Saturday, December 31, 2005

Smoking / Anaesthesia / Surgery

This an interesting article which sounds credible. It also seems like common sense to me. It might be helpful for you all to know when confronted by unhelpful or unsympathetic healthcare professionals. Essentially it's better for smokers not to give up prior to surgery if they are only doing so around the time of surgery. You need to give up months ahead to be in with a chance of deriving the supposedly possible benefits. Hit the link above for the full text or just read the quote below.

"Unfortunately, the picture is not so clear and simple. It seems to take at least 48 hours to begin to show an improvement in the increased sensitivity and increased bronchial reactivity that is seen in smokers. It probably takes as much as two weeks before these factors are improved as much as possible. So, just in terms of pulmonary effects, a short term cessation of smoking does not seem to make much of a difference.
In fact, a short term cessation may actually make things worse. It seems the effects of increased secretions, decreased ability to clear these secretions, small airway disease, etc. take as much as four to eight weeks to reverse. In fact, a couple of studies have shown that patients who quit smoking have an increased risk of pulmonary complications unless they have quit for four weeks or more. So while smokers may have more problems than nonsmokers, it seems that smokers that have recently quit actually do worse than those that keep smoking."

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Wednesday, December 21, 2005

Smoking On The Job


by Dr Phil Hammond

Should NHS staff be banned from smoking in public while wearing their uniform and ID badge, even if they're off duty and miles away from their place off work? This rather draconian proposal comes courtesy of Suffolk East Primary Care Trust, who recently announced a ban in hip and knee replacements for those with a BMI over 30. Apparently, 80% of the staff support the smoking ban but as with all rules, its success depends on its enforceability. Will the trust employ anti-smoking snoops to parole local car parks, bus shelters and pubs? Presumably they can now afford them with all the money they're saving on joint replacements. The unions are predictably outraged, with Unison calling it "an infringement of civil liberties that could force smokers underground, causing health and safety risks." Presumably all the nicotine addicts will be piling into the linen cupboards or holing out in the dungeons that most hospitals seem to have. They house the absurdly antiquated heating system but if you take a torch you can invariably find bodies of confused elderly patients who took a wrong turning on the way back from the League of Friends shop, armed with a packet of Nuttal's Mintoes. To be fair to the trust, it did announce its policy in advance, to give the staff a chance to enrol in its stop smoking clinics, but there are so many nicotine addicts working in the NHS, I'm keen to know what a sudden ban does to patient safety. Would you prefer a heart surgeon who keeps his hand steady with a drag of Capstan's Full Strength in the scrub room, or one who's dropping the scalpels and head-butting matron because he's in enforced cold turkey? As for the nurses, they're miserable enough without being denied five minutes of freezing addiction on the balcony. My guess is that smoking bans across the NHS lead to more deaths from accidents, more complaints for rudeness and more flaming linen cupboards.As for the patients, I'm not sure they're happy about it either. My local trust has banned smoking in all its premises, even on the oncology ward where it's far too late to make a difference. Watching a stream of patients with inoperable lung cancer pant their way to the smokers' room only to discover it's locked or converted into an MRSA isolation ward is just too cruel. In these days of supposed patient choice, the least we can do is let the nearly dead enjoy their fix. And that applies to the staff as much as the patients.

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Saturday, December 10, 2005

This Stinking Tide of Hypocrisy

The government's encouragement of hospital trusts to set policies which may enable them to refuse to treat smokers is a scandal! Aside from the fact that it encourages doctors to clearly contravene the spirit of The Hippocratic Oath, it also means that the only group of people who do pay for their own health care and that of others too via the exorbitant amounts of tax on tobacco, will be denied treatment on the basis that they are parasites, leaching more of their fair share of the country's health costs.

This would appear to be quite clearly outright nonsense as I have had it in black and white, twice, from the Department of Health that the estimated cost of treating smokers is £1.7 billion per annum.

Now it is also a fact that the Treasury has released the detail that the additional input from smokers to the national revenue is £8 billion although some sources cite this as more. That means smokers pay for their health care 4.7 times over, which means that they also cover the cost for many others too. In fact, it has also been stated that taxes from smokers cover the entire NHS drugs bill!

That the government should then, support the twisted hypocrisy outlined in my opening paragraph beggars belief, but the fact too, that they pretend to have no part in such matters because it is left to hospital trusts to decide such policies, is further insult to injury in a sick drama where emulation of Pontius Pilate is clearly the model. Moreover, if the government wishes to encourage the denial of treatment to smokers, then the latter should only pay greatly reduced national insurance contributions.

Another piece of disgusting hypocrisy in this charade is that when it comes to blood donation, suddenly, smokers' blood is as good as that of non-smokers. So where then, lies this notion that tobacco smoke is a deadly carcinogenic substance? If smokers are so polluted then why is their blood still acceptable? Plainly, if smokers are to be denied treatment then they, in turn, should also refuse to give blood. And I wonder what impact that would have on our blood banks? In the same vein, I am pretty sure that when it comes to the donation of organs, then smokers' organs are probably as acceptable as anyone else's.

It's fine to have excellent motives concerning the health of others but those motives should manifest themselves justly and not via the poisonous and mendacious programme of anti-smoking propaganda pursued by this government and encouraged too, it seems quite clear, by many health professionals whom one trusts should know better.

Finally, an organisation which people should be able to trust to set a good example is The World Health Organisation (WHO). The WHO has a very close relationship with Glaxo from whom it receives a significant portion of its income. Glaxo manufactures and sells a product known to be dangerous, namely Zyban or Wellbutrin, which serves as both a smoking cessation product and an antidepressant. What then, is the difference in principle between The WHO and someone who consorts with a tobacco company?

