Florida State Health Gaps Report

A recent report from the Robert Wood Johnson Foundation showed the gaps in the Florida State Health Report.  According to the report, “Every year, nearly 8,000 deaths in Florida could be avoided if all residents in the state had a fair chance to be healthy,” and fewer_smokersFlorida would have 544,000 fewer adult smokers if changes could be made.

In terms of adult smoking, the “best” Florida counties had a 14% smoking rate, which matched the “best US counties” number, while the “worst” counties were at 26%.  Breaking it down like this gives us a better picture of the state as both The Toll of Tobacco in Florida from Campaign for Tobacco-Free Kids and the State of Tobacco Control 2015 report from the American Lung Association lists Florida adult smokers at 16.8%, or about 2,661,000 smokers.

So what does the report suggest the state do to lower the adult smoking rate?  The first is to have “proactive tobacco quitlines,” which Florida has in place.  Having medical professions discuss quitting smoking with every patient would also help increase quitting.

The second strategy is to have “smoke-free policies for indoor areas.”  If every restaurant, bar, and public area in the state of Florida were smoke-free and the bans were strictly followed, it would reduce the amount of secondhand smoke everyone would be exposed to, reducing health issues in both large and small counties.

Being able to control tobacco marketing in terms of “pricing, flavoring, placement, or promotion of tobacco products,” would help counties to decrease youth access which would hopefully mean fewer adult tobacco users.

And finally increasing the price to tobacco would decrease adult use and stop some youth from ever beginning, which would ultimately mean fewer adult smokers.  If those in poverty spent less money on tobacco or quit altogether, it would mean more money in their pockets for other expenses like food, medical care and housing.  “Annual health care costs in Florida directly caused by smoking” are at $8.64 billion.

Tobacco use is a vicious cycle of reducing the income of users, and reducing their health, which goes back to reducing their income due to tobacco-related illnesses.  If Florida can remove or reduce tobacco from this cycle, it would improve the lives of the residents and reduce the loss of productivity of the state which is at $8.32 billion a year.

Of course, there is a lot more to the health report besides tobacco.  Obesity, alcoholism, uninsured residents, unemployment, poverty, housing issues, crime, and education all play a part in the Florida health equation.  But taking tobacco out of the equation would improve the health of not only the users but the state as a whole as it would have a ripple effect in other areas.

You can download and read the entire report HERE.




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Smokeless Tobacco Popular, But Comes with Risks

SmokelessTobacco_001First, it was the good news that the rate of cigarette smoking among teens decreased. Then Medical Press reported that hookah use by teens has increased, although it may not always be reported by surveillance efforts.  Now the spotlight is on smokeless tobacco. While all tobacco product use has been trending down, “during 2001-2013, current use of smokeless tobacco increased significantly among high school athletes, but not among high school nonathletes,” according to an article in Medical Daily.  It also seems that if athletes played on more than one team sport, their smokeless tobacco use increased slightly.

There are consequences to smoking that many athletes seem to be aware of, such as poor wound healing and reduced overall fitness.  However, when it comes to smokeless tobacco, athletes see this as harmless and a socially acceptable way, at least among fellow athletes, to enhance their athletic performance.  It seems the way smokeless tobacco is marketed as a “safe alternative” to cigarettes has made it more popular among the high school set. Here in Florida, our youth tobacco survey does not differentiate between athlete and non-athlete use when it comes to smokeless tobacco or any other tobacco products.

The article from Medical Daily used figures for current use of smokeless tobacco.  According to the 2014 Florida Youth Tobacco Survey, current use means the student used smokeless tobacco at least once in a 30 day period.  In 2001, 5.4% of High school students reported smokeless tobacco use.  By 2013, that number was at 5.0%, but percentages have ranged from a low of 4.6% in 2012 to a high of 6.4% in both 2010 and 2011.  The 2014 current_smokeless_001figure increased slightly from the previous year and repeats the 2001 figure of 5.4%.  The figure for 2015 has dropped to 4.9%.  The numbers for Middle school students, as shown in the above chart, are lower still.  In fact, our Florida numbers are about half of those quoted in the article.

