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A posed picture of youths vaping. — RAJA FAISAL HISHAN/The Star.

While adults claim that e-cigs are helping them quit smoking, researchers worry that it could draw children to the habit

THE good news is that smoking among children is dropping.

The bad news is that e-cigs and vape could disrupt the positive pattern.

Cambridge Behaviour and Health Research Unit senior research associate Dr Milica Vasiljevic says children are picking up e-cigs more than cigarettes.

While they may not be regular users, the mere fact that they are experimenting with e-cigs, is worrying.

Dr Vasiljevic is the principal investigator of a study on e-cig ads and children’s perceptions of tobacco smoking harms. Published in July, the paper warns that e-cigs could disrupt the trend of smoking decline among children as kids exposed to glamorous e-cig ads, perceive occasional smoking as less harmful. This may lead to more positive attitudes towards smoking and the tobacco industry.

Prof Dame Theresa Marteau, Cambridge Behaviour and Health Research Unit director and the paper’s co-author, believes their experiment is the only one showing how the appeal of tobacco smoking is increased among kids exposed to e-cig ads.

“We see a softening of attitudes towards tobacco smoking harms, and risks. That’s a concern. So if that’s your definition of ‘renormalising smoking’, than yes, that’s happening.”

While e-cigs are less harmful and hold great potential as a cessation tool, the gateway risk is under studied, and warrants further investigation, she feels. She says e-cig companies are consciously targeting children with the flavours they’re putting out.

“E-cig companies are taking their cue from the tobacco, alcohol, and sugary drinks industries. That’s how you sell products. Flavours like bubblegum, chocolate milk, and vanilla ice cream, explicitly target children. If you’re talking about cessation, you shouldn’t have flavours that children would like – what’s the point? Such flavours should be banned to protect children.”

In the old tobacco marketing campaigns, all the cool kids smoke, says Dr Vasiljevic. Now it’s vape. Many researchers and public health practitioners are concerned about the gateway hypothesis where addiction to the nicotine in e-cigs might lead people to tobacco cigarettes.

Dr Vasiljevic, who was involved in other experimental studies looking at the impact of e-cig advertising amongst children, found that e-cigs were being advertised similarly to how cigarettes were advertised in the 1950s and 1960s.

“You can’t do that with tobacco cigarette advertising anymore due to legislative restrictions but children were clearly the main entry points into the consumer market for conventional tobacco cigarettes.

“Our concern is that ads portraying e-cigs as glamorous, and healthier than tobacco, may be a contributing factor for children to start using tobacco.

“Kids may think vaping is good, it’s a gadget for the future, and it’s safe even though there’s nicotine. So these cool and glamorous ads may be resurrecting old smoking norms.

“If e-cigs are intended only for smoking cessation, then it would make sense to advertise them as a medicinal product. Tighter controls on marketing materials may be needed,” says Dr Vasiljevic.

On the reason for her focus on e-cigs and children, Prof Marteau says it’s because smoking rates – particularly in high income countries – are going down. This means that adults are stopping smoking. So, from a public health perspective, there’s a need to prevent children from starting. Fewer children are using tobacco in the UK and elsewhere, and e-cigs are threatening the progress in tobacco control policies, she says.

But the fact that tobacco prevalence among children has gone down dramatically at a time where e-cig experimentation has risen, says Paul Aveyard, Professor of Behavioural Medicine at the University of Oxford, implies that whatever gateway there is, is very small.

You can’t have both trains going in opposite directions and saying: ‘Oh it’s luring lots of people into smoking’, Prof Aveyard who is also the senior editor of the journal Addiction, and coordinating editor of the Cochrane Tobacco Addiction Group, argues.

An alternative way of looking at it, he says, is to ask why young people smoke.

“It’s the rebels – the kids who are unengaged with school, and those whose social identities are other than hardworking. Maybe e-cigs are just taking the place of cigarettes. We don’t know that anymore than we know whether e-cigs are a gateway to smoking or whether e-cigs have driven down the prevalence of smoking in young people. It’s all speculative at this point.

“I don’t want kids exposed to e-cig ads to perceive smoking as less harmful than it is, but this has to do with better ad regulations.”

