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Are Menthol Cigarettes Riskier Than Non-Menthol?

Study Shows Menthol Cigarettes Are No More Likely to Lead to Lung Cancer Than Regular Cigarettes

By Denise Mann
Reviewed by Laura J. Martin, MD

March 23, 2011 — People who smoke menthol cigarettes are no more likely — and may actually be less likely — to develop lung cancer than people who smoke non-menthol cigarettes, a study suggests.

The study, published online in the Journal of the National Cancer Institute, comes out nearly a week after an FDA advisory panel stated that removing menthol cigarettes from the market may improve public health because menthol cigarettes may be more difficult to quit than non-menthol cigarettes and may be more enticing to young smokers because of their minty taste.

Menthol cigarettes are also more popular with African-American smokers, who have a higher incidence of lung cancer.

Menthol Cigarettes and Lung Cancer

But “the new study information almost closes the door on the lung cancer issue,” says study researcher William J. Blot, PhD, of the Vanderbilt-Ingram Cancer Center in Nashville. “The main message is that cigarettes are harmful, regardless of whether they are menthol or non-menthol, and the best action is to quit smoking.”

“I don’t think there is enough scientific evidence to justify a ban of menthol cigarettes in comparison with non-menthol cigarettes,” Blot says.

In the study, researchers identified 440 people with lung cancer among 85,806 study participants from 12 Southern states. They compared the smoking status and cigarette preferences of lung cancer patients with those of 2,213 people without lung cancer.

They found that smoking menthol cigarettes was actually associated with a significantly lower rate of lung cancer and lung cancer deaths than smoking non-menthol cigarettes.

Among pack-a-day smokers, menthol smokers were 12 times more likely to develop lung cancer compared to never smokers; those who smoked non-menthol cigarettes were 21 times more likely to develop lung cancer than those who never smoked.

ose who smoked non-menthol cigarettes, and the quitting rate was similar between both menthol and non-menthol smokers. Previous studies have suggested that it may be harder to quit if you smoke menthol cigarettes.

Now Blot and colleagues plan to look at biochemical markers of tobacco smoke to see if there are any important differences between African-American and white smokers and menthol and non-menthol smokers. “Menthol is off the table, but the reason why African-American men have higher rates of lung cancer is still not clear,” he says.

All Cigarettes Pose Health Risks

All cigarettes are created equal when it comes to health risks, says Len Horovitz, MD, a pulmonary specialist at Lenox Hill Hospital in New York City. “Menthol cigarettes are as dangerous as non-menthol cigarettes and cigarettes are the No. 1 cause of heart disease, lung cancer, chronic obstructive pulmonary disease (COPD), and other diseases.”

Regardless of whether you smoke menthol or non-menthol, “set a date after which you will be an ex-smoker,” he says. There are many smoking-cessation tools available today, including nicotine-replacement systems such as patches and gum.

Amy V. Lukowski, PsyD, clinical director of the Health Initiatives Programs at National Jewish Health in Denver, says that the study should not be interpreted to mean that menthol cigarettes are any safer than non-menthol cigarettes.

“Lung cancer is only part of the picture and smoking is known to cause heart disease, stroke, COPD, and so many other diseases,” she says. “Tobacco kills and we really need to focus our efforts on cessation for smokers and stopping people from starting in the first place.”

Debate Over a Ban on Menthol Cigarettes

Lukowski is in favor of a ban on menthol cigarettes. “Almost half of young people use menthol cigarettes due to their minty taste so this is an important product to not have on the market,” she says.

The new findings dovetail nicely with the FDA panel’s recent recommendation, says David Abrams, PhD, the executive director of the Steven A. Schroeder National Institute for Tobacco Research and Policy Studies at Legacy, a public health group that aims to stamp out tobacco smoking.

The FDA panel stated that it was not clear that menthol cigarettes caused any additional risks at the individual level to the individual smoker, he says.

Although the new study did not show that there was any difference in quitting success rates among menthol vs. non-menthol smokers, “other research suggests very strongly that menthol smokers want to quit more and have more difficulty with quitting and succeeding,” he says.

“More kids start with menthol cigarettes, and adults have more trouble quitting when they smoke menthol,” Abrams. “This evidence is consistent and strong enough to warrant a ban on menthol.”

Gilbert Ross, MD, medical director for the American Council on Science and Health, a New York City-based consumer education group, sees the issue differently. “Menthol smokers have no increased risk of lung cancer or any other cigarette-related disease as compared to non-menthol smokers,” he says.

“It is well-known that menthol smokers smoke fewer cigarettes per day than regular cigarette smokers [and this is] but one reason why it is highly unlikely that banning menthol cigarettes will lead to a decrease in cigarette smokers,” Ross says. “In fact, I believe such a ban may actually increase the number of cigarettes smoked because few menthol smokers will actually quit, [instead] fleeing to illicit menthols and/or regulars,” he says. “More minors will find illicit cigarettes that are easily available from sellers who neither check ID's nor pay taxes.”

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Kita selalu mendengar orang mengeluh dan mengaduh kerana sakit belakang di bahagian bawah, sakitnya memang menyiksakan, duduk salah, berdiri salah, baring salah, terlentang pun salah. Orang yang mengidapnya saja yang tahu rasa sakitnya.

Artikel berikut mengupas tentang perkara ini dengan mendapatkan pandangan daripada beberapa pakar ortopedik.

Top Causes of Low Back Pain

Here are the top causes of low back pain and tips for prevention.

