smoking... smoking.... smoking......

[robin_himself]

People Who Smoke Light Cigarettes Less Likely To Quit

People who smoke low-tar and low-nicotine, or "light" cigarettes thinking they will reduce their health risks may actually be less likely to kick the habit, according to research conducted by University of Pittsburgh and Harvard University. As such, light cigarette smokers increase their lifetime risk of a variety of smoking-related diseases suggests the study published online by the American Journal of Public Health.

The analysis, conducted by Hilary Tindle, M.D., M.P.H., assistant professor of medicine, University of Pittsburgh School of Medicine, while she was based at Harvard Medical School, found that of 12,285 self-reported smokers, those who used light cigarettes were about 50 percent less likely to quit smoking than those who smoked non-light cigarettes. Smoking light cigarettes was associated with reduced odds of quitting for all age groups, but this effect increased with progressing age, peaking in adults age 65 and older, who were 76 percent less likely to quit than their counterparts who smoked non-light cigarettes.

Additionally, Dr. Tindle and her collaborators, who included Saul Shiffman, Ph.D., professor of psychology at the University of Pittsburgh, found that more than a third (37 percent) of the self-reported smokers said they used light cigarettes to reduce their health risks. The majority of these light cigarette smokers were female, Caucasian and highly educated. The responses were obtained as part of the 2000 National Health Interview Survey, an ongoing household survey of the U.S. population conducted by the United States Census Bureau for the National Center for Health Statistics.

According to Dr. Tindle, these findings are particularly disturbing because they translate into more than 30 million U.S. adult smokers who think they are reducing their smoking-related health risks by using light cigarettes but who, in fact, actually may be increasing such risks.

"Even though smokers may hope to reduce their health risks by smoking lights, the results suggest they are doing just the opposite because they are significantly reducing their chances of quitting. Moreover, as they get older their chances of quitting become more and more diminished," Dr. Tindle said.

Light cigarettes were first introduced to the U.S. market in the late 1960s and now account for almost 90 percent of the cigarettes sold in the United States. A number of studies have refuted the notion that they have less tar and nicotine than regular cigarettes, instead suggesting that the amounts of tar and nicotine are comparable. Furthermore, research has suggested that light cigarette smokers experience little or no long-term reduction in their risk of tobacco-related disease compared to smokers of regular cigarettes.

In the article, Dr. Tindle and her coauthors suggest that physicians and other clinicians should warn their patients about light cigarettes during routine smoking cessation counseling, because research shows that smokers are more likely to show interest in quitting if they know that lights do not reduce health risks. In addition, the authors suggest that there be disclosures on cigarette packs and warnings in advertisements whenever the term "light" or similarly misleading terms are used.

"Because smoking is such a major cause of death and disability in this country and worldwide, we believe that it is critical to give smokers accurate information on the potentially detrimental effects of the use of lights to reduce health risks and the potential impact on subsequent smoking cessation," she said.

www.upmc.edu

[robin_himself]

About 4 of every 10 adults with emphysema - a serious, often fatal disease associated with smoking - said that they still smoked when surveyed by HHS' Agency for Healthcare Research and Quality.

They weren't alone. Americans with other serious illnesses also hadn't kicked the habit when surveyed. These included:

-- Asthma sufferers - 23.4 percent

-- Stroke victims - 23.4 percent

-- People with high blood pressure - 17.4 percent

-- People with cardiovascular problems - 17.1 percent

-- People with diabetes - 16.9 percent

These data are from 2004 data from AHRQ's Medical Expenditure Panel Survey (MEPS), which collects information each year from a nationally representative sample of U.S. households about health care use, expenses, access, health status and quality. MEPS is a unique government survey because of the degree of detail in its data, as well as its ability to link data on health services spending and health insurance to demographic, employment, economic, health status, and other characteristics of individuals and families.

www.ahrq.gov

[robin_himself]

A prospective study by researchers from the Harvard School of Public Health (HSPH) has found that obesity and smoking are strongly associated with a greater risk of erectile dysfunction (ED). Meanwhile, regular physical activity appeared to have a significant impact on lowering the risk of ED. This is the first large-scale prospective study to examine the links between ED and smoking, obesity, alcohol and a sedentary lifestyle. The study will appear in the July 2006 issue of The Journal of Urology.

