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You've probably seen someone walking down the street or sitting on an airplane smoking an electronic cigarette -- a smokeless electronic device that allows the user to imitate traditional smoking methods by inhaling a vapor of liquid nicotine. Tobacco companies have recently begun promoting e-cigarettes to hook young people on tobacco, claiming they're harmless and can even help people quit smoking.

But now the U.S. Food and Drug Administration (FDA) has stepped in, proposing new rules to regulate e-cigarettes as tobacco products.

"The reality is we have limited knowledge of what is in e-cigarettes, and if the actual nicotine content on the label is reflective of what's inside. There are no standards for reporting or measuring," says Paul Cinciripini, Ph.D., director of MD Anderson's Tobacco Treatment Program. "Regulation is welcome and further clinical research is needed before e-cigarettes can be promoted as a safe alternative to smoking or as an effective means to quit smoking."

Cracking down on e-cigarettes

E-cigarette sales have jumped from $500 million in 2012 to nearly $2 billion today. This is partly due to hip packing and flavoring options that make e-cigarettes attractive to a new generation of younger smokers. Our tobacco experts are concerned that e-cigarettes may become a gateway form of nicotine for never-smokers, while also preventing those who are trying to quit from kicking their nicotine addiction.

iStock_000007172534Small.jpgBy John Chattaway

As a part of MD Anderson's mission to end cancer, we're aspiring to raise the first tobacco-free generation. It's this goal that led to the creation of the ASPIRE program.

ASPIRE, which stands for A Smoking Prevention Interactive Experience, aims to educate teens about the dangers of tobacco use, so they never start smoking. For teens who already use tobacco, it provides information and strategies to quit smoking.

This free, web-based school curriculum has enrolled participants from 28 states and one international city. The program is available in both English and Spanish.

"Young people are very picky about what and how they are taught," says Alexander Prokhorov, M.D., Ph.D., professor of Behavioral Science and director of the Tobacco Outreach Education Program. "That's why we created this online course that is fun, interactive and entertaining while still being educational."

Online tobacco and smoking prevention
ASPIRE can be accessed by anyone through the MD Anderson website. It offers information tailored specifically for one person or for groups. Those who have never smoked can use ASPIRE to learn why it's important to avoid tobacco and how to talk to others about the harms of tobacco.

quit_smoking_how_to_curb_the_urge.JPGThis Saturday, Jan. 11, 2014, marks the 50th anniversary of the Surgeon General's 1964 Report on Smoking and Health, the first major statement in the United States linking smoking to lung cancer.

With more than 200,000 people diagnosed with lung cancer each year in the United States and smoking contributing to 87% of lung cancer deaths and 30% of all cancer deaths, this landmark report and the 30 subsequent Surgeon General's Reports on smoking have greatly influenced what we do here at MD Anderson.

Here are four ways the Surgeon General's Report has impacted our work and -- and our cancer patients and their families.

1.    We've hired more researchers focused on smoking and cancer.
"The 1964 Surgeon General's Report set the stage for extraordinary increase in knowledge and research on tobacco and cancer that's occurred since then," says Ellen R. Gritz, Ph.D., chair of Behavioral Science at MD Anderson and an author and/or editor for nine Surgeon General's reports on smoking and tobacco.

AndrewDavisonandchildren.jpgBy Andrew Davison
 
I lost my dad to lung cancer. Thirteen years later, I was diagnosed with the same illness that took his life.

The difference was that he smoked two packs of cigarettes day, and I did not.

While I did smoke occasionally in my early 20s, I have been active and healthy for most of my life. But whether a person smokes or not shouldn't matter in how we approach lung cancer patients. Through my lung cancer treatment journey, I've learned we need to end the stigma surrounding lung cancer.

My lung cancer diagnosis
Almost four months ago, I was riding on top of the world, literally. In the midst of a five-hour mountain bike ride at a ski resort in Colorado, I crashed. I was a little banged up and went in to get checked out. After a few stitches and a chest x-ray, I was cleared to go home with a bag of ice and some ibuprofen.

Two hours later, while grilling at a summer BBQ, I missed a call from the clinic. The doctor left a voicemail saying that, after a second review, the radiologist had noticed a spot on the upper apex of my left lung. He said it was probably nothing, perhaps even just some scar tissue, and that I should schedule a CT scan. I turned to my wife and said, "There is no way that is good news." 

iStock_000007172534Small.jpg

By Brittany Cordeiro

Each day in the United States, about 4,000 kids smoke their first cigarette. Many of them will become daily smokers.

