projects will have a range of focuses including employer groups, health care systems, the uninsured, and the behavioral health/substance abuse populations.

The Partnership for Prevention ACTTION Grantee States are:

• Colorado - Cessation Coverage/Treatment for Colorado’s Uninsured
• Florida - Tobacco Cessation Summit & Action Plan
• Nevada - Increasing Cessation Access for All Nevadans
• New England - New England Partnership for Smoking Cessation Policy
• New York – New York State Access to Tobacco Use Treatment Strategic Planning Project
• Virginia - Virginia Partnership for Tobacco Use Cessation

Brandi Robinson
Tobacco Control Program Associate
Partnership for Prevention

To illustrate the impact of overpopulation on endangered species, The Center for Biological Diversity’s Endangered Species Condom Project is distributing free endangered species condoms. The Center will hand out 350,000 condom packets, which depict six separate species that are threatened by overpopulation. The polar bear, snail darter, spotted owl, American burying beetle, jaguar, and coquí guajón rock frog each appear on packets with their own clever safe-sex slogan. Each package contains information on the species, facts about overpopulation and the extinction crisis, and suggestions on how to stabilize the human population. The condoms will be distributed across the country by a network of 5,000 volunteers.

Condoms are not only useful in protecting against overpopulation; they also protect against the spread of sexually transmitted diseases, including chlamydia. Chlamydia is a bacterial infection that is extremely common among adolescents and young adults. CDC estimates there are about 3 million new cases annually. Left untreated in women, Chlamydia can lead to pelvic inflammatory disease which in turn can cause infertility, ectopic pregnancy, and other health concerns.

The National Chlamydia Coalition (NCC) convened in 2008 to address the continued high burden of chlamydia infection, especially among women age 25 and under. For more information, see www.prevent.org/NCC.

Alana Ward
Program Associate
Partnership for Prevention

A new study published in the British Medical Journal states that smoking cessation offers a significant benefit to early-stage lung cancer patients by reducing the progression of the disease.
“The adjusted estimates suggest that the risk for death is halved in patients who stop smoking”, say the researchers, led by Amanda Parsons, research fellow at the UK Center for Tobacco Control Studies at the University of Birmingham, United Kingdom.

“The difference in survival between patients who stopped smoking and those who continued is striking", said H. Jack West, MD, medical oncologist at the Swedish Cancer Institute in Seattle, Washington, and author of the Blowing smoke blog on Medscape Oncology. “This effect is larger than that seen with postoperative chemotherapy”, he added.

This research is both fascinating and promising, but must be considered preliminary. Only a large-scale randomized controlled trial will permit researchers to confidently draw conclusions and make patient care recommendations.

David Zauche
Senior Program Officer
Partnership for Prevention

In a page one story in yesterday’s Washington Post entitled, “FDA plans to limit amount of salt allowed in processed foods for health reason," reporter Lyndsey Layton writes:

“The Food and Drug Administration is planning an unprecedented effort to gradually reduce the salt consumed each day by Americans, saying that less sodium in everything from soup to nuts would prevent thousands of deaths from hypertension and heart disease. The initiative, to be launched this year, would eventually lead to the first legal limits on the amount of salt allowed in food products.

The FDA’s involvement is welcome news. For years public health authorities have cautioned Americans to reduce sodium consumption in order to reduce the risk of heart disease and stroke; the nation’s first and third leading causes of death. In fact, according to the Centers for Disease Control and Prevention, 69% of adults in the United States are at “especially high risk for health problems from consuming too much sodium.” You are considered high risk if you are over 40 years of age, African American or have high blood pressure.

But following advice to reduce sodium consumption is tough work. 77 percent of sodium in our diets come from processed and restaurant foods. According to the WPost story the FDA is planning to “analyze the salt in spaghetti sauces, breads and thousands of other products” and (work) “with food manufacturers” to set limits for salt that would be “designed to gradually ratchet down sodium consumption. The changes would be calibrated so that consumers barely notice the modification.” (emphasis added)

A few hours after publication of the story, the Institute of Medicine lifted a media embargo and went public with their much anticipated report “Strategies to Reduce Sodium Intake in the United States.” The report confirms that despite multiple “voluntary efforts to reduce sodium consumption in the United States during the past 40 years, they have not succeeded.”

Much is at stake. According to the IOM, “population-wide reductions in sodium could prevent more than 100,000 deaths annually.”

The heart of the IOM recommendation is a regulatory strategy similar to the approach the Washington Post indicated the FDA was considering. They recommend “the FDA set mandatory national standards for the sodium content in foods – not banning outright the addition of salt to foods but beginning the process of reducing excess sodium in processed foods and menu items to a safer level.” The report emphasized: “It is important that the reduction in sodium content … be carried out gradually, with small reductions instituted regularly as part of a carefully monitored process.”

