A young child and a chicken — neither of whom should smoke.
Smoking is the leading preventable cause of death. Each year it kills more than 5 million people around the world, 480,000 in the US alone. And for every person who dies, about 30 more have serious illnesses caused by smoking. On average, smokers die 10 years earlier than nonsmokers. Anyone who is concerned about preventive medicine must consider smoking cessation a priority. Fortunately, the Affordable Care Act (ACA) has taken a step in the right direction.
The ACA’s provisions
The Affordable Care Act requires health plans and health insurance to cover tobacco-use counseling and interventions without cost sharing or prior authorization. It requires screening of all patients for tobacco use and covering at least two attempts to quit each year. For each quit attempt, it authorizes four tobacco-cessation counseling sessions, each at least ten minutes long (including telephone, group, and individual counseling) and any FDA-approved tobacco-cessation medications (whether prescription or over-the-counter) for a 90-day treatment regimen when prescribed by a health care provider. In a separate provision, it requires that states not exclude FDA-approved cessation medications from existing Medicaid programs. These provisions should encourage providers and patients to increase their smoking cessation efforts. (more…)
The principles we espouse on Science-Based Medicine are vitally important, but some of the subjects we address are not so important in the big scheme of things. Homeopathy and electrodermal diagnostic devices don’t actually harm very many people. For today’s post, I’m going to follow the Willie Sutton rule and go where the money is, so to speak.
Smoking is the leading preventable cause of death. No prospective double blind randomized controlled studies have been done, or ever could be done; but a mountain of evidence converging from many avenues has established the health dangers of smoking beyond any doubt. Hill’s criteria of causation have been amply fulfilled. Smoking causes 90% of all deaths from lung cancer and chronic obstructive pulmonary disease (COPD). It increases the risk of coronary heart disease, stroke, several types of cancer, infertility, stillbirth, sudden infant death syndrome (SIDS), osteoporosis, and premature skin aging (wrinkles). The dangers of second-hand smoke have been amply documented, and where smoke-free laws have been passed there has been a drop in the incidence of heart attacks and of emergency room visits for children with asthma.
Two new studies published in The New England Journal of Medicine reinforce what we already knew and offer both good news and bad news. (more…)