The war on cancer: A public health triumph

In the war on cancer, the American Cancer Society announced in a yearly report by Stacy Simon that over the last 20 years, 22% fewer people have died from cancer, representing 1.5 million avoided deaths.  The biggest single reduction occurred in lung cancer, according to the Society’s Vice President for Surveillance and Health Services Research, Ahmedin Jemal.  There are fewer smokers, as millions quit, and millions of others never started smoking.

This was not primarily the result of medical care, though doctors certainly advised many of their patients to quit.  Rather, quitters used a variety of methods over multiple attempts to quit, including advice from doctors and others, smoking cessation products like patches, gums, etc., reading generic or individualized materials, quitting cold turkey, etc.  So this wasn’t “patient engagement” by the medical system per se, as quitters were not primarily benefiting from their doctors’ active medical management of their smoking.  They weren’t patients; for most quitters, cancer had not developed to the point where they required treatment for cancer.  Rather, in most cases the successful quits came from multiple self-initiated efforts by the “worried well,” often with nudging by family members.

There is much credit to share for all the lives saved, e.g., for doctors who advised patients to quit.  Yet this victory seems due more to public health efforts than to the medical system. 

Efforts to meliorate the toxic effects of other lifestyle choices about alcohol, drugs, overeating, inactivity, etc., might also benefit from focusing on public health efforts addressed to the worried well, in similar ways. 

Advice:  Have a happy New Year!   Give a hug to your public health friends, and let’s celebrate!   

Seventeen weeks today: Quitting smoking with a buddy

JLynnJ’s story:
My sister and I took the quitting plunge together. We have both smoked since we were in college, she's 36 and I'm 31. She puffed her last cigg on Jan 15th, mine was on Jan 23rd, of this year. We both used the patch and followed the directions to a "T". It's been over 4 months now, and neither of us have cheated. We even took a trip to Vegas and made it without smoking. To me, this is proof that the buddy system does work!!! So smokers, get a buddy and quit, you will be sooo glad you did.

The urge to smoke is contagious, but quitting apparently is, too. A team of researchers who showed obesity can spread person-to-person has found a similar pattern with smoking cessation: A smoker is more likely to kick the habit if a spouse, friend, co-worker or sibling did as well. What's more, smokers tend to quit in groups and those who don't stop puffing increasingly find themselves pushed to the edge of their social circles, the researchers found.

"Your smoking behavior depends upon not just the smoking behavior of the people you know, but also the people who they know," and so on, said Dr. Nicholas Christakis, a medical sociologist at Harvard Medical School and lead author of the report.
The findings back up previous studies showing that peer influence plays a key role in a person's decision to stop lighting up and provide evidence that the "buddy system" used by smoking cessation, weight loss and alcoholism programs to change addictive behavior works.

The study appears in the most recent issue of the New England Journal of Medicine.

Advice to smokers who want to quit: Find a friend who smokes, and quit at the same time.

Read another smoking cessation story.

Years of nagging are paying off: Progress in the war on cancer

The death rates from cancer are falling faster, according to today's Annual Report to the Nation by the American Cancer Society, National Cancer Institute and others. The death rate is falling more than 2% each year, about twice the pace of the previous decade. That means more than 10,000 people's lives have been saved each year.

"Years of nagging and pleading by health officials are finally beginning to pay off, experts say, in smoking cessation and increased use of mammograms, colonoscopies and other screening tests for colorectal and prostate cancer," in Denise Grady's words in today's NY Times.

But "it's still a minority of individuals that undergo screening for colon cancer. If everyone were screened appropriately, these incidence numbers would fall even more dramatically," said Dr. Neal Meropol of the Fox Chase Cancer Center.

Advice: Prevention can work.

Read another prevention story by Denise Grady, or read her source story in today's New York Times.

I get by it with a little help from my friends: Smoking cessation and patient advocates

What’s the most common source of assistance that adult smokers in America use to quit smoking? Nope, it’s not Nicotine patches, prescription pills, nicotine gum, nasal sprays, inhalers, lozenges, books, pamphlets or videos. Rather, smokers most often relied on the support of family members and friends. One quarter of them (26%) named that, in the National Health Interview Survey, according to a graph in yesterday’s USA Today by Melanie Eversley and Adrienne Lewis.

More evidence of the role of patient advocates from one’s family and social circle…

Advice: Have your family and friends help you stop smoking.

Read another of our stories about the role of a friend as a patient advocate.