LGBT Wellness Roundup: October 5

As published on Huffington Post’s new LGBT Wellness blog, see original at: http://ow.ly/DhVNO

Each week HuffPost Gay Voices, in a partnership with bloggers Liz Margolies and Scout, brings you a round up of some of the biggest LGBT wellness stories from the past seven days. For more LGBT Wellness, visit our page dedicated to the topic here. The weekly LGBT Wellness Roundup can also now be experienced as a video — check it out above.

Yet another life lost to smoking

We are deeply saddened to report that Bill Busse, a Tips From Former Smokers ad participant, has passed away. The cause of death was heart disease, which is very common for smokers. Bill shared his story on the Tips From Former Smokers Campaign about the affects that smoking had on his health (made more severe by diabetes, which he had since childhood).

The CDC released a statement from Tim McAfee, Director, CDC’s Office on Smoking and Health on the passing of Bill Busse. The CDC asks that you please direct any questions and/or condolences to TobaccoMediaCampaign@cdc.gov. The CDC will make sure that your correspondence is forwarded to Bill’s family.

Bill’s health problems didn’t stop him from heroically coming forward towarn other smokers of some of the dangers they faced if they don’t quit smoking.  Nor did his health problems stop Bill from enjoying time with his kids.

Our thoughts and prayers go out to Bill’s wife, two children and two step-children, as well as his parents and his sister.

A tip for smokers, from the man himself; “Make a list and put the people you love at the top, put down your eyes your legs your kidneys and your heart, now cross off all the things you’re okay with losing, because you’d rather smoke.”

You can view Bill Busse’s videos here.

Network training update- National Jewish Quitline!

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     Network Training Update
     National Jewish Quitline

 

 

 

Last week, Dr. Scout flew to Colorado to do trainings at the National Jewish Hospital, home of one of the country’s largest quitlines.

Dr. Scout’s training, titled  “The LGBT Population and Tobacco Use: Creating an LGBT Friendly & Inclusive Environment”, discussed smoking disparities in LGBT populations, how to improve cultural competence and inclusion, data collection, and strategies for targeting LGBT communities.

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LGBT Quitline Strategies:

  • Before they call
  • Understanding access barriers
  • Enhancing welcome at your organization
  • Once they call – creating welcoming environment
  • After they call – extra materials

Evidence of LGBT Avoidance of Quitlines:

“In a rare study in Colorado that looked at intentions of smokers to use quitlines, LGBT people who smoked and wanted to quit were 5x less likely than others to call a quit line.”

The Lessons:

  • While LGBT callers are very likely to experience stressors and triggers related to LGBT status…
  • they are very unlikely to presume the quitline is a welcoming environment to discuss these issues.
  • And hiding their LGBT status can adversely affect treatment.

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New Study Looks at Smoking Cessation among People with HIV

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Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

 

 

 

What makes smoking cessation successful among people living with HIV?  That was the question posed at an event last week at the American Legacy Foundation in Washington, DC.

Dr. Donna Shelley explained that ending smoking among people living with HIV is especially important because “smoking increases the risk of HIV-related infections” and leads to “poorer adherence to HIV meds, higher viral load,” and other health problems.  NAM, an HIV/AIDS organization, notes that HIV-positive “smokers are approximately three times more likely than non-smokers to develop the AIDS-defining pneumonia PCP” and that “oral thrush, a common complaint in people with HIV, is also more common amongst smokers.”  Dr. Shelley’s study focused on testing cessation strategies among people with HIV in New York.

When it comes to quitting smoking, it could be seen as a positive or negative that people living with HIV are already likely to have complicated medical adherence needs.  On the one hand, adding smoking cessation interventions and medications adds to the burden that many people living with HIV already face.  But on the other hand, many people living with HIV have found success at incorporating medication regimens into their lives and are used to managing their care, either on their own or with the support of a medical adherence team.  For people who are doing well adhering to their HIV-related medications and treatments, they may well be able to incorporate tobacco cessation measures with a high level of adherence.

In fact, that is what Dr. Shelley’s preliminary data suggested.  “Adherence at baseline to HIV meds,” meaning how well people remembered to take their HIV medications at the start of the study, “was closely correlated to adherence to cessation medications” by the study’s sixth week, she said.