And good news for food gourmands. The report notes “evidence shows that a decrease in sodium can be accomplished successfully without affecting consumer enjoyment of food products IF IT IS DONE (emphasis added) in a stepwise process that systematically and gradually lowers sodium levels across the food supply.”

On Thursday, April 22,  Partnership will host a briefing (“Reducing Sodium Consumption: Is it time?") on Capitol Hill with the Congressional Prevention Caucus to hear more about the adverse health effects of excessive sodium in the diet. Caucus Co-Chair, Representative Jim Moran (D. VA) will open the briefing which will be moderated by Partnership’s President Rob Gould. The briefing will include presentations by:

• Darwin Labarthe, MD, MPH, PhD, Director, Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention
• Thomas Farley, MD, MPH, Commissioner, New York City Department of Health and Mental Hygiene
• Mark Broadhurst, Director, Corporate Affairs and State Public Policy, Mars Food US
• Suzanne Hughes, RN, MSN, Preventive Cardiovascular Nurses Association

Briefings of the Congressional Prevention Caucus are open to the public. If you are able to attend this event, please email Partnership for Prevention at meetings@prevent.org

E Ripley Forbes
Director, Government Affairs
Partnership for Prevention

R.J. Reynolds new product “Camel Orbs” poses health risks to infants and children according to a new study published online April 19, 2010 in the journal Pediatrics. Orbs are dissolvable nicotine products, flavored with cinnamon or mint, that are made to look like candy. Gregory Connolly, lead author of the study and director of the Tobacco Control Research Program at Harvard School of Public Health, said, “"This product is called a 'tobacco' product, but in the eyes of a 4-year-old, the pellets look more like candy than a regular cigarette. Nicotine is a highly addictive drug and to make it look like a piece of candy is recklessly playing with the health of children."

Ingestion of tobacco products by infants and children is a major reason for calls to poison control centers nationwide. In 2007, 6,724 tobacco-related poisoning cases were reported among children five years of age and under. Small children can experience nausea and vomiting from as little as 1 mg of nicotine.

David Zauche
Senior Program Officer
Partnership for Prevention

Toronto’s ban on smoking in restaurants that led to a major decline in heart and lung hospital admissions was named the “Best Prevention Idea of the Week,” while the lack of progress in eliminating infections that can harm or kill patients in U.S. hospitals was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

Best

Smoking Ban Cut Hospital Admissions

Toronto's ban on smoking in restaurants led to a major decline in heart and lung hospital admissions, a Canadian medical research study said Tuesday. Smoking in restaurants was banned by the city in 2001. The research published in the Canadian Medical Association Journal said within three years, hospitalizations for heart conditions fell 39 percent and 32 percent for respiratory conditions, the Globe and Mail reported. Using data from two other regions in Ontario that didn't have smoking bans, the rate of admissions for heart attacks jumped by almost 15 percent during the same time period, the report said.

Worst

U.S. Hospitals Get Low Marks on Curbing Infections

U.S. hospitals are making little progress in eliminating infections that can harm or kill patients, according to reports released April 13 by the federal Agency for Healthcare Research and Quality. Researchers found that rates of bloodstream infections after operations (postoperative sepsis) increased by 8 percent, rates of catheter-associated urinary tract infections following surgery increased by 3.6 percent, and rates of certain infections due to medical care increased by 1.6 percent. However, rates of pneumonia that developed after surgery (postoperative pneumonia) fell by 12 percent.

The April 16, 2010 issue of the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report includes data collected by the Adult Tobacco Survey (ATS) during February 2003 – November 2007. Among 33 ATSs conducted in 19 states, current cigarette use by adults ranged from 13.3% (Hawaii in 2006) to 25.4% (West Virginia in 2005), with a median of: 19.2%. Among young adults aged 18-29, current cigarette use ranged from 15.8% (Hawaii in 2006) to 40.4% (West Virginia in 2005), with a median of: 26.7%.

The survey also found that with the exception of smokeless tobacco use and pipe use, the median prevalence of current use of each tobacco product was consistently highest among adults aged 18-24 years and lowest among adults aged ≥65 years. Polytobacco use ¬– current use of multiple tobacco products including cigarettes, cigars, pipe tobacco or smokeless tobacco – was also explored in the survey. The percentage of adults using two tobacco products ranged from 10.6% (South Carolina in 2007) to 18.6% (Oklahoma in 2004) (median 14.5%). The percentage of adults using three tobacco products ranged from 1.6% (South Carolina in 2007) to 4.6% (Ohio in 2006) (median 2.9%). The percentage of adults using all four tobacco products ranged from 0.0% (Iowa in 2004, Oklahoma in 2004, and South Carolina in 2007) to 0.6% (Georgia in 2004) (median 0.3%).

