Is San Francisco's vaping ban backed by science?

France24 - AFP,  26 June 2019

Jeremy Wong smokes an e-cigarette at The Vaping Buddha on January 23, 2018
in South San Francisco, California GETTY IMAGES NORTH AMERICA/AFP/File

Washington (AFP) - San Francisco has decided to ban the sale of e-cigarettes in 2020, hoping to curb a surge in vaping among adolescents. But is the policy backed up by the available evidence?

How harmful is vaping?

Unlike tobacco cigarettes, e-cigarettes do not "burn." The devices, which have been available in the US since 2006, work instead by heating up a liquid that then turns into vapor and is inhaled.

Because of this, e-cigarette users don't get exposed to the estimated 7,0000 chemical constituents present in combustible cigarettes, and vaping is generally believed to be safer than smoking.

The liquids do, however, contain nicotine, which has been studied for decades and is known to be highly addictive.

They also contain a variety of other constituents classed as "potentially harmful" according to a 2018 study compiled by the US National Academy of Sciences requested by Congress.

Though many of the flavorings in e-liquids are recognized as safe, their toxicity was studied for oral consumption in food and not inhalation, it said.

There is also "substantial evidence" that the vapor contains traces of metals, either from the coil used to heat the liquid, or other parts of the device.

Another potential red flag, according to the Centers for Disease Control and Prevention is the presence of diacetyl, which is used to add a butter flavoring to microwave popcorn but has been linked to a serious but relatively rare lung disease.

For the time being, there is "no available evidence" to show whether or not e-cigarettes use is associated with cancer, said the NAS report.

But there's a caveat. While experts generally believe vaping is a less toxic alternative to smoking, "the implications for long-term effects on morbidity and mortality are not yet clear," and would require decades of more data and studies to know for certain.

Can it help smokers quit?

Market leading maker Juul's response to the San Francisco ban was that it would "drive former adult smokers who successfully switched to vapor products back to deadly cigarettes."

Are they right about that?

A study published in February in the New England Journal of Medicine on a group of 886 patients in Britain's National Health Service found the claim to be true.

The one-year abstinence rate among e-cigarette users was 18 percent, compared to 9.9 percent among a group who used other nicotine replacement products like gum or patches.

The conversions are not, however, all in one direction.

A slew of recent studies have found that, among adolescents, e-cigarettes effectively provide a gateway toward full-fledged smoking.

Authorities are worried that decades of declining smoking rates among this demographic could go up in smoke as a result of these devices.

Regulation versus prohibition

The vaping industry is adamant it doesn't want to see underage people using its products and more must be done to prevent their sale. E-cigarettes are already illegal to sell in the US to people under 18 or 21, depending on the state.

But, the sector argues, bans are a poor policy choice because they deprive adults addicted to smoking of a valuable tool.

"To deprive those smokers from access to e-cigarettes, which we know are substantially less harmful, I think is a terrible decision, " Neil McKeganey, of the UK-based Center for Substance Use Research based, which is partly funded by the industry, told AFP.

The irony is that the sale of alcohol, cigarettes and cannabis will remain legal in San Francisco for those over 21.

The risks associated with all three are well studied. For alcohol, these include liver disease, high blood pressure and heart disease, numerous cancers. For cigarettes, heart disease, stroke, lung and various other cancers.

Numerous papers meanwhile have explored the risks of cannabis particularly on the juvenile brain.

In place of bans, makers want to see tighter regulation.

There is a lot of work to be done: an analysis of Californian vendors published Monday in the medical journal JAMA found that almost half of tobacco and vape shops did not ID young customers looking to buy vape products.

Dogs trained to offer support to troubled US veterans

Yahoo – AFP, Catherine TRIOMPHE, June 16, 2019

US military veteran Michael Kidd and his companion dog Millie leave after a training
session at the Paws of War office in Nesconset, New York -- Millie helps Kidd navigate
the difficulties of post-traumatic stress disorder (AFP Photo/Johannes EISELE)

Nesconset (United States) (AFP) - Michael Kidd, now 84 years old, fought in the Korean War. His young German shepherd Millie helps calm him down when things start to swirl, usually at night.

