The Future of Vaping Bans

The Future of Vaping Bans

HEART HEALTH

Up in the Air: The Year of Vaping

A look back on the newsmaker
of the year and what to expect
in 2020 on the future of vaping
in New York State

Since entering the market in 2006, e-cigarettes and vaping were once viewed as a “less harmful” aid to help smokers curb or quit their nicotine habit. For years, little was known about the chemicals in vaping products or the long-term effects of vapors to the human body. By 2008, the World Health Organization (WHO) spoke out against e-cigarettes, stating that, “electronic cigarettes (are) not a proven (safe) nicotine replacement therapy.” WHO also noted that while e-cigarettes smokers did not inhale combustible cigarette smoke, there was a danger in the “fine, heated mist, which is absorbed into the lungs.” In the summer of 2019, the Trump Administration and New York Gov. Andrew Cuomo both announced bans on flavored e-cigarettes. Today, you would be hard-pressed to find a health care provider who would recommend vaping products as a method of quitting smoking.

Smoking and heart health

While looking over the top newsmakers of 2019, vaping was a constant in headlines, articles, and discussions. This article will look back at the timeline from this summer that led to the eventual ban of vaping products in New York State. We’ll also examine future public policy that will likely be written in 2020 that will forever determine the future of vaping in our communities. It’s important to note that cardiologists have been at the forefront of advocating awareness and education on the dangers of tobacco products. The Surgeon General has warned that smoking causes heart disease since 1965. It has been long established that smoking is one of the modifiable risk factors of heart disease. The Centers for Disease Control and Prevention (CDC) reports that smoking damages the heart and blood vessels very quickly, narrowing vessels that allow clots to form in the arteries around the heart. This blockage starves the heart muscle for oxygen, leading to a heart attack.

Dating back to 2008 with the WHO press release against electronic cigarette smoking, health experts have been calling for more research and evidence on the safety and ingredients in vaping products. Outside of nicotine, little was known about the chemicals used to create the vapor. Legal questions also came about over the status of purchasing these products online. In late 2008, a study funded by Ruyan, Health New Zealand stated that their e-cigarette and cartridges were deemed as a “safe alternative to smoking,” having been found to contain carcinogens and toxicants below harmful levels. This news conflicted mounting evidence that suggested the contrary. Australia, Jordan, Canada, Hong Kong, Panama, Brazil, and Saudi Arabia all banned the sale and advertising of electronic cigarettes in 2009. Many of these countries took these steps towards protecting their citizens due to FDA testing that revealed that e-cigs contained carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze. While the U.S. government was proving these products were not a safe alternative to smoking, they could still be legally purchased in the United States. In 2010, the Marine Corps Base in Quantico became the first to ban the use of vaping products in their facilities.

From 2011 until August 17, 2019, news headlines would be mixed on vaping. Government agencies, health officials, researchers, scientists, and political leaders were pitted against the tobacco industry, vaping companies, lobbyists, and consumers in a back and forth debate. Every report that found dangers in vaping, that called for more regulation and research would be met with VapeFests (festivals and expos promoting the products), new sellers in shopping centers with new flavors and supplies flooding the market. At one point, it seemed like vaping had become “the new smoking” for the next generation when a WHO global report showed that the number of vapers increased from about seven million in 2011 to 41 million in 2018. On our “World No Tobacco Day” episode of HeartTalk, presented by Capital Cardiology Associates, Dr. Harlan Juster, Director of the Bureau of Tobacco Control New York State Department of Health was our guest. He noted the frustration in lowering the number of young people smoking over the past twenty years due to public health policy steps, only to have the work be undone with new vaping products. “Vaping is a unique problem in that predatory practices are being conducted by some of the manufacturers, like Juul, who offer flavors that appeal to young people.”

As of December 13, 2019, vaping had killed 52 people in 26 states (red) officials said. Another 2,409 Americans have been hospitalized after using e-cigarettes.