Adults who were employed for wages or self-employed were asked whether their employer had offered any programs to help them stop smoking or any other types of help to employees who wanted to quit smoking. Among 12 ATSs, the percentage of adults (smokers and nonsmokers combined) who reported that their employer offered any cessation programs ranged from 19.7% (New Mexico in 2003) to 28.6% (South Carolina in 2007) (median: 23.4%). The percentage of current smokers who reported employer-offered smoking cessation programs ranged from 13.5% (Idaho in 2005) to 22.5% (Iowa in 2006) (median: 18.4%).

Based on the results of the survey, CDC recommends that states establish, maintain, and fund comprehensive tobacco control programs, at least at CDC-recommended levels, to reduce tobacco-related deaths and diseases. CDC regularly evaluates the recommended state ATS questions with a goal of more closely aligning the questions with short-term, intermediate, and long-term outcome indicators to measure progress toward National Tobacco Control Program goals.

The Adult Tobacco Survey is a random-digit--dialed telephone survey of the civilian, noninstitutionalized U.S. population aged ≥18 years that collects data on tobacco use, smoking cessation, secondhand smoke exposure, risk perception and social influences, health influences, and tobacco-related policy issues in the United States.

Brandi Robinson
Program Associate
Partnership for Prevention

A new report from the Department of Health and Human Services' Agency for Healthcare Research and Quality (AHRQ) highlights the continued concern of disparities in our healthcare system. As in previous reports, the disparities relate to race, ethnicity, and socioeconomic status and "are prevalent in almost all areas of healthcare, including preventive care, treatment of acute conditions, and managment of chronic diseases".

The widest gap was seen between low-income and high-income patients, followed by Hispanics and non-Hispanics, then blacks and whites. The report also highlights the importance of the new healthcare reform law. Not surprisingly it showed that uninsured people were far less likely to receive preventive services, including mammograms, Pap smears, dental care, counseling about diet and exercise, and flu vaccination.

Christianne Johnson
Program Manager
Partnership for Prevention

During the health care debate, recommended clinical preventive services have been in the news as never before. Many people are unsure which services are recommended and for whom. An easy to use, free, interactive tool is now available. The DHHS, Office of Disease Prevention and Health Promotion has a widget which directs users to the clinical preventive services recommended for persons of their age and sex. If you want to remind a loved one what’s recommended for him or her, type in their age and sex and then email the results. When you see your healthcare provider, discuss keeping preventive care up-to-date. The preventive services and other tools are located at http://www.healthfinder.gov./ Organizations are free to add the widget to their websites.

Susan K. Maloney, MHS
Managing Senior Fellow & Senior Program Officer
Partnership for Prevention

Baltimore’s holistic approach to unhealthy housing was named the “Best Prevention Idea of the Week,” while the increase in casual sex was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

Baltimore takes a holistic approach to unhealthy housing

Baltimore is the site of the Centers for Disease Control and Prevention's first Healthy Homes program, an attempt to coordinate efforts on lead abatement, asthma and injury prevention, indoor air pollution and fire safety. "It's not unusual for a community health worker to take care of lead only to have a child die in a fire, or fall out the window," said Mary Jean Brown, chief of the Lead Poisoning Prevention branch at CDC. "The Healthy Homes approach recognizes all these things that can happen in homes. So you take your lead prevention army and equip them with tools so that they can address more than one problem at once."

WORST

Casual Sex Increasing in U.S.

People in non-romantic sexual relationships today are likely to have multiple partners, researchers have found, and that behavior could promote the spread of sexually transmitted diseases. "The United States has seen a major shift toward non-romantic sexual partnerships -- people becoming sexually involved when they are just casually dating or not dating at all," study author Anthony Paik, a sociologist at the University of Iowa College of Liberal Arts and Sciences, said in a university news release. "People can make their own choices, but we hope this information will be useful as they weigh the risks and rewards of non-romantic sexual relationships," Paik said. "We encourage people to be aware of the potential for sexual concurrency and take appropriate precautions to avoid sexually transmitted infections."

The FDA Center for Tobacco Products will launch a Stakeholder Listening Series to take full advantage of the knowledge, ideas, feedback, and suggestions from all communities interested in and affected by the Tobacco Control Act. Sessions will take place across the U.S. and summaries will be available on www.fda.gov/tobacco. Each session will focus on topics of greatest interest to the FDA's primary stakeholder communities and will include presentations by topic experts and the FDA.