Harry Stolberg -- a 42-year-old former Marine who served in Bosnia, Liberia and Nigeria -- has a chocolate Labrador named Rocky who wakes him up from his troubled dreams.

And 31-year-old Phil Davanzo -- who carried the bodies of fallen comrades during a hostage rescue operation that went wrong off Somalia in 2011 -- hopes his Rottweiler puppy will soon be trained to support him during his panic attacks.

The three US veterans, who all live on New York's Long Island, suffer from post-traumatic stress disorder (PTSD) and have sought solace through pet therapy -- namely, a loyal dog to keep them company.

The shelter animals are either trained or being trained to help them through difficult times by Paws of War, an association funded entirely by private donations that then provides the service dogs free of charge.

The group will also train a veteran's dog if he or she already has one.

Veteran Harry Stolberg says his dog Rocky helps him wake up from the nightmares that 

have come after his service overseas in the Marine Corps (AFP Photo/Johannes EISELE)

"The biggest thing is he wakes me up from nightmares," Stolberg says of three-year-old Rocky.

"He can open the door, come in my room, turn on the lights, take my blinders off me... and lick my hands so I wake up."

Rocky, whose 18 months of training were completed six months ago, also helps Stolberg navigate large crowds, which can be triggering.

"If I can't move, he will get me out of that crowd -- he will pick up on that. He will walk around me and look at it and if I don't respond, he will walk away from the crowd with me hooked up to him," he says.

Paws of War -- their acronym is a play on POW, used to signify prisoners of war -- has been active since 2014.

More than 100 dogs have been trained so far, and the therapeutic results for their masters have been significant.

Michael Kidd's dog Millie, seen here, is being trained at Paws of War to help Kidd 

when times are tough -- he says her assistance has led to a reduced need for 

medication (AFP Photo/Johannes EISELE)

Off the meds

Kidd, who suffers from severe PTSD, has been able to reduce his intake of medication thanks to Millie.

At night when things are tough, "she will come over to me, she will put her paw on my shoulder, on my chest, and just give me a big slobber," says Kidd, whose father was in Normandy on D-Day.

"That's just saying, 'I am here for you.'"

Stolberg used to need sleeping pills to get through the night, but not anymore, thanks to Rocky.

"Sleeping was my biggest problem. (...) Now I only have a nightmare once or twice a month, instead of every day," he explains.

"A lot of that is also because I know that when I go to sleep, he is in the room -- he is going to wake me up no matter what."

Rebecca Stromski, a senior trainer for Paws of War whose husband served in 

Afghanistan and Kuwait, says it takes 18 to 24 months to teach dogs what to do when 

a troubled veteran sends distress signals (AFP Photo/Johannes EISELE)

'Quite a process'

It takes 18 to 24 months to teach dogs what to do when a troubled veteran sends distress signals, according to Rebecca Stromski, a senior trainer for Paws of War whose husband served in Afghanistan and Kuwait.

"It's quite a process actually, creating a mutual respect and a connection between the service dude and the service dog," she says.

"Once the foundations are in place and the dog starts feeling if things are going well or not for the veterans, they start to do certain motions when the guys are fidgeting," Stromski explains.

"I can start and cue that behavior and use that as an alert."

In the face of seemingly interminable wars for US military personnel in Afghanistan and Iraq, deployments which began in 2001, veterans are experiencing PTSD symptoms on a regular basis.

Paws of War has more requests for service animals than it can fulfill, with 50 veterans on the waiting list, according to the group's co-founder Dori Scofield.

So far, Paws of War has trained more than 100 dogs to help troubled veterans on Long 

Island, and has more applications than it can currently fulfill (AFP Photo/Johannes EISELE)

Both ends of the leash

After running an animal shelter for 30 years, Scofield launched Paws of War after being contacted by veterans returning home from Afghanistan and Iraq.

Those soldiers had become attached to dogs they had found in those countries, but were unable to bring them back home.

Through word of mouth recommendations, the association quickly became a top meeting place for the 75,000-strong veteran community on Long Island, one of the biggest in the United States.

"We get applications every day -- we can't keep up," Scofield says. "I can't train enough dogs fast enough."

