Saturday, March 20, 2010

Cigarettes and their smoke contain more than 4,000 chemicals

The Food and Drug Administration is working to lift the smokescreen clouding the ingredients used in cigarettes and other tobacco products.

In June, tobacco companies must tell the FDA their formulas for the first time, just as drugmakers have for decades. Manufacturers also will have to turn over any studies they've done on the effects of the ingredients.

It's an early step for an agency just starting to flex muscles granted by a new law that took effect last June that gives it broad power to regulate tobacco far beyond the warnings now on packs, short of banning it outright.

Companies have long acknowledged using cocoa, coffee, menthol and other additives to make tobacco taste better. The new information will help the FDA determine which ingredients might also make tobacco more harmful or addictive. It will also use the data to develop standards for tobacco products and could ban some ingredients or combinations.

"Tobacco products today are really the only human-consumed product that we don't know what's in them," Lawrence R. Deyton, the director of the Food and Drug Administration's new Center for Tobacco Products and a physician, told The Associated Press in a recent interview.


While the FDA must keep much of the data confidential under trade-secret laws, it will publish a list of harmful and potentially harmful ingredients by June 2011. Under the law, it must be listed by quantity in each brand.

Some tobacco companies have voluntarily listed product ingredients online in recent years but never with the specificity they must give the FDA, said Matt Myers, president of the Campaign for Tobacco-Free Kids.

For example, Altria Group Inc., based in Richmond and the parent company of the nation's largest tobacco maker, Philip Morris USA, has posted general ingredients on its Web site since at least 1999.

Cigarette makers say their products include contain tobacco, water, sugar and flavorings, along with chemicals like diammonium phosphate, a chemical used to improve burn rate and taste, and ammonium hydroxide, used to improve the taste.

Scientific studies suggest those chemicals also could make the body more easily absorb nicotine, the active and addictive component of tobacco.

"Until now, the tobacco companies were free to manipulate their product in ways to maximize sales, no matter the impact on the number of people who died or became addicted," Myers said. "The manner of disclosure previously made it impossible for the government to make any meaningful assessments."

About 46 million people, or 20.6 percent of U.S. adult smoke cigarettes, according to the Centers for Disease Control and Prevention, down from about 24 percent 10 years ago. It also estimates that about 443,000 people in the U.S. die each year from diseases linked to smoking.

Tax increases, health concerns, smoking bans and social stigma continue to cut into the number of cigarettes sold, which were estimated to be down about 12.6 percent in the third quarter compared with the same period last year.

Cigarettes and their smoke contain more than 4,000 chemicals; among them are more than 60 known carcinogens, according to the American Cancer Society. But scientists say they can't yet tell all they'll learn from the new data because so little is known about how the chemicals combine to affect people.

"The reality is that we have known so little over time that it's difficult to know with much accuracy what getting a good look is going to tell us about what we could do in the future," said Dr. David Burns of the University of California-San Diego, scientific editor of several surgeon general reports on tobacco.

The real test is whether the FDA acts on the information it receives, said David Sweanor, a Canadian law professor and tobacco expert. Canadian authorities are collecting similar data, but they haven't taken much action based on it, which is critical, he said. The European Union also has similar submission requirements.

Myers warned that a list of ingredients or an unexplained product label is "just as likely to mislead as it is to inform" if consumers don't know about the relative effects of ingredients.

Altria has supported what it is has called "tough but fair regulation."

But its chief rivals — No. 2 Reynolds American Inc., parent company of R.J. Reynolds, and No. 3 Lorillard, both based in North Carolina — opposed the law. They said it would lock in Altria's share of the market because its size gives it more resources to comply with regulations and future limits on marketing under the law. Altria's brands include Marlboro, which held a 41.9 percent share of the U.S. cigarette market in the third quarter, according to Information Resources Inc.

Sunday, March 14, 2010

Sexuality and Chronic Pain

Helping yourself at home
Express your limitations and desires to your partner, says Sueann Mark, PhD, a clinical sexologist with a private practice in San Francisco. "The person in pain needs to take an inventory about what touch is pleasurable and what's not," she says.

While communication is important, it has to be done at the right time: "Talking about these issues is best done when not in bed," she says. Instead, set aside a separate time of day. And remember to think beyond intercourse: "You can find ways to maintain some sexual relationship," she says, including massage, bubble bath, cuddling, and masturbation.

Couples find what works
Through trial and error, couples have found creative ways to maintain intimacy. Jennifer, who lives with chronic migraines, says that she takes advantage of her pain-free days: "We make the best of the times that I feel better than usual," she says. "Even if we have plans, we decide that the most important thing is going to bed together."

Smyres says that she tries to initiate sex once a week and at times other than the evening, when her head often hurts. She's found that talking about sex more with her husband also helps.

Smyres is proof that by communicating and staying in touch with your partner, you can have a rich and loving relationship in spite of chronic pain: "In general, I'm very happy," says Smyres. "My husband is great and my life is wonderful, I'm in the healthiest emotional place that I've ever been."



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Thursday, March 11, 2010

The prevention and treatment of high blood pressure


Researchers at Oregon Health & Science University's School of Dentistry (www.ohsu.edu/sod) have discovered that nitric oxide is a powerful regulator of a molecule that plays a critical role in the development and function of the nervous system. The finding could someday play a significant role in the prevention and treatment of high blood pressure, which affects about one in three adults in the United States.


Changes in blood pressure are signaled to the brain by nerve cells called baroreceptors. The OHSU dental school team previously found that baroreceptors make a molecule called brain-derived neurotrophic factor (BDNF), which belongs to the family of neurotrophins that play a critical role in the development and plasticity of other nerve cells.

The OHSU dental school team found that nitric oxide is a potent regulator of BDNF in baroreceptor neurons. Nitric oxide is known for its ability to improve the elasticity of blood vessels and to lower blood pressure. It is the active metabolite of nitroglycerin, which has been used to treat coronary artery disease for more than 100 years. Nitric oxide widens small arteries and counteracts artery stiffening, and several lines of evidence also indicate that its deficiency leads to hypertension.


"This is the first study to show the role of nitric oxide in inhibiting BDNF release from peripheral nerve cells," said Agnieszka Balkowiec, M.D., Ph.D., principal investigator, associate professor of integrative biosciences in the OHSU School of Dentistry, and adjunct assistant professor of physiology and pharmacology in the OHSU School of Medicine. "This finding supports our hypothesis that BDNF is involved in establishing connections in the blood pressure control system and could someday play a significant role in the prevention of high blood pressure."


The study was supported by grants from the American Heart Association and the National Institutes of Health's National Heart, Lung, and Blood Institute, including the American Recovery and Reinvestment Act (ARRA) funds.

Dr. Balkowiec teaches physiology and neuroscience to first-year dental students and is often an invited lecturer in dental school courses on orofacial pain. Since 2004 the dental school has received more than $16.4 million in research funding.

About OHSU

Oregon Health & Science University is the state's only health and research university and Oregon's only academic health center. OHSU is Portland's largest employer and the fourth largest in Oregon (excluding government), with 12,700 employees. OHSU's size contributes to its ability to provide many services and community support activities not found anywhere else in the state. It serves patients from every corner of the state, and is a conduit for learning for more than 3,400 students and trainees. OHSU is the source of more than 200 community outreach programs that bring health and education services to every county in the state.