There are those who managed to quit and there are those who can’t just leave it alone. The US President Obama is rumoured to still succumb to the nicotine urge every now and then. However, there are some success stories among celebrities. Let us take a look at what inspired them to quit and stay away from cigarettes, as least for the time being.

Gwyneth Paltrow

In an interview with Elle magazine last year, the actress Gwyneth Paltrow revealed her love for smoking, even though she hasn’t smoked in ages.

“Man, I wish smoking didn’t kill you, I’d be smoking right now. I miss it. The last cigarette I smoked was the day I found out I was pregnant with Apple. I had to sit down and smoke one final cigarette. It’s such a beautiful thing. I’m so pissed off it gives you cancer.”

Apple is Paltrow’s eldest child, a daughter who will soon turn 6. She has a younger son Moses who is almost 4.

So why did she give up something she really enjoyed?

“But then, once you have children, if you’ve witnessed a death like I did with my father, you just can’t. I’d never want to put them through what I went through. So I don’t do it. But I’ve decided that when I’m about 70 I’m going to start smoking again. Why not? I can’t wait!”

Kate Hudson

The actress Kate Hudson reported gave up smoking late last year. Her reason – the smell.

“It was starting to drive me crazy! I didn’t like the way the car smelt, or my hair and clothes.”

In addition, there is a family side to her decision.

“It takes you away from the family and the things you’re doing. You don’t realize it at the time. Then when you’re done, you go, ‘Wow, I do so much more in a day – including eat.’”

Hudson has a 6-year old son Ryder, with ex-husband Chris Robinson.

The smell, by the way, is due to third-hand smoke that persists and causes damage for a long time.

Robbie Williams

British pop star Robbie Williams is said to be cutting down on cigarettes as an investment for the future generation. 36-year old Williams is engaged to actress Ayda Field who wants to start a family soon. However, there is mounting evidence that smoking can have some detrimental effects on sperm quality, which lower the chances of pregnancy and increases the chances of health problems for the child. Field has reported forbidden Williams to smoke inside their home. Williams is supposedly down from 60 to 10 sticks a day and is doing his best to kick the habit soon. This, from a star who was known in the past for his excessive consuming of, in addition to cigarettes, alcohol and drugs.

While most countries in the developed world are smoke-free, Switzerland, the country that is super-clean, super-efficient and super-healthy is still struggling with its anti-smoking legislations. The last time we went to a restaurant, we asked upon reservation by phone if they have a ”non-smoking section” and the answer was “yes.” When we got there, we go a table for 6 at one end of the room, the so-called non-smoking half. The other half was reserved for the smokers. There was no physical barrier whatever between the two halves. We all ended up “smoked” anyway, including my 2 little kids.

So you may ask, what’s the big deal? As long as nobody’s blowing cigarette smoke right in front of your face, it’s OK, right?

No, it’s not.

First of all, second-hand smoke spreads fast in an enclosed room. You can catch it even if you are meters away. Then there’s third hand smoke - residual tobacco smoke contamination that remains after the cigarette is extinguished”.

Have you ever wondered why the smell of cigarette smoking lingers long, long after (days!) the smoker has left the premises? Well, it’s the residues which remain on the furniture, the curtains, the carpet, the upholstery. It even remains on your clothes and your hair – and even on your skin. Third hand smoke sticks and stays. And it is deadly.

It is not nicotine that presents the most threat in third hand smoke. At least 69 carcinogens have been identified in cigarette smoke. Some of these are the so-called nitrosamines or TSNAs. TSNAs are not present in freshly produced cigarette smoke. However, the smoke residue reacts with nitrous acid, a common indoor air pollutant, to produce the deadly TSNAs.

According to researchers from the Lawrence Berkeley National Laboratory (Berkeley Lab).

“The burning of tobacco releases nicotine in the form of a vapor that adsorbs strongly onto indoor surfaces, such as walls, floors, carpeting, drapes and furniture. Nicotine can persist on those materials for days, weeks and even months. Our study shows that when this residual nicotine reacts with ambient nitrous acid it forms carcinogenic tobacco-specific nitrosamines or TSNAs. TSNAs are among the most broadly acting and potent carcinogens present in unburned tobacco and tobacco smoke.”

