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Vaping no boost to quit rates in smokers

Dual users were more likely to have stopped using tobacco, but that difference disappeared by the 1-year and 18-month interviews. By the end of the study, most dual users were back to smoking cigarettes exclusively.

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Photo by Dani Ramos from Unsplash.com

People who vape and smoke cigarettes are no more likely to drop the nicotine habit than those who just smoke.

This is according to researchers at The Ohio State University, who studied 617 tobacco users and found no differences in quit rates for “dual users” of both traditional and electronic cigarettes. The study appears in the journal Nicotine & Tobacco Research.

The research was done byLaura Sweet, Mary Ellen Wewers, Theodore Brasky, Sarah Cooper, Nathan Doogan, Alice Hinton, Elizabeth Klein, Haikady Nagaraja, Amanda Quisenberry and Wenna Xi – all of Ohio State.

Participants in the study were part of a larger group of about 1,200 rural and urban Ohioans whose habits are being followed by researchers. All of them are considered heavy tobacco users – those who smoke every day or at least some days every week.

The researchers sat down with participants every six months for 18 months to ask them about tobacco use, interest in quitting and quit attempts they’d made. They also documented what type of tobacco products the participants used.

At the first check-in, six months into the study, the dual users were more likely to have stopped using tobacco, but that difference disappeared by the 1-year and 18-month interviews. By the end of the study, most dual users were back to smoking cigarettes exclusively.

“The initial difference we saw might be due to a higher interest in quitting among the dual users, but that higher quit rate vanished with time,” said Sweet. “Tobacco is such a huge killer, and if these products help people quit, that could be really significant for public health. But in this study it looks like they don’t, and we need to know that as well.”

Though electronic products still deliver nicotine and much remains unknown about their long-term health effects, there’s general agreement that they are less harmful than cigarettes in adults.

“The hope would be that adult cigarette smokers are trying e-cigarettes because they want to stop cigarettes and are looking for alternatives to help them,” Wewers said, adding that she and others who work on tobacco prevention are concerned that younger people who vape will start there and transition to cigarettes down the road.

The researchers can’t be sure what factors contributed to their findings, but the results prompted Sweet to wonder if many adults who smoke and vape are doing so because vaping is more accepted in certain environments, rather than because vaping might help them drop nicotine altogether, she said.

Wewers said she wasn’t surprised to see a higher likelihood of quitting cigarettes at six months in the dual users, because that group expressed greater interest in quitting overall. “It makes sense that during the first few months they may do better at quitting, but given that cigarette smoking is such a cyclical thing – people quit and resume all the time – it’s not surprising that they went back to smoking after a year.”

Because this study didn’t assess light smokers or those who consider themselves “social” smokers, it’s hard to say what role vaping might play in quitting, Wewers said. But for health care providers trying how best to help heavy smokers quit, this study could help inform those doctor-patient conversations, she said.

“Providers get questions about trying e-cigarettes all the time from people who want to quit. Our paper would suggest that it’s not a promising approach – the majority don’t quit, and most of them go back to combustible products exclusively,” Wewers said. “This reinforces the recommendation that there are good, approved medications and nicotine-replacement products out there now and that those should be the first-line approach to helping smokers quit.”

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Natural therapy shows promise for dry-eye disease

Castor oil has been proposed as a natural product that could offer a safe, effective and easy-to-use alternative to existing therapies.

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Researchers at the University of Auckland are running a trial of castor oil as a potential safe and natural treatment for dry-eye disease following a successful pilot study.

While exact figures aren’t available for New Zealand, in Australia, it is estimated dry-eye disease affects around 58% of the population aged over 50. Advancing age, menopause, increased screen time, contact lens wear are just some of the risk factors for developing dry eye disease.

Blepharitis is the most common cause of dry-eye disease, accounting for more than 80 percent of cases. It is a chronic condition with no known cure.

“Currently, patients are left grappling with symptoms of dryness, grittiness and, in some cases, watery eyes that feel uncomfortable impacting on their quality of life and work productivity,” says doctoral candidate and lead clinical investigator Catherine Jennings.

Current treatments, such as antibacterials and anti-inflammatories, are generally unsuitable for long-term use, due to significant side-effects and potential for antimicrobial resistance.

“Often patients are left feeling helpless when attempting to manage a chronic condition,” Jennings says.

The current trial is of a product containing cold-pressed castor oil enhanced with mānuka and kanuka oils applied using a rollerball attached to a small glass bottle.

“The previous pilot study, conducted by our research team, was unique in its use of castor oil in such an application on the eyelids, with the product not known to be used anywhere else in the world for treating blepharitis,” says Jennings.

Castor oil comes from a flowering tropical or subtropical shrub from the species Riccinus communis. It has been used therapeutically for millenia, including more recently in eye cosmetics and eye makeup removers.

In the pilot study, 26 patients with blepharitis were treated with cold-pressed castor oil over four weeks. They had measurable improvements in symptoms, such as reduced redness of the lid margin, decreased thickening of the eyelid, and a decline in bacterial profusion, as well as reduced eyelash crusting.

Building on the success of the pilot study, the research team is now engaged in the more extensive double-blinded, randomised and placebo-controlled study. They are aiming to recruit 92 participants and generate robust scientific evidence for clinicians.