The FDA Center for Tobacco Products will develop and publish a schedule for the Stakeholder Listening Series in the coming months. Stakeholders will be notified of the schedule when published and are encouraged to visit the website and sign-up for the e-mail notification service for regular updates.

David Zauche
Managing Senior Fellow & Senior Program Officer
Partnership for Prevention

Yesterday, the U.S. Navy announced a change in policy – smoking will be banned aboard all submarines. Obviously, prohibiting smoking in such confined spaces makes sense. The question for me was “Why did it take so long?” One can reason that both smoking and non-smoking sailors would be exposed to unacceptable levels of secondhand smoke. Although prior Surgeons General and tobacco control advocates have presented evidence of the health consequences of second-hand smoke, it wasn’t until a 2009 study by the Naval Submarine Medical Research Laboratory confirmed risk to nonsmoking submariners that a policy change was successful.

Accompanying the smoking ban will be tobacco cessation education and access to nicotine replacement therapy products. Kudos to the Navy for recognizing that forcing submarine sailors to go “cold turkey” would not be a smart move. Hopefully, the cessation programs will be expanded to adhere to the Public Health Service Guidelines’ comprehensive mix of counseling and medications.

Diane M. Canova
Vice President, Policy & Programs

More U.S. smokers than ever are utilizing telephone quitlines to help them stop smoking. However, budget cuts are now limiting access to this critical service according to a report released today by the North American Quitline Consortium and other public health organizations.

"At a time when demand for quitlines is at a record level, it is more important than ever to support proven tobacco cessation efforts,” said Linda Bailey, president and chief executive officer of the North American Quitline Consortium (NAQC). "The investment of $2.19 per capita for quitlines, as recommended by the Centers for Disease Control and Prevention, is based on sound science and real-world experience. States that made the necessary investments have been able to provide cessation services to the growing number of smokers who want to quit. We commend the states that have committed the necessary funding to quitline services and encourage them to continue this practice."

The number of tobacco users calling quitlines—a telephone helpline where smokers can turn for trusted, reliable help when they want to quit—increased 116% between 2005 and 2009, according to the report. Despite this increase in demand, total funding for all U.S. quitlines decreased for the first time ever in Fiscal Year (FY) 2010. Funding has been cut despite the fact that states will collect $25.1 billion in revenue this year from tobacco taxes and legal settlements with the tobacco industry, and more states have already enacted or are considering tobacco tax increases this year. These increases will motivate more smokers to try to quit and provide additional revenue that states can use to fund quitlines and other tobacco prevention and cessation programs.

David Zauche
Senior Program Officer
Partnership for Prevention

As many as one in two sexually active young people will contract an STD before the age of 25 so MTV, Kaiser Family Foundation, CDC, Planned Parenthood, Partnership for Prevention and others are urging young people to GYT: Get Yourself Tested for sexually transmitted infections (STDs). Untreated STDs may result in infertility, increase risk of HIV transmission, or cause cervical cancer.

GYT is the central hub for STD information that includes facts and tips for talking about STDs to partners, health care providers, or parents. On the air, MTV is featuring information about STDs on MTV News and mtvU Dean’s List. The MTV “How To” Show will feature how to talk to your partner about getting tested and how to ask your doctor which tests are right for you. The Health Center/Clinic Toolkit also has fact sheets for patients and other content that can be downloaded for free.

You can also find local options for STD testing or text your zip code to the GYT short code (498669) from a mobile phone to get a text with testing centers close to you.

Partnership for Prevention leads the National Chlamydia Coalition (NCC) which strives to reduce the rates of chlamydia and its harmful effects among sexually active adolescents and young adults through increasing screening rates, public awareness and provider education.

Susan Maloney
Senior Program Officer
Partnership for Prevention

The proposed ban on text messaging at the wheel by interstate truck and bus drivers was named the “Best Prevention Idea of the Week,” while the possibility of gonorrhea becoming a drug-resistant superbug was named the “Worst Prevention Idea of the Week."

The “Best/Worst” awards are announced each week in “Prevention Matters,” the blog of Partnership for Prevention. Nominees are submitted by Partnership staff as well as the general public, and are voted on by the staff. Partnership for Prevention is a nonpartisan organization of business, nonprofit and government leaders who are working to make evidence-based disease prevention and health promotion a national priority. More information is available at http://www.prevent.org/.

