Poor Diet, Tobacco Use and Lack of Physical Activity Taking Toll on Nation's Health

While we're living longer, poor diet, tobacco use and inadequate physical activity are negatively impacting our health. These are some of the findings of research released this week by the U.S. Burden of Disease Collaborators, prompting much discussion and debate. To those of us on the front lines of promoting workplace health this comes as no surprise. This study should only add to the sense of urgency that we as a nation must have in solving this crisis. There is a direct link between the health of the U.S. workforce and the overall well being of the U.S. economy. Currently, greater than 50 percent of Americans live with one or more chronic disease. With this rising burden of chronic disease comes rising costs within the health care system, and increased premiums at a cost to employers. Compounding this, employees with chronic disease take more sick days and are less productive on the job. Workplace health is of significant importance to the economic productivity of the nation and critical to reducing the national debt. The U.S. is slipping behind its major Organization for Economic Co-operation and Development Countries (OECD) competitors regarding improvements in population health. Specifically, the U.S. falls in the bottom 20 percent of the 34 OECD countries for the following chronic diseases: ischemic heart diseases (rank: 27), lung cancer (28), COPD (32), diabetes (31), cardiopulmonary (31), chronic kidney disease (31), and hypertensive heart disease (27). Poorer health today could translate into lower productivity tomorrow. This is the first major analysis of the health status of the U.S. population in more than 15 years, led by a global collaborative of scientists from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. The study found that while Americans are showing progress in reducing death rates (adjusted for age, across a variety of diseases), we aren't living healthier. Additionally, death rates from illnesses associated with obesity, such as diabetes and kidney disease, as well as neurological conditions like Alzheimer's disease, are on the rise. Poor diet, tobacco use and physical inactivity are driving the disease burden. The negative impact on our health care system cannot be understated as people who live longer and unhealthier lives are costly -- not only in terms of health care spend, but the impact on the productivity of our workforce and the ability of U.S. businesses to compete in a global economy. A point made recently in the Bipartisan Policy Center's recent report. None of this is news to The Vitality Institute, a global health think tank focused on reducing chronic disease risk. In fact, we recently released new data indicating a dangerous gap in the chronological age of Americans and their risk adjusted Vitality Age, as calculated based on a variety of factors including those cited in this new report. So now that we so clearly understand the problem, what are we going to do about it? To that end, we've recently assembled The Vitality Institute Commission. We're bringing together prominent thinkers in health and business including: Dr. Rhonda Cornum, with deep expertise from the Department of Defense; Susan Dentzer, with Robert Wood Johnson Foundation; Ginny Ehrlich, with the Clinton Health Matters Initiative; Jeff Levi, with Trust for America's Health; Ellis Rubinstein, with the New York Academy of Sciences; Dr. Dennis Schmuland, with Microsoft; and Dr. Kevin Volpp, from the University of Pennsylvania. All with the urgent goal of placing the power of evidence-based prevention at the center of health care policies and actions in the U.S. Better evidence, smarter laws and higher levels of innovation we believe could make a difference. There is strength in numbers, and we are working with corporations, associations, federal, state, and local government to identify multi-stakeholder solutions that will address the issues facing our nation's health in bold and transformative ways. For the U.S. to maintain its economic competitiveness, our health policy efforts need to address the risk factors of preventable chronic diseases that disproportionately affect the U.S. population (e.g., physical inactivity, diet, and alcohol and tobacco consumption) by effectively investing resources to ensure that each individual has the opportunity to make beneficial contributions to society and therefore progress the economy. We will soon issue a call for wide participation to harness the myriad of great ideas and actions already making a difference at the community, city or state level to ultimately improve America's health.