The researchers, led by Constance Bacon, a former post-doctoral fellow at HSPH, and Eric Rimm, associate professor of epidemiology and nutrition at HSPH, surveyed 22,086 healthy subjects between the ages of 40 and 75 from the Health Professionals Follow-up Study who reported good or very good erectile function and no major chronic disease before 1986. Among the participants, 17.7 percent (3,905) reported new onset of ED between 1986 and 2000. The researchers adjusted the results to take into account those with and without prostate cancer during the follow-up period, since prostate cancer treatments, such as radiation or surgery, may lead to ED.

The results showed that both smoking and obesity were associated with a higher risk of the development of ED among previously healthy men with good erectile function. The researchers also found that regular physical activity showed a strong inverse association with ED risk. "We found a 2.5-fold difference in risk of ED when we compared obese men who did little exercise with men who were not overweight and averaged 30 minutes of vigorous exercise a day. (Obesity was defined as a body mass index of more than 30 kilograms in weight divided by the square of height in meters.) For men younger than 55 there was a 4-fold difference in risk for the same comparison," said Rimm. Alcohol consumption did not increase the risk of ED. In general, men without prostate cancer showed stronger associations with these lifestyle factors than those with prostate cancer.

These results suggest that ED and coronary heart disease may share many of the same risk factors. Rimm said the results should encourage men to follow a more healthy lifestyle. "Many men may choose not to change to a healthier lifestyle, which includes exercise and a prudent diet, because they perceive heart disease as something that may only develop decades in the future. Hopefully, these results will help to motivate men to adopt a more active lifestyle to avoid a problem which may be more immediate," he said.

(The Health Professionals Follow-Up Study was launched in 1986 to examine diet and chronic disease among male health professionals in the U.S.)

www.phizer.com

[robin_himself]

The U.S. government's top doctor says the debate is over, second hand smoke is not a mere annoyance but a serious health hazard that leads to disease and premature death in children and non-smoking adults. "Second hand smoke kills people," stated Surgeon General Richard Carmona, citing a report issued this week.

Among the key points in the new 670-page study is that tens of thousands of Americans die each year as a result of involuntary smoking. Over 126 million people in the United States are regularly exposed to passive smoke. He said passive smoking causes lung cancer, cardiovascular disease and a host of other illnesses.

"One of the fastest-growing groups of lung-cancer patients are individuals in their early 40s who are non-smokers," according to Karen Giammicchio, R.N., Oncology Genetics/High Risk Coordinator at The Cancer Institute at Alexian Brothers Medical Center in Elk Grove Village, Illinois.

The likely culprit for lung cancer in these cases is exposure to an environmental risk factor, such as second hand smoke, Giammicchio says. "We know that all cancer is genetic, but there must be environmental exposure -- a gene-environment interaction -- to trigger cancer," she says. Second hand smoke is a key lung cancer catalyst.

"Smoke is toxic and full of poisons," says Charles Baum, M.D., Vice President of Health Affairs for the suburban Chicago-based Alexian Brothers Hospital Network. "There doesn't need to be massive levels of exposure when combined with a genetic predisposition to trigger cancer."

The Surgeon General's new report is providing additional evidence for supporters of smoking bans at work and in public places. Baum is a longtime advocate of smoking bans and increased cigarette taxes to discourage smoking and to improve community health. He actively supported a recent effort to ban smoking in public places and to hike licensing fees for cigarette retailers in several Chicago suburban communities, and separate measures that will ban smoking in public places across Cook County, Illinois, beginning in 2007. He wants to see a similar ban enacted statewide.

Experts with the Alexian Brothers Hospital Network encourages those who have been exposed to secondhand smoke -- or other environmental risks associated with lung cancer -- to visit their doctor and to undergo a lung scan. They offer the same advice to those who smoke, or have smoked with a family history of lung cancer, stating that early detection is imperative for long-term survival rates and curability.

Recently Alexian Brothers introduced the Alexian Lung Scan, a state-of- the-art CT screening that can detect the presence of tiny irregularities or nodules that are too small to be seen in a conventional X-ray. The lung scan, which lasts 20 seconds, identifies these abnormalities. A spirometry screening for chronic obstructive pulmonary disease (COPD), such as emphysema and chronic bronchitis, is included with the lung scan. Alexian is providing the test free to the first 100 people who complete one of the network's smoking cessation programs.

The Cancer Institute at Alexian Brothers is operated by Alexian Brothers Hospital Network, which also includes Alexian Brothers Medical Center and Alexian Rehabilitation Hospital in Elk Grove Village, St. Alexius Medical Center and Alexian Brothers Behavioral Health Hospital in Hoffman Estates, Illinois.

www.alexianhealthsystem.org

[robin_himself]

The drug varenicline shows effectiveness in helping smokers quit and abstain from smoking when compared to placebo and the smoking cessation medication bupropion, according to three studies in the July 5 issue of JAMA.