Vaping kills

What changed on August 17, 2019, was the news that the CDC was actively investigating cases of vape-related illnesses in 14 states. The number of illnesses would grow to 200 cases in 22 states. On August 23rd, the first vape-related death was reported in Illinois. The person was hospitalized with severe breathing difficulties, reportedly from using e-cigarettes. On September 3rd, Oregon’s Health Authority began investigating a similar death. Three days later in Indiana, health officials confirmed a third vape-related death followed by a fourth in Minnesota, and fifth in California. Officials from the Kansas Department of Health announced the sixth vape-related death on September 10th. During the summer, when the news was focused on shark attacks and California wildfires, vaping had become a national health epidemic. Finally, on September 11th, the Trump Administration announced a game-changer for the vaping industry: pushing a ban on all flavored e-cigarettes in the U.S., including the popular mint and menthol flavors.

In his statement, Health and Human Services Secretary Alex Azad said, “the Trump Administration is making it clear that we intend to clear the market of flavored e-cigarettes to reverse the deeply concerning epidemic of youth e-cigarette use that is impacting children, families, schools, and communities.” Four days later, New York Governor Andrew Cuomo announced that New York would be the second state to issue a ban on all flavored e-cigarettes, except tobacco and menthol. He also stated that “these are obviously targeted to young people and highly effective at targeting young people.” It was finally clear; vaping was never a healthy alternative to smoking.

New York State Ban

As discussions began on the federal level and in the New York State Legislature, communities began to decide their public health policy. Dr. Guthrie Birkhead has a strong background in public health, with an extensive record working for the New York Department of Health on the state’s HIV/AIDS prevention and control program. He sat in on a recent episode of HeartTalk, presented by Capital Cardiology, to discuss the failed ban on the sale of flavored tobacco products proposed in Albany County. “The effort in Albany County was to remove the flavors that attract kids. The goal was to remove those products from the market due to the fact that 70% of young people say they tried vaping because of the flavors,” stated Dr. Birkhead. He challenged the “safety” of vaping products, pointing to a lack of regulation and data that shows e-cigs, “aren’t helping people quit smoking, it’s keeping them hooked. If you continue to vape instead of smoking combustible cigarettes, you are still putting yourself at risk. Vaping still continues the nicotine addiction while also exposing users to the dangerous chemicals that damage your lungs.”

Two New Yorkers died from vaping this fall. The first was a Bronx teenager who died from vaping marijuana. The second was a man in his 30’s who had a history of using vape products. “One of these people who was vaping the equivalent of three packs of cigarettes a day. Is that a cessation tool for someone to quit smoking,” asked Dr. Birkhead. As more facts emerged, like the first-long term study on the health effects of electronic cigarettes that linked the devices to the development of lung disease over three years, it was clear action was needed. CannaSafe lab in California released the first findings in early October, detailing the amount of formaldehyde and hydrogen cyanide in vape pens, when combined with the heat to produce vapor, creates a fatal dose of lethal chemicals. Antonio Frazier, the vice president of operations at CannaSafe stated, “People don’t die from smoking a pack of cigarettes, which is what we’re seeing with some of these illicit vape products. People are actually dying over a month of use.”

New York state health officials took action before the end of the year to apply existing tobacco laws to vaping products. Adults must be 21 to purchase items. The state also enacted a 20% tax on e-cigarettes joining eight other states and Washington DC on vaping taxes. Sellers are required to have a license. Retailers who violate the ban will face fines of up to $2,000 per violation. “We are trying to regulate the industry under the current smoking laws. In the meantime, there is still a push for local initiatives to create public health policy to solve this crisis,” Dr. Birkhead added. The issue is time; New York’s ban was extended for 90 days (through the end of 2019) but due to pending litigation from vape store owners who say the ban will close their business, is not in effect until a judge makes a ruling.

The future for vaping in New York state is cloudy at best. The Cuomo Administration expects state lawmakers to vote on a bill that would permanently ban the sale of flavored e-cigarettes and vaping liquids in all forms in January 2020. There is also a question on President Trump’s position on forcing a ban. The president has resisted moving forward on the issue after coming under fire from his supporters and lobbyists. Even without government support, as of this past summer, roughly two-thirds of Americans said they would like to see tighter e-cigarette regulations, according to a Gallup survey. This is encouraging news for community leaders. “The importance is we need to attack this problem at all levels of government. Our experience with the Clean Indoor Air laws is that they began at the country-specific laws and initiative. At a certain level, it built up to a state issue. Local initiatives like the proposed Albany County ban will push the state to take action,” said Dr. Birkhead.

