Tag Archives: tobacco study

Toenails Reveal All

Your toes tell it all, ladies.

Toenail clippings can provide evidence of tobacco exposure and help explain the risk of heart disease, at least in women, according to a unique study from the University of California-San Diego and Harvard University.

The medical researchers examined levels of nicotine in toenails of 905 women who were diagnosed with coronary heart disease from 1984 through 1998.

The women were among the 62,641 participants in the Nurse’s Health Study. Those with heart disease were randomly matched to two other participants by age and by the date that their toenails were collected.

The twenty percent of women who had the highest nicotine levels in their toenails turned out to have more than triple the risk of being diagnosed with heart disease as those whose levels put them in the lowest twenty percent. The risk remained significantly higher after the researchers took smoking into account, adjusting for the number of cigarettes smoked as well as exposure to second hand smoke.

Women's Toenails“Using toenail nicotine is a novel way to objectively measure exposure to tobacco smoke, and ultimately, to increase our understanding of tobacco-related illness, said Wael Al-Delaimy, of UC-San Diego’s department of family and preventive medicine, lead author of the study published this month in the American Journal of Epidemiology. “This would be especially helpful in situations where smoking history is not available or is biased.”

Source: Josh Goldstein, The Philadelphia Inquirer

Medicaid Could Save $10 Billion Over 5 Years if Recipients Quit Smoking, Study Says

With all the news about government spending on unnecessary items comes news that spending on a program that helps reduce medicaid expenses would be a wise decision.

America’s Medicaid system could spend $10 billion less in costs for its patients’ care over the next five years if they were to stop smoking, according to a new study by the American Legacy Foundation.

This study also found that effective smoking prevention and cessation programs could cut the cost of funding Medicaid by 5.6 percent. This is according to a recent press release issued by the American Legacy Foundation.

According to the report, the costs vary from state to state. In a state such as Wyoming the current Medicaid spending on smoking is $15 million. Meanwhile, in a much more populated state such as New York, that total is much higher, in the amount of $1.5 billion. Overall as a country, if all the smokers on Medicaid quit at the same time it would save the country $9.7 billion according to the press release.

“This report is a wake up call to the nation’s health policy makers,” said Janet Napolitano, who is the Governor of Arizona and also a board member for the American Legacy Foundation. “All of us who are struggling with the ever-rising costs of Medicaid should take these dramatic findings to heart.

With more than 8.6 million Americans suffering from tobacco-related disease, and tobacco remaining the number one preventable cause of death in our nation, we must help smokers quit. These data make clear that investing in proven tobacco cessation programs is sound fiscal and public health policy.

We can – and must – take the necessary steps to save both lives and taxpayer dollars.”, concluded Napolitano.

The amount of taxpayer money that could be saved if smoking is treated at a young age is significant. According to the press release if every state could prevent smoking among all current 24-year-olds, the savings for Medicare would range for each state from $1.4 million for Alaska, all the way up to $125 million for Texas.

The study also showed that the cost for treating women smokers is much higher than males. The average spent on a female smoker in Medicaid funds is $1,372, while for men it is $6.

Medicaid ImageThroughout the country 20.8 percent of adults in the country are current smokers based on the most recent statistics from 2006 according to the Center for Disease Control and Prevention. The CDC also revealed that smoking rates are not dropping throughout the country. This is the situation for the past two years, after witnessing the smoking rate dropping for seven consecutive years. The rates have remained steady over these past two years. Indicating that the number of potential Medicaid members who smoke is not dropping as it had in past years, increasing the likelihood of the expense of smoking on Medicaid dollars will increase.

Prnewswire.com. “Smokers Cost Medicaid System Nearly $10 Billion”.


Taking Play Seriously: Low-Level Smoking Among College Students

Cigarettes have been socially engineered to become potent symbols.

Therefore, they need to be understood as cultural products invested with cognitive and emotional salience as well as nicotine delivery devices engineered to create a population of dependent users.

In this paper, we look at the symbolism of cigarettes, but unlike many researchers examining this topic, we attend as much to what tobacco users do with cigarettes as to what smoking means to them cognitively.

Based on interviews with low-level smokers conducted on two college campuses, we suggest that students use tobacco in order to accomplish interactional goals and to structure social time and space that would otherwise be ambiguously defined.

By conceptualizing this structuring activity as play, we gain valuable insights into early stages and trajectories of tobacco use among college students.

Our conceptualization of smoking as play is not meant to trivialize low-level tobacco use. Much the opposite, we caution that the contexts in which low-level smoking takes place and the utility functions of such smoking must be taken seriously by researchers in light of current increases in tobacco use among college students.

Dog Pointing the Way What that? Nicotine delivery devices!

From: Culture, Medicine and Psychiatry
An International Journal of Comparative Cross-Cultural Research

Tobacco Industry Lied About Second-Hand Smoke

Tobacco Industry Efforts Undermining Evidence Linking Secondhand Smoke With Cardiovascular Disease

Tobacco companies have funded nearly 50 studies on the link between secondhand smoke and heart disease

But when scientists found a connection, the industry skewed their conclusions or stopped funding them, report University of California researchers.

The researchers — Eliza Tong of UC Davis and UC San Francisco’s Stanton Glantz — analyzed 5,000 internal company documents uncovered by lawsuits.

Their findings, recently published in Circulation, are the first such review of the industry’s work on secondhand smoke and heart disease. Scientists agree that frequent exposure ups disease risk by 30 percent.

Ashtray Secondhand SmokeSurprisingly, the only major media outlet to pick this story up was the Sacramento Bee.