"For teens, it may seem cool to smoke. But tobacco use at a young age can cause immediate and long-term health problems like cancer," says Alexander Prokhorov, M.D., Ph.D., director of the Tobacco Outreach Education Program at MD Anderson.

Recent data shows that the declining number of teen tobacco users has stalled. And, the tobacco industry may be to blame.

The industry advertises products, like e-cigarettes, flavored cigarillos and hookahs, as "safe" and is capturing the attention of kids.

"All tobacco products are dangerous," Prokhorov says. "We need to be proactive about educating our communities, schools and governments about the dangers of these products." 

Use the facts below to educate kids about the health risks of trendy tobacco products.

Cigarillos contain dangerous chemicals
Cigar use among high school students rose from 7% in 2009 to 12% in 2011. One main factor: flavored cigarillos.

With a steady decline in traditional cigarettes, tobacco companies are looking for new ways to get people addicted to smoking. 


Now, with the third largest U.S. tobacco company launching a massive campaign to promote electronic cigarettes, or e-cigarettes, smoking may be on rise again. In fact, about 6% of adults have tried e-cigarettes, a number that has nearly doubled since 2010, says the Centers for Disease Control and Prevention.


The e-cigarette is a smokeless electronic device that allows the user to inhale a vapor of liquid nicotine in order to imitate traditional smoking methods. The new gadget is touted as safe and harmless by tobacco companies, but our tobacco prevention and cessation experts tell a different story.

Claims that e-cigarettes are 'safe' are misleading
"We've been telling society for the past 30 years that they shouldn't smoke, and that tobacco is bad," says Paul Cinciripini, Ph.D., director of MD Anderson's Tobacco Treatment Program. "But tobacco companies are smart and have a good marketing strategy when it comes to promoting new products."

Tobacco-Free Teens.jpg
Remember playing arcade and video games as a kid? Now, researchers are playing on kids' love for video games by creating interactive games and apps for mobile devices. And, they're doing this to collect research data from patients and to deliver educational information to keep people better informed about their health. 

Here at MD Anderson, Alexander Prokhorov, M.D., Ph.D., professor of Behavioral Science, has been using the gaming concept to help people quit smoking. Prohorov's mission is to develop tobacco prevention programs targeted towards children and teens. 

His latest invention is not only timely, but industry appropriate. Prokhorov has developed a quit smoking app - available for download at no cost on the Apple iTunes Store -- called Tobacco-Free Teens. The app, designed to help prevent tobacco use and help teens stop smoking, is an animated educational experience created with the teen in mind. 

"Our app combines education and entertainment with comics and interactive games," Prokhorov says. "It motivates teens to stay away from tobacco and teaches behavioral skills to help them resist pro-tobacco pressures. Such an approach is much more appealing to youth than text-based instructional tools."

Lung cancer screening - low-dose spiral CT scan

When a massive clinical trial about lung cancer screening shows a benefit to current and former smokers, why can it take so long to become accessible for most people?

A draft recommendation by a federal task force in favor of using low-dose CT scans to screen past and current heavy smokers for lung cancer provides insight about the time lag.

The recommendation says that low-dose spiral CT lung cancer screening is only appropriate for those who:

• Are 55 to 80 years old

• Have a 30-pack-year history of smoking (which translates to 1 pack of cigarettes a day for 30 years, 2 packs a day for 15 years, etc.)

• Smoke or have quit smoking within the past 15 years

"The U.S. Preventive Services Task Force's recommendation is a great step forward for this life-saving screening," says Reginald Munden, M.D., professor of Diagnostic Radiology.

Health insurance companies expected to cover CT lung cancer screening for smokers
The task force carefully sorts the pros and cons of a preventive procedure before recommending for or against. Its rulings are highly influential, so both governmental and private health insurers tend to wait for its recommendations before deciding whether to pay for a procedure, Munden says.

The task force's recommended B rating for the procedure, subject to a comment period that ends Aug. 26, is significant. Right now, 95% of the people who want screening have to pay for it out-of-pocket, because only two health insurance companies cover it. Medicare and Medicaid don't reimburse for it, but the task force's recommendation is expected to change that.

