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By John Schieszer
Medical Minutes 

New approaches to fight, treat smoking, tinnitus

Also: Latest numbers show cancer rates continue to decline

 

February 1, 2018



E-cigarettes may help some smokers

A new study is suggesting that smokers who are willing to use e-cigarettes tend to smoke less and have increased quit attempts. As e-cigarettes become more popular, fewer people are taking up smoking traditional cigarettes. However, there is debate whether this electronic nicotine delivery system can help people quit smoking altogether.

“Combustible cigarettes are the most harmful form of nicotine delivery. Alternative delivery of nicotine through e-cigarettes, could significantly reduce harm and the risks of cancer and other diseases to smokers,” said Matthew Carpenter, Ph.D., a tobacco control and addiction expert at the Medical University of South Carolina (MUSC).

Carpenter and his team evaluated e-cigarettes in terms of usage, product preference, changes in smoking behaviors and nicotine exposure. The study included 68 smokers and 46 were randomized to use e-cigarettes as much as they wanted, and 22 were randomized to a control group.

Those in the e-cigarette group were given a device with either high or low doses of nicotine. Everyone was followed over a period of four months. The study was published in Cancer Epidemiology, Biomarkers & Prevention and is one of the few randomized studies in the U.S. to examine the effects of e-cigarettes and quit attempts.

Results showed that when smokers were given e-cigarettes without any accompanying instructions or requirements for use, uptake was strong, and many participants went on to purchase their own e-cigarettes. This suggests that e-cigarettes might give smokers a suitable alternative to combustible cigarettes. Those who used e-cigarettes smoked less and were more likely to quit smoking, as compared to those in the control group.

Of the two e-cigarette models used in the study, the more powerful device, with a higher dose of nicotine, showed stronger outcomes. People using e-cigarettes throughout the study smoked an average of 37 percent fewer cigarettes, showing a positive effect when making the switch and potentially serving as a tool to help smokers quit.

A new way of treating tinnitus

A team of scientists has now come up with an experimental device that may quiet the phantom noises of tinnitus sufferers. It is now possible to combat ringing in the ears in a whole new way by generating two kinds of specially timed pulses. With this approach, one of the pulses is delivered through earphones and the other through electrodes placed on the skin of the face or neck.

Millions of Americans hear ringing in their ears (tinnitus) and there have never been any really effective treatments. However, a team from the University of Michigan is reporting promising results of the first animal tests and a clinical trial with 20 human tinnitus patients.

The device uses precisely timed sounds and weak electrical pulses that activate touch-sensitive nerves. This steers damaged nerve cells back to normal activity. Human participants reported that after four weeks of daily use of the device, the loudness of phantom sounds decreased, and their tinnitus-related quality of life improved. A sham “treatment” using just sounds did not produce such effects.

“The brain, and specifically the region of the brainstem called the dorsal cochlear nucleus, is the root of tinnitus,” said researcher Susan Shore, PhD, who is a Medical School professor at the University of Michigan. “When the main neurons in this region, called fusiform cells, become hyperactive and synchronize with one another, the phantom signal is transmitted into other centers where perception occurs.”

This new approach is called targeted bimodal auditory-somatosensory stimulation. The device plays a sound into the ears, alternating it with precisely timed, mild electrical pulses delivered to the cheek or neck. This sets off a process called stimulus-timing dependent plasticity (STDP). The approach aims to re-set the activity of fusiform cells, which normally help our brains receive and process both sounds and sensations such as touch or vibration.

Cancer rates continue to decline

Some very good news to report in the war on cancer. The cancer death rate dropped 1.7 percent from 2014 to 2015, continuing a drop that began in 1991. The American Cancer Society has issued its latest numbers and it estimates that there will be 1,735,350 new cancer cases and 609,640 cancer deaths in the United States in 2018. The cancer death rate dropped 26 percent from its peak of 215.1 per 100,000 population in 1991 to 158.6 per 100,000 in 2015.

A significant proportion of the drop is due to steady reductions in smoking and advances in early detection and treatment. There have been overall declines in death rates for the four major cancer sites (lung, female breast, prostate and colorectal). Over the past decade, the overall cancer incidence rate was stable in women and declined by about 2 percent per year in men. Prostate, lung, and colorectal cancers account for 42 percent of all cases in men, with prostate cancer alone accounting for almost one in five new diagnoses.

For women, the three most common cancers are breast, lung and colorectal, which collectively represent one-half of all cases. Breast cancer alone accounts for 30 percent of all new cancer diagnoses in women. The lifetime probability of being diagnosed with cancer is slightly higher for men (39.7 percent) than for women (37.6 percent).

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

 
 

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