Thursday, May 4, 2017

Social Smoking Carries Same Heart-Disease Risks as Everyday Habit

One in 10 Americans screened said they sometimes smoked, study found
Social Smoking problems
Newswise, May 4, 2017 – Social smokers’ risk for high blood pressure and high cholesterol is identical to those who light up every day, new research has found.

This large, nationally representative study is the first to look at blood pressure and cholesterol in social smokers. More than 10 percent of 39,555 people surveyed said they were social smokers, meaning they didn’t smoke every day. That’s on top of the 17 percent who called themselves current smokers.

Among current and social smokers (after researchers adjusted for differences in factors including demographics and obesity), about 75 percent had high blood pressure and roughly 54 percent had high cholesterol.

“Not smoking at all is the best way to go. Even smoking in a social situation is detrimental to your cardiovascular health,” said lead author Kate Gawlik, assistant professor of clinical nursing at The Ohio State University.

“One in 10 people in this study said they sometimes smoke, and many of them are young and already on the path to heart disease,” she said. 

Smoking is a risk factor for unhealthy blood pressure and cholesterol and both are significant contributors to cardiovascular disease, the leading killer of men and women worldwide. 

The study appears in the American Journal of Health Promotion

“These are striking findings and they have such significance for clinical practice and for population health,” said study senior author Bernadette Melnyk, dean of Ohio State’s College of Nursing and chief wellness officer for the university.

Melnyk said doctors and nurses should strive to identify social smokers and offer them advice and tools to quit smoking.

“This has been a fairly neglected part of the population. We know that regular smoking is an addiction, but providers don’t usually ask about social smoking,” Melnyk said.


“The typical question is ‘Do you smoke or use tobacco?’ And social smokers will usually say ‘No’.”

Participants in the study were screened from February 2012 to February 2016 as part of Ohio State’s Million Hearts educational program.  The U.S. Department of Health and Human Services in 2012 launched Million Hearts, a five-year initiative to improve cardiovascular health co-led by the Centers for Disease Control and Prevention and the Centers for Medicare & Medicaid Services. Ohio State was the first university-wide partner. 

During the screenings, participants identified themselves as nonsmokers, current smokers or social smokers. The screenings also included measures of blood pressure and total cholesterol.

Social smokers in the study were more likely to be younger (between 21 and 40 years old), male and Hispanic. After the researchers took into account demographic and biometric differences between the smokers and social smokers in the study, they found no difference in the risk of hypertension or high cholesterol.

Social smokers were defined as those who do not smoke cigarettes daily, but who smoke in certain social situations regularly. 

The good news about this study is there’s plenty of room for intervention and prevention of future death and disease, the researchers said. 

“Simple healthy lifestyle behavior changes including appropriate aspirin therapy, blood pressure control, cholesterol management, stress management and – very importantly – smoking cessation can do away with much of the risk of chronic disease,” Melnyk said. 

The percentage of participants who called themselves “current smokers” was in line with estimates from the CDC, which reports that 17.8 percent of U.S. adults identify as smokers.

Gawlik and Melnyk said those who consider themselves social smokers should be aware that the toll on their cardiovascular health could be just as great as if they smoked every day.

And this study should prompt clinicians to rethink how they ask patients about smoking, they said.

“Are you a smoker?” isn’t likely to work with social smokers, because they don’t think of themselves as addicted, Gawlik said.

In the study, the researchers advise asking “Do you ever smoke cigarettes or use tobacco in social situations such as at bars, parties, work events or family gatherings?”

Another option: “When was the last time you had a cigarette or used tobacco with friends?” 

Furthermore, clinicians working with smokers should be aware that cutting back on smoking isn’t a good answer from a heart-health perspective.

“Doctors and nurses need to educate patients that social smoking is still a major health risk and is not a long-term healthy choice,” Gawlik said.

Limitations of the study include the fact that the researchers don’t have information about prior smoking behavior, just what the participants reported at the screenings. In addition, the screenings were open to people who chose to participate, meaning the study subjects were self-selected.

Gawlik said she’d like to know more about how many of those who smoke socially go on to become everyday smokers.

“That’s a huge area for clinical intervention because you might be able to reach them before they’re completely and totally addicted,” she said.


