medical news

Women may skip radiation therapy over child care concerns

Child care issues may keep breast cancer patients from getting the treatments they need, a new study suggests.

Mothers with young children were more likely to skip recommended radiation treatments after breast cancer surgery because of worries about the time involved, researchers found.

In particular, women who had a breast tumor removed were less likely to undergo radiation therapy afterwards if they had kids age seven or younger at home.About 81 per cent of women surveyed in the study who had younger kids received radiation therapy. The rates of radiation therapy for women with older kids or none at all ranged between 84 and 87 per cent.

Put another way, one in five women with young kids in the study skipped potentially life-saving post-surgery treatment, said Ya-Chen Tina Shih, an economist and associate professor of medicine at the University of Chicago in Illinois who co-led the study.

“We were surprised because women in the younger age range have the longest life expectancy, so we expected to see a higher compliance rate among them,” she told Reuters Health.

“Women may think, ‘I really need to take care of the kids at home,’ and they may act on what they believe is most important at that time,” Shih said.

“But they may not be aware of how important radiation therapy is.”

Women who have “lumpectomy” surgery to remove a breast tumor – the researchers did not include patients who had mastectomies – are usually advised to follow up with radiation therapy, which requires a serious time commitment. The radiation treatments take up to an hour, five days a week, for up to seven weeks, the researchers report.

“Many have hypothesized that young children might be a barrier for younger women, but this paper is the first to demonstrate that,” wrote Dr. Nancy Keating in an email to Reuters Health.

Keating, an associate professor at Harvard Medical School’s Department of Health Care Policy in Boston, was not involved in the new study.

“It suggests there is a modifiable barrier to improving care: providing child care,” Keating said.

For their study, Shih and her team looked at 21,008 patients who filed breast cancer surgery claims between 2004 and 2009 with employer-sponsored insurance.

From the data provided by Truven Health Analytics, researchers knew how many kids – dependents – were in a woman’s household.

The team found additional barriers to radiation therapy. Patients who enrolled in HMO plans, or PPO plans with fixed reimbursement amounts, were less likely to follow through with the treatment. If a patient had to travel far for the surgery itself, then she was also less likely to get radiation.

But this study’s biggest contribution is highlighting how childcare may play a role, Keating said.

Women, like those in the study, who chose breast-conserving surgery and not a mastectomy, “may not understand that the surgery is equivalent to mastectomy in terms of outcomes if women also get the radiation,” Keating wrote.

Shih pointed out that one weakness in her team’s report, published in the Journal of the National Cancer Institute, was that they did not talk to the patients themselves to record their reasons for not getting radiation therapy.

The study shows an association between the age of a woman’s children and her likelihood of opting out of radiation, but does not prove cause and effect.

Future studies could also investigate the rates of radiation therapy among women without insurance, or with less generous benefits, Shih said.

But for now, “the person in charge of a patient’s entire cancer care needs to make sure that they know if a patient has younger kids,” Shih said.

“If friends and family can make a commitment to help with the patient’s child care needs for a month or two – that could make a big difference,” she said.

The findings “suggest that providers, like hospitals, physician groups or health systems, could potentially help by providing assistance with child care,” Keating said.

Source: Khaleej times

Scientists discover new way of overcoming human stem cell rejection

Human embryonic stem cells have the capacity to differentiate into a variety of cell types, making them a valuable source of transplantable tissue for the treatment of numerous diseases, such as Parkinson’s disease and diabetes.

But there’s one major issue: Embryonic stem cells are often rejected by the human immune system.

Now, researchers from the University of California San Diego may have found an effective way to prevent this rejection in humans. Utilizing a novel humanized mouse model, the scientists have revealed a unique combination of immune suppressing molecules that stop the immune system from attacking the injected stem cells – without shutting the system down completely.

This discovery could ultimately help resolve some of the major problems currently limiting the use of embryonic stem cells for certain conditions, paving the way for the development of more effective human stem cell therapies.

“This is a generic way of immune suppression, so it could potentially be applied not just for stem cells therapies, but for organ transplants as well,” Yang Xu, a professor of biology at UC San Diego and lead author of the study, told FoxNews.com. “It can be very broad.”

Embryonic stem cells are different from the other cells in a patient’s body, making them “allogenic.” This means the immune system will recognize them as foreign agents and attack them.

