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Why You Should Quit Smoking Before Surgery

Physicians and surgeons all agree on the link between smoking and postoperative complications.  We don’t agree (or know) how much time is required between cessation of smoking and surgery for optimal risk reduction.

Dr.Thomas Fiala wrote a nice blog post, Smoking Cessation and surgical complications, recently  discussing the 3rd reference article below.

Smokers that quit smoking before surgery had 41% fewer complications. The researchers found that each week of cessation increases the effect by 19%.

Trials of at least 4 weeks’ smoking cessation had a significantly larger treatment effect than shorter trials (P = .04).

Smokers that quit had lower rates of total complications, fewer wound healing complications, and fewer pulmonary complications.

Read more »

*This blog post was originally published at Suture for a Living*

New Cigarette Labels From The FDA

The FDA will soon require new cigarette package labeling to deter smoking. So in politically-correct governmental fashion, they are asking which labels you’d like to see. (You can pick your favorites here.) My personal favorite (so far) is the one shown to the left, but its impact factor pales in comparison to this example found in England. (That, my friends, is cancer!)

Ironically, it appears the FDA isn’t too sure how forceful it should be in these warnings about the dangers of smoking. They offer a cornucopia of milquetoast labeling options, many of which contain cartoons. Might such unrealistic portrayals defy they hard-hitting message they want to project? Worse, at least one cartoon (seen here) even seems to promote cigarettes AND drug use together!

In an even more astonishing example, some images almost make me what to take up smoking so I can blow big bubbles. Since I could never do this well before, maybe I should take up smoking! Seriously, is an empowerment message what the government wants to portray?

Make these labels big, ugly, and real. Anything else is a waste of taxpayer’s money.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

How Much Pesticide Is In That Cigarette?

I had a fascinating discussion with an ex-tobacco farming expert. He’s an expert because he used to grow tobacco, but not anymore. If you’re a smoker, or user of any tobacco leaf product, what he said should shock you. I take that back — you’re a smoker: “shocked” is never going to happen to you.

What did he say that was so striking? I’m not a farmer, so it became a little difficult to understand all the science behind the conversation. Needless to say, he said they used to farm vegetables and tobacco side by side. He said something about potato farming being timed with tobacco crops, and when the potato market went south he got out of the tobacco farming business for good and went with just vegetables. Now he’s a full-time vegetable farmer.

While he was a tobacco farmer, how did he run his tobacco farm? Like I said, he grew vegetables and tobacco side-by-side. He used different pesticides for the vegetables than he did for the tobacco farming. He farmed based on the concept that people who ate vegetables were looking for a healthy food. So he used pesticides in their lowest recommended concentration and applied them at the longest recommended time frame between applications and used the safest formulations available. None of his chemicals carried the skull-and-crossbones warning. And what about the tobacco farming? Read more »

*This blog post was originally published at The Happy Hospitalist*

Screening For Lung Cancer: New Findings And Continued Controversy

Lung cancer screening has been an area of considerable controversy. Before today, there had been no evidence that screening patients for lung cancer, either with a CT scan or chest x-ray, saved lives.

For years, doctors have been waiting for the results of the large, randomized National Lung Screening Trial (NLST), conducted by the National Cancer Institute.

[Yesterday] it was announced that the trial was stopped early, with a bold, positive finding:

All participants had a history of at least 30 pack-years, and were either current or former smokers without signs, symptoms, or a history of lung cancer.

As of Oct. 20, 2010, the researchers saw a total of 354 deaths from lung cancer in the CT group, compared with 442 in the chest x-ray group.

That amounts to a 20.3% reduction in lung cancer mortality — a finding that the study’s independent data and safety monitoring board decided was statistically significant enough to halt the trial and declare a benefit.

Previously, only breast, colon, and cervical cancer has had the evidence back up its screening recommendations. It’s still early in the game, but it appears that lung cancer may be following in that same path. That said, there are a variety of concerns before opening up the floodgates to screening chest CTs. Read more »

*This blog post was originally published at*

Stop Smoking Treatment: Don’t Stop It Too Soon

Butt stopDoctors may want their patients to stick with a smoking cessation regimen even if it’s not initially working, report researchers who found that “delayed quitters” accounted for a third of former smokers who went a year without cigarettes.

Quit rates may be significantly increased by just continuing in motivated but initially unsuccessful patients during the first eight weeks of treatment, according to research published online in the journal Addiction. There’s actually two types of successful quitters: Those who quit immediately and those who are “delayed” but eventually successful. Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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