Perhaps the 2014 oral cancer diagnosis of Curt Schilling or the death the same year of Tony Gwynn, who attributed his oral cancer to years of smokeless tobacco use, played some part in lowing smokeless tobacco use numbers in the Florida 2015 survey among athletes.  We may never know.  But the news did seem to educate the athletes that smokeless tobacco isn’t the safe alternative they have been lead to believe.  Whether students are athletes or not, education is the key in reducing tobacco use and preventing it in the first place

Click HERE for the Medical Daily article.


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2015 Great American Smokeout

GASO2It’s November and that means the Great American Smokeout is here once again on November 19th to remind tobacco users to take one day and give up tobacco.  It doesn’t matter what form of tobacco you use, giving it up for one day could be the start of giving it up for good.

When the Great American Smokeout started in the 1970s, smoking and secondhand smoke were everywhere.  Much has changed since those first events took place.  Bans on smoking in workplaces and restaurants have improved the air quality for everyone. Increased taxes on cigarettes have caused some smokers to quit and discouraged some teens from starting.

Over the years, millions have quit tobacco.  In 1965 more than 42% of adult smoked.  Today that number is at about 16.8%, according to the recent report from Morbidity and Mortality Weekly with 40.0 million people smoking cigarettes and another 15 million smoking cigars or pipes, according to the American Cancer Society. Another 9 million use smokeless or spit tobacco.

If you have thought of quitting, the Great American Smokeout is a great way to take the thought of quitting for a test drive for one day.  If you think you may need help, the links below are to help you get started, but others sites are available by typing in “websites to help you quit smoking” or “websites to help you quit smokeless tobacco” in the search bar.  And don’t forget about the American Cancer Society phone number above as another resource to help you quit.

Smoking: Smokefree.gov
Smoking: TobaccoFreeFlorida.com
Smoking: UCanQuit2.org is an education campaign for the U.S. military
Smokeless Tobacco:  Killthecan.org






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Not a lot of truth in tobacco advertising

How do you advertise a deadly product and make it look fun and safe?  You only need to look to the tobacco industry to answer that question.  For decades their print ads have featured respectful looking and admired individuals, such as doctors, nurses and celebrities.  Their radio and television advertising had catchy jingles and music that brought images of their product to mind.  Even after over 40 years of television advertisements being off the air, a version of the Magnificent Seven theme song used in the Marlboro ads still conjures up images of the cowboy and his horse around a campfire from those of us who still remember.  These days email and direct marketing advertising gets the newport_001message directly into the hands of tobacco users, but magazine advertising can still be found, and Trinkets and Trash tries to report on it all.

Tobacco ads certainly try to keep up with the times, like this picture of a cute couple enjoying a takeout drink and a selfie.   Notice how healthy they look, how great their hair looks.  Also notice that there isn’t one single cigarette or a pack of cigarettes anyplace in the picture besides the border the ad company added.  This isn’t an ad about cigarettes, it’s an ad about having fun, and you don’t need a cigarette to have fun.

L&M1Tobacco advertisements these days also seem to want to be helpful in some way, like giving you hints on how to stay warmer now that the virginiaslimsweather is cold (just move the furniture around, according to L&M). Notice that the Surgeon General’s warning, which is required to be on all print advertisements, blends into the upper part of the ad, making it almost unnoticed.  Virginia Slims has traded in their long-legged models for recipes so you can “have it all this fall.”  And logging into their site to get the recipes means they will have brigadeall your information to start sending you coupons.

American Spirit wants to show you they are concerned about the environment by sending you a “cigarette butt pouch” so you can send back your smoked butts in a prepaid pouch to be recycled into things like flower pots.redseal

Babies and dogs make great ad copy and both Skoal and Red Seal smokeless tobacco ads feature dogs.  Red Seal shows a man sitting in the back of his pick-up with a can of dip between him and his dog.  Sort of gives you that subliminal message that the dip is your loyal friend and will always be by your side.  And since hunting season is here, Grizzly has come out with camouflage cans, because no self-respecting hunter would be seen with anything else.

