PORTLAND, Ore. - Thursday is the American Cancer Society's 35th annual Great American Smokeout. It's "Decision Day" for the roughly 16 percent of Oregonians who smoke cigarettes, and experts say you can add up to eight years to your life by quitting. But 35 years ago, they probably didn't anticipate trends like hookah bars. In Oregon, the highest percentage of tobacco use, above 20 percent, is among people ages 18 to 24, and water pipes packed with flavored tobacco are the latest rage.
State epidemiologist Dr. Katrina Hedberg says it appears to be tobacco companies' latest attempt to get young people to try their products, with flavors from mint to margarita.
"It goes by the name 'shisha,' and it has usually very strong flavorings; it's very sticky, gooey type of tobacco that smells very strongly of whatever flavor has been added to it. But it's still tobacco."
Part of the hookah's popularity is its communal set-up: the pipes have tubes that allow more than one person to smoke at once. And although Oregon has a smoke-free law for public places, there are two exemptions, for cigar bars and retail "smoke shops." Dr. Hedberg says the second category has become problematic, as the bar owners say they are "retailing" tobacco.
"Hookah lounges are trying to get certified under this exemption. But we don't believe that the Legislature intended that kids and young adults be smoking there, on-site, as much as they are."
Every year, 5,000 Oregonians die from tobacco use, and after 15 years of decreasing numbers of smokers in Oregon, Dr. Hedberg says the hookah trend makes state officials a little nervous.
Of the 36 million Americans who still smoke daily, most would rather not, according to American Cancer Society spokesperson Allison Miller. She says studies show about 70 percent of smokers say they want to quit, and for the most part, smoke-free work place laws are helpful.
"Second-hand smoke has 4,000 chemicals, 60 of which are known to cause cancer, and just getting that out of all of our work places is a tremendous step forward in the fight against cancer."
The American Cancer Society says one-third of cancer deaths could be prevented if people avoided tobacco products. But others see smoking as a personal choice, and a source of revenue for the state.
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Toughing it out during spring allergy season is not in your best interest if you want to avoid asthma later in life.
New Mexico has plenty of grass and weed pollens carried by the wind which contribute to itchy, watery eyes, a stuffy nose and sneezing fits this time of year.
Dr. Osman Dokmeci, associate professor of internal medicine at the University of New Mexico, suggested for those who suffer acutely, seek an allergy test and possibly medication to prevent asthma from taking hold.
"One out of 10 has asthma in America," Dokmeci pointed out. "Having seasonal allergies increases your chance of developing asthma at least fivefold."
He recommended treating allergies early and as aggressively as possible. May is "Asthma Awareness Month," which aims to bring attention to the health issue and highlight improvements in care and quality of life. Nationwide, asthma affects more than 25 million Americans, including 4 million children, and disproportionately affects certain racial and ethnic groups.
Allergies do not "cause" asthma but people who have allergies, or have family members who have allergies, are more likely to get asthma than those who do not. Research shows allergy season is starting earlier and lasting longer. A 2022 study from the University of Michigan found pollen count could increase by 200% by the end of the century due to climate change, which is why Dokmeci stressed it is important not to ignore the problem.
"There's no treatment that actually makes your asthma not happen," Dokmeci explained. "But once you develop asthma, there are good treatment options."
The estimated economic impact of asthma is more than $80 billion per year from direct and indirect costs, such as missed school and workdays.
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Recent research shows approximately half of people who die by suicide had contact with a health care professional within the month prior to their death.
However, a recent study shows only 8% of hospitals are currently implementing all four recommended suicide prevention practices: safety planning, warm handoffs to outpatient care, patient follow-up and lethal means counseling.
Melissa Tolstyka, director of Behavioral Health Services for Trinity Health Ann Arbor, said a seamless transition from inpatient to outpatient care is critical. At Ann Arbor, she saw a 46% increase in compliance with comprehensive suicide risk assessments and patients discharged on the suicide care pathway now receive a safety plan, which she sees as progress.
"We continue to see a need for really robust programming," Tolstyka explained. "Not just within the behavioral health world, but in the medical world as well. Our organization really wanted to focus on bringing the behavioral health and the medical services together to enhance our safer suicide care practices for our patients."
The initiative is being piloted across various units at Trinity Hospitals in Ann Arbor and Grand Rapids including the emergency department, psychiatric medical and inpatient nursing units. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.
Casie Sultana, clinical nurse leader for Trinity Health Grand Rapids, prioritizes patient well-being, emphasizing support and improvement over solely managing risks within the facility.
"We want to be someplace that people feel welcome to come to who are dealing with suicide," Sultana emphasized. "You feel so alone. It's a very lonely journey and we want people to come seek help and feel welcomed when they do that."
Susan Burchardt, clinical services manager at Trinity Grand Rapids, advised other hospitals considering a similar program to learn from organizations already using it.
Support for this reporting was provided by The Pew Charitable Trusts.
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Access to reduced-price medication is a necessity for many rural Missourians with low income.
Rep. Cindy O'Laughlin, R-Shelbina, the Senate Floor Leader, said Big Pharma is trying to confuse legislators with unrelated hot-button topics such as abortion access and illegal immigration in a last-ditch effort to stop the state from joining a program to force drugmakers to sell medicines at a discount.
"Appealing to nuclear topics, which really do not apply in this situation, is a disingenuous way to try to defeat a bill that is actually good for Missouri," O'Laughlin asserted.
O'Laughlin pointed out the program is transparent, and uses the tax money saved to help low-income families deal with chronic conditions such as diabetes.
The drugmakers object to the government forcing them to give significant discounts, arguing hospitals' and for-profit pharmacies' bottom lines, particularly those owned by pharmacy benefits managers, are being exploited. Nationally, 46% of contract pharmacy agreements involve pharmacies linked to the three largest benefits managers.
Rep. Tara Peters, R-Rolla, introduced the 340B contract pharmacy access billand said the lobbying is absurd.
"Federally, 340B program does not allow for abortion drugs," Peters stressed. "Why would any legislation that we're trying to pass in the state allow for that? I mean, the thought of that even being in existence is absolutely ludicrous."
The Missouri Senate passed the bill 27-3 on Monday and it now goes to the House.
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