Effectiveness data for smoking cessation interventions

Quitting tobacco

Summary of effectiveness data for smoking cessation interventions (abstinence at least six months) based on all latest Cochrane Review

Intervention (source)	Quit rate (%)	Comparator	Odds ratio (95% confidence interval)	Increased chances of quitting successfully
Self-help interventions		No intervention	1.24(1.07-1.45)	24%
Physician advice		Brief advice vs. no advice	1.66(1.42-1.94)	66%
		Intensive advice vs. no advice	1.84(1.60-2.13)	84%
		Intensive vs. minimal	1.37(1.20 to 1.56)	37%
Nursing intervention		Usual care	1.28(1.18 to 1.38)	28%
Individual behavioural counselling		Minimal behavioural intervention	1.39(1.24 to 1.57)	39%
Group behaviour therapy		Self-help programme	1.98(1.60-2.46)	98%
Telephone counselling		Without telephone counselling	1.41(1.27-1.57)	41%
		Less intensive vs. no	1.33(1.21-1.47)	33%
Quit and Win contests	8-20%	Baseline community rate
Nicotine replacement therapy (NRT)		Placebo or non-NRT	1.58(1.50-1.66)	58%
Bupropion		Placebo	1.94(1.72 to 2.19)	94%
Varenicline		Placebo	2.33 (1.95 to 2.80)	133%
Clonidine		Placebo	1.63 (1.22 to 2.18)	63%
Nortriptyline		Placebo	2.34(1.61 to 3.41)	134%
Healthcare financing systems		Directed at smokers vs. no	4.38 (1.94 to 9.87)	338%
		Directed at providers vs. no	1.33(1.01 to 1.77)	33%

http://www.who.int/tobacco/quitting/summary_data/en/

How to Be Thankful For Life by Changing Just One Word

by James Clear — 

My college strength and conditioning coach, Mark Watts, taught me an important lesson that applies to life outside of the gym…

As adults, we spend a lot of time talking about all of the things that we have to do.

You have to wake up early for work. You have to make another sales call for your business. You have to work out today. You have to write an article. You have to make dinner for your family. You have to go to your son’s game.

Now, imagine changing just one word in the sentences above.

You don’t “have” to. You “get” to.

You get to wake up early for work. You get to make another sales call for your business. You get to work out today. You get to write an article. You get to make dinner for your family. You get to go to your son’s game.

I think it’s important to remind yourself that the things you do each day are not burdens, they are opportunities. So often, the things we view as work are actually the reward.

Embrace your constraints. Fall in love with boredom. Do the work.

You don’t have to. You get to.

Smartphones Are Destroying Your Posture

Smartphones Are Destroying Your Posture

If cell phone radiation giving us all cancer and prematurely wiping out the nearly 2 billion people that use smartphones worldwide wasn't enough to worry about, a new study suggests our precious hand-screens are giving us all back problems, too. Of course they are.

According to a study published in Surgery Technology International, chronic screen-staring could be adding up to 60 pounds of force to your spine, depending on if you're more of an eye-shifter or all-out huncher when it comes to reading texts and scrolling through what you've missed on Instagram.

The human head is not weightless, it turns out, so when you tilt it forward it is, in effect, pulling on your spine in a way that your spine isn't meant to be pulled on so frequently. Writes back surgeon Kenneth Hansraj: "As the head tilts forward the forces seen by the neck surges to 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees."

You're not going to throw your back out after a single heavy day of phone-gazing, but over time the added stress "could deteriorate the back and neck muscles to the point of needing surgery."
But if back surgery's not your thing, there's hope: The radiation cancer could wipe us all out first.