In Malaysia, the Health Ministry defines devices that contain nicotine as e-cig, and those without as vape, or vaping.

The ministry’s deputy director-general (public health) Datuk Dr Chong Chee Kheong says e-cigs with nicotine are regulated under the Poison Act 1952. Nicotine is grouped under Group C Poisons and cannot be sold or supplied by retailer to any person except as dispensed medicine or an ingredient of a dispensed medicine.

“E-cigs without nicotine is not controlled under any law – for now.”

It’s worrying, he says, that ads for non-nicotine liquids or vape, are not banned on social media and the Internet.

“While e-cigs containing nicotine are banned, when it’s advertised online, we don’t know whether it’s really nicotine-free because you cannot tell from the physical look of the liquids.”

Consumers Association of Penang’s (CAP) education officer N.V. Subbarow shares the concern – especially with newer, sleeker devices, like Juul, hitting the market.

Juul which mimics the nicotine hit of a real cigarette, has popped up in schools across the US, sparking concern among parents, educators and regulators.

‘Juuling’ refers to the recreational use of the device which resembles USB drives.

The sale of fruit and candy flavours in convenience stores and gas stations, has been banned by the US Food and Drug Administration (FDA) to counter a surge in teenage use of e-cigs by more than 75% since last year. The FDA will also introduce stricter age-verification requirements for online sales of e-cigs, Reuters recently reported.

Subbarow fears that children and adolescents who see ‘Juuling’ clips on YouTube, will be tempted to try the fad.

“Curiosity gets the better of them and they pick up an e-cig even though they have never smoked before. That’s dangerous.”

International Islamic University Malaysia Assoc Prof Dr Mohamad Haniki Nik Mohamed calls on parents and teachers to be alert.

E-cigs used to be huge but now the latest in the market is a flat, and sleek version that fits into the pocket, Dr Mohamad Haniki, who is the National E-cigarette Survey (NECS) 2016 principal investigator, says.

By Christina Chin
Read more @ https://www.thestar.com.my/news/education/2018/12/09/the-woes-of-vape/#1surLLQzWFhB3GSS.99

JOHOR BARU: At least 80 percent of all blindness or limited vision cases can be prevented or treated.

Health Minister Dr Dzulkefly Ahmad said that based on a National Eye Survey in 2014, there are at least 1.2 percent or 63,000 Malaysians who had been diagnosed as blind in the country.

“There are also some 350,000 people or 5.4 percent with limited vision,” he said.

According to Dr Dzulkefly, 58 percent of those going blind was due to cataract while 10 percent due to diabetes and 7 percent because of glaucoma.

Dr Dzulkefly said that with an ageing population and increase in diabetic cases, the ministry expects increase in eye diseases such as cataract and glaucoma.

He said this at the launch of the national level World Sight Day here on Thursday (Oct 11).

By Nelson Benjamin
Read more @ https://www.thestar.com.my/news/nation/2018/10/11/health-ministry-80-percent-of-eye-diseases-are-preventable-treatable/#y2LXtBCLKRIemfLk.99

I’m going to begin the fourth anniversary article of In Your Face with a cliche – that speed kills. In most cases, that is true. However, the opposite is true in the case of a stroke – a lesson driven home when I overcame a stroke at the end of August.

And how did I learn this lesson that got me the swift medical care that saved my life? This was a lesson I learned when I interviewed National Stroke Association of Malaysia (Nasam) founder Janet Yeo for an article I wrote to help Nasam raise awareness for Stroke Awareness Day, which falls on Oct 29.

“First look at the face, the face will be a little distorted. Then ask the person to raise their arms. Strokes always affect one side, so an arm will keep falling down. Then listen to their speech and ask them to smile, if the speech is slurred and they have difficulty smiling it is time to call the hospital. And this is what I always urge people – go straight to the hospital, don’t go to a clinic. Go to the emergency ward,” said Yeo.

In this instance, a pearl of wisdom from an interview for a previous In Your Face preserved my quality of life and prevented me from serious brain damage as my quick action led to me receiving expert medical attention within half an hour of symptoms – before any lasting damage could occur

On this, Yeo said that strokes are not something that adults – especially senior citizens – have to worry about as even children can also get strokes.