Ohio State has led a national effort through Million Hearts, which now has over 150 participating organizations and universities, to provide free education and support to health care providers, students and community members looking to reduce cardiovascular death and disease. More information is available at https://millionhearts.osu.edu/ 

Tuesday, May 2, 2017

Aggression Disorder Linked to Greater Risk of Substance Abuse

Alcohol addiction and aggressive behavior disorder People with intermittent explosive disorder at five times greater risk for substance abuse than those who don’t display frequent aggressive behavior

Newswise, May 2, 2017 — People with intermittent explosive disorder (IED)—a condition marked by frequent physical or verbal outbursts—are at five times greater risk for abusing substances such as alcohol, tobacco and marijuana than those who don’t display frequent aggressive behavior, according to a new study by researchers from the University of Chicago.\
In the study, published Feb. 28, 2017 in the Journal of Clinical Psychiatry, Emil Coccaro, MD, and colleagues analyzed data from more than 9,200 subjects in the National Comorbidity Survey, a national survey of mental health in the United States.

They found that as the severity of aggressive behavior increased, so did levels of daily and weekly substance use. The findings suggest that a history of frequent, aggressive behavior is a risk factor for later substance abuse, and effective treatment of aggression could delay or even prevent substance abuse in young people.

IED affects as many as 16 million Americans, more than bipolar disorder and schizophrenia combined. It is often first diagnosed in adolescents, some of whom are as young as 11, years before substance abuse problems usually develop.

 IED runs in families and is thought to have a significant genetic component, although Coccaro said people tend to treat it as a social-behavioral issue instead of as a true neurobiological disorder.

“People don’t see this as a medical problem. They think of it as simply bad behavior they have developed over the course of their lives, but it isn’t. It has significant biology and neuroscience behind it,” said Coccaro, who is the Ellen C. Manning Professor of Psychiatry and Behavioral Neuroscience at UChicago.

Previous research has implied that aggressive behavior in IED is due to the presence of other psychiatric disorders, such as anxiety or depression. But the new UChicago study found no such relationship.

While substance abuse, like excessive drinking, can clearly make aggressive behavior worse, the onset of IED almost always precedes the development of chronic substance abuse. Coccaro and his team found that IED preceded substance abuse in 92.5 percent of the cases where subjects developed both disorders.

Coccaro emphasized that early psychological intervention, medication and cognitive therapy are the most effective treatments to prevent, or at least delay, substance abuse problems in adolescents diagnosed with IED.

“What you’re really treating is the emotional dysregulation that leads to aggression,” Coccaro said. “The earlier you treat this dysregulation, the more likely you are to offset other disorders that come later down the road.”


The study, “Intermittent Explosive Disorder and Substance Use Disorder: Analysis of the National Comorbidity Survey Replication Sample,” was supported by the National Institute of Mental Health. Additional authors include Jennifer Fanning, PhD, and Royce Lee, MD, both from the University of Chicago.

Study Confirms Link Between Alcohol Consumption, Breast Cancer Risk in Black Women

Black Women Breast Cancer Link alcohol consumption
Newswise, May 2, 2017– Alcohol consumption is known to be a risk factor for breast cancer based on studies predominantly done in white women. Now a University of North Carolina Lineberger Comprehensive Cancer Center study has found the same risk exists for black women, an understudied group.

Researchers found in the new study that black women who drank more than 14 alcoholic drinks per week had a significantly higher risk of invasive breast cancer than those who drank less.

The findings, published in the journal Cancer, Epidemiology, Biomarkers & Prevention, confirmed the link between alcohol consumption and breast cancer risk, which has been seen in other studies drawn from majority white populations.

And while some breast cancer risk factors - like age or genetics -- aren’t easily modified, alcohol consumption is one risk factor that women, regardless of race, can change to potentially lower their cancer risk.

“Minority groups are often understudied because they represent a smaller proportion of study populations. This work avoided that limitation by working with a consortium of many different studies, including more than 20,000 black women,” said Melissa Troester, PhD, a member of UNC Lineberger and professor of epidemiology in the UNC Gillings School of Global Public Health.

“We found that the patterns observed in other studies examining alcohol and breast cancer risk hold in black women, too.”

The researchers analyzed data for 22,338 women from the African American Breast Cancer Epidemiology and Risk (AMBER) consortium, which combines data from four large breast cancer studies.

Researchers evaluated alcohol as a risk factor for invasive breast cancer as well as for specific breast cancer subtypes, such as estrogen receptor positive or negative cancer.

“Our study demonstrated there is benefit in creating consortia to focus on understudied groups,” said the study’s first author Lindsay Williams, a graduate research assistant at UNC Gillings.

When they studied the data across all breast cancer subtypes, they found consuming seven or more alcoholic drinks per week was linked to increased risk of breast cancer across all subtypes.