Have journalists become so cynical and novelty-consumed that we don’t even bother to tell the public when tobacco companies are once again caught in a cover up that, in ethical if not legal terms, is close to murder?

Sacramento Bee
Source: Brandon Keim, WiredScience

Denial of a Smoker Can Lead to Dying My Way

“One thing that we humans do very well is to defend ourselves psychologically, and our most potent weapon is denial.

But when confronted with a terminal disease, denial flies out of the window. We have to find another defense.”

If we are smokers, and lung or throat cancer is diagnosed, denial is replaced with a sense of shame and/or guilt…For many, smoking after being told that they have a life-threatening illness is their way of saying: “I did it my way, I don’t regret it, and I am still in control.”

Professor Robert West – Director of tobacco studies at Cancer Research UK

Cigarette Smoking and Its Impact on Spinal Fusions

Learn About the Prevalence of Cigarette Smoking

According to the American Cancer Society, “48 million adults (25.7 million men and 22.3 million women) were current smokers in the United States in 1997.”

Many of these adult smokers started during their teenage years. Unfortunately, even today people still begin to smoke cigarettes despite published statistics that show its negative impact on health.

The adverse effects of smoking include nicotine addiction, an increased risk of lung and other types of cancer, higher rates of arteriosclerosis (hardening of the arteries) and heart disease, as well as decreased life expectancy.

Cigarettes contain dried tobacco leaves and flavorings, which include more than 4,000 chemicals. Some of these substances are harmless until burned and breathed.

The Spine and Cigarette Smoking

Picture of SpineBone is a living tissue dependent on the functions and support provided by the other body systems. When these systems are not able to perform normally, bone is unable to rebuild itself. The formation of bone is particularly influenced by physical exercise and hormonal activity, both of which are adversely affected by cigarette smoking.

Many smokers have less physical endurance than nonsmokers, mainly due to decreased lung function. Cigarette smoking reduces the amount of oxygen in the blood and increases the level of harmful substances, such as carbon monoxide. This, combined with the effects of smoking on the heart and blood vessels, can limit the benefits from physical activity.

In men and women, cigarette smoking is known to influence hormone function. Smoking increases estrogen loss in women who are perimenopausal or postmenopausal. This can result in a loss of bone density and lead to osteoporosis. Osteoporosis causes bones to lose strength, becoming more fragile. This silent disease is responsible for many spine and hip fractures in the United States.

Spinal Fusion and Cigarette Smoking

Defined Spinal fusion is a surgical procedure used to join bony segments of the spine (e.g. vertebrae). In order for the fusion to heal, new bone growth must occur, bridging between the spinal segments. Sometimes fusion is combined with another surgical technique termed spinal instrumentation. Instrumentation consists of different types of medically designed hardware such as rods, hooks, wires, and screws that are attached to the spine. These devices provide immediate stability and hold the spine in proper position while the fusion heals.

Spinal fusion (also termed arthrodesis) can be performed at the cervical, thoracic, or lumbar levels of the spine. It takes months to heal. Your doctor may order post-operative radiographs (x-rays) to monitor the progress of this healing.

The long-term success of many types of spinal surgery is dependent upon successful spinal fusion. In fact, if the fusion does not heal, spinal surgery may have to be repeated. A failed fusion is termed a nonunion or pseudoarthrosis. Spinal instrumentation, although very strong, may even break if nonunion occurs. Needless to say, spine surgeons try to minimize the risk of this happening.

Cigarette Smoking and Failed Fusion

Certain factors have been found to affect the success of spinal fusion. Some of these factors include the patient’s age, underlying medical conditions (e.g. diabetes, osteoporosis), and cigarette smoking. There is growing evidence that cigarette smoking adversely affects fusion. Smoking disrupts the normal function of basic body systems that contribute to bone formation and growth. As mentioned previously, new bone growth is necessary for a fusion to heal.

Research has demonstrated that habitual cigarette smoking leads to the breakdown of the spine to such a degree that fusion is often less successful when compared to similar procedures performed on non-smokers. In a study of patients undergoing anterior cervical fusion (fusion of the neck), it was observed that smokers had an increased rate of nonunion (up to 47%) as compared to non-smokers.1

Another study evaluated tobacco use in patients who underwent lumbar (low back) fusion. The patients who smoked had failed fusions in up to 40% of cases, compared to only 8% among non-smokers.2 Similar findings have been reported in other studies as well.

Post-Operative Infection

Cigarette smoking compromises the immune system and the body’s other defense mechanisms, which can increase the patient’s susceptibility to post-operative infection. A study conducted by Thalgott et al showed that cigarette smoking was a risk factor for infection following spinal fusion.3


Clearly, cigarette smoking is detrimental to spinal fusion. People who are facing fusion or any spinal surgery should make every effort to stop smoking. Quitting the habit beforehand will decrease the associated risks and increase the likelihood of a successful spinal fusion surgery.

Your physician recognizes the importance of smoking cessation and can provide information about available treatment options.


1. An HS, Simpson JM, Glover JM, Stephany J. Comparison between allograft plus demineralized bone matrix versus autograft in anterior cervical fusion. A prospective multicenter study. Spine 1995; 20: 2211-16.

2. Brown CW, Orme TJ, Richardson HD. The rate of pseudarthrosis (surgical nonunion) in patients who are smokers and patients who are nonsmokers: a comparison study. Spine 1986; 9: 942-3

3. Thalgott JS, Cotler HB, Sasso RC, LaRocca H, Gardner V. Postoperative infections in spinal implants. Classification and analysis — a multicenter study. Spine 1991: 8: 981-4.
Original Source: Larry Davidson, M.D. Spine Universe, Memphis, TN, USA 07/28/2006