“Our youngest stroke survivor had a stroke in her mother’s womb, but it was only found out when she was unable to turn as a baby. By the time they diagnosed her, she was nearly a year old. Today, she’s going to school and learning ballet. We have a lot of survivors at our centres in their 20s and 30s,” she said

Yeo added that 52,000 people in Malaysia will get a stroke every year, and according to global statistics one in every six people gets a stroke daily.

“If you look at the statistics, one in six people will get a stroke. These statistics are accurate, and this means that someone you know could very well have a stroke. It could be someone in your family or a friend. It could be you. We have to think carefully before saying that a stroke will never happen to us,” said Yeo.

It would be fair to say that if I hadn’t learned this from her – I might have dismissed the possibility that I was having a stroke offhand – and not sought the right treatment rapidly enough, and on that note I am also sharing links to four life lessons I’ve learned over the years writing In Your Face after the end of this article.

She added that strokes – which are caused when brain cells die due to an interruption in the blood nourishing our body’s nerve centre – are the third largest cause of deaths in Malaysia after heart diseases and cancer and that strokes are the single most common cause of severe disabilities in Malaysia.

It was at this point that Yeo shared with me the importance of the post-stroke rehabilitation provided by Nasam through its physiotherapists, occupational therapists, speech therapists and counselors. at its nine centres nationwide

“There is life after a stroke despite the damage, because you can still live your life and enjoy your life even though you are a wheelchair user. We have a philosophy that there is a life after a stroke,” said Yeo.

In fact, she encourages stroke survivors to live their lives fully instead of giving up because they face challenges after having a stroke.

“I want to discourage stroke survivors from thinking that they have to wait until they get better before they go out and live their lives. I tell them that it takes a long time to recover from a stroke, I had a stroke 28 years ago and I am still recovering. The moment I came home from the hospital, my husband said that I’m going out for dinner, to the market and I am going back to the office. I lived my life. I went through it and now I am preaching what I practiced,” said Yeo.

“I could have been bedridden or a wheelchair user as my stroke was that severe, but my husband believed that I would rise to the challenge if he challenged me. I want stroke survivors to challenge themselves and believe in themselves,” added Yeo.

Yeo added that a stroke can be seen as a challenge for a person to overcome by reinventing themselves.

“I tell stroke survivors to approach every day with a new outlook, that they’re going to work and not laze around in bed. Get ready, shower, dress well and treat coming to Nasam as if they’re coming to work for two hours. And what is the purpose of the work? To rebuild yourself. It is a yes I can mindset that is aimed at lifting the spirit,” said Yeo.

She added that Nasam helps people develop new talents they never knew they had and believe that there’s a life after a stroke.

“We have been blessed with a lot of talents, so let’s move on to the next talent. We get people to see that a stroke is a turning point and to see the positive points about it – that they’re making new friends and discovering talents they never knew they had,” said Yeo, who added that Nasam helps about 500 people every day.

At this point I asked her how people can seek Nasam’s help if they or someone they know has been affected by a stroke.

“They just call up for an appointment at any one of the centres. An appointment has to be made because we need to arrange for our chief physiotherapist to do an assessment. What will happen when they come in is that the stroke survivor will be given an introduction to Nasam and what we do, and the centre’s chief physiotherapist will assess them and prescribe the program best suited to them depending on their age and the severity of the stroke so that we are more effective,” said Yeo.

She also said that Nasam – contactable via email at info@nasam.org – welcomes the support of the public.

“Participate in our activities. If we’re having a Stroke Games, come and cheer us on. Come and volunteer your time. When we have a public forum, come and listen. Additionally, we are starting to recruit new volunteers as we have arts, craft and music in our holistic programme. These are all the programmes we have. So be a volunteer. Teach them how to do handcraft, teach them how to do gardening. Be a volunteer,” she said.

Yeo added that more therapists were also needed.