One way of overcoming this rejection problem is to give patients immunosuppressant drugs, which suppress the entire immune system. While short term use of immunosuppressants has been successful for many organ transplants, embryonic stem cell therapies for chronic diseases require long term use of these drugs – which can often be very toxic and increase the risk of cancer.

“In order for the patient to really use this therapy, they have to decide: Do they want a lifelong use of immunosuppressant drugs, or are they willing to live with the symptoms of their disease,” Xu said.

Source: news.nom

Woman’s tragic death witnessed by family on laptop

A nurse in a Michigan hospital kissed the patient’s forehead. More than 6,000 miles away, Sanaz Nezami’s family in Iran watched on a laptop computer and wept.

Nezami, a vibrant 27-year-old woman who could speak three languages, wanted to pursue an advanced degree in engineering at Michigan Technological University. Instead, she was brain dead just a few weeks after unpacking her bags, the victim of a fatal beating by her new husband, according to police.

Technology allowed family in Iran to watch her final hours. The family’s faith in the hospital staff led to consent for an extraordinary donation: Nezami’s heart, lungs and other life-saving organs were transplanted to seven people in the U.S., a remarkable gift that occurs in less than 1% of all cases.

“We wanted God to perform a miracle and bring Sanaz back to life,” her sister, Sara Nezami, said in a phone interview from Tehran. “But this is a miracle. Sanaz gave her life in order to give life.”

A nurse who took care of Sanaz Nezami said the experience was “eye-opening” for hospital staff.

“The family was willing to trust us to know she wasn’t coming back,” Kim Grutt said.

In August, Nezami married Nima Nassiri in Turkey and lived with him temporarily in the Los Angeles area, where he was born and raised. Her sister said the two met over the Internet.

Nezami, a native of Tehran, had a bachelor’s degree in engineering and a master’s in French translation. She wanted a doctorate degree in environmental engineering.

On Dec. 7, she asked her sister to proofread some English-to-Persian translation she was doing on the side.

“I was shocked,” Sara Nezami said. “Sanaz was a very precise girl, but she omitted some lines. I asked, ‘Are you OK?’ She told me there was no problem.”

The next day, Sanaz Nezami was rushed to a hospital with severe head injuries and was transferred to Marquette General Hospital. Police believe she was assaulted by her husband, who has been charged with second-degree murder. His attorney, David Gemignani, declined to comment.

“Her brain was so swollen and so damaged, there was no longer any blood flow,” explained Gail Brandly, who supervises nurses at the hospital.

No one knew anything about Nezami, so Brandly ran her name through Google. Suddenly, the stranger who couldn’t speak for herself came alive through a résumé posted online.

After about 24 hours, the hospital reached relatives in Iran. Immediate travel to the U.S. was impractical due to visa requirements, so a laptop was set up so the family could see Nezami on life support and talk to nurses and doctors over Yahoo Messenger.

“It isn’t something we’ve done in the past. It’s not every day we’re dealing with family members so far-flung,” said Dave Edwards, spokesman for the hospital.

At one point, Grutt was asked to stroke Nezami’s head and kiss her forehead.

Nezami was buried Dec. 18 in a local cemetery. As a light snow fell, the hospital’s chaplain, the Rev. Leon Jarvis, read Muslim prayers over the casket while about 20 people, mostly nurses and others who cared for her, watched.

Source: detroit free press

Medicaid expansion increased visits to emergency rooms

People newly enrolled in a health insurance program for the poor were more likely to visit the emergency department for care than people who remained uninsured, Boston-area researchers have found, providing the best evidence to date that the national Medicaid expansion that began this week is unlikely to lead to a decline in costly emergency services.

The study was published online Thursday by the journal Science, just as millions of Americans have become newly eligible for Medicaid coverage under the Affordable Care Act. Some politicians have suggested that people who were uninsured and didn’t have a regular doctor or put off basic treatment until their condition became serious, would, once they had coverage, get the primary care they needed to avoid trips to the emergency department.

Previous research on what happened to ER usage in Massachusetts, which expanded its Medicaid program and mandated that most residents have health insurance in 2006, have reached conflicting conclusions. But the new study, of about 25,000 low-income adults randomly selected in 2008 to enroll in Oregon’s Medicaid program, found that the newly insured increased their use of all types of medical care, including prescription drugs, hospital stays, and outpatient visits. Emergency department visits were no exception.