Dr. Shelley also noted that the people for the study were recruited from healthcare clinics, which often are in more regular contact with their patients than are other types of medical providers.  That’s because these settings tend to offer multiple, highly coordinated services.  So, for example, if a client comes in to see her therapist but has missed an appointment with her primary care doctor, the staff person checking her in can make sure she reschedules with her doctor or gets the prescription refill or referral that she might need.

The research tested three adherence regimens: smoking cessation medication alone; medication and adherence text messages; and medication, text messages, and adherence counseling phone calls.  Interestingly, the research found that the group with the best adherence were those who received the medication and text messages, but not the phone calls, which many people reported as being “too much.”  People also stressed that they liked texts with positive reinforcement – like “stay on track” or “look how much money you’ve saved this month” – versus messages that just reminded them to take their medication.

It’s unclear whether the results are unique to people living with HIV, or would have been the same for others, as well.  But it’s worth noting that people who are already managing HIV-related care preferred quick positive reinforcement on quitting smoking rather than lengthy counseling on taking their meds or daily messages telling them to take their pill.

It’s true that HIV is not just a problem for the LGBT community.  But given that 63% of new HIV infections in 2010 were among men who have sex with men, and that LGBT people smoke at a rate that is 68% higher than the population in general, the intersection of smoking and HIV is a critical topic for LGBT health advocates to keep in mind.

E-Cigarettes: Friend or Foe for the LGBT Communities?


E-Cigs

 As published on Huffington Post’s new LGBT Wellness blog, see original at: http://www.huffingtonpost.com/scout-phd/e-cigarettes-friend-or-foe_b_5024583.html

Working in tobacco control sometimes elicits interesting reactions from people. Some try to hide their smoking. While I certainly appreciate not being near the smoke itself, I’ve got great empathy for smokers. In fact, since most smokers have already tried to quit, they’re much more likely to be fellow fighters against tobacco than non-smokers. Sometimes they ask me how to best quit and I’m happy to tell them (hint, call 1-800-QUITNOW). These days everyone’s asking me something new: What about e-cigarettes? The shortest answer is “they could be helpful for a few, but we all worry about our youth.”

First, if you’re not familiar with e-cigs, they are battery-powered imitators of old-school cigarettes, designed to deliver nicotine, flavor and other chemicals through vapor inhaled by the user. Most of them have a swag little electronic light at the tip to make it seem more like an old-school cig. Some now have other names like e-hookah to avoid any cigarette associations. The claim is here’s a no-combustion device to get your nicotine fix, great for cessation and great to smoke in places where cigarettes are banned.

There is one study supporting the effects of e-cigs in helping people quit smoking but now another study is out contravening it. Considering how toxic cigarette smoke is, we all applaud anything that helps reduce the amount of cigarette smoke in the air. But if you’re trying to use e-cigs as a cessation device it’s a bit dicey right now because they’re unregulated, so the amount of nicotine you get in each dose varies, and sometimes does not match the advertising. It’s commonly known that it only takes about two weeks to kick the nicotine addiction of smoking, but anyone who’s quit will tell you, it’s the social habit of smoking that draws you back again and again. I’m not sure how putting a cigarette replacement in your mouth helps you kick that social habit — sounds to me like it’s just perpetuating it. Plus there is a new study showing other toxic chemicals in the vapor. To top it off, there’s no real science on the long-term effects of inhaling nicotine vapor. So while I’m willing to bet it’s better than inhaling tobacco smoke, that’s like saying I bet it’s better than inhaling truck exhaust. Nicotine is so toxic, poison control centers just issued an alert about high numbers of calls on accidental exposure. Just touching the liquid is enough to cause vomiting and ingesting as little as a teaspoon of some of the liquid nicotine concentrations can be fatal. I hope people set a higher bar for their own cessation journey.

The real problem is, as anyone who’s visited a vaporium can see, it’s not a cessation game. Vaporiums and e-cigs are all about enticing, and particularly enticing young people. Wander into your local vaporium belly up to the “bar” and you’ll be shocked to see how many vaporiums look like the lovechild of a hip coffee shop and a candy store. I’m not sure exactly which adult Marlboro user would switch to cotton candy flavored nicotine cartridges, or banana nut bread, or cherry limeade. Sounds to me more like flavors I’d find at a little league game. To make it worse, these products are easily available online and many states aren’t yet doing anything to restrict access to minors. Data show LGBT youth continue to smoke at rates much higher than their non-LGBT counterparts and the number of youth experimenting with e-cigs is rising rapidly… the very last thing we need is to have some fancy new gadgetry on the market enticing LGBT youth to start using a highly addictive drug to deal with the stress of stigma against us all.

