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Stanford University School of Medicine

Bringing an end to smoking

the_end_game_portrait-bannerI came of age during the "tobacco wars," when industry executives were being vilified in Congress and heavily penalized for peddling a dangerous, often deadly, product. And I live in Northern California, where tobacco and cigarette smoking are frowned upon.

So I was surprised recently to discover how many people in this country still smoke. While researching a story for Stanford Medicine magazine on smoking prevention, I learned that more than 40 million Americans are held hostage to nicotine and light up every day. The number who die from smoking-related ailments continues to rise - to more than 480,000 people a year. Equally worrisome is a sharp rise in use of e-cigarettes among teens, which exposes the vulnerable, still-developing brain to nicotine and could make these youth more prone to regular cigarette use as adults.

In the face of these persistent trends, researchers at Stanford, including several at the Stanford Prevention Research Center, are looking to new technologies and approaches to help people quit smoking for good. My story outlines some of these strategies, including a novel way of using Twitter to provide peer support to those wanting to stop. Judith Prochaska, PhD, an associate professor of medicine, recently led a study of 160 smokers, half of whom got peer support through Twitter. Results of the study were impressive, with 40 percent in the Tweet2Quit group remaining smoke-free after two months, she and her colleagues reported.

Prochaska has several other smoking prevention projects under way, including one that targets unemployed smokers, who have a tougher time finding a job and are paid less than their peers when they do find employment, according to her research. The project is unusual in that provides a wide range of resources, including an online program, that these smokers can access at unemployment centers, where many spend their time.

Several Stanford researchers are studying smoking trends among teens and their vulnerability to tobacco advertising, which is ubiquitous in the state. "Everybody complains that there are so many fast-food restaurants, but in California there are 28 tobacco retailers for every McDonalds," Lisa Henriksen, PhD, senior research scientist at the Stanford Prevention Research Center, told me. "These retailers are literally omnipresent."

That is important because teens who frequent outlets with tobacco advertising are more prone to start smoking than those who aren't exposed to these marketing messages, she has found.

But the biggest trend among young people is skyrocketing use of e-cigarettes which, until recently, were not regulated by the state or federal government. Bonnie Halpern-Felsher, PhD, professor of pediatrics and adolescent medicine, says young people harbor misperceptions about e-cigarettes and get little information about the products' health risks from school, parents, health educators and others. So she is developing a new online tool that she plans to distribute to school districts across the state. She also encourages students to be skeptical of an industry that has a history of lying to consumers.

"I tell kids that industry leaders have been dishonest before," Halpern-Felsher says. "Can you trust them? And I point out that over 500,000 people die every year from smoking. So the industry needs replacement smokers."

Previously: Quitting smoking: Best drug differs for men and women, Study sheds light on physicians testifying in court that smoking didn't cause cancer and New landscape for e-cigarettes: Stanford tobacco expert weighs in on new FDA regulations
Image by Jeffrey Decoster

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