Over an 18-month period, about 42 percent of the new Medicaid enrollees visited the emergency department. In the same period, about 35 percent of those who did not receive Medicaid visited the emergency department.

“Basic economic theory is, if you lower the price, people use it more,” said Amy Finkelstein, a Massachusetts Institute of Technology economist and a senior author on the paper.

It was not a foregone conclusion in this case, however, that reducing the cost of an emergency room visit would increase use, she said, because the cost of a visit to a primary care doctor and of preventive services that may have helped them avoid the emergency room also decreased with insurance coverage.

Yet, emergency department use among those on Medicaid increased during businesses hours, nights, and weekends. While there was no increase in visits classified as non-preventable emergencies, there was an increase for visits deemed preventable or treatable by a primary care doctor.

A 2011 study found that overall emergency department visits increased in Massachusetts in the two years after the state expanded insurance coverage under the 2006 state health care law, though visits for “low severity” problems declined slightly. Dr. Peter Smulowitz, an emergency physician at Beth Israel Deaconess Medical Center and lead author on that study, said he and colleagues have more recently reviewed emergency department use across Massachusetts and found a small increase in pockets of the state that had seen the largest gains in insurance coverage. The study is pending publication.

Data published in the New England Journal of Medicine in 2011, however, found that ER usage was already increasing in Massachusetts and nearby states before the expansion of health insurance coverage here, and that the law did not change the trend in Massachusetts when compared to the other states.

The Oregon study is unique in that it is a randomized controlled study, considered the gold standard in medical research but rarely feasible in health policy research. The state of Oregon created a valuable study scenario when, because the state had money only for a small expansion of the program, it held a lottery for Medicaid coverage, providing insurance to some people and leaving others uninsured.

Past work by principal investigators Finkelstein and Katherine Baicker, a professor of health economics at Harvard School of Public Health, and their colleagues at the National Bureau of Economic Research in Cambridge has found that the lottery winners were more likely to report feeling better about their mental and physical health and had less financial strain, including fewer bills sent to collection. But there was no improvement in key health factors, such as blood pressure or blood sugar levels, as compared with the uninsured.

With the latest study, Baicker said, the body of research out of Oregon has disproved both the worst and best predictions for Medicaid — that it is an expensive program that does little to improve access to care and overall health, or alternatively, that it is a money-saving program that clearly improves health. The results are far more nuanced.

“Policymakers should make decisions based on this evidence that the program has real costs. It’s not free,” she said. “And, it has real benefits. Beneficiaries are clearly better off.”

Source: the boston globe

Jahi McMath family, hospital to meet for settlement talks

A federal magistrate has ordered settlement talks between attorneys for Children’s Hospital Oakland and the family of a 13-year-old girl who has been declared brain dead.

U.S. Magistrate Donna Ryu will meet in her Oakland courtroom Friday with both sides in hopes of brokering a deal in the ongoing legal fight over Jahi McMath. A separate hearing has been scheduled Friday before Judge Evelio Grillo of Alameda County Superior Court in Oakland.

Jahi’s family has accused the hospital of denying the girl a tracheostomy tube that is required to transfer her to another site, as well as withholding the insertion of a feeding tube that will provide her nutrition. They maintain that she is not dead because her heart is still beating and she is hooked up to a ventilator.

Hospital representatives have said that they’ve never objected to the girl receiving a tracheostomy but would not allow the procedure done in its hospital or performed by its staff because of the ethical and legal issues related to operating on a deceased person.

The hospital’s doctors declared Jahi dead on Dec. 12, three days after she underwent a tonsillectomy that resulted in complications.

The hospital would arrange for Jahi to be moved to another site for the procedure, or for long-term care, but has not heard from any facility, doctor or medical transport service regarding her case, hospital spokesman Sam Singer said.

Christopher Dolan, attorney for Jahi’s family, has filed requests in three separate courts seeking orders to force the hospital to insert tracheostomy and feeding tubes, but judges have declined to do so.

In court papers filed in federal court Thursday, Dolan again asked for an order for the tubes to be inserted.

“At this point, Jahi has not had nutrition for nearly three weeks,” he wrote. “She is in desperate need of a tracheostomy tube and a gastric tube.. This court should grant plaintiff the relief to allow for Jahi’s transport.”

Grillo has issued a restraining order that prevents the hospital from disconnecting Jahi from a ventilator until at least 5 p.m. Tuesday.