Tobacco advertising has changed from the past.  You no longer have to show someone using the product or even show the product in the picture, as the case with Virginia Slims, to sell into the concept that you will suddenly be someone different by using their product. The ads attempt to lull you into thinking the tobacco industry cares about you or the environment.  The print ads require a Surgeon General’s warning, but shouldn’t they be required to show the truth in their advertising as well?  Then again, showing cancer, heart attacks and strokes from using tobacco products isn’t really good for business.

All the pictures used are from the October 2015 Trinkets & Trash Surveillance Update. Click HERE to read about other tobacco news from Trinkets & Trash





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Military smoking is down, but more needs to be done

Today on Veteran’s Day, we thank those men and women who chose to serve our nation and quite literally put their lives on the line.  News articles discuss the concerns people have over health care for our vets and how more needs to be done for them.  But tobacco use is higher in the military than in the civilian population and some are reluctant to put bans in place.  Why is it our military personnel are still being targeted by the tobacco industry?  And even worse, why is it being allowed?

SmokesThe tobacco industry and the military have a long relationship. The government bought tobacco to offer free cigarettes to the dough boys in WWI at a time when pipes and cigars were more popular. When the servicemen came home, the tobacco industry had a group of young men willing to payCamels1 to continue their addiction.  During World War II about 30% of cigarettes were shipped overseas and people at home were encouraged to buy tobacco to send it to the troops.  Another war ends and another group of men and women came home addicted to smoking from the free tobacco handed to them.  The economy begins an upward trend and veterans have jobs and money in their pockets to pay for their tobacco addiction.

By the time of the Korean Conflict, America was weary of fighting.  There were no stars traveling America to encourage patriotism.  But that didn’t stop cigarettes from being included in C-rations.  According to an entry in a forum from a man whose father served in Korean, ” he claimed the army was generous with smokes because studies vietnamhad shown GI’s who smoked were more likely to volunteer for extra duties and special operations.”  Another time of fighting, another group coming home addicted to nicotine.

Vietnam was another unpopular time but cigarettes were there for the troops in their rations.  Although there was already evidence by 1964 that smoking was hazardous to your health, it wasn’t until 1975 that the practice of cigarettes in rations ended.  Smoking in the military reached a high of over 50% in 1980.

Even with all the documentation about the health effects of tobacco use, many in the military believe it is their personal freedom to use tobacco.  While smoking rates in the general population are at about 15%, rates in the military are at 24%.  This “freedom” is a burden on our military to the tune of “approximately $1.9 billion a year to cover medical care linked to tobacco use, as well as lost productivity.”   It exacts a heavy toll on the health of our older veterans who are addicted and living with tobacco-related health issues.  Their health struggles now should serve as a warning to younger military servicemen and women about the dangers of tobacco use.

militaryAccording to Senator Dick Durbin, “One in three members of the military today says they started using tobacco after they enlisted. Why? Well, because we make it easy for them,”   Congress and the Department of Defense are looking at banning sales of tobacco on military bases to try to cut tobacco use rates, but critics are arguing that it is unfair to ban tobacco because service members are already “making significant sacrifices.”  One critic, Rep Duncan Hunter, a Marine reservist who served in Iraq and Afghanistan, claims that while the men and women in uniform are out fighting for your freedom, you are taking away theirs by attempting to ban tobacco sales at military exchange stores. His amendment “which prohibits the military from restricting the sale of legal products already sold in military stores,” was “overwhelmingly approved by the House Armed Services Committee, 53-9.

Times have changed.  While states are looking at raising the minimum age to purchase tobacco to 21 to keep youth from starting to use tobacco, the military exchanges sell tobacco at discounted rates, making it easier and cheaper for our military to start a deadly habit.  Those outside of the military understand the need to limit tobacco use among the troops, not as a punishment or to make life more difficult, but to protect their health now and in the future. The only winner in this tobacco war is the tobacco industry, and they and their proponents will fight all the way to the bank.