"The implications are huge," says Therese Bevers, M.D., medical director of MD Anderson's Cancer Prevention Center. "Health plans, under the Affordable Care Act, are required to cover any screening or service given an A or B rating by the U.S. Preventive Services Task Force. They're not only required to cover it, but to cover it without any co-payment or deductible so the patient is able to get this at no out-of-pocket cost."

active man

One in two men will be diagnosed with cancer during their lifetime. And, one in six men will be diagnosed with prostate cancer, the second leading cause of cancer-related deaths in American men, just behind lung cancer.

So, what can men do to protect themselves from cancer? We recently spoke with John Papadopoulos, M.D., assistant professor of Urology. He works at the MD Anderson Regional Care Center in Katy.

Here's what Dr. Papadopoulos had to say.

What are some easy tips for men to help men prevent cancer?

There are a lot of things men can do to protect themselves from cancer:

  • Avoid tobacco - even celebratory cigars - and limit alcohol to no more than two drinks per day.
  • Maintain a healthy weight and stay physically active each day.
  • Maintain a healthy diet. Make fruits and vegetables the biggest part of every meal and go easy on the meat. Limit the amount of red meat you eat to 18 oz. week and avoid processed meats like hot dogs and pepperoni. 
  • Wear sunscreen and practice sun safety. 
  • See a doctor regularly and get the screening exams you need. Many men avoid seeing a doctor because they're afraid, but if you do have a chronic disease like cancer, diabetes or heart disease, the earlier we catch it, the easier it will be to treat. 

Keep in mind that doing these things doesn't guarantee you won't get cancer. But living a healthy lifestyle can put you in fighting shape if you do develop cancer.

READ: Men: Health for your age

What cancer screening exams do men need? And, when should most men start screening?

Most men need both a prostate exam (digital rectal exam and PSA test) and a colonoscopy starting at age 50. This is the appropriate age for screening if you don't have a family history (father, son, brother) of prostate or colon cancer and you're not African American, which can make you more likely to develop these cancers.

How to quit smoking mary dewberry_final.JPGBy Mary Dewberry

In January 1989, MD Anderson went smoke-free. It happened the same month and year that I started working here.

Now when people see me, they think of the American Cancer Society's Great American Smokeout (GASO) and saying no to tobacco. That's because for 23 years, I've helped coordinate GASO's logistics and direct people to resources here at MD Anderson during the event, which is held every November.

But for me, GASO isn't about trying to quit for one day or one week. It's about providing resources to help year-round.

Here are a few of the resources I recommend to those trying to quit.

Katrina Burton, MD Anderson Staff Writer

Breannacheer.jpgWith nearly one in five teens smoking cigarettes, there is no better advocate for smoking-cessation than Breanna Jordan, a senior at Stone Mountain High, a school nestled in DeKalb County in Georgia.

As a member of the National Honor Society, varsity cheerleader squad and active participant of SADD (Students Against Destructive Decisions) - a student-run program that discourages students from drinking, smoking and engaging in destructive behaviors - Jordan is no stranger to peer pressure and what's popular among teens.

"Smoking is the in thing to do for those going through the cool phase," says Jordan. "There is a lot of stress that comes with being a teenager, and some think that smoking among other things helps relieve that stress."

Jordan says it is not only the hygiene problems - bad breath, bad teeth and body odor - that have made her say no to smoking, but diseases like cancer that concern her. Jordan, like most people, has either had a personal experience with cancer or knows someone whose life has been touched by the disease. Just last year her aunt died of a non-smoking related cancer - ovarian cancer.

By Will Fitzgerald, MD Anderson Staff Writer

A first-of-its-kind study has found that CT scans detect lung cancer at an earlier, curable stage in the population at highest risk compared to traditional X-rays -- resulting in 20% fewer deaths from the disease. Until now, there's been no recommended screening tool to detect early lung cancer. However, these results may be a major breakthrough.

 

MD Anderson was one of 33 sites that participated in the NCI-led trial. Reggie Munden, M.D., professor in the Department of Thoracic Imaging, is the study's principal investigator at MD Anderson. In this video, he explains the findings, significance and hope that could transform the way lung cancer is detected and treated.

Resources
Lung cancer trial results show mortality benefit with low-dose CT (NCI news release)

Video from ABC News

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