The ultimate goal is to sustainably improve quality of life for this large group of patients using a natural, safe and effective product, principal investigator Professor Jennifer Craig says.

“Castor oil has been proposed as a natural product that could offer a safe, effective and easy-to-use alternative to existing therapies,” Craig says.

“My hope is this study will produce evidence-based guidance for clinicians with regard to offering castor oil as a possible management option for patients suffering from blepharitis, so they continue to enjoy a great quality of life, read the books they love, be productive in their work environment and enjoy other visual hobbies.”

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For epilepsy, yoga may be good for your mind

People who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

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For people with epilepsy, doing yoga may help reduce feelings of stigma about the disease along with reducing seizure frequency and anxiety, according to new research published in the November 8, 2023, online issue of Neurology, the medical journal of the American Academy of Neurology.

“People with epilepsy often face stigma that can cause them to feel different than others due to their own health condition and that can have a significant impact on their quality of life,” said study author Manjari Tripathi, MD, DM, of All India Institute of Medical Sciences in New Delhi. “This stigma can affect a person’s life in many ways including treatment, emergency department visits and poor mental health. Our study showed that doing yoga can alleviate the burden of epilepsy and improve the overall quality of life by reducing this perceived stigma.” 

For the study, researchers looked at people with epilepsy with an average age of 30 in India.

Researchers measured stigma based on participants’ answers to questions such as: “Do you feel other people discriminate against you?” “Do you feel you cannot contribute anything in society?” and “Do you feel different from other people?”

Researchers then identified 160 people who met the criteria for experiencing stigma. Participants had an average of one seizure per week and on average took at least two anti-seizure medications.

Researchers then randomly assigned participants to receive yoga therapy or sham yoga therapy. Yoga therapy included exercises in loosening muscles, breathing, meditation and positive affirmations. Sham yoga consisted of exercises that mimic the same yoga exercises, but participants were not given instructions on two key components of yoga believed to induce a relaxation response: slow and synchronized breathing, and attention to the body movements and sensations during practice.

Each group received seven supervised group sessions of 45 to 60 minutes over three months. Participants were also asked to practice sessions at home at least five times a week for 30 minutes. They tracked seizures and yoga sessions in a journal. After the three months of therapy, participants were followed for another three months.

Researchers found when compared to people who did sham yoga, people who did yoga were more likely to reduce their perceived stigma of the disease. People who did yoga had an average score of seven at the start of the study and an average score of four at the end of the study, while people who did sham yoga had an increase from an average score of six at the start of the study to an average score of seven at the end.

Researchers also found that people who did yoga were more than four times as likely to have more than a 50% reduction in their seizure frequency after six months than the people who did sham yoga.

In addition, people who did yoga were more than seven times more likely to no longer have seizures than those who did sham yoga.

There was also a significant decrease in anxiety symptoms for people who did yoga versus people who did not. They saw improvements in quality of life measures and mindfulness.

“These study findings elevate the need to consider alternative therapies and activities for people with epilepsy facing stigma,” said Tripathi. “Yoga may not only help reduce stigma, but also improve quality of life and mindfulness. Plus, yoga can be easily prerecorded and shared with patients online using minimal resources and costs.”

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Eating a vegan diet could reduce grocery bill 16%, saving over $500 a year – study

Total food costs decreased in the vegan group by 16%, or $1.51 per day, compared with no significant change in the control group. This decrease was mainly attributable to savings on meat, -$1.77 per day, and dairy, -$0.74 per day. Changes in purchases of other food groups (e.g., eggs and added fats) also contributed to the observed savings.

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Food costs decrease 16% on a low-fat vegan diet, a savings of more than $500 a year, compared to a diet that includes meat, dairy, and other animal products, according to a new analysis from the Physicians Committee for Responsible Medicine published in JAMA Network Open.

“We knew that a vegan diet significantly reduces your risk of conditions like heart disease, diabetes, and obesity—and now we have proof that opting for beans instead of beef will also lead to significant savings on your grocery bill,” says study co-author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine.

The research is an analysis of a Physicians Committee study in which participants were randomly assigned to a vegan group or control group. The vegan group was asked to follow a low-fat vegan diet consisting of fruits, vegetables, grains, and legumes, while the control group was requested to make no diet changes. Calorie intake and food costs were not limited for either group.

For the food cost assessment, the participants’ dietary records were linked to food price data from the U.S. Department of Agriculture Thrifty Food Plan, 2021.

Total food costs decreased in the vegan group by 16%, or $1.51 per day, compared with no significant change in the control group. This decrease was mainly attributable to savings on meat, -$1.77 per day, and dairy, -$0.74 per day. Changes in purchases of other food groups (e.g., eggs and added fats) also contributed to the observed savings.

These savings outweighed the increased spending on vegetables, +$1.03 per day; fruits, +$0.40 per day; legumes, +$0.30 per day; whole grains, +$0.30 per day, and meat and dairy alternatives.

The findings support previous research showing that a plant-based diet provides more cost savings than one that includes animal products.

In addition to the cost savings, the study found that a low-fat vegan diet resulted in weight loss and improved body composition and insulin sensitivity in overweight adults.

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