We pass on smoking down through the LGBT generations socially. I’ve always called it an STD for us, a socially transmitted disease. So I also worry about adult e-cig use. Every time you “light up” you’re perpetuating the huge LGBT cigarette culture, all of us laughing and having fun and hanging out, with cigarettes in our mouths.

We already have cessation aids that deliver you nicotine in controlled regulated doses, you can find those on every drugstore shelf. Nicely, there’s not one gummy bear or watermelon flavored nicotine patch, spray or gum. So while e-cigs might help a few in quitting, I say the big picture on e-cigs for the LGBT communities is we need to think of our youth and “beware of the wolf in sheep’s clothing.”

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 Dr. Scout, Director

 The Network for LGBT Health Equity

 

 

Follow Scout, Ph.D. on Twitter: www.twitter.com/scoutout

FDA Launches Youth Anti-Smoking Campaign, with LGBT Effort to Follow

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Corey Prachniak is an LGBT rights, HIV policy,
and healthcare attorney. 
He serves on the Steering Committee
of the Network for LGBT Health Equity
and tweets @LGBTadvocacy.

 

This morning at the National Press Club in Washington, the Food and Drug Administration unveiled a $115 million anti-smoking campaign aimed at youths – the first-ever such campaign in the FDA’s history.  Commissioner of Food and Drugs, Dr. Margaret Hamburg, explained that the effort would specifically target “on-the-cusp youth smokers,” aged 12 to 17, who either had recently begun smoking or who were open-minded to trying it.

Mitch Zeller, Director of the FDA Center for Tobacco Products, noted that when compared to regular smokers, these “at risk teens are even harder to reach because they don’t even see themselves as smokers.”  Instead, they believe that they are only casual users who will not get hooked.

I had the opportunity to ask the panel about their plan to prevent smoking among LGBT youths.  Much as Director Zeller noted that at risk youths don’t consider themselves smokers, many youths might not consider themselves LGBT, and are instead are still processing how they feel or working on coming out.

Responding to my question, the Center’s Director of the Office of Health Communication and Education, Kathy Crosby, said, “We understand that there are sensitivities and we understand that there are cultural issues, as well,” in reaching LGBT teens.  Crosby noted that while the campaign on the whole targeted youths aged 12 to 17, they will launch a subsequent LGBT campaign that may instead focus on 17 to 18-year-olds who are more likely to identify as LGBT.  The hope is that by targeting that subgroup, the message will trickle down to younger teens who are entering the LGBT community.

Ms. Crosby noted that this LGBT sub-campaign is still in the initial stages of development, and will likely take one to two years to take off.  Director Zeller added that the LGBT effort will have “similar themes” to the broader campaign being launched this month, but will be “more targeted” to LGBT youths.100_4885

Directing anti-smoking efforts at LGBT youths is necessary given that the LGBT community has long been a target of tobacco corporations – and has disproportionately high rates of tobacco use to show for it. According to research recently compiled by the Network, LGBT people smoke at a rate that is 68% higher than the population as a whole.  Although the LGBT community spends $7.9 billion – with a “b” – on tobacco products each year, crucial Surgeon General reports on smoking did not even mention LGBT people until a 2001 document entitled “Women and Smoking.”

The new FDA campaign, entitled “The Real Cost,” will “highlight the real costs and health consequences of tobacco use” by focusing on things that young people care about, such as outward appearance and having control over their lives, said Commissioner Hamburg.  The FDA’s research – which will continue for two years as they track 8,000 teens exposed to the ad campaign – revealed that these concerns are more relevant to young people than are long-term consequences, such as heart and lung health, that seem too distant to be real threats.

“It’s different than what we’ve heard before,” said youth activist Daniel Giuffra, “and I think teens will respond to this.”  By using social media in addition to traditional media buys, Mr. Giuffra believes the campaign will “get a conversation started, something we haven’t been able to do before.”

It is a conversation that the LGBT community – and their advocates – desperately need to have.

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We’re working toward a tobacco-free future for LGBT communities!

Here at the National LGBT Cancer Network Summit in NYC, we wanted to get in on the Surgeon General Report excitement! #SGR50photo

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