Written by Michael Arce, Marketing Coordinator
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Diabetes Awareness Month

Diabetes Awareness Month

HEART HEALTH

Diabetes Awareness Month

Striving for a life free of diabetes and its burdens

November is Diabetes Awareness month. The number of Americans living with diabetes is staggering: the Centers for Disease Control reported in July of 2017 that nearly 100 million people living in the U.S. have diabetes or pre-diabetes. The report finds that as of 2015, 30.3 million Americans – 9.4 percent of the U.S. population – have diabetes. As diabetes is becoming more prevalent in our communities, culturally, there is a concern that adults are treating their diagnoses as a condition that can be managed with medication, not as a disease that can cause long-term damage if left untreated. This month on HeartTalk presented by Capital Cardiology Associates, we discussed the impact of diabetes in the Capital Region from the medical and community health perspectives.

Theresa Beshara is a Nurse Practitioner in Family Health at St. Peter’s Hospital Diabetes and Endocrine Care Center. She has almost twenty years of experience working with diabetics, their families, and caregivers. Theresa attributes bad lifestyle choices as one of the main factors contributing to our nation’s diabetes problem. “We are more sedentary (than earlier generations); we don’t tend to exercise as much. Our diets are better than they were 20 years ago, but we still enjoy fast food meals. We do eat a lot more carbs, and it’s a matter of genetics: we can’t change that piece.” Diabetes does have a hereditary element; it tends to run in families. However, for most people living with diabetes, it is usually a combination of both genetics and lifestyle choices that influence risk factors.

“I think there is a stigma right now with Type 1 that you cause yourself to have it when really it is an auto-immune disease,” says Laura Greenaway, Development Director of the American Diabetes Association in Albany. On our recent HeartTalk episode, Laura shared her family history, how her sister was diagnosed with Type 1 and how different her childhood home went without sodas, sugary snacks, and candies that could be found in her friends and neighbors kitchens. “With Type 2, there is a misbelief that you ate too much, and people aren’t aware of the hereditary factor. Diabetes is a disease that isn’t talked about because it’s not visible. What we are trying to do is help educate people about the different causes, ways to prevent it, and what their risk is.”

As diabetes detection has improved through innovations in technology and testing, nothing replaces the importance of having a yearly discussion with your health care provider on your risk. It’s a talk that needs to happen earlier in life. “If we can get our teenagers to work with their parents to make better food choices, get them involved with an exercise program or school sports, those two things will help with prevention,” said Theresa Beshara. When we talk about the long-term damage unmanaged diabetes does to the body, it’s alarming how an excessive amount of sugar in the system, over time, affects the arteries and blood vessels. As the cardiovascular system stiffens, it causes the heart to work harder to push blood throughout the body. What takes years to develop eventually becomes high blood pressure or atherosclerosis, both triggers for stroke, kidney issues, peripheral vascular disease, and heart failure. This is the mission of the American Diabetes Association, a life free of diabetes and its burdens. “Diabetes is more than blood sugar monitoring; it is a disease that affects every organ in your body and can cause long-term damage if untreated. It is something we all should want to prevent,” said Greenaway.

Awareness. Education. Engagement. Prevention. Those are the goals for the American Diabetes Association during November. “When we talk with physicians or diabetes educators, our partners in the community awareness programs, we talk about the day to day things that people can do,” stated Felix Perez, Market Director for the American Diabetes Association. Capital Cardiology Associates is proud to join the cause to encourage at least 30-minutes of daily activity or exercise, a heart-healthy diet, living smoke-free, and making responsible choices with alcoholic beverages. If you’re ready to make a difference, stand up and be counted by clicking here.

Written by: Michael Arce, host of HeartTalk presented by Capital Cardiology Associates

High blood pressure causes brain lesions later in life

High blood pressure causes brain lesions later in life

HEART HEALTH

Your heart and brain health are connected

How high blood pressure causes brain lesions later in life

Your heart and brain health are connected. Two studies regarding memory loss in seniors indicate that instead of being a sign of simply aging, short-term memory loss could be a symptom of the effects of hypertension or high blood pressure.

