Aiding reduction of smoking with nicotine replacement medications: hope for the recalcitrant smoker?

OBJECTIVE: To assess the effect of the various nicotine replacement therapies (NRT) on smoking reduction. DESIGN: During an initial sampling week, the subjects familiarised themselves with nicotine gum, patch, nasal spray, vaporiser (vapour inhaler) and sublingual tablet. A crossover design was used during the next four study weeks; during two of these weeks the subjects could select one nicotine replacement product of their choice to use, whereas during the other two they were randomly assigned a product to use. SUBJECTS: 143 men and women smoking an average of 22.6 (SD 7.0) cigarettes per day and exhibiting a Fagerstrom Tolerance Questionnaire (FTQ) score of 7.0 (SD 1.9). INTERVENTIONS: Subjects were asked to use as much NRT as they wished, yet to smoke enough to feel comfortable. MAIN OUTCOME MEASURES: Self- reported cigarette consumption, exhaled carbon monoxide (CO), withdrawal symptom score, cotinine plasma levels and motivation to quit were monitored over a period of five weeks. RESULTS: Self-reported smoking declined steadily over the five weeks, from 22.6 (SD 7.0) to 10.4 (SD 1.0) (P<0.001) cigarettes daily (54% decrease), with the biggest drop (37%) during the first product-sampling week. Smoking reduction was greater on average during the weeks when the subjects could choose their nicotine product than when products were assigned. CO readings decreased from 22.7 (SD 8.5) to 14.8 (SD 8.4) ppm (P<0.001) confirming a reduction in smoking (35% decrease), although cotinine levels remained steady, suggesting that subjects were titrating nicotine to their original levels. Withdrawal scores decreased over time (32% decrease, P<0.001), showing that there was no discomfort associated with the smoking reduction, and motivation to quit was enhanced by the treatment in most subjects (93%). CONCLUSIONS: NRT for aiding smoking reduction appeared to be safe, was associated with a clinically significant reduction in smoke exposure over a five-week follow up, and increased motivation to stop smoking. A smoking reduction procedure may help the very recalcitrant smoker gain confidence and increase the control over his/her smoking behaviour. More controlled research is needed to follow up these promising results.


     

保障食品安全,造福人民健康

0 前言 一般认为,食品安全包括两个方面:一是食品的充足供应,解决贫困、消除饥饿,实现人人温饱;二是食品的卫生与营养,摄入食物无毒无害,无食源性疾病污染物,提供人体所需的基本营养物质。现阶段,无论是中国还是国外绝大部分人口温饱问题已经解决,然而随着生产技术、产业结构、生存环境的改变,生活水平的逐步提高,食物链变得长而复杂,消费习惯的不断改变;人才的跨国交流,物质的世界贸易,科技和信息高速发展,检测手段更加先进,发展繁荣与食品安全的矛盾却日益突出,食源性疾病的控制和预防任务艰巨。在21世纪,在人类追求高质量生活和健康长寿…     

Estimating the health consequences of replacing cigarettes with nicotine inhalers

Background: A fast acting, clean nicotine delivery system might substantially displace cigarettes. Public health consequences would depend on the subsequent prevalence of nicotine use, hazards of delivery systems, and intrinsic hazards of nicotine.     

Understanding why smokers do not want to use nicotine dependence medications to stop smoking: qualitative and quantitative studies.

Smokers' expected outcomes of using nicotine dependence medications may act as barriers to their use. In Study 1, 27 smokers were interviewed. Framework analysis was used to identify key themes in smokers' expectations of using nicotine dependence medications. In Study 2, a convenience sample of 212 smokers completed a survey. Multiple regression and mediation analyses were used to examine relationships between self-efficacy, outcome expectations, and intentions to use nicotine dependence medications. In Study 1, three themes emerged as factors for smokers' decisions to use nicotine dependence medications: (a) their effectiveness, (b) their desirability, including adverse effects, and (c) access to nicotine dependence medications. In Study 2, outcome expectations explained large amounts of variance in models predicting intentions to use (a) nicotine replacement therapy (f (2) = .97), and (b) bupropion (f (2) = .73). Effectiveness outcome expectations were the principal predictors in both models. Mild adverse effects outcome expectations explained additional variance in model 1, and medication-aversion outcome expectations explained additional variance in model 2. The effect of craving control outcome expectations on intentions in models 1 and 2 were mediated by effectiveness outcome expectations. Effectiveness outcome expectations were strong predictors of intentions, whereas outcome expectations that these medications are desirable were additional predictors. Expectations of effectiveness appear to be influenced by the ability of the medications to control cravings to smoke. Interventions aimed at increasing the likelihood with which smokers use nicotine dependence medications may be more successful if they address these expectations.     