[H/T: Science of Us]




(adopted from - http://www.msn.com/en-in/lifestyle/other/smartphones-are-destroying-your-posture/ar-BBf3r4s?ocid=HPDHP)

THE POWER OF THREE - Deccan Herald- Living- November 15, 2014

Deccan Herald- Living- November 15, 2014.jpg

http://youtu.be/l3U9Foli8jM

Pawan Gupta MS, M.Ch., FSOG, FAIS

Associate Director, Institute of Cancer Care, Jaypee Hospitals, Sector 128, Noida 

Mob: 9811290152

Mission Win over Cancer - Sri Suresh Prakash

Understanding Breast Cancer - The Sunday Tribune by Dr Pawan Gupta

The Sunday Tribune (Spectrum) - 26 October 2014 - National - Understanding breast cancer 

http://www.tribuneindia.com/2014/20141026/spectrum/main2.htm 

HEALTHUnderstanding breast cancerMost breast cancers can be detected by self-examination and save many lives
Dr Pawan Gupta

BREAST cancer is the most common cancer in women in India and accounts for 25 per cent to 31 per cent of all cancers in women in Indian cities. (Source: PBCR 2009 2011). According to Indian figures for 2012, around 144,937 women were newly detected with breast cancer and 70,218 women died of breast cancer. For every 2 women newly diagnosed with breast cancer, one woman is dying of it.

We are witnessing an age shift, and the average age of developing breast cancer has shifted from 50-70 years to 30-50 years; and cancers in the young tend to be more aggressive.

Breast cancer happen in men too. The number of cases is around 1 per cent.

In India 1 in 28 women will develop invasive breast cancer during their lifetime. As India becomes westernised, the incidence rate for breast cancer increases. A 2005 study conducted by the International Association of Cancer Research, Lyon, projected that there would be 2,50,000 cases of breast cancer in India by 2015, a 3 per cent increase per year. Currently, India reports roughly 1,00,000 new cases annually.

About 40 per cent of women will discover a breast lump at some point in their lives. Although a lump doesn't necessarily mean cancer, what women do immediately after that discovery can mean the difference between. It is important to see a doctor if you detect any lumps or other abnormalities in your breast.

A diet rich in vegetables, fruit, poultry, fish, and low-fat dairy products has been linked with a lower risk of breast cancer

Lumps and bumps are normal in every breast. You need to know 'what is normal' for you and be aware of changes. In India, approximately 40 per cent of breast cancers are first diagnosed at stage IV. In the USA, approximately 6 per cent of all cases are first diagnosed at stage IV.

Stage IV means the cancer has already spread from the breast to other organs such as the bones or lungs. While there is currently no cure for stage IV breast cancer, in many cases it can be manageable with treatment for many years.

Early detection can improve the prognosis for survival in most cases. With early detection not only survival improves but the woman can preserve her breast also and avoid chemotherapy too.

3 minutes, 3 fingers once in 30 days

Women should be familiar with the look and feel of their breast. Early detection is a woman's best protection. It just takes 3 minutes to examine each breast.

n 3 steps: Look, feel and check

n 3 fingers: Feel your breast with 3 fingers.

n 30 days: You need to check your breast only once a month.

Most breast cancers are detected by a woman herself. The 3 minute-3 finger campaign intends to empower every woman to practice self-breast awareness from the age of 20 onwards to notice any new abnormality in the breast which needs to be treated at the earliest.

Symptoms to look for

n Development of a lump or swelling.

n Skin irritation or dimpling.

n Nipple pain or retraction (turning inward).

n Redness or scaling of the nipple or breast skin.

Discharge from nipple other than breast milk (you may observe staining on your sheets or bra). Clear fluid is more concerning than bloody, green or blackish fluid.

Dilation of the pores in only one area of skin on the breast that may have an orange peel appearance.

At the onset of any of these changes, contact your doctor as soon as possible.

If you find even a small change, call your doctor. Remember, most of the time, these changes in the breast may not be cancer.

Your doctor may arrange for you to visit her/him first for a clinical breast exam or have you go directly for diagnostic evaluation in a breast-imaging facility prior to seeing you.