Nitrous acid is emitted by unvented gas appliances and vehicle engines. The researchers tested for TSNA before and after exposure to cigarette smoke. In one tests, they detected TSNA concentrations which were 10 times higher after exposure. In another test, they detected substantial amounts of TSNAs in a truck of a heavy smoker driver. There are several types of TSNAs. During the test, the researchers found three TSNAs, the NNA, the NNN, and the NNK, which are all potent carcinogens.

“Breathing air in a room today where people smoked yesterday can harm the health of infants and children.”

According to lead author Mohamad Sleiman

“Time-course measurements revealed fast TSNA formation, up to 0.4 percent conversion of nicotine within the first hour… Given the rapid sorption and persistence of high levels of nicotine on indoor surfaces, including clothing and human skin, our findings indicate that third-hand smoke represents an unappreciated health hazard through dermal exposure, dust inhalation and ingestion.”

What about smoking outdoors? Most restaurants here in Switzerland simply declare the terrace or the patio as their smoking lounge. Does not help? Well, the researchers say it does, but not much. The residues will still stick to your clothes and your body anyway and you will carry them with you when you go inside.

What about ventilators and windows? They also help only minimally. The residues will still stick and stay, no matter what.

What about e-cigs? The researchers believe that they too are not completely harmless. They also produce residues that can be hazardous.

Those of you smokers who have kids, can you imagine the danger you are putting your children in, each time you hold them in your arms? The carcinogens are in your clothes, on your very skin! According to one of the authors:

“Those residues follow a smoker back inside and get spread everywhere. The biggest risk is to young children. Dermal uptake of the nicotine through a child’s skin is likely to occur when the smoker returns and if nitrous acid is in the air, which it usually is, then TSNAs will be formed.”

A 2009 study revealed that people are not really convinced that third-hand smoke is dangerous. In a survey about the statement:

“Breathing air in a room today where people smoked yesterday can harm the health of infants and children.”

…only 65% of non-smokers and 43% of smokers agree.

While Americans are debating whether to lower the minimum legal drinking age from 21 to 18, teenagers in Europe are falling into coma or are dying from overintoxication. Many countries in Europe have a minimum legal drinking age of 18. In England, a country where adulthood (e.g legal age) is at 16, there is no such thing as minimum age for drinking. According to English law, parents are allowed to give their children alcohol at home – starting – brace yourself – at age 5!

Recently however, UK’s Children Secretary Ed Ball issued a warning about the dangers of under-age drinking (source: BBC). This is in response to a survey carried out by Mumsnet which revealed that many parents in Britain do not consider alcohol consumption a serious risk to the underaged, e.g. those between the age of 9 and 16 years. Most parents are more worried about illegal drugs, vehicular accidents and teenage pregnancy. In fact, only about twenty-five (25%) of parents surveyed took the time to talk to their kids are the dangers of alcohol. About two-thirds (approximately 66%) of the parents did not consider the fact that their children get access to alcohol before they reach 16 a problem. In fact, a previous survey showed that 20% of 13-year-olds already consume alcohol at least once a week.

The Children Secretary, however, emphasized that alcohol is closely linked to risky behavior and the very issues that most parents are most concerned about in the first place, namely teenage pregnancy and traffic accidents.

According to Mr. Ball

“Research tells us that young people who regularly drink alcohol are more likely to fall behind in school, be involved in road traffic accidents or have unsafe sex…If parents discuss the link between alcohol and these other issues, they can make sure it’s their child making the decisions, not the alcohol.”

Secretary Ball is not the one campaigning against laxness about alcohol. England’s chief medical officer Sir Liam Donaldson said in a BBC interview that “children aged under 15 should never be given alcohol, even in small quantities.” In fact, a new official guidance was issued recently that says adolescents under 15 should not consume alcohol and those under 18 should only drink under the supervision of an adult. Donaldson continues:

“Across England, 500,000 children between the ages of 11 to 15 years will have been drunk in the past four weeks….
The science is clear – drinking, particularly at a young age, a lack of parental supervision, exposing children to drink-fuelled events and failing to engage with them as they grow up are the root causes from which our country’s serious alcohol problem has developed…
The more [children] get a taste for it, the more likely they are to be heavy drinking adults or binge drinkers later in childhood.”

