ASH Daily News for 24 June 2008

Young Pop Star's Emphysema Startles Experts

The shocking revelation by her father that 24-year-old British singer-songwriter Amy Winehouse may have a mild form of emphysema leaves experts with more questions than answers. It's possible that Winehouse, in addition to her well-publicized use of drugs and cigarettes, has a congenital condition that contributed to her current crisis, one lung doctor said. "If you see emphysema in a young person, you have to think of that," said Dr. Len Horovitz, a pulmonary specialist with Lenox Hill Hospital in New York City.

Dr. Norman Edelman, chief medical officer of the American Lung Association, added, "Generally, we don't really see emphysema until a person is in their 40s, but in a small number of people it could occur much earlier, especially in someone who smoked a long time. There's also the possibility - not a probability - that she's got a genetic variation. Five percent of people with emphysema have a genetic predisposition."

According to the Associated Press, Winehouse apparently collapsed at her north London home last Monday and was admitted into a London hospital, where she has been all week. Winehouse's father, Mitch Winehouse, told the London Sunday Mirror that his daughter was told she would have to wear an oxygen mask unless she stops smoking drugs and cigarettes.

However, he has since modified that statement. According to MTV News, Mitch Winehouse told BBC 1 Radio on Monday that his daughter fainted at her home on June 16 and has been diagnosed with what he called "a small amount of emphysema." The soul singer's lungs do show a small amount of scarring, but her illness has not progressed "too far," her father said. "It's not irreparable. Really, she can't even smoke anymore, let alone that other thing. With patience, her lungs will recover completely. She's responding very well to treatment, she's flourishing," he said.

The singer's U.S. publicist, Tracey Miller, agreed, saying on Monday that Winehouse is "showing early signs of what could lead to emphysema but is reacting well to treatment." What is well-known is that Winehouse has a long history of drug abuse, including crack cocaine. According to Horovitz, smoking crack can also result in a condition known as "acute crack lung," which shows up from one hour to 48 hours after smoking large quantities of crack. "It's temporary, but it can cause a certain amount of destruction of the lung tissue. But if you have enough [episodes], it adds up to a lot of lung disease," Horovitz explained.

Emphysema involves damage to the air sacs or alveoli in the lungs, reducing the amount of oxygen the body can take in. Symptoms typically include shortness of breath and a chronic cough, according to the U.S. National Institutes of Health. The most common cause is smoking. The disease, once entrenched, cannot be reversed. The condition can be stabilized, however, if a person stops smoking. Still, "lung units or alveoli do not come back," Horovitz said. Symptoms can be treated with bronchodilators, steroids, inhalers and, in a worst-case scenario, oxygen, Horovitz added.

According to AP, Winehouse's lung capacity is at 70 percent. Physicians generally conduct pulmonary function tests by taking into account height, weight, ethnic group and smoking history. They then calculate a predicted lung function. Healthy lung function for a person with Winehouse's demographic would probably hover around 80 percent or more, Horovitz said. "This is not moderate or severe emphysema. It's mild emphysema," Horovitz stressed. "But with the natural aging process, when you're 54, you're going to have moderate to severe emphysema."

The singer's career and young life have been marked by both highs and lows. Her 2006 album, Back to Black won five Grammy awards, including Best New Artist, Record of the Year and Song of the Year. But her alcohol and drug dependencies have been widely reported. According to MTV News, Mitch Winehouse told the BBC that she is currently "smothered" in nicotine patches to help her kick the smoking habit. Winehouse understands that "the only thing that can go into her lungs right now is fresh air," her father said. "She doesn't have emphysema, she has traces of it. Obviously, if she doesn't quit smoking, it's going to get worse."

Source: healthfinder.gov, 23 June 2008
Link: http://tiny.cc/eGN2S

Prenatal cigarette smoke exposure affects infants' cardiorespiratory control

Prenatal cigarette smoke exposure, the main risk factor for sudden infant death syndrome (SIDS), has an adverse effect on spontaneous recovery of breathing pauses and oxygen saturation during hypoxemia in preterm infants, researchers report. Preterm infants are among the most vulnerable groups for SIDS, but the effects of prenatal cigarette smoke exposure and hypoxemia on their cardio-respiratory control have not been investigated, explain Shabih Hasan and colleagues from the University of Calgary in Alberta, Canada, in the American Journal of Respiratory and Critical Care Medicine.

Hasan and team recorded cardiorespiratory variables under baseline normoxemic and hypoxemic conditions in 22 spontaneously breathing preterm infants between 28 and 36 weeks' gestation, 12 of whom were born to smokers and 10 of whom were born to nonsmoking mothers. The team found that spontaneous recovery of breathing pauses and oxygen saturation levels were significantly reduced in infants exposed to cigarette smoke compared with the control group during the hypoxemic and post-hypoxemic periods, respectively.

In addition, cigarette-smoke-exposed infants showed a significantly greater increase in heart rate during the hypoxemic challenge period compared with the control infants. "We have shown that as compared with infants of nonsmoking mothers, spontaneous recovery of breathing pauses and oxygen saturation values are adversely affected in cigarette-smoke-exposed infants during the hypoxemic and post-hypoxemic periods, respectively," the authors write. They conclude: "These observations could help explain why these infants are at a particularly high risk for SIDS."