Links used for this blog can be found in the highlighted words.  Check out the following links to read more about the military and tobacco:
Up in Smoke?
Rates of Smoking Are Down, But Still High in the Military

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Vaping Your Way to Possible Lung Issues

vaping_001Proponents of electronic cigarettes argue that the devices are much safer than smoking traditional cigarettes.  However, as they gain popularity, cases of lung injuries are starting to be reported due to the chemicals used in the e-liquids.  Currently there are no testing requirements or standards on liquids by the manufacturers.

An investigation by the Milwaukee Journal Sentinel found diacetyl, a chemical known to destroy “the lungs’ tiniest airways, leading to scar tissue buildup that blocks airflow,” as well as a second chemical, in some locally made e-liquids.  This chemical previously came to light for causing injuries and deaths to microwave popcorn workers.

Investigators looked at the link to diacetyl after an e-cigarette user was admitted to the hospital with a rare form of pneumonia and with her lungs failing.  She had been vaping a sweet flavored e-liquid for several months.  She was put on a ventilator for several days, but it took months before her lungs “showed normal pulmonary functioning.”  According to the article, “a study of more than 150 sweet-flavored e-liquids last year found nearly 70% contained diacetyl.”

A man in another state was diagnosed with a “severe allergic reaction…related to a chemical exposure” caused by vaping cinnamon-flavored e-liquid.  Inhaling strong chemicals can cause inflammation over time which can lead to permanent scarring and damage.  Once the man stopped vaping, his allergy symptoms cleared up, but it took months before he had normal pulmonary function.

As of now, e-cigarette-caused illnesses are not making the headlines, but as vaping grows in popularity, especially among teens, more incidences like these reported may become news.  Many teens believe the myth that they are inhaling water vapor.  As more research is completed on e-liquids, other chemicals will be highlighted.  For now, it seems the old saying “it’s better to be safe than sorry” would apply to e-cigarette use.

Click HERE for the entire article on this subject.







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COPD Awareness and What You Need to Know

copd5What is it like to have a disease and not even know it?  According to a Chronic Obstructive Pulmonary Disease fact sheet, “half of the estimated 24 million people who have COPD don’t even know it,” yet it is the third leading cause of death in the U.S.  At the moment there is no cure, but knowing the signs and symptoms could help you seek the necessary treatment that could help you better manage your disease.

COPD isn’t just one disease, but a group of diseases, such as chronic bronchitis and emphysema, that make breathing difficult.   Smoking is the leading cause of COPD, with 9 out of 10 COPD patient deaths related to smoking, but those exposed to secondhand smoke at home or work may also be affected.  Other sufferers may have had long-term exposure to irritants in the workplace, such as chemicals or dust.  In some incidences, a genetic condition may cause the condition.

COPD1COPD comes on gradually and gets worse over time.  The cough and phlegm production you had on occasion becomes an everyday occurrence.  Walking and activities become more difficult because you become short of breath and you find you are wheezing more often. And speaking of breathing, it becomes more difficult, if not impossible, to take a deep breath.  There is no cure, and your symptoms won’t just go away, but the sooner you have an honest talk with a doctor about your symptoms, the sooner you can start your path to living better with COPD.

Many believe COPD is an “old age disease”, but the younger you start smoking, the earlier you can develop it.  Supermodel Christy Turlington had been smoking for 15 years when she was diagnosed at age 31 with early-stage emphysema.  Amy Winehouse died at age 27 and had been diagnosed with COPD at age 24.  There is no average age for this disease, but quitting smoking and early diagnosis are key to living a better life.

If you would like more information on COPD, you can click on the following links which were used for this blog:
COPD: What Can You Do About COPD?
COPD: Better Talk Means Better Treatment.
COPD among Adults in Florida

If you would like to hear what coughing, wheezing and hacking from COPD sounds like, click on the link, then click on the pulsating words:  http://www.nhlbi.nih.gov/health/educational/copd/copd_widget/copd_widget.html

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Key Findings on Electronic Cigarette Use Among Adults

A new study has come out from the Centers for Disease Control (CDC) on electronic cigarettes.  Whether you believe they are an alternative to traditional tobacco-leaf cigarettes or a smoking cessation tool, there is also some controversy surrounding the devices as to whether they are attracting non-smokers to an addictive habit.

