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Smoking, tobacco use among teens continues to drop even as use of e-cigs grows

Daily smoking prevalence among 12th grade boys increased 4.9% annually 1991 to 1998, but saw annual declines of 8% between 1998 and 2006 and 1.6% from 2006 to 2012. However, from 2012 to 2019, prevalence declined at a 17% annual rate. Overall, Daily smoking prevalence among 12th graders fell to about 2% by 2019.

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Photo by Matt Tsir from Unsplash.com

Despite the increase in use of e-cigarettes among adolescents, cigarette and smokeless tobacco prevalence declined more rapidly between 2012 and 2019 than in previous periods, according to a new study.

The analysis by the University of Michigan and Georgetown University shows that past 30-day and daily use of both cigarettes and smokeless tobacco fell more rapidly since 2012, even as e-cigarette use began to increase–leading to historical low levels of both cigarette use and smokeless tobacco among teens in the United States.

“While the increases in e-cigarettes are indeed concerning and is something we need to address and reverse, the decreases in other tobacco products, in particular, cigarettes–the most concerning form of tobacco use–are accelerating,” said lead researcher Rafael Meza, associate professor of epidemiology and global health at U-M’s School of Public Health.

“We are in a stage where cigarette smoking is going away. That’s something that we need to highlight and celebrate. This acceleration in the decrease occurs across grades, across races, across sexes. So it’s really occurring across the board and suggests that it’s a general pattern, that kids are just not into smoking anymore.”

Meza and colleagues wanted to understand long-term and recent trends in cigarette smoking and smokeless tobacco product use among adolescents by grade (8th, 10th, 12th), gender and race. Utilizing data from the nationally representative Monitoring the Future survey at U-M from 1991 to 2019, they examined the use prevalence of tobacco products in the last 30 days among key sociodemographic groups, identifying change of trend years for U.S. secondary and high schools.

They found that daily smoking prevalence among 12th grade boys increased 4.9% annually 1991 to 1998, but saw annual declines of 8% between 1998 and 2006 and 1.6% from 2006 to 2012. However, from 2012 to 2019, prevalence declined at a 17% annual rate. Overall, Daily smoking prevalence among 12th graders fell to about 2% by 2019.

“This is an astoundingly low rate, and our goal from a public health perspective should be to keep smoking at this rate or lower,” said researcher David Levy, professor of oncology at Georgetown.

Similar results were observed for both boys and girls in all grades and for both African American and white teens. Smokeless tobacco use showed more variability through 2012, followed by consistent declines in the last five years. MTF data also shows similar rapid decreases in cigar and cigarillo use among adolescents in recent years, suggesting a general pattern across traditional tobacco products.

Meza said the results are important because while e-cigarettes are concerning on their own, there have been concerns that the increase in use of e-cigarettes could result in an uptick in the use of other tobacco products, including cigarette smoking that could potentially upend the declines we’ve seen the last couple of decades.

“But in contrast, what we found is that the decline in smoking has accelerated,” he said. “So I think the good news is that the rapid increase in e-cigarette use has not yet resulted in a reversal of the decreasing trends of cigarette smoking and smokeless tobacco use, and if anything, those trends have accelerated.”

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LIFEST: InsuRUNce 2024 slated on Oct. 12

Held in its second year, LUAP Insurance Festival or LIFEST is being held to commemorate the Life Insurance Consciousness Week, per Proclamation No. 1059, which declares the first week of October for the said observance.

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On October 12, 2024, the Life Underwriters Association of the Philippines (LUAP) and the Insurance Commission (IC) is set to host the biggest gathering of life insurance companies and the general public through its LIFEST: InsuRUNce 2024, a night run that will be held at Bridgetowne Destination Estate in Pasig City. 

Held in its second year, LUAP Insurance Festival or LIFEST is being held to commemorate the Life Insurance Consciousness Week, per Proclamation No. 1059, which declares the first week of October for the said observance. 

“We recognize the importance of the general public being able to be aware of the benefits of life insurance, which is the main reason why we have partnered with LUAP for this activity this year,” said Atty. Reynaldo A. Regalado, Insurance Commissioner. “We believe that LUAP, together with us at the Insurance Commission, have the leverage and influence to gather and unify life insurance companies in a significant activity such as this one.”

The LIFEST: InsuRUNce 2024 is a night run that includes three categories: pet run, kiddie run, and a regular fun run for running enthusiasts. Each category will be inclusive of a race shirt, race bib, and goodie bag. For the 3Km, 5Km, and 10Km run, additional glow sticks and neon socks will be provided. Pet and kiddie run will only cover 1Km. The run is open to the public via RaceYa: https://register.raceya.fit/event/lifest-2024

Awards and prizes will be provided for the 1Km Kiddie Run, 3Km, 5Km, and 10Km categories: Medals for top 3 male and female and a Top Senior runner for the 10Km category. For the 1Km Pet Run, the awards that will be provided will be: Best Dressed Award, Most Glamorous Dog, and Best Instagram Post. 

“As an association composed of life insurance companies in the country, we at LUAP have seen collaboration beyond company colors. LUAP Insurance Festival or LIFEST is a testament of our commitment to foster camaraderie among financial advisors no matter what their company colors are,” said Nonna Medina, 2024 LUAP National President. “For the second year, we want financial advisors to take a breather, have fun, and celebrate life.”