She has opened satellite offices in Florida and in northern New York state. She has also launched a free mobile veterinary clinic where veterans can bring their companion animals.

Dogs who might have ended up put to sleep in shelters now have homes, and veterans are rediscovering "a reason to get up every day, get moving, get out," Scofield says.

"It has been just so awesome, helping both ends of the leash."

War, depression, suicide: American veterans are finding help

France24 – AFP, 13 June 2019

Roger King, an Iraq war veteran from Long Island, has put his own physical and
psychological struggles to use as he helps other veterans adapt to civilian life Roger
King, an Iraq war veteran from Long Island, has put his own physical and
psychological struggles to use as he helps other veterans adapt to civilian life AFP

Center Moriches (United States) (AFP) - Roger King was 19 when he enlisted in the US Marine Corps in 2005. He left four years later after two deployments in Iraq, where a sniper's bullet nearly cost him his life.

Once home, he faced a new set of problems in his return to civilian life on New York's Long Island, including a suffocating sense of anxiety and difficulty being in group situations.

King was suffering from post-traumatic stress disorder (PTSD) and a traumatic brain injury (TBI) -- two afflictions sadly common among veterans of the largest army in the world, bogged down in seemingly endless conflicts in Iraq and Afghanistan.

Increasingly depressed by the challenges of his new life, King began drinking.

This solidly built 33-year-old man quietly confides that he attempted suicide -- twice.

Russell Keyzer -- another New Yorker -- joined the National Guard shortly after the September 11, 2001 terror attacks.

Now 42, he suffers from flashbacks, insomnia, panic attacks and other PTSD symptoms following two years with NATO's multinational force in Kosovo, where periods of relative stability alternated with violent outbursts.

After returning home in 2008, Keyzer sank into a life of drinking and depression. His marriage came crashing down and he found himself homeless. On no fewer than seven occasions, he says, he attempted to kill himself.

Today, King and Keyzer say they are doing much better, thanks in large part to an aid group for veterans, the Joseph P. Dwyer Veterans Peer Support Project, a non-profit organization created in 2012 in tribute to an army medic who killed himself in 2008 after returning home from Iraq.

'More needs to be done'

King and Keyzer spoke about their darker times at a recent "Wellness Day" organized by the association at a park in the coastal village of Center Moriches.

Veterans enjoyed a picnic, a salute to the US flag, yoga, meditation and kayaking -- all activities intended to foster a sense of security and camaraderie.

Some 20 organizations also set up stands to offer assistance.

"More needs to be done," King said. Groups like the Dwyer Project "should have been done in World War I, World War II, Vietnam."

He now leads a group of a dozen veterans for the project. They meet weekly.

"We thought of AA, NA," he said, referring to Alcoholics Anonymous and Narcotics Anonymous, but "it's like you never really thought maybe this might help for veterans."

Now, King added, "the compassion and the caring is getting there."

Keyzer agreed.

"If the proper resources were there when we came home, we would not be in this position ... We would not have turned to drugs, we would not have turned to alcoholism," he said.

But he added: "Things are slowly changing for the better every day. There are more and more veterans' programs out there."

Peer support

Psychological support groups like the Dwyer Project have indeed been multiplying across the United States, as the world's leading superpower struggles to help its 20 million veterans -- nearly 10 percent of the adult population -- overcome their challenges and thoughts of suicide.

Many recent veterans are at the opposite end of the spectrum from the proud and smiling men and women who assembled in Normandy last week to mark the 75th anniversary of the D-Day invasion during World War II.

More than 6,000 veterans -- many of them gun owners -- killed themselves each year from 2008 to 2016, according to a report published late last year by the US Department of Veterans Affairs (VA).

By comparison, a total of 6,951 American troops died in major war zones between 2001 and 2018, according to an analysis from Brown University.

Faced with those sobering statistics, the VA -- which administers some 1,200 hospitals and clinics -- has made suicide prevention a priority, establishing a hotline for troubled veterans that is among the most heavily used in the world.

Increasing awareness

The Veterans Crisis Line was launched in 2007 with a staff of 14; it now has more than 900 employees, with three call centers across the country including one in upstate New York, director Matt Miller told AFP.