Alcohol consumption is prevalent among teenagers. Yes, in teenagers, even if we as parents wouldn’t want to believe it. This is despite the fact the high minimum legal drinking age in the US. In Germany, coma and death due to alcohol intoxication has been reported in adolescents as young as 13. In Switzerland, a recent survey revealed that teenage girls may actually consume more alcohol than their male peers. In other words, except in Islam countries where alcohol is forbidden, teenage alcohol consumption is becoming a major health and social concern.

Previous studies (source: Medscape) on teen alcohol abuse reveal the following figures in survey of 8^th and 12^th graders:

• 16% of 8^th graders and 44% of 12th graders have had at least 1drink in the last 30 days.
• 30% of 12th graders engage in binge drinking.
• 3% of 12th graders consume alcohol every day.

Alcohol abuse in adolescents is not just about hormones and growing pains. The problems does not just stop with the abuse. Most often, alcohol consumption during adolescence is associated with more serious problems, including:

• psychosocial problems
• increased rates of mental health disorders
• neurocognitive deficits
• reduced motivation
• higher likelihood of subsequent adult alcohol abuse

There are interventions which try to curb adolescent alcoholism. These interventions can be categorized into two formats:

• Individual treatment, e.g. treatment provided directly to the teenager
• Family-based treatment, e.g. treatment provided to and through the family.

Researchers analyzed data from research studies to see how effective these interventions are. The results revealed the following:

• Cognitive behavioral therapy integrated with a 12-step was most successful in reducing alcohol consumption.
• Other effective interventions are brief motivational interviewing, active aftercare, multidimensional family therapy, and brief intervention with both adolescent and parent.
• Family-based therapies that included cognitive behavioral therapy, behavioral treatment, triple-modality social learning, multidimensional family therapy, and brief interventions had a moderate effect on alcohol consumption reduction.
• Individual therapies seems to be more effective compared to family-based  interventions in reducing alcohol consumption.
• The rate of dropping out from intervention programs is high.
• Effects of interventions wane with time, becoming less effective 6 months.

According to Dr. Stephen J. Tripodiassistant professor in the College of Social Work at Florida State University in Tallahassee.

“One of our aims as scholars is to bridge the divide between research and practice. There is a lot of valuable information here for clinicians who work in alcohol treatment centers for adolescents and for clinicians who have adolescent clients with alcohol problems. While we clearly understand the inherent flaws in the concept of evidence-based interventions, we support the steps included in the process of evidence-based practice.”

The results of the study suggest that interventions focused on the individual is more effective than family-based intervention 9in the management of alcoholism in teenagers.

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Alcoholic drinks weren’t created equal. They come in different sizes, strengths, tastes, and yes – colors. You’d think that the last one is the least important when it comes to the after effects. But actually color does matter, according to researchers at Brown University.

The study looked at 95 young adults aged 21 to 33 who were healthy and were partial to alcoholic drinks. The participant were given caffeine-free cola mixed with bourbon, vodka or tonic water to drink until the alcohol drinkers reached the level of being “legally drunk”, i.e. their breath alcohol concentrations were on average 0.11. The intoxicated participants were then allowed to sleep it off. During sleep, the participants were hooked up to sleep monitors which also recorded brain activity. The following day, the participants were awakened and were asked to report on the severity of their hangovers without the aid of coffee or aspirin. Here are some of the findings:

• Dark drinks such as bourbon resulted in more severe hangovers compared to those reported by the vodka drinkers. Hangover symptoms reported include headache, nausea, loss of appetite and thirst.
• The alcohol drinkers’ sleep quality was greatly diminished regardless of the color of the drink.
• The alcohol drinker’s capacity to perform safety-sensitive tasks was also diminished, even up to the following morning. The type of alcohol has not type in their performance.
• Expectedly, those who imbibed tonic water fare better in terms of sleep and task performance the next day. It was also no surprise that they didn’t report any hangover symptoms.

According to Brown researcher Damaris Rohsenow

“People did feel sicker the morning after bourbon than after vodka, but they still feel plenty sick after drinking all that vodka.”

The differences in the severity of hangovers may be due to natural chemicals generated during the distillation process. According to Rohsenow, bourbon contains 37 times more toxic compounds than vodka does, including nasty organic molecules such as acetone, acetaldehyde, tannins and furfural. Thus, the clearer the liquor, the less of these substances it contains, and the less severe are the hangover symptoms.

