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Latest Posts

The Best Thing A Patient Can Do Following A Heart Attack

I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good.  And the Italians are out to prove me right.  The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.

In a study of just under 1,300 patients,  Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients.   Researchers also found that resuming smoking increased  death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications.  And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.

That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important.  And that’s why I give many of my smoking patients my smoking lecture.  You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? Read more »

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

Smokeless Tobacco And The U.S. Launch Of Snus

This week the respected CBS documentary news show “60 Minutes” included a feature on smokeless tobacco, focusing on the recent launch of snus in the United States. The show was relatively balanced in focusing on the main potential risks and benefits of snus.

It started by featuring a young man who enjoys using snus in places where he cannot smoke, while continuing with a pack-a-day smoking addiction. The interviewer gave him the bad news: “You are a dual user.”

It then had a segment with the widely respected Swedish nicotine addiction expert, Dr Karl Fagerstrom, who stated that snus is 90-99% less harmful than smoking (while admitting some risks, including of pancreatic cancer). Read more »

This post, Smokeless Tobacco And The U.S. Launch Of Snus, was originally published on by Jonathan Foulds, Ph.D..

Dr. Val And Jim Belushi Raise Awareness Of COPD

valjimbelushiIt’s not every day that a physician is invited to be screened for chronic obstructive pulmonary disease (COPD) by a comedian. But this event was no joke – actor Jim Belushi is in a contest with Danica Patrick, Bruce Jenner, Patty Loveless, and Michael Strahan to see who can get the most Americans screened for COPD. It’s a tough race for a good cause – though I’m not sure if Jim stands much of a chance in a competition against Danica Patrick. Maybe my blog readers will vote for Jim and give him the bump needed to keep him in the running? Please take the screening test here, or forward it to friends who may be at risk (age over 35, history of smoking).

Like any good blogger, I had my trusty digital recorder with me and got in a few questions with Jim. Special thanks to South African blogger Delre Roberts, who gave me the idea for my leading joke to Jim via Facebook: “How’s a comedian going to screen a doctor for COPD?  See how short of breath she gets from his jokes?” Good one, Delre! You got a laugh out of Jim… Check it out:

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Once You Have Lung Cancer, Should You Bother To Quit Smoking?

Most smokers dread lung cancer. They are aware that by continuing to smoke the chances of developing lung cancer are increased 20 times, and that once it has developed the treatment is unpleasant and prognosis poor. Many patients (and unfortunately many clinicians) assume that once you have lung cancer it is too late to quit.

This week a new report was published in the BMJ, based on a review of the evidence that smoking cessation after diagnosis of a primary lung tumour affects prognosis. The study, by Drs Parsons, Daley and Aveyard at the UK Centre for Tobacco Control Studies, combined the data from 10 studies. They found that those who quit smoking after diagnosis were significantly less likely to develop another tumor and significantly more likely to still be alive 5 years later. Read more »

This post, Once You Have Lung Cancer, Should You Bother To Quit Smoking?, was originally published on by Jonathan Foulds, Ph.D..

Trying To Quit Smoking? Should You Cut Down Or Go Cold Turkey?

Most specialist smoking cessation services advise patients to select a quit date and quit smoking completely on that day (usually along with medication), but many smokers prefer the idea of cutting down gradually. What are the pros and cons?

I theory, cutting down gradually might provide a “softer landing” in that it might spread out the nicotine withdrawal over a longer period, rather than giving the nicotine receptors an abrupt shock of no nicotine. It also seems to fit with common sense that it might be easier to change the behavior gradually rather than all at once. Read more »

This post, Trying To Quit Smoking? Should You Cut Down Or Go Cold Turkey?, was originally published on by Jonathan Foulds, Ph.D..

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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