The study used information from a survey conducted from more than 36,000 U.S. adults, and was gathered “as part of the National Health Interview Survey, an ongoing survey of a variety of health issues.”  Statistics have been gathered on youth for several years, but this survey is the first time adult usage has been analyzed.

figure1Young adults, or those in the 18-24 year old age group, had the highest usage in several categories.  The percentage of those in this category who had ever tried an e-cigarette at least once, came in at 21.6% with numbers of other groups declining with age.  The percentage of those in this same age group who were non-smokers, but tried an e-cigarette was at 9.7%, which would prompt people to believe the devices are a gateway for adults, as well as teens, to start using nicotine.  Of course it would make sense that this group would have higher numbers; they are into trends and fads, grew up in a digital age, and are more willing to take risks on a product that is marketed by the industry as safe by producing “harmless water vapor,” but has few health studies.

About “12.6% of adults had ever tried an e-cigarette even one time in their lifetimes,” and about “3.7% of adults currently use e-cigarettes every day or some days.”  In both ever tried and current use, men were more likely than women to use e-cigarettes.

Figure3What is surprising is the number of current cigarette smokers, former smokers and never smokers who are currently using e-cigarettes; 15.9% of current cigarette smokers are also currently using e-cigarettes so they are getting their nicotine two ways. Those who were former cigarette smokers of at least a year or more who no longer use tobacco, but use e-cigarettes instead came in at 22.0%.  Respondents who said they never smoked cigarettes, or 0.4%, are currently using e-cigarettes.  The number may not be high but it should be questioned as to why an adult, who was adamant about not smoking traditional tobacco cigarettes, decided to begin using e-cigarettes.  It would also be interesting to see the age of the never smokers in this category.

The Florida Youth Tobacco Survey has been collecting electronic cigarette data since 2011, meaning that those who are now considered an adult at 18 could have started using e-cigarettes when they were 14.  Our Florida high school students have one of the lowest current smoking rates in the nation at 6.9% (current meaning they smoked at least once in the past 30 days), but it is a different story for electronic cigarettes.  The numbers have continued to climb upward, giving teens a 526.7% increase in electronic cigarette use since 2011.  While 6.0% reported having ever tried e-cigarettes in 2011, the 2015 number stands at 37.6% for high school students.  Current use, or use at least once in 30 days, shows an increase of 409.7% since 2011 with 15.8% of high school students reporting use.

The high numbers of electronic cigarette use for our teens means much higher numbers for adults in any future National Health Interview Surveys.  Education on e-cigarettes for both teens and adults is still the key as studies have yet not proven their safety, and no long term studies are available.  At the moment it seems like all we can do is “wait and see” what happens to those using the devices.

Click HERE for the National Health Interview Survey results.

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October Observances 2015

As the month of October winds down, there are so many observances for the month that need to be mentioned.


One of the most widely observed health campaigns for October is National Breast Cancer Awareness Month. The campaign was founded in 1985 with the goal of promoting “mammography as the most effective weapon in the fight against breast cancer.”  Breast cancer, which is the second most common cancer in women, was once a disease that was talked about in whispers.  Now women are sharing their stories, as well as organizing events, such as walks to “raise funds for research into its cause, prevention, diagnosis, treatment and cure.”  Breast cancer can strike a woman, and even some men, at any age. While some breast cancers have no known cause, genetic factors, such as a BRCA gene mutation may play a part in some while others may be due to environmental factors such as smoking.  When researchers conducted a cohort study of women, they found smokers had an increased risk of breast cancer compared to nonsmokers, especially those who started smoking at an earlier age.

Survival rates of breast cancer have improved over the years due to early detection through breast self-exams and mammograms, which is key.   New guidelines have come out this past month regarding when a woman should start having mammograms.  Talk to your doctor about what is best for you.