At 1 p.m. on Tuesday, U.S. District Judge Saundra Brown Armstrong in Oakland is expected to hear arguments about possible violations of Jahi’s civil rights, and the rights of families – not doctors, lawyers or politicians – to determine a loved one’s death, based on their religious or personal beliefs.

Source: SF gate

Doctors Spend Very Little Time Talking About Sex With Teens

A new study published in JAMA Pediatrics has revealed that many doctors spend very little time discussing sex with their teenage patients – if they do at all. According to Counsel and Heal, researchers from Duke University analyzed the audio recordings of 253 annual doctors’ visits for adolescents between the ages of 12 and 17

A new study published in JAMA Pediatrics has revealed that many doctors spend very little time discussing sex with their teenage patients – if they do at all.

According to Counsel and Heal, researchers from Duke University analyzed the audio recordings of 253 annual doctors’ visits for adolescents between the ages of 12 and 17. They found that the doctors discussed sex in only 65 percent of the visits, with the conversations lasting an average of 36 seconds. In the other 35 percent of visits, the topic of sex wasn’t brought up at all.

The study’s authors argue that such limited exchanges won’t help meet the “sexual health prevention needs of teens.”

“It’s hard for physicians to treat adolescents and help them make healthy choices about sex if they don’t have these conversations,” said lead author Stewart Alexander, associate professor of medicine at Duke. “For teens who are trying to understand sex and sexuality, not talking about sex could have huge implications.”

The study also revealed that only 4 percent of the teenage patients had prolonged discussions about sex with their doctors. Additionally, the female patients were twice as likely as their male counterparts to spend more time talking about sex.

Source: all news

A boy received lungs after the nation’s organ transplants rules.

Javier Acosta can finally start to breathe easy. The New York boy received a new set of lungs after challenging the nation’s organ transplants rules.

Acosta, as well as Pennsylvania’s Sarah Murnaghan, forced the Organ Procurement and Transplantation Network to change the rules that allowed adolescents and adults to receive organs based on their needs or sickness. Up until now, children had to wait until they turned 12 years old to be put on the waiting list.

Javier had surgery on October 13th after his mother Milagros Martinez successfully filed a lawsuit allowing him to be put on the same list as those over 12. Javier’s mom waited to tell everyone the news about the transplant until he recovered from the surgery.

Javier suffers from the genetic disease cystic fibrosis. The disease is extremely familiar to his family. Javier’s brother died from cystic fibrosis four years ago, just months before he turned 12 and would have been considered an adolescent.

Javier remains under hospital supervision from the transplant. His mother says his prognosis is good and he is “doing fine.”

Source: airing news

Don’t ignore dental problems

Most people don’t give their oral health much importance, which later leads to painful dental ailments, reports TOI.

Common bacterial infections Says aesthetic dental surgeon Dr Shantanu Jaradi, “The human mouth contains around 500 to 1,000 types of bacteria, which perform various functions. While some are harmful, most oral bacteria help prevent diseases.

Gingivitis and periodontitis are the most common types of bacterial infection. These affect the gums and tooth-supporting structures. Adds dental surgeon Dr Karishma, “There are various types of oral infections, which can be bacterial, viral or fungal.”

The triggers Dental caries is mainly caused by a bacteria, which produces an acid that affects the enamel of the teeth. This happens due to improper or insufficient oral hygiene or wrong food habits. For example, excessive intake of sugar, etc.

“Gingivitis and periodontitis are caused by the build-up of plaque and calculus (hardened plaque), poor oral hygiene, genetic factors, underlying systemic conditions like diabetes, smoking, or a poor immune system. In Pericoronitis, gums around an erupting wisdom tooth may get infected due to bacterial colonisation in that region. Infection around an implant is known as peri implantitis and it’s causes are similar to those of periodontitis.

Traumatic tooth extraction or failure to follow post-extraction instructions may lead to it. It may also be triggered when the extraction site is unclean. Dry socket happens when the blood clot dislodges from the extraction socket,” says Dr Karishma.

Symptoms – Teeth sensitivity, lodging of food particles in the teeth and toothache are the most common symptoms of dental caries. – Periodontitis and gingivitis result in bleeding gums, soreness, bad breath, loose teeth, difficulty in chewing, etc. – Pericoronitis can be suspected when there is swelling of gums around the last molar in the lower jaw, pain and difficulty while opening and closing the mouth. In some cases, the pain extends to the ear. – Peri implantitis results in pain, loose implants, difficulty in chewing, etc. – Post-extraction infection or dry socket causes swelling, delayed healing, foul smell and severe pain.

