Secondhand Smoke Exposure Linked to Adverse Pregnancy Outcomes

Roswell Park/University at Buffalo study finds significant risk for women who never smoked

BUFFALO, N.Y. — Secondhand smoking is linked with pregnancy loss, including miscarriage, stillbirth and tubal ectopic pregnancy, according to new research from scientists at Roswell Park Cancer Institute (RPCI) and the University at Buffalo (UB). The study findings, published online by the journal Tobacco Control, mark a significant step toward clarifying the risks of secondhand smoke exposure.

“This study demonstrated that pregnancy outcomes can be correlated with secondhand smoking. Significantly, women who have never smoked but were exposed to secondhand smoke were at greater risk for fetal loss,” says the study’s lead investigator, Andrew Hyland, PhD, Chair of RPCI’s Department of Health Behavior.

While there was previously some evidence that smoking during pregnancy was associated with the three outcomes of fetal loss studied here — spontaneous abortion or miscarriage (loss of a fetus before 20 weeks of gestation), stillbirth (loss of a fetus after 20 or more weeks of gestation) and tubal ectopic pregnancy — such evidence for secondhand smoke (SHS) exposure had been limited. This study is significant in two ways: One, it considered lifetime SHS exposure rather than only during pregnancy or reproductive years, taking into consideration smoke exposure in participants’ childhood and adult years. Two, the comparison group of never-smokers was limited to women without any SHS exposure, producing a truer control group compared to previous studies.

The large sample size and comprehensive assessment of SHS exposure added strength to the findings. Historical reproductive data, current and former smoking status, and details about SHS exposure over lifetime were collected from the Women’s Health Initiative Observational Study. This allowed for a study group of 80,762 women.

“The statistical power gained from the large cohort of women that was available is noteworthy,” added co-author Jean Wactawski-Wende, PhD, Professor in the Departments of Social and Preventive Medicine and Obstetrics and Gynecology, and Vice Provost for Research Advancement and Strategic Initiatives at UB. “As a result of the Women’s Health Initiative Observational Study, participants came from a broad range of geographic areas and had multiple ethnic, educational and socio-economic backgrounds. This allowed for a comprehensive assessment of detailed information on exposures, outcomes and potential confounders.”

Women with the highest levels of SHS exposure — despite never having smoked themselves — had significantly greater estimates of risk for all three adverse pregnancy outcomes, and these risks approached the risk seen among women who smoke (those who smoked more than 100 cigarettes in their lifetime). The highest levels of lifetime SHS exposure were defined by childhood exposure for longer than 10 years, adult home exposure for more than 20 years and adult work exposure for more than 10 years.

“This study offers new information for women regarding the lifetime impact secondhand smoke can have on reproductive outcomes and their ability to successfully bring a pregnancy to full term,” says Dr. Hyland. “The strength of the study also provides public-health professionals and others with information upon which to base health guidelines about the significant consequences of secondhand smoke.”

Buffalo-Area Pharmacists Say No to Tobacco Sales in Pharmacies

BUFFALO — More than 75 percent of Western New York pharmacists say tobacco sales in pharmacies should be legally banned, according to research conducted by Roswell Park Cancer Institute (RPCI) and the University at Buffalo (UB), published in BMC Research Notes. The study found that more than 86% of pharmacists surveyed would prefer to work in a pharmacy that does not sell tobacco products.

The research, led by James Marshall, PhD, Senior Vice President for Cancer Prevention and Population Sciences at RPCI, evaluated the opinions of Western New York pharmacists about the sale of tobacco products in pharmacies and about their role in helping their patients to stop smoking.

“The sale of tobacco products in pharmacies in any locality sends conflicting messages to consumers who visit pharmacies for medication or health products,” said Dr. Marshall. “Pharmacists, dedicated to protecting the health of their customers, recognize tobacco sales as contrary to their professional ethics. They would, in overwhelming numbers, prefer not to be selling cigarettes. This research will inform policymakers and elected officials as they consider regulations of tobacco sales in pharmacies.”

The 2010 survey evaluated opinions of 148 pharmacy mentors from the UB School of Pharmacy and Pharmaceutical Sciences (UBSoPPS) and 345 local supervising pharmacists. Participants were contacted by mail and email. The combined response rate for both surveys was 31%.

The pharmacist’s role in assisting patients to stop smoking also was evaluated. The survey found that more than 75% of pharmacists say they “sometimes” or “rarely/never” ask about tobacco use. The majority of pharmacists also indicate that they are not required to document tobacco use among patients or to enter such information into patient records.

“A striking finding is that pharmacy mentors were more likely than supervising pharmacists to be familiar with patients’ tobacco use and take steps to offer advice and information about how to quit smoking,” said Peter Brody Jr., PharmD, Director of Experiential Education at UBSoPPS. “It was also surprising that area pharmacists seemed not to take full advantage of the opportunity to educate and counsel patients regarding tobacco use. We need to better understand why and do what we can to help correct this issue.”

“This research presents several interesting findings, including that the overwhelming majority of pharmacists would support legislation banning the sale of tobacco in pharmacies,” added Edward Bednarczyk, PharmD, Chair of the Department of Pharmacy Practice at UB. “Importantly, this study also shows a considerable gap between theory and practice, with a substantial majority of pharmacists finding the sale of tobacco in pharmacies inappropriate, but doing little to prevent the sale or engage patients regarding tobacco use and smoking cessation.”

The study, Tobacco sales in pharmacies: a survey of attitudes, knowledge and beliefs of pharmacists employed in student experiential and other worksites in Western New York,” can be accessed at http://www.biomedcentral.com/1756-0500/5/413/abstract.