BEST

Government Set to Ban Texting by Truck, Bus Drivers

The Transportation Department last Wednesday proposed a ban on text messaging at the wheel by interstate truck and bus drivers, following up on its call to reduce distractions that lead to crashes. The proposal would make permanent an interim ban announced in January by Transportation Secretary Ray LaHood, applying to drivers of buses and commercial trucks over 10,000 pounds. The drivers could face civil or criminal penalties. The proposal "keeps our commitment to making our roads safer by reducing the threat of distracted driving," LaHood said.

WORST

Gonorrhea Close to Gaining Superbug Status

Unless medical experts devise a new way to treat it, gonorrhea -- the world's second most common sexually transmitted infection, after chlamydia -- will soon become a drug-resistant superbug. "This is a very clever bacteria. If this problem isn't addressed, there is a real possibility that gonorrhea will become a very difficult infection to treat," Catherine Ison, a British gonorrhea specialist, told Reuters. Right now, gonorrhea is treated with a single antibiotic dose, of either cefixime or ceftriaxone. But some strains of the illness are becoming resistant to both drugs, meaning treatment could become increasingly difficult without innovations.

The United States is continuing to make great strides toward the elimination of tobacco smoke in the country’s air. According to the Americans for Nonsmokers’ Rights Foundation, as of April 1, 2010, 32 states, along with Puerto Rico, the Northern Mariana Islands, and the District of Columbia have strong state/commonwealth laws in effect that qualify for at least one of the 100% smokefree list categories (workplaces, restaurants, and/or bars). A total of 38 states and the District of Columbia now have 100% smokefree air laws in effect at the local level. Adding to this growing list, by July 5, 2010, Michigan, Kansas and Wisconsin will all be 100% smokefree. More specifically, 57.2% of the U.S. population now lives in cities or states with smokefree non-hospitality workplaces; 68.1% in areas with smokefree restaurants; and 57.1% in areas with smokefree freestanding bars. Forty-one percent of the population is currently protected in all three categories.

For more smokefree lists, maps and reports visit Americans for Nonsmokers' Rights.

Alex Einhorn
Policy and Program Intern

• Require Internet sellers to pay all federal, state, local or Tribal tobacco taxes and affix tax stamps before delivery to any customer;
• Mandate that the age and identification of purchasers be checked at purchase and at delivery
• Require Internet vendors to comply with state and local laws as if they were located in the same state as their customers;
• Provide federal and state enforcement officials with new tools to block delivery of cigarettes and smokeless tobacco products that evade federal or state laws; and
• Ban the delivery of tobacco products through the U.S. mail. 

Partnership recently awarded grants to several state and local organziations to improve preventive services.

With funding from the Centers for Disease Control and Prevention, one-year grants were awarded to regional, state and local organizations to implement innovative strategies to increase chlamydia screening and follow-up care. The grants are also designed to encourage collaboration among local affiliates of the National Chlamydia Coalition (NCC). Comprised of 40 member organizations, the NCC was established to address the continued high burden of chlamydia infections, especially among women age 24 and younger.

Grants have been awarded to a variety of organizations, including county and state health departments, school-based health centers, a department of juvenile services, and a university, among others. The projects will address one or more barriers to chlamydia screening and will be designed to reach a variety of audiences. Lessons learned from the projects will be shared widely so that models can be replicated in other communities. For a complete list of grantees and project descriptions, click here.

Partnership also awarded six ACTTION State Grants for the implementation of innovative strategies to increase access to tobacco cessation treatments. Funds are to be used primarily for the development of state alliances/summit meetings and the creation of strategic plans. The projects will range from focusing on employer groups and health care systems to the uninsured and the behavioral health/substance abuse populations. For a complete list of grantees and project descriptions, click here.

With funding from the Pfizer Foundation, Partnership hopes to dramatically increase access to and use of proven tobacco cessation treatments through this grant program. The focus of the ACTTION state grants is system and policy change in tobacco cessation, rather than the delivery of programs or direct services.

A new study published this week in Nature Neuroscience adds to the evidence that food addiction is real and similar in some ways to drug addiction. The study of rats, high calorie food consumption, and obesity revolves around brain reward systems and what provides pleasure. The study’s findings are outlined in BusinessWeek.

“The results of this study could provide insight into a mechanism for obesity,” Paul Kenny, an author on the study and professor at Scripps Research Institute, said in a statement. “It’s possible that drugs developed to treat addiction may also benefit people who are habitual overeaters.”

Obesity-related diseases cost the United States an estimated $150 billion each year, according to U.S. federal agencies. An estimated two-thirds of American adults and one-third of children are obese or overweight.

David Zauche
Senior Program Officer
Partnership for Prevention