Prevention Matters

Smoking cessation significantly increases cardiac health later in life, says a new study from Tel Aviv University.

The research found that quitting smoking after a heart attack has about the same positive effect as other major interventions such as lipid-lowering agents like statins or more invasive procedures.

"We found that people who quit smoking after their first heart attack had a 37 percent lower risk of dying from another, compared to those who continued to smoke," said Dr. Yariv Gerber of TAU's Sackler School of Medicine.

Twenty-two institutions across the country are participating in a Phase III clinical trial to determine whether a new investigational "nicotine vaccine" is safe, effective and capable of stimulating an immune response. Approximately 1,000 male and female smokers aged 18 to 65 will take part in the 12-month study NicVAX, a vaccine developed by Nabi Biopharmaceuticals.

Nicotine molecules are so small that they can pass through the body's brain/blood barrier without triggering a reaction from the immune system. However, NicVAX stimulates the immune system to produce antibodies that bind to or capture nicotine
molecules in the bloodstream, making them too large to cross the blood-brain barrier. As a result, many of the expected rewards from smoking are blocked, making it easier for the smoker to become and remain abstinent.

“Smokers continue to smoke even when they know it’s harmful because of these ‘brain effects,’” explained David Gonzales, Ph.D., principal investigator and clinical investigator in medicine at the Oregon Health and Science University, one of the 22 test centers. “While a smoking cessation medication such as varenicline prevents nicotine from binding to receptors once it is in the brain, NicVAX is designed to block nicotine before it enters the brain.”

Increasing insurance co-pays is "an ill-advised cost containment strategy" according to a new study in the New England Journal.of Medicine. The study found that, when Medicare plans raise co-payments for outpatient care, older people cut back on doctors’ visits, then wind up needing more expensive hospital care, a new study reports.

The study compared patients whose Medicare plans had almost doubled co-payments to similar plans that kept co-payments steady. The higher co-pay plans saw a slower initial increase in outpatient visits, but  an additional 2.2 additional hospital admissions per year, 13.4 more annual inpatient days and a 0.7 percent increase in the number of enrollees who had been hospitalized.

The New York Times reports that tobacco manufacturer Altria apparently hopes to navigate around indoor smoking ban laws by persuading the Food and Drug and Administration to let them market smokeless tobacco as far less harmful than cigarettes. 

"While public health doctors agree that the smokeless products are far less hazardous to individuals than cigarettes, they still have concerns because all tobacco products contain nicotine and carcinogens," write the Times' Duff Wilson and Julie Creswell.. "They also contend that promoting smokeless products — some in tiny packages in the shape of cigarette packs — would attract new, perhaps younger customers and maintain the addiction for smokers who might otherwise quit. They note that Altria is adding flavorings to its smokeless products that have long been used in candy.Furthermore, critics say, "

The chairman of the Senate Health Committee tells The Hill that negotiators from the White House, Senate and House reached a final deal on healthcare reform days before Scott Brown’s victory in Massachusetts. Sen. Tom Harkin, D-Iowa said negotiators had an agreement in hand on Friday, Jan. 15 - four days before Scott Brown's surprise Senate win in Massachusetts turned the debate on its head.

“We had an agreement, with the House, the White House and the Senate," Harkin said. "We sent it to [the Congressional Budget Office] to get scored and then Tuesday happened and we didn’t get it back.”

Brown’s Jan. 19 victory gave Republicans control of 41 seats in the Senate, enough to sustain a GOP filibuster of the healthcare bill. But Harkin told reporters in a Monday telephone conference that health reform legislation is still "very much alive."

He said he has been advocating in recent days for the House to pass the Senate version of the health care bill along with a package of revisions that would be passed through the reconciliation process, which would only require a simple majority in the Senate. Harkin predicted that Democrats would pursue that course in the coming weeks and most likely finish by early March.

That differs from the assessment of White House Chief of Staff Rahm Emmanuel, who Thursday told the New York Times that Democrats would try to act first on job creation, reducing the deficit and imposing tighter regulation on banks before returning to the health measure.

In the UK, the National Health Service is ramping up its support for people trying to give up smoking in a bid to halve the number of smokers from 21% to 10% of the population by 2020. According to a new government strategy, every smoker will be able to get help from the NHS to suit them if they want to give up, with new types of support available at their convenience. The government is also considering the case for plain packaging and will review legislation to decide whether to extend the smoking ban from enclosed public places and workplaces to areas like entrances to buildings.