“Just a few years ago I had to employ therapists from Mumbai. We were using locums for quite some time, and quite a few therapists in Malaysia at the time were being hired by the hospitals. When I say therapists I mean physiotherapists, occupational therapists and speech therapists. Speech therapists and occupational therapists are very hard to come by,” she added

By Tan Yi Liang
Read more @ https://www.thestar.com.my/opinion/columnists/in-your-face/2018/10/08/i-am-33-and-i-just-had-a-stroke/#zQpD8XwsYkQlx6ks.99

GREATER AWARENESS … Nancy (3rd right) and Annie (far left) with recipients of the Prosthesis and Mastectomy Bras.

KOTA KINABALU: Breast cancer remains the number one killer cancer in Sabah with negative stigma contributing to the continuously increasing number.

In 2017, Queen Elizabeth Hospital II (QEH II) recorded a total of 168 breast cancer patients with more than half being in the late stages – 40 per cent in Stage 4 and 22 per cent in Stage 3.

According to QEH II Pink Ribbon Centre medical officer in charge Dr. Farhana Harzila, the late detection was mostly caused by fear and painless lumps among patients apart from myths revolving around cancers.

“They’re afraid of the stigma that once you have cancer, you will die as well as all the painful treatments; we have a lot of myth that once you get chemotherapy, you will pass away and once you are operated, the cancer will spread more – these are all wrong,” she said.

As the number of cases continued to rise by less than 20 people in the hospital, she noted that around 1 in 1,000 people are diagnosed with the disease which is also the number one killer in Malaysia.

With a majority being detected in the final stages, she urged for a greater awareness and education in the community particularly in rural areas.

What is more alarming was that more people from as young as 20 years old have been detected with the disease with the exact cause of the cancer yet to be identified.

“Previously, statistics showed age group of 41-50 as the highest (number of patients). Although it is similar now, but 31-40 and also 20-30 years are picking up so people need to be careful because even though they are under 40, it is not impossible to get breast cancer.

“There is no specific reason why breast cancer develops, it’s all about the risk factors among which are family history, way of life, and a history of cancer – there is a chance for you to get recurrence,” she said.

While breast cancer is common among women, it could also affect men, although it is rare – two male patients were detected with the disease in 2016.

“It is actually much easier to detect among men because it’s easier to feel the lump.

“For women, if the lump is deep seated inside, we cannot feel it so that is why we need mammogram especially for those aged above 40 years old – we can see the imaging even though you don’t feel anything.

“We encourage our women to do mammogram after 40 years old – that’s our way to detect early,” she said to reporters after a Kinabalu Pink Ribbon (KPR) press conference here yesterday.

The Pink Ribbon centre at QEH II, she said, was established in Feb this year to focus more on breast cancer patients.

It receives referrals from health clinics via the Ministry of Health from both rural and urban areas – all patients aged 30 and above who are found to have lumps bigger than 5cm will be referred to the centre.

“Breast cancer is a journey treatment, not a one year treatment – we need to see in within 5 to 10 years of progress.

“With the Pink Ribbon centre just established this year, we are working very hard and we hope to get more correct data with patients’ survival rate,” she said.

The centre currently has two medical officers, two dedicated staff nurse and a specialist on breast cancer while the QEH II Breast Clinic which has now seen a decrease in number of patients has 10 medical officers, two specialists and more than 10 nurses.

by  DK RYNI QAREENA.

Read more @ http://www.newsabahtimes.com.my/nstweb/fullstory/26995

KUALA LUMPUR: Obesity and non-communicable diseases (NCDs) in the country have reached a worrying level and on the rise, the Dewan Negara was told Monday.

Health Minister Dr Dzulkefly Ahmad said the Health and Morbidity Survey conducted by the ministry found that one out of two Malaysians were overweight or obese.

“The survey also found 17.5 per cent suffered from diabetes, 30.3 per cent had hypertension and 47.7 per cent had high cholesterol levels,” he said when replying to a question from Senator Datuk Lee Tian Sing on the obesity problem in the country.

Dr Dzulkefly said the main factors for obesity were unbalanced nutrition, not burning enough calories daily, mother’s nutrition intake during pregnancy, breast feeding practices and children’s dietary habits which were influenced by the parents and peers. “The strategy to tackle obesity has already been started comprehensively, as early as infancy and on to childhood and adulthood,” he said.

BERNAMA.

Read more @ http://www.newsabahtimes.com.my/nstweb/fullstory/26450