Although nearly 41 percent of smokers try to quit smoking each year, relapse is common, and only about 10 percent achieve and maintain abstinence. The negative effects of nicotine withdrawal account, in part, for low success rates, according to background information in the article. Approved pharmacotherapies to treat nicotine dependence (e.g., nicotine replacement therapy and bupropion) have had important, but moderate efficacy, with reported rates of quitting generally twice those of placebo. Additional and more effective therapies are needed.

David Gonzales, Ph.D., of Oregon Health & Science University, Portland, and colleagues with the Varenicline Phase 3 Study Group evaluated the efficacy of varenicline compared with placebo and sustained-release (SR) bupropion in generally healthy adult smokers. Varenicline is a non-nicotine drug that is thought to be beneficial for smoking cessation by stimulating the release of the chemical dopamine in the brain to reduce craving and withdrawal while simultaneously blocking the reinforcing effects of smoked nicotine. Most other smoking cessation pharmacotherapies are nicotine replacement products.

Participants in the study were 1,025 smokers (10 cigarettes or more per day) with fewer than 3 months of smoking abstinence in the past year. The randomized, double-blind, phase 3 clinical trial was conducted at 19 U.S. centers from June 2003 to April 2005. Participants were randomly assigned to receive brief counseling plus either varenicline twice per day (n = 352), bupropion SR twice per day (n = 329), or placebo (n = 344) orally for 12 weeks, with 40 weeks of nondrug follow-up.

The carbon monoxide-confirmed 4-week continuous abstinence rate for weeks 9 through 12 was superior for varenicline (44.0 percent) vs. placebo (17.7 percent) and vs. bupropion SR (29.5 percent). Bupropion SR was also superior to placebo. The continuous abstinence rate for weeks 9 to 24 was superior for varenicline (29.5 percent) vs. placebo (10.5 percent) and vs. bupropion SR (20.7 percent). The continuous abstinence rate for weeks 9 through 52 was significantly greater for varenicline (21.9 percent) than for placebo (8.4 percent) but no longer significant compared with bupropion SR (16.1 percent).

Varenicline reduced craving and withdrawal and, for those who smoked while receiving study drug, also reduced smoking satisfaction. No sex differences in efficacy for varenicline were observed. Varenicline was safe and generally well tolerated, with study drug discontinuation rates similar to those for placebo. The most common adverse events for participants receiving active-drug treatment were nausea for varenicline and insomnia for bupropion SR.

"Varenicline is an efficacious therapy for smoking cessation. In this trial, varenicline was more efficacious than placebo at all time points and more efficacious than bupropion SR at the end of 12 weeks of treatment and at 24 weeks," the authors write.
(JAMA. 2006;296:47-55.)

Editor's Note: This study was supported by Pfizer Inc., which provided funding, study drug and placebo, and monitoring. For the financial disclosures of the authors, please see the JAMA article.

Varenicline Shows Long-Term Effectiveness

In another study, Douglas E. Jorenby, Ph.D., of the University of Wisconsin School of Medicine and Public Health, Madison, Wis., and colleagues with the Varenicline Phase 3 Study Group conducted a study designed identical to that of Gonzales et al to assess the efficacy and safety of varenicline for smoking cessation compared with placebo and bupropion SR during initial treatment and long-term follow-up.

This randomized, double-blind, placebo-controlled trial was conducted at 14 research centers between June 2003 and March 2005 and consisted of a 12-week treatment period with follow-up of smoking status to week 52. The study included 1,027 adult smokers, 65 percent of whom completed the study. The participants were randomized to varenicline twice daily (n = 344), bupropion SR twice daily (n = 342) or placebo (n = 341) for 12 weeks, plus weekly brief smoking cessation counseling.

The researchers found that varenicline produced higher continuous abstinence rates than placebo at all time points. During the last 4 weeks of treatment (weeks 9-12), 43.9 percent of participants in the varenicline group were continuously abstinent from smoking compared with 17.6 percent in the placebo group and 29.8 percent in the bupropion SR group. For weeks 9 through 24, 29.7 percent of participants in the varenicline group were continuously abstinent compared with 13.2 percent in the placebo group and 20.2 percent in the bupropion group. For weeks 9 through 52, 23 percent of participants in the varenicline group were continuously abstinent compared with 10.3 percent in the placebo group and 14.6 percent in the bupropion SR group.