The number of incoming calls has grown steadily, now totaling some 650,000 a year, he said.

"We are all increasing in our awareness" of suicide, he said, not just among veterans but among all civilians, where the rate -- while lower than among veterans -- has been climbing.

Fifty years after the hell of Vietnam and more than 17 years after US troops first intervened in Afghanistan, "there is a lot more awareness" about veterans' needs, said Marcelle Leis, who heads the Dwyer Project after 20 years in the Air National Guard.

But she quickly adds: "We have a lot of work to do."

Unlike the norm during the Korean and Vietnam wars, she said, troops sent to Iraq or Afghanistan often serve "multiple tours" and struggle while "going back and forth in this constant state of hyper-vigilance."

As they cope with the difficult return to civilian life, veterans have an added handicap: in their former military culture, asking for help could be seen as showing weakness.

"A lot of what we do is education to ask for help and garner support -- and learn that that's a sign of strength," Leis said.

She is cheered by the fact that many Vietnam veterans, even as they battle their own demons, have been quick to join support groups to help younger veterans.

"It is giving them a new sense of purpose, and helping them heal," Leis said.

'My blood is pumping'

King credits a Vietnam veteran as the first person to encourage him to seek psychotherapy, a crucial step on the road to healing.

While he admits to still having difficult moments, the former Marine, now married and the father of a three-month-old, has plans for the future: with a newly earned history degree, he hopes to work as a high school teacher.

And while he still misses the adrenaline rushes of combat, his weekend job as a firefighter helps make up for it.

"The alarm goes off, my blood is pumping (and) I'm going out to save somebody," King says with a smile.

More than 6,000 American war veterans kill themselves each year. Support groups are bringing veterans together in a bid to stop the deathshttps://t.co/RR57ZYQuVD

— AFP news agency (@AFP) 13 juni 2019

Dutchman wins prestigious prize for work with seeds and small farmers

DutchNews, June 11, 2019

Photo: Marcel Bakker via World Food Prize Foundation

This year’s World Food Prize, the most important global prize in the field of farming and food, has been awarded to Dutchman Simon Groot for his work in helping millions of smallholder farmers to use good seeds. 

This work, the organising committee says, ‘enabled them to to earn greater incomes through enhanced vegetable production, benefitting hundreds of millions of consumers with greater access to nutritious vegetables for healthy diets’. 

‘Simon Groot has dedicated his life to improving the livelihoods of millions around the world,’ Kenneth Quinn, president of the World Food Prize Foundation, said at the award announcement on Monday. 

Groot, now 84, and his partner in the Philippines, started East-West Seed in 1982. Today, the team has developed vegetable varieties with enhanced disease resistance and significantly higher yields which are now used across Asia and beyond. The company serves 19 million smallholder farmers in more than 60 tropical countries.

Announcing the 2019 World Food Prize Laureate, from the Netherlands, Mr. Simon N. Groot. #FoodPrize19 pic.twitter.com/LzKIefa3Nw

— The World Food Prize (@WorldFoodPrize) 10 juni 2019

In an interview with the Volkskrant, Groot said he thinks it regrettable that seed production is in the hands of a few big companies such as Bayer/Monsanto and Syngenta. 

The big companies, he said, are limiting supplies because there is little money to be made from minor breeds. ‘Big companies look at the importance of shareholders,’ he said. ‘Traditional seed companies put the interests of farmers first. We are friends to farmers.’ 

The prize was founded in 1986 by Norman E. Borlaug, recipient of the 1970 Nobel Peace Prize. Groot is the first Dutch national to take the prize.

Award-winning teen writer Noa Pothoven chooses to die due to ‘unbearable suffering’

DutchNews, June 5, 2019 - By Senay Boztas 

A 17-year-old girl from Arnhem who suffered from years of PTSD, depression and anorexia after being sexually assaulted as a child has died. 

Noa Pothoven, the author of the award-winning book Winnen of Leren (‘winning or learning’) wrote in a post on Instagram – which has now been deleted – that she was ‘being let go because my suffering is unbearable.’ 