However, the lack of hangover symptoms does not mean the drinker is fit enough to perform certain tasks. All alcoholic drinks are created equal when it comes to postdrinking impairment.

Partying, feasting, drinking. That was what most of us did on New Year’s Eve. Then we crashed into bed in the wee hours of the morning and slept through most of New Year’s Day. So how did you feel the morning after? Some of us may have suffered from mild to severe hang over. Some of us may just feel fine and dandy. But the question is, are really fit enough to get on with our daily routine?

Well, researchers at Brown University have this question in mind when they conducted their study. The study participants consisted of 95 healthy people aged 21 to 33 who were nevertheless heavy drinkers. The participants got legally drunk for a night (legally drunk = 0.080 percent Blood Alcohol Concentration all states in America) and then had 8 hours of sleep. The following morning, the sober participants were tested on how well they cna make quick decisions and pay attention.

The study results showed that even after hours of rest, with blood alcohol level at zero, the participants still exhibited some degree of postdrinking impairment. This impairment can affect the ability to drive a vehicle, operate complex machinery, or make critical decisions.

According to researcher Damaris Rohsenow, professor of Community Health at Brown University:

“Don’t consider driving the morning after the night before. If a person is going to get drunk, they should be doing it on a night when they are not going to be needing to drive the next morning.”

There are misconceptions about the duration of the effects of alcohol.  Many people think that alcohol can easily be “slept off”. Others believe a strong cup of coffee would easily do the trick. However, alcohol’s effects persist long after the last drink has been downed. Alcohol in the stomach and intestine will continue to enter the blood stream. Once in the blood, the alcohol circulates throughout the body and into the brain.  Alcohol easily penetrates the so-called blood-brain barrier and once in the brain, it stays there for a while and cause impairment.

What about the effect of caffeine?

Does coffee really sober you up?

According to the National Institute on Alcohol Abuse and Alcoholism

“Caffeine may help with drowsiness, but it doesn’t counteract the effect of alcohol on decision-making or coordination. The body needs time to metabolize (break down) alcohol and even more time to return to normal. There are no quick cures—only time will help.”

Caffeine is not only found in coffee. It is found in most cola drinks, and in high quantities in the so-called energy drinks. Thus, when kids and adolescents drink these seemingly harmless beverages, they are actually imbibing significant amounts of caffeine. And it seems that caffeine has some addictive effects on kids.

A caffeine habit is legal and socially acceptable. However, there is no age limit to caffeine addiction. Whereas many adults would openly declare being addicted to caffeine, they’d be horrified to hear that children, too, can be caffeine addicts. And its effects may be xxx in children than in adults.

Researchers at the University at Buffalo searched for answers to the following questions:

How strong is caffeine’s appeal in young people who consume an abundance of soft drinks?

What impact does acute and chronic caffeine consumption have on their blood pressure, heart rate and hand tremor?

Does consuming caffeinated drinks during adolescence contribute to later use of legal or illicit drugs?

Here are some preliminary results:

• A lot of children as young as 8 years old are consuming high amounts of caffeine.
• When comparing between those who usually consumed a lot of soft drinks, and those who consumed less, the results showed a significant difference between boys and girls but not between high and low consumers. The male study participants worked harder and longer on a computer-based exercise to obtain caffeinated drinks compared to the females.
• Study participants do not “taste” caffeine in the drinks

According the researcher Dr. Jennifer Temple neurobiologist, assistant professor of exercise and nutrition sciences at the University at Buffalo:

“We had a lot of kids who were drinking not only soda, but coffee. I had 12-year-old girls who said that all they had that morning was a cup of coffee. I started thinking — ‘This can’t be good.”

The study is basically focusing on a behavior called “food reinforcement.” The results showed a difference in reinforcing potential of caffeine between males and females regardless of habitual caffeine consumption. Temple speculates that

“…these sex differences could be based on the effect of circulating hormones at the time of the test, although this was not measured, and the possibility that females are less sensitive to the effects of caffeine.”

The answers to the physiological question on the effects of caffeine heart rate and blood pressure are still being written. The third and perhaps the most important question, i.e. the caffeine-illegal drug addiction link, still remains to be answered in the ongoing study.