Did you know it was Adopt a Dog Month?  If you aren’t a dog person, no problem because October 29th is National Cat Day.  So what do these four-legged furry critters have to do with tobacco?  If you have a cat or dog and expose them to secondhand smoke, they are facing respiratory health problems, Lucyallergies and even cancers.  In fact, “the ASPCA, one of the largest animal rights groups in the U.S., lists tobacco smoke as a toxin that is dangerous to pets.”  And it’s not just secondhand smoke that is dangerous, third-hand smoke is particularly toxic to them as well.  Third-hand smoke is the invisible toxic gases that clings to clothing, interiors of cars, carpeting and furniture, as well as your pet’s toys.  Whenboxer your pet grooms him- or herself, they are ingesting those toxins.  Cats living with a smoker are found to have nicotine and other toxins in their urine and are “twice as likely to develop malignant lymphoma.”  Long-nosed dogs living with smokers are found to have “a higher incidence of nasal tumors and cancer of the sinus.”  Those short-nosed dogs, like boxers, have higher lung cancer rates.   So protect your fur babies by either quitting or taking your smoking outside and away from them.  And remember, even if you smoke outside, your pet will still smell the smoke on your clothing.

psoriasisWorld Psoriasis Day is also October 29th and they hope to bring awareness to this condition that affects two to three percent of the world’s population, or more than 125 million people.  Psoriasis is a chronic, inflammatory disorder that primarily involves the skin, and is more common than many people think.  While some have silvery, scaling plaques involving the skin, others may also have inflammatory polyarthritis or psoriatic arthritis.  Both “psoriasis and psoriatic arthritis cause major physical, functional and psychosocial disability.”  Smokers have a much higher risk for psoriasis, which can “about double a person’s risk of acquiring psoriasis.” The more you smoke, the more the risk increases. Smoking also decreases the effectiveness of treatment as the nicotine affects the immune system and skin cell growth.  Bottom line, “if you do smoke, consider stopping – you may have a higher likelihood of remission.”

September was National Menopause Month, but October is World Menopause Month and another chance to find information.  And while there are thousands of jokes regarding thisosteoporosis subject, it’s no laughing matter to those who are going through it.  During menopause women experience a change in hormone levels, specifically a decrease in the production of estrogen.  This decrease can effect many parts of the body including bone density.  Women who smoke have been been found to have a higher risk of developing osteoporosis and their bone loss is more rapid, doubling the risk of having a fracture.  Cigarette smoking has also been linked to earlier menopause and more hot flashes.  But there is hope for those who quit.  A study found that “after one year without smoking, a group of postmenopausal women had improved bone density, compared with women who continued smoking.

So many more observances for this month, and so little time to share them all.




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Red Ribbon Week 2015

redribbonRed Ribbon Week is celebrated October 23 – 31, 2015 with the theme “Respect Yourself – Be Drug Free.”  The Red Ribbon Campaign is “the oldest and largest drug prevention program” which started in the 1980s, and this year it is estimated that 80 million people will participant in Red Ribbon Week activities.  While it originally started out as a campaign against drugs, Red Ribbon Week has evolved as a means to change behavior of our youth and have them remain free of all drugs, including tobacco.

For the past five years the Red Ribbon Campaign has offered an annual photo contest as a “fun and creative way for parents and schools to educate children about the dangers of drug use while they decorate their homes and schools using this year’s theme,” shown above. Entries are accepted through November 3, with winners announced December 4.   For more information on rules and entries, click HERE.  Beginning November 4, friends and family can vote for their favorite entry.

According to the Red Ribbon Campaign site, talking to your children about drugs can reduce the likelihood of them using drugs by 42%.  Setting rules about not using drugs, including tobacco, and monitoring your child’s behavior will reduce their risk.

And if you need a smile for the day, meet Johanna Colón, the 2015 National Red Ribbon Week Youth Ambassador who shows everyone what respect is all about.  Respecting yourself and doing what you know is right, like remaining drug free, will help you succeed in life.

Click HERE for more information on Red Ribbon Week



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