According to the AD, her last days were spent in a hospital bed in her family’s living room, saying goodbye to her near and dear, and her sister announced her death on Sunday. 

Although it has been widely reported around the world that she died through euthanasia – following an unconfirmed report from the Central European News wire service – the circumstances of her death are unclear. A journalist from Politico Europe has claimed that the reports were incorrect and due to a failure of checking. 

In her Instagram post, the young woman had said that she would stop eating, and expected to die within 10 days. 

She had, however, investigated the possibilities of euthanasia through the Levenseindekliniek in Den Haag last year, according to The Gelderlander local newspaper, and then been rejected. 

The young woman had written critically about her traumatising experiences of isolation cells in psychiatric care institutions, and praised GroenLinks MP Lisa Westerveld when she took up the subject of inadequate youth care in the Netherlands. 

After suicide attempts, last year she had said that she would try trauma therapy a final time and her mother, Lisette, told The Gelderlander that she was choosing ‘the road towards death’ while her family wanted her to choose life. 

A spokeswoman for Westerveld, who was one of the people invited to say goodbye to Ms Pothoven before her death, said: ‘as far as we know, she died because she didn’t eat any more,’ adding that the girl has not yet been buried. 

The euthanasia clinic that the young woman reportedly consulted last year would not confirm or deny if she was a patient. Elke Swart, spokeswoman for the Levenseindkliniek in The Hague, said: ‘We cannot say anything about it. There are very few young adults in euthanasia clinics, and it’s even rarer to see them for psychiatric reasons. Euthanasia of someone who is 60 is very different to that of someone who is 16. But we follow the law, which says someone must be in unbearable suffering with no other alternative.’ 

Although euthanasia has been legal in the Netherlands since 2002, the number of cases dropped for the first time in a decade last year. Three cases have been referred to the public prosecution service for not following strict rules, and some commentators have said doctors are more wary after more controversial circumstances involving dementia (2.4% of the 6,126 euthanasia cases last year) and psychiatric forms of suffering (1%). The vast majority of euthanasia procedures, however, involve someone with a terminal sickness, and 66% last year related to untreatable cancer.

A 17-year-old rape victim was NOT euthanised in the Netherlands.@euronews @Independent @DailyMailUK @dailybeast are all wrong
It took me about 10 mins to check with the reporter who wrote the original Dutch story.
Noa Pothoven asked for euthanasia and was refused (cont.) pic.twitter.com/e7PYQSCxG1

— Naomi O'Leary (@NaomiOhReally) 5 juni 2019

Related Articles:

Why international newspapers reported the death of Noa Pothoven as ‘euthanasia’…when it wasn’t - New

Media misreport Dutch teen Noa Pothoven's death as euthanasia

FNV members to vote on pension deal, finally agreed after nine years

DutchNews, June 5, 2019

Ministers, unions and employers have reached a deal on reforming the Dutch pension system, nine years after talks first started. 

The agreement, which still has to be voted on by members of the FNV trade union federation, involves a slowdown in the planned increase in the state pension age and gives workers the option to retire early – both of which were key union demands. 

The new deal involves freezing the state retirement age at 66 years and four months for the next two years. After that it will increase in increments until it hits 67 in 2024. 

Then onwards, the state pension age will continue to rise in line with increases in life expectancy – based on an eight month increase for every year we live longer. 

The talks had broken down last November when the unions walked out but resumed earlier this week after ministers indicated some compromises were on the table. 

For example, ministers have agreed to bring in some form of early retirement scheme which is aimed at people doing heavy physical work but which is open to everyone. 

The scheme is most attractive to people on low incomes. Employers will have to pay a fine if workers earning more than €19,000 a year quit early. The money, ministers say, will compensate for the loss of premium and tax income. 

It will also be easier for the self-employed to join a pension fund, but it will not be compulsory. 

Insurance 

However, freelancers will be required by law to take out insurance against becoming unable to work through illness. This, commentators say, was one the demands made by GroenLinks and the social democratic party PvdA in return for their support in steering the deal through the senate. 

There may be an opt-out for people who show they have sufficient reserves to support themselves. Currently just 20% of freelancers have such a policy, and the cost runs into hundreds of euros a month. 

