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Anchor lead: A new committee hopes to inform e-cigarette use worldwide, Elizabeth Tracey reports

In honor of World No Tobacco Day, an international committee has developed a policy brief to help inform lawmakers worldwide in regulating e-cigarettes, which are poised to addict a new generation to nicotine. Enid Neptune, a lung expert and tobacco activist at Johns Hopkins and a member of the committee, says the situation is urgent.

Neptune: We looked at electronic cigarette use among youth worldwide. The investigators reflected nine countries. Could we come up with a set of recommendations that could be integrated into regulatory policy globally and we were able to construct that. Much of this comes from first world countries like the United States and Europe, but we know that because these products are so attractive and has such significant uptake by youth, that this is going to be a global problem.   :31

Neptune notes that domestically the electronic cigarette called Juul has been banned in many high schools. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Should the public health community change its ways on e-cigarettes? Elizabeth Tracey reports

Pubic health researchers have largely adopted the idea that e-cigarettes are less harmful than combustible cigarettes and therefore are preferable, but Enid Neptune, a lung expert and tobacco activist at Johns Hopkins, says these views have morphed into other conclusions by teenagers when considering vaping.

Neptune: The commentary by the public health community researchers that electronic cigarettes are healthier than combustible cigarettes has been transformed to the idea that they’re healthy. And the idea that they are less toxic than combustible cigarettes has been transformed to they’re nontoxic. And therefore they use these products thinking they’re healthy and also thinking that they do not have nicotine in them when Juuls have the highest content of nicotine among all e-liquids.  :34

Juuls in particular have taken the nation’s high schools by storm. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A new law restricting flavored tobacco products has been upheld in California, Elizabeth Tracey reports

A new law banning the sale of flavored tobacco products in the city of San Francisco was being challenged by big tobacco, but has been upheld by voters, making the city the most restrictive in the nation with regard to the sale of flavored vaping liquids and other products. Enid Neptune, a lung expert and tobacco activist at Johns Hopkins, applauds the action.

Neptune: Everyone accepts that these flavorings are an initiating tool for young people, especially adolescents and young people to start using these devices. The point of controversy is whether you need to have thousands and thousands of flavorings in order to encourage established smokers to use these products. And the evidence thus far is that you don’t. these flavorings have a unique appeal to teenagers. They don’t have the same appeal to established smokers.  :33

E-cigarettes have been positioned as quit assist devices for smokers of combustible cigarettes. At Johns Hopkins, I’m Elizabeth Tracey.

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Program notes:

0:13 Medicine abounds with acronyms

1:11 Will be 13 years

2:10 Was contemplating leaving nursing

3:07 Ethical competence

4:07 Know thyself sentiment

5:09 This is hitting me on different areas of my body

6:09 The role of courage

7:05 I'm a believer now

8:05 Made a huge impact

9:04 There was a procedure

10:04 Bringing the patient home

11:15 End

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Anchor lead: If you’re told your infant has tongue tie, should it be treated? Elizabeth Tracey reports

Women are encouraged to breastfeed their infants, but a condition called ‘tongue tie,’ where the infant’s tongue may have additional tissue beneath it that reduces its mobility, is sometimes the reason breastfeeding is difficult or impossible. Yet increasing rates of both diagnosis and treatment of tongue tie are concerning. That’s according to Jonathan Walsh, a pediatric head and neck surgeon at Johns Hopkins and one author of a recent review of tongue tie.

Walsh: With tongue tie I feel like my job is to inform the parents as best as I can. But also to give them realistic expectations that it does help many infants but not all breastfeeding difficulties are tongue tie. And I think when the mother can make a more informed choice about does she take the risk of this procedure within the first week or two weeks of life of her child. That there’s appropriate expectations and appropriate management and care teams surrounding them to say hey, if it doesn’t work, what’s our next step?  :29

Walsh encourages parents to seek out a comprehensive approach to tongue tie. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Is a condition called tongue tie in infants associated with lower rates of breastfeeding? Elizabeth Tracey reports

Some infants have a bit of tissue beneath their tongues that renders it somewhat less mobile, and may compromise their ability to breastfeed. At least that’s the theory, but Jonathan Walsh, a pediatric head and neck surgeon at Johns Hopkins and one author of a recent review on the topic, says there’s a lot that’s not known about tongue tie and its management.

Walsh: The idea of tongue tie has been around for centuries. People have noticed  infants with the tissue underneath the tongue that’s tethering it. But it wasn’t until the early 90s that the World Health Organization and UNICEF really had a push to say hey, we should do better as a world to encourage breastfeeding. How best to support women to do it when it doesn’t go well? That’s where tongue tie comes in, and so we have seen significant rises in the diagnosis and treatment of tongue tie. What we don’t know is if these are overdiagnosis.  :33

Walsh says careful evaluation is key. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Johns Hopkins is providing rehab services at a gym, Elizabeth Tracey reports

Rehabilitation and exercise often go hand in hand, and now Johns Hopkins has taken that to the next level in providing rehab services in a local exercise facility. Pablo Celnik, director of physical medicine and rehabilitation at Johns Hopkins, describes the strategy.

Celnik: We are doing rehab in a health facility, it makes sense. You can continue to do the rehab but then you can refer them to the health treatments with a personal trainer perhaps or on their own. But they have some distance provision, they have some access to the therapists if needed plus any questions and consultation.   :16

Celnik notes the many benefits of such a partnership.

Celnik: Here we are bringing our expertise from an academic institution within high technology, teaching, as well as research. Patients like that, they like to participate in areas that helping in terms of the location of teaching, and perhaps even participate in research activities, while they’re doing their clinical care.  :16

At Johns Hopkins, I’m Elizabeth Tracey.

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