How to avoid it “Regular brushing and flossing are the basic precautions. They will help get rid of the bacteria, which try to stick to the surface of our teeth to form plaque. Diet also influences oral health,” says Dr Shantanu. Adds Dr Karishma, “Avoid foods that have excessive sugar, use a fluoridated toothpaste, visit your dentist regularly, floss, use a waterpik (water flossers), maintain optimum blood sugar levels, quit smoking, get professional clean-ups done regularly and go for the extraction of an impacted wisdom tooth if it is causing you repeated episodes of pericoronitis.”

Common oral bacterial infections are:
– Dental caries
– Periodontitis
– Gingivitis
– Pericoronitis
– Peri implantitis
– Post extraction infection/dry socket

Source: Viral News chart

10 tips to manage high BP without pills

Hypertension on the high? Here are top 10 tips to get it down and keep it down.

Seven in 10 adults are at a greater risk of stroke or heart attack because their blood pressure is too high. Desk jobs, lack of exercise and eating salty fast foods have contributed to the problem, even among the young. If your level is consistently at or above 140mmHg/ 90mmHg (referred to as 140 over 90). The 140 figure is the systolic pressure — the pressure reached when the heart forces the blood around the body — and 90 is the diastolic pressure — the lowest pressure that occurs between heartbeats when the heart relaxes.

In India, experts say, the prevalence of hypertension ranges from 20-40 per cent in urban adults and 12-17 per cent among rural adults. But there’s no reason to worry. Simple measures will help to cut your risk.

1. Go for a weekly jog
Jogging for just an hour a week can increase your life expectancy by six years, according to a Copenhagen City Heart cardiovascular study of around 20,000 men and women aged from 20 to 93.

Researchers believe jogging delivers multiple health benefits, improving oxygen uptake and lowering blood pressure, as well as many more benefits. However, any physical activity can help lower blood pressure by strengthening the heart so it can pump more blood with less effort, thereby decreasing the force on the arteries. Power walking can be just as effective as jogging.

2. Enjoy yoghurt
Just one small pot a day can reduce your chances of developing high blood pressure by a third, according to a study presented at the University of Minnesota in the US. Scientists think naturally occurring calcium can make blood vessels more supple, enabling them to expand slightly and keep pressure low.

They found those who ate a 120g pot daily were 31 per cent less likely to develop high blood pressure over a 15-year period than those who did not.

3. Go bananas
Eating potassium-rich foods, such as bananas, and reducing salt intake could save thousands of lives every year, according to a new study published in the British Medical Journal online.
Potassium is an important mineral that controls the balance of fluids in the body and helps to lower blood pressure. Making sure you eat five.

4. Down with salt
Salt draws in fluid, raising the volume and pressure of blood in your arteries. But it’s not just the salt cellar you have to worry about — processed foods such as biscuits, breakfast cereals, takeaways and ready meals contain 80 per cent of the salt we consume, says the Blood Pressure Association. Check labels: more than 1.5g salt per 100g is a lot, but less than 0.3mg per 100g is a little.

5. Lose weight
Research has shown that dropping just a few kilos can have a substantial impact on your blood pressure. Excess weight makes your heart work harder and this strain can lead to high blood pressure.

6. Don’t smoke
The nicotine in cigarettes stimulates your body to produce adrenaline, making your heart beat faster and raises your blood pressure, making your heart work harder.

7. Work less
Regularly putting in 40 hours per week at the office raises your risk of hypertension by 14 per cent, the University of California, US, found.The risk rises with overtime. Compared with those who worked fewer than 40 hours a week, workers who clocked up more than 51 hours were 29 per cent more likely to have high blood pressure. Overtime makes it hard to exercise and eat healthily, say researchers. So try to down tools with enough time to relax in the evening and eat a healthy supper. Set a message on your computer as a reminder to go home.

8. Seek help for snoring
Loud, incessant snoring is a symptom of obstructive sleep apnea. And more than half of those with this have blood pressure significantly higher than expected for their age and general health.

Cutting out cigarettes and alcohol and losing weight will help.