Written by Blad

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Friday, December 09, 2005

NICE Health Care Discrimination

The National Institute for Health and Clinical Excellence (NICE) its suggested is looking into recommending who receives particular treatments from the NHS depending on "Social Value Judgements". I think that sounds a little bit scary. I've just been to their website and browsed a pdf document, which goes into significant length about how these judgements will be developed. It is discussed under various headings including age, socio-economic class and self inflicted disease. This has already reached the news with a Trust limiting hip replacement to those people who are below a certain body mass index, before NICE published any guidelines. Am I the only one who finds this a frightening prospect?

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Tuesday, December 06, 2005

Do Smoking Bans cause a 27 to 40% drop in admissions for myocardial infarction in hospitals?

December 5, 2005Antismokers claim that studies have shown that bans bring about an immediate and drastic decrease in heart attacks among nonsmokers exposed to smoke at work.
This claim was never true to begin with - the cited studies never separated and analyzed nonsmokers as a separate group - and it has now been pointed out in the pages of the BMJ that even the claim of saving lives among the combined population of smokers and nonsmokers might be worthless.

While many making that claim may have believed their information to be accurate, it is now obvious that its basis has been thrown strongly into question. As Jacob Sullum noted in a December 1st reaction to the announcement, "An effect this dramatic (i.e. an immediate and pronounced drop of hospital admissions for heart attacks) should have been noticed all over the country..."

Just a week before the Chicago Aldermen were due to vote on a citywide smoking ban, two independent researchers working together, David W. Kuneman and Michael J. McFadden, unveiled a new study covering a population base roughly 1,000 times as large as the previous town-based studies. The new study indicates strongly that rather than a 30% decrease in heart attacks, statewide smoking bans seem to have literally NO EFFECT AT ALL on heart attack rates. Incredibly the data even indicates that California's statewide heart attack rate went UP by 6% in the first full year of their total smoking ban!

The data for the study and the basis of its design have been backed up and expanded by well-known antismoking researcher Michael Siegel who has come out in support of the researchers' approach as providing "compelling evidence that brings into question the conclusion that smoking bans have an immediate and drastic effect on heart attack incidence." His observation is echoed by researcher Kuneman who asks, "Ever wonder why you didn't hear about post ban heart attack declines in New York City? Or in Minneapolis or Los Angeles? Now you know!"

On December 4th the British Medical Journal entered the fray with the online publication of a Rapid Response by Mr. McFadden outlining the new research and posing sharp criticisms of the earlier studies and of the refusal of the authors of those studies to respond to previous criticisms and questions. McFadden points out that the data in the Kuneman/McFadden study are fully open for public examination and far less selective than the data in the earlier studies and notes with pride that he and his co-researcher have been quick to respond to all queries posted about their methodology on Dr. Siegel's web blog.

He also poses the wider ranging question of whether studies commissioned by the "Antismoking Industry" should begin to receive the same cautious reception accorded those commissioned by "Big Tobacco." The current study, as well as an earlier one by the duo, were unfunded and neither researcher receives grants for their work from either interest group. Kuneman sharply asks the question, "Why the difference between the studies? For one thing we weren't dependent on antismoking-targeted grants!"

At this point there appears to be very little, if any, real scientific support for the claim that protecting nonsmokers from normal levels of exposure to secondary smoke prevents any heart attacks. And it is this claim that has always provided the impressive numbers upon which ban advocates have pressed legislators to pass smoking bans.

Without those numbers proponents of extreme bans are left with little other than the widely discredited EPA figures relating ETS to lung cancer and a few isolated instances of hospitality workers who have come to believe that their own cancers were caused by working in smoking establishments. Samantha Phillipe, editor of the longstanding smokersclubinc.com newsletter, notes that while it's always a cause for sadness when someone becomes ill that it's even more sad when they are misguidedly advised to blame family and friends for their illness.

Without a compelling body of scientific evidence backing them up, smoking bans are an unnecessary and overbearing intrusion of government into the spheres of free choice, private property and free enterprise. And the Kuneman/McFadden study points up just how uncompelling even some of the strongest and most publicised evidence actually is.

References:

1)Article:http://kuneman.smokersclub.com/hospitaladmissions.html

2)Mike Siegel's blog analysis and followup comments:http://tobaccoanalysis.blogspot.com/2005/11/new-study-casts-doubt-on-claim-that.html

3) BMJ Response:
http://bmj.bmjjournals.com/cgi/eletters/328/7446/977#123038

4) Jacob Sullum's REASON column:
Hit and Run

Michael J. McFaddenAuthor of "Dissecting Antismokers' Brains"Mid-Atlantic Regional Director of SmokersClubInc.comweb page: http://pasan.thetruthisalie.com/
Email:mailto:Cantiloper@aol.com

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Sunday, December 04, 2005

Smokers Rights Newsletter

Many apologies to Samantha Phillippe. Oversight meant that I had neglected to include a link to her ground breaking Smokers Rights Newletter. She has single handedly assimmilated and distributed any pertinant matters relating to smokers rights. I believe she has been the catalyst to most of our awareness of the subject and a tremendous resource. She has I am sure facilitated our organisation into a cohesive group internationally. Perhaps most importantly she has through her hard work introduced many friends over the electric air waves and produced a better world to live in. Three cheers for Samantha.

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Saturday, December 03, 2005

Chief Medical Officer Should Resign



This a little present from Blad.

You may hear from him later.

Thanks Blad!!

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Friday, December 02, 2005

Manners

Is it me or do all Anti-smokers seem to be selfish, narrow-minded and rude?
I believe in a simple "way of life" derived from christian morals although I am an atheist.
That is "do as you would be done by" or in all your dealings with fellow human beings share, be tolerant and above all be courteous.
Does anyone agree?

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