Risk factors

A woman is at an increased risk of breast cancer.

n As a woman ages, risk increases across all ages until approximately age of 80.

n If she has certain inherited genetic mutations for breast cancer (BRCA1 and/or BRCA2).

n If a woman has dense breast tissue as determined by a radiologist when reading her mammogram.

n Has two or more first-degree relatives (mother, sister, daughter, father or brother) diagnosed with breast cancer at an early age.

Minor factors

n Has had no biological children.

n Had her first child after age 30.

n Never breastfed a child.

n Reached menopause after age 55.

n Had her first period before age 12.

n Drinks more than one alcoholic beverage per day.

Gained significant weight after menopause.

Used menopausal hormone replacement therapy (HRT, in particular HRT containing both estrogen/progestin hormones) recently or for a long time to treat symptoms of menopause.

While you can't change many known risk factors for breast cancer (being female, one's age, family history, etc.), you can modify your lifestyle to reduce at least some of the risks, including:

n Postmenopausal obesity.

n Weight gain as an adult (especially in your forties and fifties).

n Use of hormone replacement therapy (HRT) containing both estrogen/progestin hormones.

n Maintaining a sedentary lifestyle.

n Cigarette smoking.

n Alcohol consumption.

Can breast cancer be prevented?

There is no sure way to prevent breast cancer. But there are things all women can do that might reduce their risk and help increase the odds that if cancer does occur, it is found at an early, more treatable stage.

You can lower your risk of breast cancer by changing those risk factors that can be changed. Body weight, physical activity, and diet have all been linked to breast cancer, so these might be areas where you can take action.

Both increased body weight and weight gain as an adult are linked with a higher risk of breast cancer after menopause. Alcohol, even low levels, also increases risk of breast cancer.

Many studies have shown that moderate to vigorous physical activity is linked with lower breast cancer risk.

A diet that is rich in vegetables, fruit, poultry, fish, and low-fat dairy products has also been linked with a lower risk of breast cancer. Most studies have not found that lowering fat intake has much of an effect on breast cancer risk.

It's not clear at this time if environmental chemicals that have estrogen-like properties (like those found in some plastic bottles or certain cosmetics and personal care products) increase breast cancer risk. If there is an increased risk, it is likely to be very small. Still, women who are concerned may choose to avoid products that contain these substances when possible.

— The writer is associate director, surgical oncology,
Jaypee Hospital, Noida

Some helpful tips

n Get regular, intentional physical activity.

n Reduce your lifetime weight gain by limiting your calories and getting regular physical activity.

n Avoid or limit your alcohol intake.

n Women who choose to breastfeed for at least several months may also get an added benefit of reducing their breast cancer risk.

n Not using hormone therapy after menopause can help you avoid raising your risk.

n After 40, get a mammogram done every year.

Cancer 'tidal wave' on horizon, warns WHO

The globe is facing a "tidal wave" of cancer, and restrictions on alcohol and sugar need to be considered, say World Health Organization scientists.

It predicts the number of cancer cases will reach 24 million a year by 2035, but half could be prevented.

The WHO said there was now a "real need" to focus on cancer prevention by tackling smoking, obesity and drinking.

The World Cancer Research Fund said there was an "alarming" level of naivety about diet's role in cancer.

Fourteen million people a year are diagnosed with cancer, but that is predicted to increase to 19 million by 2025, 22 million by 2030 and 24 million by 2035.

Read More : http://www.bbc.co.uk/news/health-26014693

(Submitted by Jamshed Sidhwa )

Even Mr. Perfectionist has his flaws! Keep away from Tobacco please Mr Amir Khan

Aamir Khan is back to smoking again, dhoom 3 to blame

The Cycle of Change! Where are you today!

The news of Aamir khan taking to smoking again is highly demotivating for the people who wish to quit. The blame of relapse is being put on his new release Dhoom 3.

From ‘satyamev jayate’ to his ‘atithi devobhawa’ campaign, Aamir Khan emerged as a symbolic icon. If reports are to be believed, the superstar has taken up smoking again despite his resolution to quit smoking forever in January 2011. This will have a major impact on those who take him as their role model and also to them who are amid the process of quitting tobacco.