9. Switch to decaf
Duke University Medical Center, North Carolina, US, found caffeine consumption of 500mg, roughly three cups, increased blood pressure by three points. Effects lasted until bedtime.

Scientists say that caffeine can raise blood pressure by tightening blood vessels and magnifying the effects of stress.

10. Think beetroot
A study published in the journal Hypertension found drink ing a 250ml cup of the juice can cut blood pressure readings in those with high blood pressure by around seven per cent. It’s thought the effect is produced by beetroot’s naturally high levels of nitrate. Eating other-rich foods — cab bage and spinach — might also help

Source: Viral news chart

Strict parenting may reduce teen smoking

Parents who set limits are less likely to have kids who smoke, regardless of their ethnic and racial backgrounds, according to a new U.S. study.

Researchers surveyed middle schoolers from diverse backgrounds and found those whose parents had an “authoritative” and “structured” parenting style were also more likely to be discouraged from smoking by their parents and less likely to become smokers.

“Many past studies have examined broad parenting styles, however this study looked at how specific parenting strategies may help protect youth from cigarette smoking initiation,” said Cassandra Stanton, an assistant professor in the oncology department at Georgetown University, who led the study.

“We also note that unlike many studies in the area that are conducted in largely white middle class samples, this study was conducted in an urban multi-ethnic low-income school district,” Stanton told Reuters Health.

It’s important to identify ways of helping parents prevent kids from starting to smoke, Stanton’s team writes in the Journal of Pediatric Psychology, because the majority of lifetime smokers begin before the age of 18.

Although the number of teenage smokers has declined significantly, one in three young adults reports smoking at least once in the past 30 days, according to a 2012 report by the U.S. Surgeon General.

Past research has found links between low discipline, parental disengagement and increased risk of smoking, Stanton’s team notes. Rates of smoking vary among ethnic groups, with white students smoking daily at a rate twice that of African American and Latino students. However, African Americans and Latinos experience significantly higher rates of smoking-related health complications later in life compared with whites.

To delve deeper into which parenting strategies are effective among a diverse set of families, the researchers recruited 459 eighth graders from two low-income inner-city schools in the Northeast. The students averaged 13-years-old, with 29 percent identifying themselves as Hispanic, 34 percent as African American, 17 percent as non-Hispanic white and 20 percent as other/mixed ethnicity.

The students took a comprehensive survey in class with parental consent. The survey asked about the student’s smoking history and whether the student’s parents smoked. It also asked questions about parenting styles, such as discipline and warmth, and whether the student would receive punishments and discussion of the dangers of tobacco if caught smoking.

The researchers then followed up four years later to assess whether students had smoked.

Stanton’s group found that what they called controlling parenting, which was associated with rule enforcement, curfews and set bedtimes, was more likely than a less strict, more understanding parenting style to go hand in hand with so-called anti-tobacco parenting strategies.

Those anti-tobacco strategies include punishing a child if he or she has been caught smoking and discussing with the child the motivations behind smoking and why smoking is so dangerous. Being on the receiving end of such anti-tobacco strategies was in turn linked to a lower likelihood of lifetime smoking for the student.

The association held regardless of race or ethnicity, which the researchers say should be reassuring because other cultural differences don’t seem to alter the effectiveness of this approach.

It is important for parents to take an active role in protecting their children from developing an addiction to tobacco, Stanton said.

“Setting and enforcing clear standards of behavior and actively monitoring and supervising a teen’s activities are important strategies for protecting youth from risky behavior,” she said.

“To protect youth from experimenting with tobacco and ultimately developing an addiction to tobacco, it is important to talk about the risks of tobacco, as well as set and enforce clear rules and consequences that are specific to tobacco.”

Heather Patrick at the Health Behaviors Research Branch of the National Cancer Institute, who was not involved in this study, believes structure and authority in parenting is an important tool in preventing teens from smoking. However, she cautions, “heavy-handed” parenting can often cause stress and strain in the relationship.

Patrick said smoking cessation interventions should be tailored to different groups to be more effective. “It’s helpful for intervention materials to have images that show a diversity of racial and ethnic groups,” she wrote in an email.

It’s also helpful, she said, for anti-smoking messages to provide examples, “like how to deal with cravings, how to be smoke free when all of your friends are smoking, or how to deal with conflict at home, to connect with the kinds of experiences real teen smokers face.”

Source: US web daily