By Stephanie Watson
Reviewed By Brunilda Nazario, MD

It’s hard to find any part of Elin Laird’s life that hasn’t been touched by pain. “I can’t stand for too long. I can’t sit for too long. Pretty much if I’m at home, I’m lying in bed,” says the 39-year-old single mother. “I can’t be as active in my son’s life. I can’t travel as much. I’ve lost so much of my life.”

Laird describes the pain of her herniated disc as similar to having “an ice pick shoved in the base of my spine.” It’s a pain that no therapy – from steroids to painkillers to surgery – has managed to budge. And she is far from alone in her discomfort.

“Eighty percent of the population of the United States, at some point in their life, is going to have back pain,” says Ronald J. Wisneski, MD, an orthopedic surgeon, specialist in spinal disorders and spine surgery, and associate in the Department of Orthopedic Surgery at Geisinger Medical Center in Danville, Pa. Most of the time, that pain is centered in the lower back.

What could be triggering your back pain? To get an idea, the author talked to two orthopedic surgeons about the most common causes of lower back pain — and what you can do about it.

What Causes Herniated Discs and Sciatica

Why is the lower back a target area for pain? “Generally speaking, the lower back is subject to a lot of mechanical stress and strain,” says Gunnar Andersson, MD, PhD, professor and chairman emeritus of the Department of Orthopedic Surgery at Rush University Medical Center in Chicago. “The reason is the weight of the upper body, which always puts loads on the lower back.”

Supporting all that upper body weight is the spine, which is made up of more than 30 small bones called vertebrae stacked one on top of the other. A spongy piece of cartilage, called a disc, sits between each vertebra. It acts as a shock absorber, preventing the bony vertebrae from grinding against one another.

With age, these cushioning discs gradually wear away and shrink, a condition known as degenerative disc disease. Discs can also tear or become injured. Sometimes the weakening of a disc can put pressure on its jelly-like center. Wisneski describes this process as similar to a bubble forming on your car’s tire.

“You hit a bump in the road, then all of a sudden that tire goes pop,” he says. In the case of your back, that pressure can lead to a herniated disc (also called a “slipped disc”), in which the center of the disc bulges outward.

Sometimes that bulging causes the material from inside the disc to press on the sensitive nerves that carry messages to the brain. The result can be the kind of excruciating pain Laird has experienced. “If I move wrong, I get what I call a ‘sonic boom’ — this jolt of electricity through my pelvic area,” she says.

A herniated disc can put pressure on the nerve that extends down the spinal column, causing pain to radiate to the buttocks and all the way down the leg. This condition is called sciatica.

Other Conditions Causing Lower Back Pain

Deteriorating discs are just one of many sources of low back pain. Others include:

* muscle and ligament strains

* skeletal problems

* degenerative conditions such as arthritis, osteoporosis (brittle bones), and spinal stenosis (a narrowing of the spine that puts pressure on nerves)

Less commonly, low back pain can be a sign of a serious medical condition such as diabetes or a pinched nerve. In the case of a pinched nerve, the pain may be accompanied by symptoms like fever, chills, night sweats, or loss of bladder control.

Back Strain and Pain

Even with the more sophisticated techniques available to diagnose what’s causing low back pain, many times doctors don’t know what caused the problem. “It’s very hard for us to identify the reason for a patient’s pain,” Andersson says.

When Martin Snyder, 42, first started experiencing low back pain in his early 20s, his doctor blamed it on stress. “I said, ‘But I don’t have any stress,'” Snyder recalls. Eventually he was diagnosed with degenerative disc disease, but he and his doctors still have no idea what triggered it.

Straining your back would seem to be one obvious cause of low back pain. “There’s a lot of studies that indicate that back pain is more frequent among people who do a lot of heavy physical lifting,” Andersson says. “Things can happen when you do lifting that can cause significant overloading of your spine.” Although too much strain may be part of the equation, it isn’t always entirely to blame for lower back pain.

Lower Back Pain: Is It in Your Genes?

One of the main reasons a person develops low back pain and another doesn’t may lie in their genes. With disc degeneration, Andersson says, “If you take twins — one who is doing heavy physical work and one who is doing desk work — and you compare their MRI exams, they are essentially identical. This tells you that genetic factors are very important.”

If you have chronic low back pain, you’ve likely inherited the tendency, and you’re probably hardwired for it. The lower back contains sensitive receptors called nociceptive fibers, which send pain signals to the brain. “Some people have a lot of nociceptive fibers — for example, in their discs — while others have relatively few,” Wisneski tells WebMD. That may be why one person can lift heavy weights many times and never experience low back pain, while another who barely lifts anything is in constant agony.

5 Ways to Ease Low Back Pain

Just because it’s possible to inherit low back pain doesn’t mean the matter is completely out of your control. “It’s how we’re born and how we take care of ourselves,” Wisneski says.

If you sit in an uncomfortable chair all day, work a jackhammer, or regularly twist your body into uncomfortable positions, your lower back will suffer for it. Smoking — the bad habit that increases the risk of dozens of diseases — can also lead to backaches. One study found that smokers are nearly a third more likely to have low back pain compared to nonsmokers.

Try these five tips to prevent or ease lower back pain:

* If you smoke, get help to kick the habit.

* Practice good posture whenever you sit or stand. When lifting something, lift with your knees, not with your back.

* Do exercises to strengthen the muscles that support your back — especially the abdominals, hips, back, and pelvic area. Developing strong core muscles can make a big difference in how you feel. “When my abs are in good shape and I’m well worked out, I’m the least susceptible,” Snyder says.

* Fight the urge to crawl into bed whenever your lower back acts up. ,/span> “Our bodies are meant to be used,” Wisneski says. “If you have pain, sometimes you develop a ‘disease of disuse.”

* See your doctor and get treated for low back pain early on, so you can stay moving and keep active.

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