Controlling your blood pressure younger in life will have an impact on your memory later in life. Researchers from University College London in the U.K. studied high blood pressure in men from 36 to 43 years old led to smaller brain volume at 69 to 71. What they recently reported was that high and rising blood pressure in middle age was associated with brain function later in life. The American Heart Association defines high blood pressure (HBP or hypertension) when your blood pressure, the force of blood flowing through your blood vessels, is consistently too high. It’s been a known risk factor for heart disease, heart failure, heart attack, stroke, and cardiovascular disease. The new study exploring uncontrolled HBP as a risk factor for dementia connected brain and heart health.

“This has been a real game-changer for us in the past few months,” says Dr. Robert Benton, Director of Clinical Research at Capital Cardiology Associates. With around 15–20% of our blood going to the brain, physicians have long understood the importance of blood flow and reducing blockages or flow to the body’s most essential organ. In the UK study, doctors found white matter brain lesions, a sign of blood vessel damage in the brain, an indicator of aging, and a risk factor for cognitive decline. Dr. Benton acknowledged that showing adults the damage uncontrolled blood pressure is doing to their brain would be an effective awareness tool. “I wish we had a brain CT score as we do for heart patients,” he said. Cardiac CT for Calcium Scoring is a scan that uses an x-ray focused on the functions of your heart. The images show cardiologists the amount of plaque in the arteries of the heart that has calcified or hardened. This can blockage or narrowing of the arteries is an indicator of atherosclerosis or coronary artery disease (CAD). People with a higher content of calcium (score) of calcium have an increased risk of heart attack or cardiac events. “In just a few seconds, we could get a better picture of spots on the brain associated with HBP. That’s one of the things on my wish lists for tests! I think this would really get the message across. ‘This tiny bit of scar on your brain could let to forgetting where your keys are, or worse,” added Dr. Benton.

In the SPRINT MIND trial published in January, investigators from the Wake Forest School of Medicine in Winston-Salem, looked into whether aggressively lowering blood pressure could protect the heart, kidney, and brain over five years. Aggressively lowering blood pressure in hypertensive older adults did not significantly reduce dementia risk, SPRINT MIND investigators reported. “The real question becomes when you frequently decrease blood pressure through medication, sometimes in older people, dizziness or disorientation can be a negative side effect,” Dr. Benton commented. This is a challenge that physicians face when prescribing treatment. “You have a symptom and sign that is very clear and distressing. What do people complain about when they get older? Forgetfulness. Now there is evidence linking that lack of controlled blood pressure with objective evidence of damage to the brain. This has led me to be more aggressive in the last several months in presenting this issue with patients: you could lose memory due to uncontrolled high blood pressure. Your health today affects how you will live in the future. No one wants to lose their independence over hypertension and high blood pressure,” said Dr. Benton.

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

Eating Fresh and Healthy for your Heart

Eating Fresh and Healthy for your Heart

NUTRITION

Eating Fresh
and Healthy
for your Heart

How to sneak “good foods” into your daily meals

Eat right. Get exercise. Live healthy. Whether you are watching the morning talk shows, talking with friends, visiting family, or scrolling through your newsfeed; at some point in the day, you come across a new diet, “superfood,” or way of eating that enhances your health and happiness. Why? Nearly 90% of Americans fall below the fruit and vegetable consumption recommendations — we all struggle to find creative ways to make healthy choices every day.

Super foods

Every season, there is a new “superfood” that catches media attention and appears in everything from salads, smoothies, to side dishes. Blueberries, salmon, kale, and acai are just a few examples of foods that have garnered the superfood label. Most nutrition experts disagree with the definition of a superfood, calling it a marketing term. Catrina is the owner of Catrina K Fitness. As a NASM Certified Personal Trainer and Corrective Exercise Specialist with a specialization in Nutrition, she explained how companies created the term to market their products through media hype. “I think if you look at it this way if you ever go to a dietician and ask them, ‘what superfoods do you recommend?’ They will tell you there is no such thing as a superfood. If you go to your doctor and ask, ‘what superfood should I take for heart disease?’ They are never going to tell you that goji berries are the way to go.”