WHO reveals how tobacco control measures are improving health worldwide

The World Health Organization’s (WHO) Report on the Global Tobacco Epidemic 2013 shows more people worldwide are benefiting from tobacco control measures. The report, released today, said that 2.3 billion people living in 92 countries (a third of the world’s population) are now covered by at least one measure protecting them against tobacco’s effects. This figure has more than doubled in the past five years. But tobacco use continues to be the leading global cause of preventable death, killing approximately six million people and causing more than half a trillion dollars of economic damage annually. In 2008, WHO identified six evidence-based tobacco control measures that are the most effective for reducing tobacco use. Known as “MPOWer”, the measures correspond to one or more of the demand reduction provisions included in the WHO’s Framework Convention on Tobacco Control: • Monitor tobacco use and prevention policies, • Protect people from tobacco smoke, • Offer help to quit tobacco use, • Warn people about the dangers of tobacco, • Enforce bans on tobacco advertising, promotion and sponsorship, and • Raise taxes on tobacco. • The report says three billion people now live in regions with national anti-tobacco campaigns and, as a result, hundreds of millions of people are less likely to start smoking. Professor of Health Policy at Curtin University Mike Daube said the report’s findings are positive, despite the harsh realities of tobacco’s impact worldwide. “We are making global progress in tobacco control – more countries banning tobacco advertising, implementing non-smoking provisions, mandating health warnings and running public education programs – but the grim reality is that around the world each year people are still smoking six trillion cigarettes, leading to six million deaths,” he said “The power of the tobacco industry remains immense. It continues to oppose and delay action in developed countries and to promote its products ruthlessly in developing countries,” he noted. “The catastrophic news is that more than 60 years after we learned unequivocally about the dangers of smoking, this remains our largest preventable cause of death and disease and action by most governments is slow, limited and resisted by the tobacco industry at every step.” Associate Professor Billie Bonevski, a research fellow for the Cancer Institute NSW and a research academic in the School of Medicine and Public Health at the University of Newcastle, referred to the report’s finding that low- and middle-income countries are a target for the tobacco industry and said more needs to be done to stem their power in these places. “Resources should be directed to these countries to ensure they are equipped with the workforce and legislative power to counter the tobacco industry’s efforts. Tobacco control efforts need to reach the whole of the population, especially people who find it difficult to stop smoking,” she said. “Even in developed countries, we’re seeing a concentration of smoking amongst socially disadvantaged and vulnerable sub-groups of the population. Bans on tobacco advertising and promotion alone are unlikely to help highly addicted smokers to quit. Evidence-based nicotine dependence treatments need to be easily accessible for these smokers.” Professor Daube said that while Australia was doing well, the battle is far from over. “It is encouraging that Australia is a world leader in tobacco control – but we cannot afford to be complacent: we must continue to show other countries that we can win our battles against Big Tobacco.”

Two new cigarettes win FDA clearance

Lorillard Inc., the largest U.S. maker of menthol cigarettes, has won the first two clearances to market new tobacco products among 500 requests, under authority given in 2009 to U.S. health regulators. The Food and Drug Administration cleared two of Lorillard’s Gold Box cigarettes for sale in the United States. The rulings benefiting the company from Greensboro, N.C., are the first handed down by the agency since lawmakers gave it the power to determine which current tobacco products can remain on the market and which new ones can be introduced. The FDA cleared the cigarettes through a “substantially equivalent” determination that makes a judgment as to whether products have the same characteristics as existing ones or raise new public health questions. The agency denied four other requests for the determination, it said last week in a statement. “It is important to emphasize that an SE decision does not mean that the agency considers a product to be safe,” wrote Mitch Zeller, head of the FDA’s Center for Tobacco Products, in a blog post on the agency’s website. “We are proud to be the first company in the industry to receive authorization to begin marketing these new products in the U.S. through the FDA’s substantial equivalence pathway,” Murray Kessler, Lorillard’s chairman and chief executive officer, wrote in an email. The agency “carried out its evaluation process in a deliberate manner reflecting sound science,” he said. The FDA couldn’t reveal which substantially equivalent requests they denied for legal reasons, Jennifer Haliski, an agency spokeswoman, said in an email. The new products cleared were Newport Non-Menthol Gold Box 100s and Newport Non-Menthol Gold Box, according to Zeller’s blog. “While today’s development is a positive step, there is still work to be done,” Bonnie Herzog, an analyst at Wells Fargo in New York, said Tuesday in a note to clients. The lack of FDA substantial equivalence rulings “has been an overhang,” she said. Congress granted the FDA authority over tobacco products in 2009 and the new regime has created a backlog of requests at the agency. As of earlier this month, there were 500 requests to approve products not currently sold and 3,500 for products already in stores, Zeller said in a June 6 interview. “Today’s decisions are just the first of many forthcoming product review actions to be issued,” Zeller said in the agency’s statement.