初榨椰子油品质特征及健康功效的研究进展

初榨椰子油（VCO）是近年来备受关注的功能性油脂。随着VCO市场的增长,对VCO功效的报道也越来越多,然而近年来对椰子油的功效有一定的争议。为了正确认识椰子油,促进VCO在大健康领域的推广应用,介绍了VCO的加工工艺、感官特征、质量指标、脂肪酸组成及微量活性成分,并对VCO的抗氧化、抗菌、抗病毒、抗炎等健康功效及其在心血管疾病、糖尿病、阿尔茨海默病、肥胖、肿瘤等疾病防治方面的研究进展进行了综述。VCO是一种具有一定健康功效的功能性油脂。     

Risk-based approach to evaluate the public health benefit of additional wastewater treatment

The City of Stockton, CA operates a wastewater treatment facility that discharges tertiary treated effluent during the summer and secondary treated effluent during the winter to the San Joaquin River. Investigations were carried out between 1996 and 2002 to provide insight regarding the potential public health benefit that may be provided by year-round tertiary treatment. A hydraulic model of the San Joaquin River and a dynamic disease transmission model integrated a wide array of disparate data to estimate the level of viral gastroenteritis in the population under the two treatment scenarios. The results of the investigation suggest that risk of viral gastroenteritis attributable to the treatment facility under the existing treatment scheme is several orders of magnitude below the 8-14 illnesses per 1000 recreation events considered tolerable by U.S. EPA, and winter tertiary treatment would further reduce the existing risk by approximately 15-50%. The methodologies employed herein are applicable to other watersheds where additional water treatment is being considered to address public health concerns from recreation in receiving waters.     

杏仁油的提取、营养组成及健康功效研究进展

杏仁油是以杏的种仁为原料,经过压榨、浸提等工艺得到的一种功能性植物油,具有抗氧化、抗炎症、抗肿瘤和预防心血管疾病等功效。文章从杏仁油的提取工艺、营养组成和健康功效等方面,对近年来国内外有关杏仁油的研究成果进行了全面综述,并对其未来发展方向进行了展望。     

Increased intakes of selenium‐enriched foods may benefit human health

Selenium is an essential nutrient and deficient intakes compromise health in domestic animals and humans. A recommended dietary allowance (RDA) of 55 µg d^?1 has been set for adult males and females in the United States; most North Americans consume more than this amount, but many residents of Europe, Asia and Africa consume less. While there are very few reports of outright Se deficiency in people consuming mixed Western diets that have Se intakes below the RDA, there is evidence that dietary intakes of selenium greater than the requirement may help reduce the risk of cancer, especially prostate cancer, to men. Selenium metabolism depends on the chemical form of Se in the diet, and some forms are better for some actions (e.g., cancer reduction) than other forms. Foods may contain different amounts and chemical forms of Se; consequently the benefits of Se may depend on the particular foods consumed. There are many reports of the chemistry and health benefits of Se from plant foods; animal foods also contain Se, but there are fewer reported studies. Fully understanding the health benefits of Se that may be gained by consumption of Se‐enriched foods will require multidisciplinary approaches by teams of medical researchers, chemists, nutritionists, and agricultural scientists. Copyright © 2007 Society of Chemical Industry     

Biological activities and health benefit effects of natural pigments derived from marine algae

The importance of marine algae as sources of functional ingredients has been well recognized due to their valuable health beneficial effects. Therefore, isolation and investigation of novel ingredients with biological activities from marine algae have attracted a great deal of attention. Among functional ingredients identified from marine algae, natural pigments (NPs) have received particular attention. These NPs exhibit various beneficial biological activities such as antioxidant, anticancer, anti-inflammatory, anti-obesity, anti-angiogenic and neuroprotective activities. This contribution focuses on biological activities of marine algae-derived NPs and emphasizing their potential applications in foods as well as pharmaceuticals areas.     

Is there a health benefit of reduced tobacco consumption? A systematic review.