Many people do not start taking prescription drugs in order to get high. There are many valid reasons to take them: to ease pain, to help fall asleep, or to ease depressive symptoms. Unfortunately, long-term use of these drugs presents a very serious risk – addiction.

As an example in this USA Today report, a woman who took the painkiller drug Percocet for rheumatoid arthritis for 10 years developed dependence for the drug. What started as a normal daily dose progressed to six or seven pills a day.  The pills not only eased her chronic pain, it gives her an energy boost that brings a feeling of high.

There are those, however, who abuse prescription drugs with the aim to get high and these are mostly teenagers and young adults.

Thus, here comes a hidden but serious epidemic in many developed countries: prescription drug abuse.

According to figures from the US Department of Health and Services:

• In 2000, 43 percent of those who ended up in hospital emergency rooms from drug overdoses-nearly a half million people-were there because of misusing prescription drugs.
• In seven cities in 2000 (Atlanta, Chicago, Los Angeles, Miami, New York, Seattle, and Washington, DC) 626 people died from overdose of painkillers and tranquilizers. By 2001, such deaths had increased in Miami and Chicago by 20 percent.
• From 1998 to 2000, the number of people entering an emergency room because of misusing hydrocodone (Vicodin) rose 48 percent, oxycodone (OxyContin) 108 percent, and methadone 63 percent. The rates are intensifying: from mid-2000 to mid-2001, oxycodone went up in emergency room visits 44 percent.
• Over the past decade-and-a-half, the number of teen and young adult (ages 12 to 25) new abusers of prescription painkillers such as oxycodone (OxyContin) or hydrocodone (Vicodin) has grown five-fold (from 400,000 in the mid-eighties to 2 million in 2000).
• New misusers of tranquilizers such as diazepam (Valium) or alprazolam (Xanax, called “zanies” by youth)-medicine normally used to treat anxiety or tension-went up nearly 50 percent in one year (700,000 in 1999 to 1 million in 2000).
• More than 17 percent of adults over 60, wittingly or not, abuse prescription drugs.
• In 2000, more than 19 million prescriptions for ADHD drugs were filled, a 72 percent increase since 1995. An estimated 3 to 5 percent of school-age children have ADHD. A study of students in Wisconsin and Minnesota showed 34 percent of ADHD youth age 11 to 18 report being approached to sell or trade their medicines, such as Ritalin.
• Among 12- to 17-year-olds, girls are more likely than boys to use psychotherapeutic drugs nonmedically.

As previously posted here, prescription drug abuse is on the rise and ranks second only to marijuana abuse. The most commonly abused prescription drugs are painkillers, particularly those that contain opioid compounds. Examples are morphine and codeine, the latter also found in cough syrups.

Unfortunately, with addiction comes an even bigger risk – overdose. Thousands of people in the US die of prescription drug overdose each year. Fatal overdose rates on painkillers have supposedly surpassed those on heroin and cocaine in recent years.

So why is prescription drug addiction on the rise?

• They are easy to obtain. The medicine cabinet at home is still the main source of prescription drugs. Many teens are abusing drugs available at home.
• People do not get addicted on purpose. They start taking the drugs for a valid reason and end up as junkies. The popular medical soap “Dr. House” illustrates how people, even medical doctors, who take painkillers regular get hooked without meaning to do so.
• People believe prescription drugs are not illegal and therefore less of an evil than illegal drugs such as cocaine or heroin. Doctors are sometimes unknowing facilitators when patients go from doctor to doctor for new prescriptions.
• Some people are genetically predisposed to addiction, even to drugs that are normally that considered addictive.
• The rise of Internet sites which sell prescription drugs illegally has increased remarkably in recent years, making access to these drugs easier.
• People who are not addicts may try to sell their prescription drugs to third parties for cash.

How can prescription drug abused be prevented?

• Start prevention at your own home. The advocacy group Five Moms are campaign for parents to secure their medicine cabinets.
• Electronic medical records can alert doctors to unusual patient behavior such as frequent visits to different doctors and unusually frequent requests for prescriptions. According to USA Today, 39 American states have electronic records which track potentially addictive prescription drugs but the database is only available within each state and can easily be circumvented by crossing the stateline.
• Health authorities recommend that doctors perform unannounced inventories of patient’s drug supply or conduct random urine tests.