Yes stress is one of the major causes for relapse!

Stress:
Smokers often mention stress as one of the reasons for reverting back to smoking. Stress is a part of our life, smokers and non-smokers alike. The difference is that smokers use nicotine to cope with stress. While quitting, new ways of handling stress must be learnt.

Let us have a look at the important factors for tobacco addiction:

·         Physical

·         Psychological

·         Social

the three factors have to be taken care of to win over tobacco habit.

It is known that after 48 hours of quitting nicotine level in our body is negligible. So once Aamir Khan left smoking for more than a year, there is no more physical factor present in him. It is only the psychological and social factors which dominate. Look at the social model of quit tobacco cycle.

A person who is quitting may relapse any time. It is generally assumed that the maintenance phase for the quit cycle is 6 months to 5 years. So one has to be careful and watch for the triggering factors. Although stress is blamed by most as the reason to go back to smoking, one has to understand that there are many more ways to relieve stress than smoking. 

Exercise is a good stress reducer. Exercise can also help with the temporary sense of depression that some smokers experience when they quit. Deep breathing exercise is an easy way of relieving stress. Just do 10 rounds of deep breathing whenever you are stressed and have a craving. All Spiritual practices such as prayers and meditation have been used very successfully.

Lot of people ask me “Can’t I just take one puff”

No not at all. One puff will break all your efforts and you will have to start all over again.

There are some key elements in quitting smoking successfully. These four factors are crucial:

1. making the decision to quit
2. Setting a quit date and choosing a quit plan
3. Dealing with withdrawal
4. Maintenance or staying quit

Be careful. Know your triggering factors and be prepared how to cope with them.

No not a single puff after you has quit!

(Dr Pawan Gupta - The author is a cancer surgeon and tobacco counselor)

और भी... http://aajtak.intoday.in/story/aamir-khan-is-back-to-smoking-again-dhoom-3-to-blame-1-748663.html

Most common Regrets of the Dying

Subject: Most Common Regrets of the Dying

Priorities become crystal clear when people are about to die. This has been the observation of nursing staff while working with terminally ill patients. Bronnie Ware spent several years caring for dying people in their homes. She shares the five most common regrets the dying have. For many years I worked in palliative care. Some incredibly special times were shared. I was with most of them for the last three to twelve weeks of their lives. People grow a lot when they are faced with their own mortality. Each experienced a variety of emotions, as expected, of denial, fear, anger, remorse, more denial and eventually acceptance. Though, every single patient found their peace before they departed. When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five: 1. I wish I’d had the courage to live a life true to myself, not the life others expected of me. This was the most common regret of all. When you are on your deathbed, what others think of you is a long distance away from your mind. Most people had not honoured even a half of their dreams and died knowing that it was due to choices they did not make , invariably due to influence of others. When people realise that their life is almost over and look back, it is easy to see how many dreams have gone unfulfilled. It is very important to try and honour at least some of your dreams along the way, till your health is intact. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it. 2. I wish I didn’t work so hard. This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence. By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle. 3. I wish I’d had the courage to express my feelings. Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result. We cannot control the reactions of others. However, although people may initially react when you change the way you are, by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Alternately, it releases the unhealthy relationship from your life. Either way, you win. 4. I wish I had stayed in touch with my friends. Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying. It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks…. love and relationships. 5. I wish that I had let myself be happier. This is a surprisingly common one. Many did not realise until the end that hapiness is a choice. They had stayed stuck in old patterns and habits. The so called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. Deep within, they longed to laugh properly and have silliness in their life again. Bottomline: How wonderful would it be, not to have any of these five regrets , just as you are about to depart. Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

Breast Cancer Risk Factors

Question 1:
Does the woman have a medical history of any breast cancer or of ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS)?