"At the end of the treatment period, the odds of quitting smoking with varenicline were significantly greater than the odds of quitting with either placebo or bupropion SR," the authors write.

Treatment was discontinued due to adverse events by 10.5 percent of participants in the varenicline group, 12.6 percent in the bupropion SR group, and 7.3 percent in the placebo group. The most common adverse event with varenicline was nausea, which occurred in 101 participants (29.4 percent).

"Reducing smoking rates in the U.S. population will require a combination of efforts from individuals, health care systems, insurers, and policy makers as part of a comprehensive tobacco-control strategy. Advances can be made by improving the use of existing smoking cessation treatments and by developing better treatments. Varenicline … has demonstrated a robust ability to increase cessation rates (short-term and long-term) compared with both placebo and a first-line smoking cessation medication (bupropion SR), and may represent an advance in the treatment of tobacco dependence," the authors conclude.
(JAMA. 2006;296:56-63.)

Editor's Note: The data reported in this article were derived from a clinical trial sponsored by Pfizer Inc., which provided funding, study drug and placebo, and monitoring. For the financial disclosures of the authors, please see the JAMA article.

Varenicline Helps to Prevent Relapse For Smokers Who Have Achieved Abstinence

In another study, Serena Tonstad, M.D., Ph.D., of Ulleval University Hospital, Oslo, Norway and colleagues with the Varenicline Phase 3 Study Group conducted a randomized, double-blind, placebo-controlled trial evaluating the efficacy of an additional 12 weeks of varenicline used for relapse prevention in smokers who successfully achieved abstinence following an initial 12-week varenicline treatment.

According to background information in the article, 50 percent to 60 percent of people who are initially successful at quitting smoking go on to relapse within a year. A recent comprehensive review of existing studies concluded that currently there is no evidence-based relapse prevention intervention available.

The study was conducted at multiple medical clinics in 7 countries with follow-up to 52 weeks after study baseline. Of 1,927 cigarette smokers recruited between April 2003 and February 2004 and treated for 12 weeks with open-label varenicline twice per day, 1,236 (64.1 percent) did not smoke, use tobacco, or use nicotine replacement therapy during the last week of treatment and 62.8 percent (n = 1,210) were randomized to additional treatment or placebo. Participants were assigned to receive either varenicline, 1.0 mg twice per day (n = 603), or placebo (n = 607) for an additional 12 weeks.

The continuous abstinence rate for weeks 13 to 24 was higher for participants randomized to varenicline than for participants randomized to placebo (70.5 percent vs. 49.6 percent). The continuous abstinence rate for weeks 13 to 52 was also higher for the varenicline group than for the placebo group (43.6 percent vs. 36.9 percent). Adverse events reported in the open-label period were mostly mild; no difference in adverse events between varenicline and placebo was observed during the double-blind period.

"In the field of relapse prevention--in which there is a notable lack of positive findings--these results represent an important new development," the authors write.

The researchers add that at the end of this trial, as in all existing literature on smoking cessation with 1 year of follow-up, more than 50 percent of participants in each group returned to smoking. "Thus, an examination of longer medication periods is warranted."

"In conclusion, extended use of varenicline helps recent ex-smokers to maintain their abstinence and prevent relapse. Varenicline is the first smoking cessation treatment to demonstrate a significant long-term relapse prevention effect," the authors write.
(JAMA. 2006;296:64-71.

Editor's Note: This study was sponsored by Pfizer Inc., which provided funding, study drug and placebo, and monitoring. For the financial disclosures of the authors, please see the JAMA article.

Editorial: Varenicline for Smoking Cessation - Definite Promise, But No Panacea

In an accompanying editorial, Robert C. Klesges, Ph.D., Karen C. Johnson, M.D., M.P.H., and Grant Somes, Ph.D., of the University of Tennessee Health Science Center, Memphis, Tenn., comment on the studies on varenicline and smoking cessation.

"It is important for clinicians to moderate some of the potential enthusiasm that is likely to occur as the result of the publication of these trials, FDA approval of the drug, and promotion by this manufacturer. On the one hand, these studies demonstrate that varenicline is associated with higher smoking cessation rates than placebo and may produce better cessation rates than bupropion, a first-line-approved smoking cessation drug. Importantly, varenicline represents a third class of drug with probably a different mechanism of action than either nicotine replacement therapy or bupropion. On the other hand, varenicline definitely is not a panacea for smoking cessation. Many participants in these trials experienced adverse events, stopped taking their study medication before they should have, and discontinued participation in the studies. Importantly, the majority of participants in these 3 studies did not quit smoking even with varenicline."

