Thursday, February 10, 2011

Smoking harms mental health but quitters arrest decline, study finds

This study seems methodologically sound

SMOKING accelerates mental decline and damages parts of the brain linked to dementia, an Australian study has found. But there is good news for long-term smokers: quitting reverses the harmful effects on the brain.

The study assessed brain function using standard performance tests, matching the results to brain scans in 229 elderly smokers who were trying to give up and 98 non-smokers.

The research, repeated at six-monthly intervals for two years, was the first in the world to track changes in smokers' mental performance over a lengthy period.

It found the smokers, who were aged 68 and over, lost a disproportionate number of brain cells in regions important for memory and active thinking. "For the first time it shows what we see with our memory tests is confirmed by changes in the brain," said Osvaldo Almeida, professor of geriatric psychiatry at the University of Western Australia.

The smokers who failed to quit slid into mental decline twice as fast as non-smokers, but "those who quit, don't decline faster than those who never smoked", said Professor Almeida, a consultant at the Royal Perth Hospital where the patients were recruited.

"It's a good thing for your brain to quit," he said. "People who stop smoking, in terms of memory and cognitive function, do as well as people who never smoked."

While the quitters did show some grey matter loss 18 months after giving up, Professor Almeida said the damage was not significant and not in brain regions significant to cognitive impairment.

"The study suggests even later in life, if people stop smoking, it will have a positive effect on their brains," he said. The results, published in the journal NeuroImage, meant action could be taken to reduce the burden of Alzheimer's disease without waiting for a "magic pill".

"If people understand that smoking is an important risk factor … that contributes to progressive intellectual decline, this would hopefully reduce the burden of dementia in Australia."

Professor Almeida plans to continue testing participants at five-year intervals.

Kaarin Anstey, director of the dementia collaborative research centre at the Australian National University, said: "Before, people might have thought, 'it's too late for me … there's no point in me giving up because the damage is already done'. There's a very positive message in this research showing it's never too late and these quitters are getting a benefit, even in their 70s."


Australia: Useless health regulators

If people knew they were on their own they might be more cautious -- but they have the illusion of being protected by government regulation

The Therapeutic Goods Administration is calling for submissions as to how it can improve its transparency. Which is not before time, given that a recent spot check of 400 so-called alternative medicine products found that nine out of 10 breached TGA regulations.

I decided to put my own two bobs' worth in. In the interests of transparency, I reproduce an edited version of my own submission to the review here. It's not as good as the more detailed submissions from Choice magazine and the Consumers Health Forum of Australia, but I found writing it to be, well, therapeutic. I wrote:
At the moment the TGA appears to operate as a rubber stamp for health fraud. It beggars belief that the "Aust L" "self-assessment" system allows people to sell untested products for medicinal use without having to provide so much as a jot of evidence for their efficacy.

The fact that a recent spot check found that 90 per cent of so-called complementary and alternative medicine products do not comply with regulations shows that the system is broken.

To help with transparency:

* All "Aust L" listed products should carry a warning box stating something to the effect of "The makers of this product have shown zero evidence that this product works for any disease or condition or that it can improve your general health or wellbeing."
Products that are known to be scientifically implausible should be labelled as such. The labelling should explain that scientific implausibility doesn't mean that "it works but we don't know how"; that it means "it can't possibly work as claimed unless much of our accumulated knowledge of physics, chemistry and physiology is completely wrong".

* The complaints process should not be so completely opaque. Some weeks ago I used the TGA's online complaints submission to submit a complaint (about the sale of colloidal silver for human consumption and the treatment of serious diseases in what seems a clear breach of the Therapeutic Goods Act). When I called to check up on the complaint a week later I was told it had never arrived so I had to re-submit it by email. Complaints submitted online should get a receipt number, like you do when you pay a bill online.

* People who make complaints should be informed of the result of the investigation - if indeed any investigation takes place. I have no idea whether my complaint will be investigated, and I get the impression that I will never find out unless I keep hassling people to check up on it.

* The TGA should be issuing a hell of a lot more advisories. The list of advisories is very short and threadbare. For instance, there is only one mention of homeopathic "immunisations" - a warning from 2002 not to use homeopathic "vaccines" for meningococcal disease. There is no warning about homeopaths selling useless "immunisations" for other diseases (including whooping cough, a serious respiratory infection that has been killing Australian children again in recent years). Also, there are no warnings about colloidal silver, ear candling and countless other things on which Australians are wasting their money and risking their health every day.

* There should be real consequences for breaching the Act. As long as the manufacturers and retailers of alternative nostrums feel free to scoff at the TGA they will continue to put people's health at risk.

What do you think? Do you think the TGA should do more to tell consumers that there is no evidence to support many of the remedies being sold in pharmacies, supermarkets and health-food stores? Do you think people who want to sell alternative remedies should have to prove that they work before they can be approved for sale? Submissions to the TGA review close tomorrow, by the way.


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