This review presents the available evidence on the health effects of reduced smoking. Smoking reduction was defined as reduction of the daily intake of tobacco without quitting. Only published papers were reviewed. Case reports and studies without a thorough definition of smoking reduction or health outcome were excluded. We searched in personal databases, BioMail Medline Search, Medline, the Cochrane Database of Systematic Reviews, and EMBASE. We followed the QUORUM standards for systematic reviews, and both authors read and discussed all publications. A total of 25 studies (31 publications) were identified: 8 articles reported on effects on the cardiovascular system; 11 on the airways; 7 on carcinogens, DNA damage, and lung cancer; 3 on birth weight; and 4 on other health effects. Some papers assessed more than one outcome. In most studies, reduction was defined as less than 50% of baseline tobacco consumption. Most of the studies were small, with the populations selected and short follow-up periods. The limited data suggest that a substantial reduction in smoking improves several cardiovascular risk factors and respiratory symptoms. In addition, smoking reduction is associated with a 25% decline in biomarkers and incidence of lung cancer and a small, mostly nonsignificant, increase in birth weight. There seem to be no substantial beneficial effects on lung function. The evidence on other health effects and mortality is too limited to draw conclusions. A substantial reduction in smoking seems to have a small health benefit, but more studies are needed to determine the long-term effects of smoking reduction.     

Public health implication of refrigerated pasteurized ('sous-vide') foods

Food that upon pasteurization is stored in hermetically sealed containers at food temperatures not exceeding 3 degrees C could be designated by the generic term Refrigerated Pasteurized Foods of Extended Durability, REPFEDs. If not properly processed or protected against recontamination, or if temperature-abused, REPFEDs may present serious health risks. However, control is readily available. Sound microbial ecology, supported by expert risk assessment, allows the design and introduction of longitudinally integrated manufacture, distribution, handling by outlets and consumers and culinary preparation, which result in the assurance of the wholesomeness of the commodity as eaten. Recent progress, including intrinsic preservation by the incorporation of starter cultures, bacteriocins or particular enzymes, opens vistas for attractive future developments. Once microbiological safety has been built into the REPFED-line, monitoring can be limited to (i) real-time tests particularly applied to the factory environment; and (ii) rapid, simple examination for marker organisms of freshly manufactured products versus those approaching expiration dates. Such audits will allow rapid retrieval of incidental process failure and its rectification. It also serves to substantiate measurements of food temperature and spot checks on intrinsic inhibitory attributes. The application of scientific knowledge and technological expertise should primarily be entrusted to the industry itself, heeding Lord Plumb's strategy of "partnership along the food production chain from farm to fork." It should be supported and validated by Public Health Authorities. At all stages safety communication with the public should be ensured.     

葡萄籽油的提取工艺、营养成分及健康功效研究进展

葡萄皮渣是在葡萄加工过程中产生的大宗副产物，包括葡萄皮、果肉和葡萄籽等。葡萄籽油（grape seed oil，GSO）是从葡萄籽中获取的一种高营养价值植物油，富含多不饱和脂肪酸、生育酚、植物甾醇和酚类物质等营养成分，具有抗氧化、抗炎症、降血脂、减肥和抗菌等多种生理功效。文章系统综述了GSO的提取工艺、营养组成和健康功效，并对未来一段时期内GSO的研究开发方向进行了展望。     

Public health impacts of combustion emissions in the United Kingdom

Combustion emissions are a major contributor to degradation of air quality and pose a risk to human health. We evaluate and apply a multiscale air quality modeling system to assess the impact of combustion emissions on UK air quality. Epidemiological evidence is used to quantitatively relate PM(2.5) exposure to risk of early death. We find that UK combustion emissions cause ～13,000 premature deaths in the UK per year, while an additional ～6000 deaths in the UK are caused by non-UK European Union (EU) combustion emissions. The leading domestic contributor is transport, which causes ～7500 early deaths per year, while power generation and industrial emissions result in ～2500 and ～830 early deaths per year, respectively. We estimate the uncertainty in premature mortality calculations at -80% to +50%, where results have been corrected by a low modeling bias of 28%. The total monetized life loss in the UK is estimated at ￡6-62bn/year or 0.4-3.5% of gross domestic product. In Greater London, where PM concentrations are highest and are currently in exceedance of EU standards, we estimate that non-UK EU emissions account for 30% of the ～3200 air quality-related deaths per year. In the context of the European Commission having launched infringement proceedings against the UK Government over exceedances of EU PM air quality standards in London, these results indicate that further policy measures should be coordinated at an EU-level because of the strength of the transboundary component of PM pollution.