"Clearly, quitting smoking, even with pharmacological and behavioral assistance, is extremely difficult. Patients currently cannot and probably never will simply be able to 'take a pill' that will make them stop smoking. Smokers must want to stop smoking and must be willing to work hard to achieve the goal of smoking abstinence," the authors write. "Although much research needs to be conducted to establish the effectiveness of varenicline, stop smoking researchers and clinicians, as well as smokers wanting to quit smoking, now have another product available that appears to help increase the probability of smoking cessation."
(JAMA. 2006;296:94-95.)

www.jamamedia.org

[robin_himself]

A decision announced today by the Florida Supreme Court effectively leaves 700,000 Florida smokers with little or no redress against U.S. tobacco companies that have profited by selling highly addictive cigarettes, which most smokers begin using before they are old enough to legally purchase the products. Ironically, this is in spite of the fact that the Court upheld findings about the grave dangers and addictiveness of cigarettes as well as the actions of the tobacco companies in misrepresenting these dangers. The ruling underscores the fact that Big Tobacco will literally be able to litigate to death a smoker's claim for justice.

Today's court decision said that compensatory damages must be paid to two of three individual plaintiffs in the case, but that tobacco companies do not have to pay $145 billion in punitive damages to smokers included in the class action portion of the case. Those dollars had been requested on behalf of Florida citizens and residents (and their survivors) who have suffered, presently suffer or who have died from diseases caused by their addiction to cigarettes that contain nicotine.

Few individuals can withstand the financial and time-consuming hardships associated with years of expensive and lengthy litigation against these huge companies. The American Legacy Foundation(R) notes the dangerous message that this ruling makes about public health: we know that cigarettes include highly addictive nicotine and that more than 80 percent of smokers start before they are adults, but that the companies who manufacture and market the products responsible for the nation's number-one cause of preventable death -- tobacco use -- can hide behind procedural roadblocks to avoid most liability.

Requiring smokers to file individual cases, instead of benefiting from our legal system's ability to address large-scale issues through class action suits, places a great burden on individuals already suffering the adverse effects of tobacco, including the costs associated with treating tobacco- related disease. Yet again, it is an example of Goliath standing on David's neck -- a bellwether decision that is bad for public health and even worse for American smokers.

The American Legacy Foundation(R) is dedicated to building a world where young people reject tobacco and anyone can quit. Located in Washington, D.C., the foundation develops programs that address the health effects of tobacco use through grants, technical assistance and training, youth activism, strategic partnerships, counter-marketing and grassroots marketing campaigns, research, public relations, and outreach to populations disproportionately affected by the toll of tobacco. The foundation's national programs include Circle of Friends(R), Great Start(R), a Priority Populations Initiative, Streetheory(R) and truth(R). The American Legacy Foundation was created as a result of the November 1998 Master Settlement Agreement (MSA) reached between attorneys general from 46 states, five US territories and the tobacco industry.

www.americanlegacy.org.

[VincentVan]

All this is very intresting Robin , and it´s quite obvious that it really worries you.
That´s why now I feel curious: Do you smoke ?
VV.

[robin_himself]

I'm actually in the middle of a attempt to quit! I haven't smoked for 2 months.... and its getting better. The reason I quit smoking is not because of the health problems I stated above ironically.... its because I find that I want to get to a state where I can smoke tobacco recreationaly... with moderation. Like once in a couple of months... sitting outside in the garden.. looking up to the sky and stars and having a nice tobacco smoke! And not this crazy addiction.


And well..... the reason why I posted this articles in one thread is because I wanted to try to keep everything together..... people normally skip the smoking/quit-smoking section

[robin_himself]

Although African Americans smoke fewer cigarettes and inhale them less deeply than Caucasians, they contract emphysema at an earlier age, according to a study by Temple University researchers in the journal Chest.

The study, which confirms findings from a smaller preliminary study published last year, also offers evidence of biological differences in the distribution of emphysema and the severity of lung destruction between African Americans and Caucasians, leading researchers to conclude that the mechanism underlying the disease might also vary between the races.

"Not everyone who smokes gets emphysema or the same type of emphysema," says Wissam Chatila, MD, lead author and associate professor of medicine at Temple University School of Medicine and Hospital. "Our study supports previous findings that there might be something different between African Americans and Caucasians who are susceptible to the bad effects of smoking. The next question -- why is this so?"