Explanation
A medical history of ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS) increases the risk of developing invasive breast cancer. The method used by the Breast Cancer Risk Assessment Tool to calculate the risk of invasive breast cancer is not accurate for women with a history of DCIS or LCIS. In addition, the tool cannot accurately predict the risk of another breast cancer for women who have a medical history of breast cancer.

Question 2:
What is the woman's age?

Explanation
The risk of developing breast cancer increases with age. The great majority of breast cancer cases occur in women older than age 50. Most cancers develop slowly over time. For this reason, breast cancer is more common among older women.

Note: This tool only calculates risk for women 35 years of age or older.

Question 3:
What was the woman's age at time of her first menstrual period?

Explanation
Women who had their first menstrual period before age 12 have a slightly increased risk of breast cancer. The levels of the female hormone estrogen change with the menstrual cycle. Women who start menstruating at a very young age have a slight increase in breast cancer risk that may be linked to their longer lifetime exposure to estrogen.

Question 4:
What was the woman's age at her first live birth of a child?

Explanation
Risk depends on many factors, including age at first live birth and family history of breast cancer. The relationship of these two factors in white women is shown in the following table of relative risks.

Relative Risk of Developing Breast Cancer*

Age at first
live birth # of affected relatives
0 1 2 or more
20 or younger 1 2.6 6.8
20-24 1.2 2.7 5.8
25-29 or no child 1.5 2.8 4.9
30 or older 1.9 2.8 4.2

For women with 0 or 1 affected relative, risks increase with age at first live birth. For women with 2 or more first degree relatives, risks decrease with age at first live birth.

* Adapted from Table 1, Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Shairer C, Mulvihill JJ: Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst 81(24):1879-86, 1989. [PubMed Abstract]

Question 5:
How many of the woman's first-degree relatives - mother, sisters, daughters - have had breast cancer?

Explanation
Having one or more first-degree relatives (mother, sisters, daughters) who have had breast cancer increases a woman's chances of developing this disease.

Question 6:
Has the woman ever had a breast biopsy?
6a: How many previous breast biopsies (positive or negative) has the woman had?
6b: Has the woman had at least one breast biopsy with atypical hyperplasia?

Explanation
Women who have had breast biopsies have an increased risk of breast cancer, especially if their biopsy specimens showed atypical hyperplasia. Women who have a history of breast biopsies are at increased risk because of whatever breast changes prompted the biopsies. Breast biopsies themselves do not cause cancer.

Question 7:
If known, please indicate the woman's race/ethnicity.

Explanation
The original Breast Cancer Risk Assessment Tool was based on data from white women. But race/ethnicity can influence the calculation of breast cancer risk. The model for African American women was derived from the Women’s Contraceptive and Reproductive Experiences (CARE) Study (see reference 5) and NCI’s SEER Program. The model for Asian and Pacific Islander women in the United States was derived from the Asian American Breast Cancer Study (AABCS) and NCI’s SEER Program (see reference 6). For Hispanic women, part of the model is derived from white women who participated in the Breast Cancer Detection Demonstration Project and from SEER data. The risk estimates for Hispanic women are therefore subject to greater uncertainty than those for white women. Calculations for American Indian and Alaskan Native women are based entirely on data for white women and may not be accurate. Researchers are conducting additional studies, including studies with minority populations, to gather more data and to increase the accuracy of the tool for women in these populations.

Note: If the woman's race/ethnicity is unknown, the tool will use data for white females to estimate the predicted risk.

Question 7a:
What is the sub race/ethnicity?

Explanation
To calculate breast cancer risk using Asian-American as the race/ethnicity, the sub race/ethnicity needs to be known. If the sub-category of race/ethnicity is not known, then “Unknown” should be selected in Question 7, rather than Asian-American. The “Other Asian American” category includes women of Asian Indian/Pakistani, Korean, Vietnamese, Laotian, and Kampuchean descent. The “Other Pacific Islander” category includes women of Guamanian, Samoan, and Tongan descent.