Source: medwire news, 24 June 2008
Link: http://tiny.cc/9n1l5

Altria stubs out Marlboro Ultra Smooth: report

Altria Group Inc's Philip Morris USA has cancelled its Marlboro Ultra Smooth cigarettes, highlighting challenges it faces in trying to grow its tobacco business despite a decline in U.S. cigarette sales, The Wall Street Journal reported on Monday. Altria gets nearly all its revenue from Philip Morris USA after spinning off its Philip Morris International operations, the Journal reported.

Philip Morris's sales volume fell 4.6 percent last year, worse than the 4 percent decline in the overall U.S. cigarette market, the Journal reported. Underlying sales volume fell 3.6 percent, the Journal added. The company expects overall cigarette sales to fall at an annual rate of 2.5 percent to 3 percent in coming years, the Journal reported.

Philip Morris has turned to developing tobacco products that are not as risky to their user's health, the Journal said. Ultra Smooth cigarettes include an activated carbon filter that delivers nicotine but with potentially less exposure to the carcinogens of conventional cigarettes, the Journal reported. A Philip Morris spokesman was unavailable for comment.

Source: Yahoo Finance, 23 June 2008
Link: http://tiny.cc/gIrBK

Canada: Smoking linked to fire that killed five people

A house fire that killed five people in central Labrador on the weekend seems to have been a smoking-related accident, said a police investigator who spent hours yesterday examining the damaged building. Those who died in the Happy Valley-Goose Bay fire included Paulette Jacque, 33; Kathleen Jararuse, 17; and a 24-year-old woman whose identity was withheld by police at the request of her family. Charlotte Jacque, 5, Ms. Jacque's daughter, and Matthew Allen, 13, died in a St. John's hospital, hours after they were airlifted from Happy Valley-Goose Bay, police said yesterday.

"I suspect anywhere you go in this community right now, the conversation will centre on this tragic event," said Leo Abbass, mayor of the town of about 8,000. He noted that candlelight vigils had already been held and that crisis-management teams were working yesterday with the peers of the young victims. According to one report, butterflies were released at Charlotte Jacque's school as part of a ceremony with her classmates. The two women and the teenager died of smoke inhalation. Autopsies on the two younger victims are expected to be conducted today.

Four other people who were in the building at the time of the early Sunday fire escaped. An 11-year-old boy, Ms. Jacque's son, was still in hospital late yesterday. Mr. Abbass predicted that the town would rally around the survivors and the families of the victims. "Those who survive still have to have a place to live," he said. "Certain items that they require, I suspect it's only a matter of time before something is in place to help them."

Constable Terance Munro, a fire investigator with the local RCMP detachment, said that there was substantial fire damage on the first floor of the home and extensive smoke damage upstairs. "The fire started in the downstairs part of the house," he said late yesterday. "It was determined to be an accidental cause." Constable Munro said that smoking-related materials appeared to have sparked the deadly blaze. He had no information on where in the house the victims and survivors were when the blaze broke out. Police said the home had a working smoke alarm.

The local fire department was called to the two-storey building shortly after 6 a.m. on Sunday. Fire Chief Carl Oldford said the blaze was easily contained but still presented a challenge for firefighters, with thick smoke and toxic fumes. "It was quite difficult at first because of the visibility." RCMP Corporal Keith MacKinnon said yesterday morning that police were investigating whether alcohol played a role in the incident.

Source: globeandmail.com, 24 June 2008
Link: http://tiny.cc/XQTVp

Forest in the House

Posted by Simon Clark: On July 1st, the first anniversary of the public smoking ban in England, Philip Davies MP is hosting a reception for Forest in the House of Commons. This is an invitation only event to which we are inviting MPs and a small representative group of people for whom the legislation has had a major social or economic impact. (The group includes include smokers, tolerant non-smokers, pub and bar owners, to name a few.)

If you have a message for your MP (or MPs generally) concerning the smoking ban, please comment here or email me direct. We are particularly keen to register with MPs the negative impact the ban is having on many people's lives. Describe how the ban has affected you personally.

Also, what amendments to the current legislation would you like to see introduced following the review of the Health Act in 2010? Third, has the ban influenced you to cut down or quit smoking? Fourth, what do you think of the government for introducing a comprehensive ban (ignoring its manifesto commitment to exclude private clubs and pubs that don't serve food) and will it influence your vote at the next election?

We need your name and (optionally) your age and occupation. The best comments will be added to the document we are sending to MPs to mark the launch of our Amend The Smoking Ban campaign.

Source: Taking Liberties: Simon Clark .... Stuff and Nonsense, 20 June 2008
Link: http://tiny.cc/bBcJP

Was the Smoking Ban Right?

A debate between Polly Toynbee, journalist, writer and columnist for The Guardian, and Madsen Pirie, head of the Adam Smith Institute: http://www.totalpolitics.com/magazine/mag_platform02.php

Source: totalpolitics.com
Link: http://tiny.cc/gKKpT