Women who previously drank alcohol, and later stopped, had lower risk than women who reported recent use – indicating that women may be able to reduce their risk by drinking less.

However, they did find significantly higher risk for some women who have never drank alcohol.

The researchers said that the group of women that avoids alcohol also sometimes includes women who have other health conditions, and some of these health conditions can increase risk for breast cancer. The finding may direct additional research.

“In the future, it may be worth-while to better characterize women who identify as never drinkers to understand reasons for abstaining from alcohol,” Williams said.

The researchers underscored that the study is important as alcohol consumption can be changed or addressed.

“Overall, our findings among African American women mirror those reported in the literature for white women, namely that high levels of alcohol intake – more than one drink per day – are associated with increased breast cancer risk,” Troester said.

“Alcohol is an important modifiable exposure, and women who are concerned about their risk of breast cancer could consider reducing levels of exposure.”


In addition to Troester and Williams, other authors include: Andrew F. Olshan, Chi-Chen Hong, Elisa V. Bandera, Lynn Rosenberg, Ting-Yuan David Cheng, Kathryn L. Lunetta, Susan E. McCann, Charles Poole, Laurence N. Kolonel, Julie R. Palmer, and Christine B. Ambrosone.

Monday, March 20, 2017

Anxiety Is a Stronger Harbinger of Alcohol Problems Than Stress

Anxiety Harbinger of Alcohol Problems
Newswise, March 20, 2017 — Stress and anxiety are widely believed to contribute to drinking. Alcohol is thought to reduce tension caused by stress (the “flight or fight” response) as well as alleviate the unpleasant symptoms of anxiety (anticipation of the unpredictable, impending threats).

Prior research, however, has yielded inconsistent findings as to the unique relations between stress and anxiety, on the one hand, and alcohol consumption and alcohol use disorders, on the other hand.

This study was designed to examine how differences in self-reported levels of anxiety, anxiety sensitivity, and perceived stress impact the frequency and intensity of drinking, alcohol craving during early withdrawal, and alcohol craving and stress reactivity.

Recent drinking was assessed in 87 individuals (70 men, 17 women) with alcohol use disorders (AUDs). Three distinct measures were used to evaluate anxiety, anxiety sensitivity, and perceived stress.

A subset of 30 subjects was admitted to a medical center to ensure alcohol abstinence for one week: measures of alcohol craving were collected twice daily. On day 4, subjects participated in a public speaking/math challenge, before and after which measures of cortisol and alcohol craving were collected.

In these heavy drinkers, measures of anxiety as compared with perceived stress were more strongly associated with a variety of alcohol-related measures.


While alcohol studies often use the terms anxiety, anxiety sensitivity, and stress interchangeably, this study showed the importance of differentiating among the three terms given their unique relationships with drinking, craving, and stress reactivity among individuals with AUDs.

Thursday, March 9, 2017

Alcohol’s Effect Can Be More Damaging to Women


Alcohol effect can be more damaging to Women
Newswise, March 9, 2017— Listen up ladies.Women simply don’t metabolize alcohol in the same way as men. It’s called the telescoping effect.

Several research studies have shown that some women who drink heavily can do as much damage to their bodies in four to five years as a man who has been drinking for 20 to 25 years, according to Laura Veach, Ph.D., director of screening and counseling intervention services at Wake Forest Baptist Medical Center.

“It has something to do with the concentration of water and fat, but we’re really not sure that we understand the whole picture because there is much less research on how women process alcohol,” Veach said.

“We do know that alcohol stays in the liver longer in women than in men, which may explain why women can experience more impairment and liver damage.”

Knowing what constitutes a standard drink size and learning to count and visually measure drinks can help women stay healthy, just as getting an annual physical or skin cancer check does, Veach said.

Here are some things to remember:
• According to the National Institute on Alcohol Abuse and Alcoholism’s website Rethinking Drinking, a standard drink is five ounces of wine, 12 ounces of beer or one-and-a-half ounces of liquor.
• A regular bottle of wine contains five standard drinks.
• For women, no more than seven standard drinks a week are recommended.
• Risky drinking is considered to be four standard drinks in any one day or drinking episode.
• It takes about an hour per drink for the liver to metabolize alcohol.

“Get a measuring cup and pour out five ounces of wine to see what that really looks like,” Veach said. “It might surprise you to see how it looks in a wine glass, especially because the size and shape of glasses can vary so much. 


“That one simple thing can really help you keep track of how much you are drinking the next time you’re out with friends and help you avoid risky drinking.”

Thursday, February 16, 2017

Think Binge Drinking Is Safer for Your Liver Than Regular Heavy Drinking? Think Again.