What is essential is to do your research when you come across a new food that has nutritional or health benefits. Blueberries, kale, and sweet potatoes, for example, often get more attention because of the research given to them versus other berries, leafy greens, or squash. Most of the exciting superfoods fit into the exotic category, like acai berry, that might be healthy but are not more nutritional on their own over less exciting or expensive fruits. Another tip is to check the nutrition labels of drinks or products made from superfruits – the added sugar may be the reason you prefer the taste.

Catrina also pointed out that “too much of a good thing is a good thing” when trying to maximize the benefits of superfoods. She advises adding them to snacks and meals instead of making them the primary serving. “Make sure you’re not telling yourself, ‘this is going to cure my illnesses.’ It’s a treat just like anything else, and moderation is key. No one food will cure you, and none of them are superior to other foods. Fruits and vegetables are great and healthy for you, but there is no superfood.”

Healthy foods and picky eaters

“Children aren’t the only picky eaters at the dinner table. There is a fair share of adults who push fruits and veggies to the side in favor of mac and cheese. Some of these adults are even us. If you are trying to change your diet plan, Catrina advises getting ideas on how to sneak healthy foods into some of your favorite dishes. “Let’s say your husband is a huge mac and cheese fan, throw in some broccoli or chop up some peppers and onions and see if they even notice.” The key to successfully eating healthy is to start slow with incremental changes, especially when dealing with picky eaters. “I’m also not a big believer in forcing children to finish the plate. Don’t tell them they have to eat their vegetables to earn dessert. These actions put negative connotations with healthy foods. I’m a big believer in the “test and try method”; put the food on their plate and wait to see what they eat. Alternatively, encourage them to try or taste it. With a little help, your picky eater will soon make good choices on their own,” Catrina said.

The tough part for home cooks is getting new ideas for old dishes. Catrina’s suggestion may come from a surprising source. “I always get ideas from restaurants,” she revealed. “If you get grilled asparagus from somewhere and you really like it then start grilling it at home!” There are a couple of ways to bring that restaurant dish taste to your home kitchen. One, is browsing for healthy copycat takeout recipes online. Love that grab-and-go breakfast burrito? There’s a quick and healthy way to make it that doesn’t require pulling up to the drive-thru window! A change you will notice in “healthy home dishes” is a noticeable reduction for salt, fat, and sugar in the recipes. These ingredients are added to dishes by chefs for flavor, seasoning, or as a preservative. Many store-bought frozen foods, canned, or pre-packaged foods are high in sodium so try to use fresh ingredients when possible.

“Another big tip is seasoning,” adds Catrina. “The reason you like dishes in a restaurant and not at home is because you’re just heating a vegetable and throwing it on a plate. There are other ways to cook vegetables besides microwaving them, like grilling or oven-roasting them. Once you learn how to season, roast, and add olive oil or dressing to your veggies, you will taste the difference. Try different flavors to see if they encourage everyone in the house to eat it or if it makes you want to make it more.”

Healthy eating for the whole family

The goal for every busy home cook is to make one meal that everyone can enjoy. A simple tip to encourage interest in meals is inviting your children to help make them. Studies show that children are more excited about eating healthy foods when they are involved. Give them age-appropriate tasks and keep a step-stool handy. Not only does prepping one meal saves time in the kitchen, but it also saves money for the household. The average American household spends over $4,350 on food every year. When you add dining out, we pay another $3,000 at restaurants, take-out/delivery, and quick-service vendors.

The other challenge with healthy eating is that eating healthy is often more expensive. Catrina acknowledged the difficult choice parents make when trying to balance their time, budget, and nutrition needs. “This is a difficult socio-economic topic. It is hard to tell a family that is not making much money, ‘you need to cook everything at home.’ Unfortunately, in our society, fast food or convenience foods are the less expensive alternative. This is a fact that no one fully addresses. However, it is just about managing your time, managing your money, finding what your family likes, maybe learning how to bulk shop for those items, and also not demonizing food. If you can only afford a few cans of tuna for your protein that week, or less expensive cuts of meat, that’s fine. Make the smart choices that are best for your family’s health and get creative in making healthy dishes. Eggs are a great source of protein. Serving them with breakfast, let’s children know that there are other foods on the plate, not just the sugary, sweet, or carb options.”

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.