While researchers begin to tackle this puzzle, Chatila notes that the current study contains important implications for primary care doctors of African American patients. By identifying the disease early and avoiding misdiagnosis, patients can receive better treatments and achieve improved outcomes. Along with an understanding of how severe emphysema develops, the work may also aid in shaping antismoking policies and smoking cessation programs that specifically target African Americans.

"If African American patients are smoking and suffering some degree of breathing disturbances, the study shows that we need to pay better attention, even if they seem too young to have emphysema," said Chatila, who is also a pulmonary specialist at the Temple Lung Center.

Confirmation of earlier findings on racial biological differences was important because of understandable skepticism about such distinctions.

"People question whether racial differences in disease are due to factors such as the environment, socioeconomic status or health care disparities," says Chatila.

The researchers acknowledge that such issues may play an important part in the development and onset of the disease and further, that a much higher proportion of African Americans will need to be studied before resolving issues of race and environment that might influence emphysema risks and outcomes.

The Temple team examined 1198 patients with severe or very severe emphysema who were enrolled in the National Emphysema Treatment Trail (NETT). Severity, distribution and physiologic impact of emphysema in both groups were determined using cardiopulmonary function tests, quantitative computed tomography (CT) of the chest, and a quality of life questionnaire.

Forty-two participants were African Americans (3.4%), compared to 1156 (95%) Caucasians. However, when matched in respect to age, height, smoking and pulmonary function, researchers were still surprised to find differences in how the disease progressed in the two races, in particular that African Americans were younger and smoked less than whites.

The report notes that while "few doubt the answer lies in the complex genotype- environment interaction, the extent to which each factor plays a role in the development of emphysema remains enigmatic."

Chatila, whose interest in this area of research originated when he and his colleagues noticed that African American patients were presenting with chronic obstructive pulmonary disease (COPD) that was often under treated and misdiagnosed, has already begun to explore the cellular differences and inflammation in patients with emphysema to see if these can explain some of the differences observed in the study.

www.temple.edu

[robin_himself]

Researchers in Boston studied elderly male twins and found that those who smoke or have a history of smoking had an increased risk of developing age-related macular degeneration as compared to those who never smoked. At the same time, those who ate more fish and had diets with higher levels of omega-3 fatty acids reduced their risk of this blinding disease. Their findings are published in the July 2006 issue of the Archives of Ophthalmology.

Researchers at the Massachusetts Eye and Ear Infirmary and Department of Biostatistics at Harvard Medical School studied 681 male twins from the National Academy of Sciences-National Research Council World War II Veteran Twin Registry. To determine genetic and environmental risk factors for Age-related Macular Degeneration (AMD), twins were surveyed for a prior diagnosis of AMD and underwent an eye examination, fundus photography, and food frequency and risk factor questionnaires. The study included 222 twins with intermediate and late-stage AMD and 459 twins with no signs of the disease.

"Current smokers had a 1.9-fold increased risk of developing AMD, while past smokers had about a 1.7-fold increased risk," said Johanna M. Seddon, M.D., director of the Epidemiology Unit at the Massachusetts Eye and Ear Infirmary and an associate professor of ophthalmology at Harvard Medical School. "We also found that increased intake of fish reduced the risk of AMD, particularly if they ate two more servings per week. Dietary omega-3 fatty intake was also inversely associated with AMD. This study of twins provides further evidence that cigarette smoking increases risk while fish consumption and omega-3 fatty acid intake reduce risk of AMD."

AMD is the leading cause of irreversible visual impairment and blindness among persons aged 60 and older. With the elderly population steadily growing, the burden related to this loss of visual function will increase. Limited treatment options exist and prevention remains the best approach for addressing this public health concern.

Lead author Dr. Seddon and her colleagues previously reported that the heritability of AMD is high (46% to 71%) in this same cohort of twins (Arch Ophthalmol 2005). They also found that systemic markers of inflammation, including serum levels of high sensitivity C-reactive protein, as well as plasma homocysteine are associated with AMD (JAMA 2004, Am J Ophthalmol 2006). A decade ago they reported the increased risk of AMD with cigarette smoking (JAMA 1996), and the decreased risk of this disease related to dietary intake of carotenoids and foods rich in lutein and zeaxanthin (JAMA 1994). They also found in several of their study cohorts that fish intake appears beneficial and reduces risk of AMD (Arch Ophthalmol 2001, 2003, and current article), and high body mass index or obesity is also a risk factor for progression of the disease. (Arch Ophthalmol 2003).

www.meei.harvard.edu