University at Buffalo Police Department Installs the First Permanent Prescription Drug Drop Box in Western New York

BUFFALO, N.Y. -- The University at Buffalo Police Department is the first police agency in Western New York and the first university in New York State to place a permanent “drop box” in their police department headquarters for citizens to safely dispose of expired, unused and unwanted prescription drugs.
“The University at Buffalo has been participating in the national take-back days for several years,” said University at Buffalo Police Chief Gerald W. Schoenle. “However, we wanted to provide a safe and secure place where our community members could go at any time to dispose of these drugs and not wait months for a special day.”
UB’s round-the-clock collection site will be at the university Police Department HQ Building at Bissell Hall on the North Campus. UB Police expects to set up a second site on UB’s South Campus later this spring.
Rates of prescription drug abuse in the United States are increasing at alarming rates, especially for young adults who report they can easily obtain prescription pills from medicine cabinets in their own and other people’s homes.
The University Police starting looking into this type of program after Schoenle saw a demonstration at the International Chiefs of Police (IACP) Conference last year by the MedReturn Company, a company which sells the secure Drug Collection Units.
Although MedReturn has many units throughout the country, the UB Police site at Bissell Hall is the first one in New York State. An agency must comply with certain legal requirements before starting such a program. The effort was a collaborative effort between UB Police, the School of Pharmacy & Pharmaceutical Sciences, the Student Health Center, Erie County Department of Environment and Planning and the Erie County Department of Health.

Frank Scarpinato of the Erie County Department of Environment and Planning hopes that other police departments throughout Erie County will soon follow the lead set by UB.
Cheryll Moore, community coalition coordinator for the Erie County Department of Health, helped UB Police in obtaining the Sharps collection box provided by the Health Department.
Local Drug Enforcement Administration (DEA) officials have scheduled another National Prescription Drug Take Back Day 10 a.m. to 2 p.m. Sat., April 28. Collection sites including those on the UB campus will be announced in March.
Americans participated in the DEA’s third National Prescription Drug Take-Back Day on Oct. 29, 2011, turned in more than 377,086 pounds (188.5 tons) of unwanted or expired medications for safe and proper disposal at the 5,327 take- back sites available in all 50 states and U.S. territories.
“The students and faculty from our school have been working on drug disposal programs with the DEA for several years,” said Karl Fiebelkorn, associate dean at UB’s School of Pharmacy & Pharmaceutical Sciences
Inspector Daniel Jay, commander of the UB Police Criminal Investigation section, is coordinating this project for the University Police. UB Police Investigations will be responsible for the drug and needle destruction.
“Prescription drug abuse is a major problem on college campuses,” said Jay. “This is a new way to dispose of your unused or unwanted medication in a legal safe manner. This new program will take drug disposal efforts to a new level.”
Schoenle spoke with Gil Kerlikowske, U.S. director of National Drug Control Policy, about this program when he was at UB in October. Kerlikowske expressed his support of UB’s proposed program, noting that proposed legislation will allow other sites to collect prescription drugs besides law enforcement agencies.
“We anticipate that several other police agencies will take up this very worthwhile initiative,” Schoenle said. “Not only does this program help with the prescription drug abuse problem, this is also in keeping with UB’s Green initiatives in keeping drugs out of our landfills and waterways.” 

ROSWELL PARK WILL LEAD $5.1M GENE-SEQUENCING EFFORT FUNDED BY NYS INITIATIVE

Effort will examine genetic factors in common diseases and advance field of personalized medicine

BUFFALO, NY — The Roswell Park Cancer Institute Genome Project was approved December 8, 2011 as part of Gov. Andrew Cuomo’s Regional Economic Development Council initiative. RPCI will lead this project, which will compile and analyze the detailed genetic data (the “genomes”) of Western New York citizens. This will significantly enhance our ability to develop personalized, more effective medical care plans and treatments for citizens of Western New York (WNY) — and beyond.

The $5.1 million award for the RPCI Genome Project covers the two-year pilot phase of the project. During this phase of the project, 1,000 area residents will be asked to donate a blood sample and provide detailed medical information; all these data will be collected in a fully protected way to ensure the privacy of all participants. The Genome Project will examine genetic factors that play a role in cancer as well as common diseases such as diabetes, heart disease and hypertension.

RPCI President and CEO Donald L. Trump, MD, FACP, and Deputy Director Candace Johnson, PhD, will lead the RPCI Genome Project as Co-Principal Investigators. Partners include the University at Buffalo, Kaleida Health, the Catholic Health System and Erie County Medical Center as well as the three major health insurers in WNY (HealthNow/BlueCross BlueShield, Independent Health and Univera Healthcare), The P2 Collaborative and HEALTHeLINK.

The Roswell Park Cancer Institute Genome Project was championed by WNY Regional Economic Development Council (WNYREDC) Co-Chairs Satish K. Tripathi, University at Buffalo President, and Howard A. Zemsky, Managing Partner of Larkin Development Group, along with Andrew Rudnick, President of the Buffalo Niagara Partnership and Health & Life Sciences Co-Chair for the WNYREDC.

“Together, they ably and energetically oversaw the maturation and development of this proposal, working closely with RPCI at every stage,” said Dr. Trump. “We are grateful for the leadership they, Governor Cuomo and all the members of the Western New York Regional Council have provided through this ambitious development program, and eagerly look forward to implementing this effort.”

For more information, visit RPCI’s website athttp://www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or email askrpci@roswellpark.org.