Effect of alcohol of body
Newswise, February 16, 2017 — Alcoholic liver disease (ALD) occurs on a spectrum of severity. The majority of people who drink excessively develop a fatty liver, which though often symptom free, can progress to a state of inflammation, fibrosis, and cell death that can be fatal.

Little is known about liver disruption that may occur in problem drinkers who are not alcohol dependent. To help understand the development of ALD, this study used a rodent model to examine differences in liver damage between binge drinkers and heavy drinkers.

Researchers at UCSF compared the metabolic effects in mice of repeated binge-like alcohol drinking, a single binge-drinking session, and repeated moderate alcohol drinking. Several markers of early- and later-stage liver disruption were examined.

Results indicated that even limited binge-like alcohol drinking disrupts liver function, which could lead to more severe forms of liver damage. These findings point to several aspects of early liver dysfunction seen in humans, including fatty liver, induction of the liver metabolic enzyme CYP2E1, and increased alcohol metabolism.


The study, funded by the NIH/NIAAA, also demonstrates the great potential value of preclinical studies for understanding human disorders.

Monday, February 13, 2017

Gambling Addiction Triggers the Same Brain Areas as Drug and Alcohol Cravings

Gambling and Drug Addiction triggers
Newswise, February 13, 2017 — Gambling addiction activates the same brain pathways as drug and alcohol cravings, suggests new research.

The study, by international scientists including researchers from Imperial College London, suggests targeting these brain pathways may lead to future treatments for the condition.

The findings, published in the journal Translational Psychiatry, also suggest connections between the parts of the brain that control our impulses may be weakened in people with gambling addiction.

This work provides vital clues into the biology of gambling addiction, which is still largely unknown, explained Dr Henrietta Bowden-Jones, co-author from the Department of Medicine at Imperial, and director of the National Problem Gambling Clinic, at Central and North West London NHS Foundation Trust.

"Gambling addiction can have a devastating effect not just on patients, but also their families. It can result in people losing their job, and leave families and children homeless.

"We know the condition may have a genetic component - and that the children of gambling addicts are at higher risk of gambling addiction themselves - but we still don't know the exact parts of the brain involved. This research identifies key brain areas, and opens avenues for targeted treatments that prevent cravings and relapse."

The study, funded by the UK Medical Research Council, found that two brain areas, called the insula and nucleus accumbens, are highly active when people with gambling addiction experience cravings.

Activity in these areas, which are found deep in the centre of the brain and involved in decision-making, reward and impulse control, has been previously linked to drug and alcohol cravings.

Problem gambling may affect up to 593,000 people in the UK. The condition can be treated by talking therapies, such as cognitive behavioural therapy, or medications that combat cravings.

In the research, which was conducted between Imperial and the National Problem Gambling Clinic, scientists studied 19 patients with gambling addiction, and 19 healthy volunteers.

The most commonly reported problematic forms of gambling among the patients were electronic roulette and sports gambling.

Each volunteer went into a magnetic resonance imaging scanner - which uses a powerful electromagnet to monitor brain activity - and were shown various images. These included pictures of gambling scenes, such as a roulette wheel or a betting shop.

All participants were asked to rate their level of craving when they saw the images.

The team, which included scientists from the University of British Columbia and the University of Cambridge, then assessed which brain areas were activated when the volunteers experienced cravings.

They found that, in problem gamblers, the insula and nucleus accumbens were highly active when they were shown an image associated with gambling, and experienced a craving.

Interestingly, the team also found that weaker connections between the nucleus accumbens and an area called the frontal lobe in problem gamblers were associated with greater craving.

The frontal lobe, which is involved in decision-making, may help keep the insula in-check by controlling impulses, explained Professor Anne Lingford-Hughes, co-author from the Department of Medicine at Imperial.

"Weak connections between these regions have also been identified in drug addiction. The frontal lobe can help control impulsivity, therefore a weak link may contribute to people being unable to stop gambling, and ignoring the negative consequences of their actions. The connections may also be affected by mood - and be further weakened by stress, which may be why gambling addicts relapse during difficult periods in their life."

Professor Lingford-Hughes added that monitoring activity and connections in the insula and nucleus accumbens in gambling addicts may not only help medics assess effectiveness of a treatment, but may also help prevent relapse - a common problem in addiction.

The group are now investigating which treatments may reduce activity in these areas, in an attempt to reduce cravings.


They would also like to compare the brain activity of problem gamblers with people who gamble but do not have an addiction, to investigate why the addiction escalates in some but not others.