Registration to the fun run will end on Thursday, October 10, 2024.

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Young vapers perform worse in exercise testing

On average, the group of young vapers had lower ‘peak exercise capacity’ (186 watts) than the group who did not vape or smoke (226 watts) but similar capacity to the group of smokers (182 watts). This is a measure of the maximum amount of physical exertion that a person can achieve.

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Young people who vape perform worse than non-vapers in tests designed to measure their capacity for exercise, according to a study presented at the European Respiratory Society (ERS) Congress in Vienna, Austria. The research also showed that the performance of young vapers was similar to that of young smokers.

The study adds to growing evidence that long-term use of vaping is harmful and challenges the idea that vaping could be a healthier alternative to smoking.

The research was presented by Dr Azmy Faisal, senior lecturer in cardiorespiratory physiology in the department of sport and exercise sciences at Manchester Metropolitan University, UK. He said: “Previous research has shown that vaping is linked to lung inflammation and damage, and harmful changes to the blood vessels. Although, some research suggests that vaping could be used to cut back or quit smoking, we don’t yet know what longer-term vaping use does to our bodies.”

The study included 60 people in their 20s who all had normal lung function according to spirometry testing. Twenty were non-smokers and non-vapers, 20 had been vaping for at least two years and 20 had been smoking for at least two years.

Each person took part in an incremental exercise test on a static bike. This is the gold-standard for testing physical ability and how well a person copes with exercise, looking at their heart, lungs, and muscles’ responses at harder and harder levels until they reach their maximum. They were also given blood tests and an ultrasound scan to analyse how well their arteries were functioning.

On average, the group of young vapers had lower ‘peak exercise capacity’ (186 watts) than the group who did not vape or smoke (226 watts) but similar capacity to the group of smokers (182 watts). This is a measure of the maximum amount of physical exertion that a person can achieve. At peak exercise, vapers and smokers were also less able to consume oxygen on average (2.7 litres per minute and 2.6 litres per minute) compared to the non-smoking non-vaping groups (3 litres per minute).

Both vapers and smokers showed signs that their blood vessels were not working as well as the non-smoking and non-vaping group, according to the blood tests and ultrasound scans. The smokers and the vapers were more out of breath, experienced intense leg fatigue and had higher levels of lactate in their blood, a sign of muscle fatigue, even before they reached their maximum level of exercise.

Dr Faisal said: “In this study, we looked at a group of young people with no apparent signs of lung damage. Among the people who had been vaping or smoking for at least two years, we saw important differences in how well they coped with exercise. The smokers and the vapers had measurably excess breathing while using the exercise bikes. They found it harder to breath, their muscles became more fatigued, and they were less fit overall. In this regard, our research indicated that vaping is no better than smoking.”

Dr Filippos Filippidis is Chair of the ERS Tobacco Control Committee, a reader in public health at Imperial College London and was not involved in the research. He said: “Vapes are being sold cheaply and in a variety of flavours to appeal to young people. As a result, we’re seeing more and more young people take up the habit without knowing what the long-term consequences could be to their health.

“Although it’s always a challenge to know if the associations we find in these studies are causal or a result of some other systematic differences between groups, people who vape need to be aware that using these products could make them less fit and able to take part in exercise. Doctors and policymakers also need to know about the risks of vaping, and we should be doing all we can to support children and young people to avoid or quit vaping.”

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Some adverse pregnancy outcomes may increase risk of heart disease later in life

A self-reported history of gestational hypertension was associated with cardiovascular disease. Women with preeclampsia or all three adverse pregnancy outcomes also had a numerically higher prevalence of heart disease, but it did not meet the standards of statistical significance. No association was found between gestational diabetes and heart disease.

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Pregnancy-related hypertension has already been proven to lead to a number of negative health outcomes later in life, including more bothersome menopause symptoms like hot flashes, the risk of dementia, kidney problems, and stroke. A new study suggests it can also lead to cardiovascular disease during menopause. Results of the study were presented at the 2024 Annual Meeting of The Menopause Society in Chicago, USA.

In the new study involving nearly 400 women with a mean age of 81.6 years, researchers sought to assess the association between a self-reported history of preeclampsia or eclampsia, gestational hypertension, and gestational diabetes with cardiovascular outcomes in postmenopausal women.

What they found is that a self-reported history of gestational hypertension was associated with cardiovascular disease. Women with preeclampsia or all three adverse pregnancy outcomes also had a numerically higher prevalence of heart disease, but it did not meet the standards of statistical significance. No association was found between gestational diabetes and heart disease.

“Future research based on a larger sample size is needed to better understand the role adverse pregnancy outcomes may have in cardiovascular disease development and risk stratification,” says Marie Tan, lead author from Drexel University College of Medicine in Philadelphia.

More detailed results will be discussed at the 2024 Annual Meeting of The Menopause Society as part of the presentation entitled “The association between adverse pregnancy outcomes and cardiovascular disease in menopausal women: results from a cross-sectional analysis.”

“Cardiovascular disease is the number one cause of mortality in women and it’s important to study any new risk factors” says Dr. Stephanie Faubion, medical director for The Menopause Society. “Although future research is still needed, studies like this are important and remind us to thoroughly discuss a patient’s health history, including any complications or adverse outcomes during pregnancy.”

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