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Nicotine addiction is one of the most difficult habits to break. That is why researchers are always busy finding ways and means to help people stop smoking. Over the years, many smoking cessation therapies have been developed, including anti-smoking patches, nicotine gums, and nicotine lozenges.

A recent study reports that a combination of two of these therapies may be the best way to break the smoking habit. The study looked at 1504 adults who smoked about 10 or more cigarettes a day during the past 6 months. The study participants were randomly assigned to one of the 6 different smoking cessation therapies:

• bupropion SR (sustained release; Zyban, GlaxoSmithKline), 150 mg twice daily for 1 week before a target quit date and 8 weeks after the quit date;
• nicotine lozenge 2 or 4 mg for 12 weeks after the quit date;
• nicotine patch, 24-hour, 21, 14, and 7 mg titrated down during 8 weeks after quitting
• nicotine patch plus nicotine lozenge;
• bupropion SR plus nicotine lozenge;
• placebo (1 matched to each of the 5 treatments).

All the treatments used in the study except bupropion are available over-the-counter.

In addition, all participants underwent counselling, consisting of 6 individual sessions lasting 10 to 20 minutes. The first 2 sessions were scheduled before cessation.

The results showed that among the 6 treatments, the combination of patch and lozenge was the most effective in helping patients quit smoking, with a 40% quit rate in 6 months. So why is this combi therapy more effective than others? The authors believe it has something to do with the additive effect of the two interventions.

According to researcher Dr. Megan E. Piper, assistant professor, at the Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison

“When you put a patch on, it’s steadily putting nicotine into your blood, and so it’s generally taking the edge off some of your withdrawal all the time,” said Dr. Piper. “But some people have times when they always have a cigarette — after a meal or when stressed at work, for example. These people can use the lozenge instead of going for a cigarette in those moments of intense craving.”

But what about counselling? It helps a lot, too, and plays an important role not only in cessation but in preventing relapse.

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What do retired professional athletes and sportspersons do in their “old age”? They take it easy, they enjoy life, they coach, or they write a book and tell all.

This is what Andrei Agassi just did in his autobiography entitled “Open.” I have never read it and I doubt if I ever will as I am not a big fan of tennis. However, what makes Agassi’s book so controversial is because the title has a double meaning. It is not only about his game or his personal life. It is about his honesty and his admitting to taking the recreational drug crystal meth during his professional years.

About crystal meth

Crystal meth (source: chemistry.about.com) is officially called methamphetamine or metamfetamin. It is usually used in crystalline form, thus the name. So what does crystal meth do? It has some positive and negative effects. On the upside, it can

• change moods and cause elation
• enhance energy and performance
• lead to weight loss
• increase sexual drive

The downsides are

• addiction
• loss of appetite
• sleeping problems
• mood swings, even psychosis
• potential for overdose

Crystal meth is not the only recreational drug used by athletes. The most common performance-enhancing drugs used by professional athletes are:

• Anabolic steroids
• Androstenedione  
• Creatine
•  Stimulants
• Diuretics

Why take drugs?

Agassi is not the first professional athlete to use forbidden drugs nor will he be the last. He joins the likes of star sprinter Marion Jones, cyclist Jan Ulrich and fellow tennis pro Martina Hingis. But the big difference is that the aforementioned athletes got caught; Agassi didn’t. According to his autobiography, he tested positive for drugs but lied before the governing body of ATP and got away with it.

So why do athletes take drugs?

Agassi wrote that he started taking the drug when his career was in crisis. Clearly, drugs can enhance performance. According to this Australian report, here are some of the reasons why athletes take performance-enhancing drugs:

• winning can attract lucrative sponsorship deals and endorsements;
• society places great emphasis on success in sport, which puts more pressure on an athlete to win;
• some banned drugs can speed recovery from injury, which means athletes can be back training and competing more quickly;
• some athletes believe their competitors are using drugs and that to be competitive, they need to take drugs as well;
• some athletes’ desire to win is so great that they are willing to use any means, including cheating, to gain success; and
• some coaches may push drug use to enhance their athletes’ chances of winning, which boosts their profile as a successful coach.

Coming up next: the health effects of performance-enhancing drugs.

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