E-Cigarettes Still Have Health Hazards

It’s been seven years since electronic cigarettes (e-cigarettes) hit the U.S. market and the number of smokers using them has steadily increased. Today, one out of five smokers -- an estimated 9 million Americans -- smoke e-cigarettes either exclusively or in addition to the light-it-with-a-match variety. E-cigarettes have a similar look and feel to the real thing, minus the actual tobacco and smoke. It’s a mechanical version of a cigarette -- the tip even lights up to mimic burning ash -- with a battery that heats up a cartridge of liquid nicotine solution to create vapor you can inhale for a nicotine fix. Problem is, e-cigarettes aren’t actually a healthy alternative to smoking. Unlike other nicotine products like cigarettes, chewing tobacco and dip snuff, e-cigarettes don’t carry any health warnings, but that doesn’t mean they are less harmful (which 70 percent of smokers believe). Because the U.S. Food and Drug Administration (FDA) isn’t yet regulating the product, manufacturers don’t have to disclose what chemicals are used in the nicotine solutions or potential health risks. “Because there are so few well-designed studies on e-cigarettes, there are a lot of unknowns about their use and safety,” says Cheryl Healton, Ph.D., president and chief executive officer of Legacy, a nonprofit anti-tobacco organization in Washington, D.C. Before you decide to light up virtually, here’s a look at what we know about e-cigarettes: They may cause cancer. Just because you’re not ‘puffing’ on a real cigarette doesn’t mean you’re no longer at risk for cancer. A 2009 analysis discovered antifreeze and other carcinogens and toxic chemicals in e-cigarette nicotine solutions. And eliminating secondhand smoke may be a myth, too: A 2012 study on indoor air found that e-cigarette vapors release carcinogens and toxins like nicotine and formaldehyde into the air. They are not approved as smoking cessation tools. There’s no scientific evidence that e-cigarettes will help people stop smoking, which is why the FDA and the World Health Organization view them as tobacco alternatives, not smoking cessation tools. Boston psychiatrist Keith Ablow, M.D., disagrees. “I’ve seen two-pack-a-day smokers quit after a week or two with e-cigarettes,” says Ablow, who is currently studying how e-cigarettes help many smokers kick the habit. E-cigarette cartridges have varying nicotine levels so users can gradually reduce exposure and curb nicotine cravings, says Ablow. The actual device may satisfy a behavioral need to simulate the act of smoking. They may entice kids to smoke. E-cigarettes, which come in yummy, kid-friendly flavors like bubblegum and cola, aren’t subjected to age verification laws. Only five states -- California, Minnesota, New Hampshire, New Jersey and Utah -- prohibit selling them to minors. They may get former smokers addicted again. Former smokers beware; this is not a case of have your cake and eat it, too. E-cigarettes will get you hooked again – they still deliver highly-addictive nicotine, which is what made you a slave to smoking in the first place. Even so-called nicotine-free cartridges aren’t a safe alternative because studies have detected low levels of nicotine in them. “Picking up these devices is like playing with fire,” says Healton. “If you’ve managed to quit, stay quit.” And don’t rely on e-cigarettes to help you quit smoking. If you want to quit (or know someone who does) visit SmokeFree.gov for information about programs that are scientifically proven to work.