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Anchor lead: A very large number of cancer deaths might be avoided, Elizabeth Tracey reports

Cancer deaths are declining nationally, a recent study reported, and that’s great news. Perhaps even more noteworthy is that almost half of the 600,000 plus cancer deaths that will occur in 2019 might have been avoided. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, explains.

Nelson: The estimate is that 45% of those deaths are actually from what are called modifiable risk factors, things that you could change. Cigarette smoking is probably 29% of them, diet and physical activity, obesity, access to vaccinations against human papilloma virus. Race and ethnic minorities, socioeconomic status, educational status, many times they all go together, and the screening utilization is 20 to 30% lower in folks without a high school education versus college graduates. :31

Nelson says lots of help is available to help those struggling with risks such as smoking and obesity. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Many young people who use e-cigarettes don’t know they contain nicotine, Elizabeth Tracey reports

Among teenagers who use e-cigarettes, a startling number may not even know the products they’re using contain nicotine, a recent study found. Among the 500+ subjects, 40 percent of those who thought they were using nicotine free products weren’t. Michael Blaha, a tobacco regulation expert and cardiologist at Johns Hopkins, comments.

Blaha: It was extraordinarily amazing to find out how little kids unfortunately know about all the details about vaping products. Sometimes they don’t know that there’s nicotine in the products. Sometimes they think that the message is that they’re perfectly safe, not just a little bit safer. Sometimes they think that since it’s not smoking and it’s not specifically banned for example in their school, and sometimes they find because it seems to them more socially acceptable that it must be okay to do.  :29

Blaha says providing accurate information, especially regarding the addictive nature of nicotine use, must be provided again and again to at risk populations such as teenagers. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Seizures may be one consequence of vaping, Elizabeth Tracey reports

Evidence is emerging that e-cigarettes may be less harmful than combustible cigarettes but there are still dangers associated with their use, including the risk of seizures. Michael Blaha, a tobacco regulation expert and cardiologist at Johns Hopkins, explains.

Blaha: There is a signal now that people who use electronic cigarettes are more likely to have seizures. This is likely via central neural mediated pathways involved with nicotine and other products, and just one of the many ways electronic cigarettes probably have some bad effects on our health. Electronic cigarette products in 2016 were deemed to be tobacco products for the first time, so the FDA since 2016 has the opportunity to regulate these devices. Now we’re going to see how the FDA will do this with new products. :29

Blaha says most cases of seizures involved young, first time users, and notes that such an adverse event has also been seen with intentional or accidental swallowing of e-liquid. He believes that additional adverse health consequences of vaping will continue to emerge. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Can a ‘heat not burn’ device make smoking less harmful? Elizabeth Tracey reports

The tobacco giant Philip Morris is about to unleash a new nicotine delivery device on the market, called IQOS, for which it has gotten FDA approval. This is a so-called heat not burn device. Michael Blaha, a tobacco regulation expert and cardiologist at Johns Hopkins, explains.

Blaha: This is very complicated. The FDA has recently taken a stance toward what we call modified risk tobacco products. What modified risk means is a tobacco product that causes less harm we think than smoking, but certainly more harm than if you don’t do it at all. And there’s a discussion right now whether that’s a good thing to approve these products that might cause less harm and get people away from smoking and to a different product but there’s always that downside potentially increasing the access to these devices to people who don’t smoke cigarettes and that might be their first entry into the tobacco world.  :30

This harm reduction strategy may benefit current smokers of combustible cigarettes but seems just one more way to addict people to nicotine for those who don’t smoke. Similar devices are already being sold in 47 countries worldwide. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What’s the likely impact of requiring tobacco product purchasers to be 21 or older? Elizabeth Tracey reports

Hawaii was the first US state to raise the age for buying tobacco products to 21, and several other states soon followed suit. Now there’s a movement afoot to institute a federal mandate. Michael Blaha, a tobacco regulation expert at Johns Hopkins and a cardiologist, comments.

Blaha: There’s an incredible energy around raising the age for purchasing tobacco products to 21 these days both at the state and the federal level. The idea is to make it a little more difficult for those young people to access these addictive tobacco products. They get addicted to nicotine at such a young age when they’re so vulnerable. By raising the age we might make an impact on this addiction to tobacco products. We do have some evidence that when you raise the age to buy tobacco products you see less sales to young folks of these cigarettes and other tobacco products and therefore we hope less addiction of these young people. :30

Blaha notes that some large national drugstore chains have also committed to cease selling vaping and other tobacco products, with an eye toward reducing access and addiction among vulnerable people. At Johns Hopkins, I’m  Elizabeth Tracey.

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Anchor lead: Medicine rationing on the part of patients may have serious consequences, Elizabeth Tracey reports

If you’re having trouble affording your prescription medications do you skip doses, cut pills in half or seek alternatives? You’re among many nationally in the 18-64 age range who do so, a recent CDC study found. Scott Berkowitz, an accountable care expert at Johns Hopkins, says these strategies are accompanied by real dangers.

Berkowitz: So much of our management of patients these days relates to chronic illnesses in many of our patients, especially as they age with multiple chronic illnesses, whether that’s diabetes or high blood pressure or high cholesterol, and so the management of these conditions over time is increasingly with medications. And so the ability to take medications is really important for their long term care, and also helps to avoid potentially hospitalizations or other more costly procedures because they’re getting the right management.  :29

Berkowitz urges anyone who’s having trouble paying for a needed medication to talk with their care provider about it as there are programs to help. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What do people do when they can’t afford their medicines? Elizabeth Tracey reports

Affordable medication isn’t just a problem for older people, a recent CDC study reported. In fact, among the 60% of Americans in the 18-64 age range who have been prescribed medicines, strategies such as taking the medicine less often, choosing alternative therapies or asking for generics abound. Scott Berkowitz, an accountable care expert at Johns Hopkins, comments.

Berkowitz: It certainly sounds like for the uninsured it’s particularly marked. They have to make decisions and adopt strategies at times to cope with the inability to afford those medicines, and that may sometimes mean not taking them as much or not exactly following the instructions, skipping doses. But even some patients with coverage, whether its commercial coverage or Medicare and Medicaid, as well at times need to make decisions or not take their medicines, because they feel that they’re challenged because of their ability to afford those prescriptions. :29

Berkowitz applauds efforts on Capitol Hill to understand this problem better and craft solutions to enable people to afford their prescriptions. At Johns Hopkins, I’m Elizabeth Tracey.

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