More details about this part of the agreement are due in the coming days. 

Fund changes 

Pension funds will also have the option of offering employees two sorts of pensions – one in which the premium varies in line with interest rates and one in which funds can take more risk – and spread that risk over all participants, broadcaster NOS said. 

Although employers organisations and smaller unions have backed the new plan outright, the FNV has said it is up to the members to decide whether or not to support the new deal.

Chairman Han Busker said he expects a ‘tough discussion’ with members but said the agreement as it now stands is ‘justifiable’.

Obamacare led to better cancer outcomes: studies

Yahoo – AFP, June 2, 2019

The findings come as the administration of President Donald Trump is renewing its 

efforts to strike down the Affordable Care Act signed into law by his predecessor 

Barack Obama (seen) (AFP Photo/Juan BARRETO)

The findings come as the administration of President Donald Trump is renewing its efforts to strike down the Affordable Care Act signed into law by his predecessor Barack Obama (seen) (AFP Photo/Juan BARRETO)

Chicago (AFP) - A pair of studies have found that Obamacare led to an increase in early-stage ovarian cancer detections and helped nearly erase racial differences in the timely treatment of a range of cancers.

The findings, which were presented at the American Society of Clinical Oncology annual meeting in Chicago, come as the administration of President Donald Trump is renewing its efforts to strike down the Affordable Care Act signed into law by his predecessor Barack Obama.

The study on ovarian cancer screening was led by Anna Jo Smith at the Johns Hopkins Department of Gynecology and Obstetrics in Baltimore.

"Having health insurance plays a major role in whether or not a woman has access to care providers who can monitor symptoms and act on those symptoms if necessary,"she said.

The five-year survival rate for women diagnosed with early-stage ovarian cancer is 75 percent, but the figure drops dramatically to 30 percent for those diagnosed at a later stage.

The ACA was signed into law on March 2010, and by 2016-17, some 12.7 million people were covered under the law.

The percentage of Americans who were uninsured dropped from 16 percent in 2010 to less than 12 percent by 2016.

The researchers used data from the National Cancer Database to look at the years before (2004-2009) and after (2011-2014) the passing of the ACA.

They looked at the stage of the diagnosis and the time to treatment for the 21 to 64 age group, and compared it to those 65 and older, which was used as a control group because they had access to publicly funded Medicare before and after.

They found that there was a relative gain of 1.7 percent in early-stage diagnosis and a 1.6 percent improvement in receiving treatment within 30 days.

The team wrote in a statement: "While a 1.7% difference in being diagnosed earlier may not sound very large, for the 22,000 women diagnosed with ovarian cancer in the United States annually, it means that close to 400 more women could be diagnosed at an early, treatable stage."

Racial differences erased

The second paper on Obamacare found that differences between whites and blacks in timely care "practically disappeared" following the passage of the law.

Two key provisions of the ACA were granting states permission to expand public funded Medicaid coverage to low-income citizens starting in 2014, and providing subsidies to those who could not afford to buy private insurance if they did not qualify for Medicaid.

The study looked at the records of 2.2 million people diagnosed with advanced cancers including non-small cell lung cancer, breast, urothelial, gastric and esophageal, colorectal, renal cell, prostate, and melanoma cancers.

"Prior to Medicaid expansion, African American patients were 4.8 percentage points less likely to receive timely treatment as compared with white patients," the researchers wrote.

After the ACA was passed, 6.1 percent more blacks received timely treatment as well as 2.1 percent of whites, making the differences between the races statistically insignificant.

"Many studies have described racial disparities that exist in cancer care, but few have shown what types of interventions improve health equity -- we now have evidence that Medicaid expansion can mitigate certain health disparities," said study author Amy J. Davidoff at the Yale School of Public Health.

Trump's Justice Department announced in March an abrupt escalation in the administration's push against Obamacare by siding with a Texas federal court ruling that declared the health care law unconstitutional.

That ruling is currently being appealed and the resulting impasse looks increasingly likely to end up in the Supreme Court -- putting a politically radioactive issue center stage as the country moves towards the 2020 presidential election.