News in brief - Sept. 11, 2000

Teens may be smoking less - Findings indicate how some exposures may protect against asthma risk - New drug shows promise for early-onset alcoholics - Diabetes rates rising

Teens may be smoking less

Current smoking rates among U.S. high school students may have leveled or begun to decline during the late 1990s after years of steady increases, according to new statistics released last month by the Centers for Disease Control and Prevention. In 1995, the high school smoking rate was 34.8%. In 1997 it went up to 36.4%. In 1999, it dropped to 34.8% again.

High school males drove these numbers by demonstrating a slight downturn; 35.4% in 1995, up to 37.7% in 1997 and down to 34.9% in 1999. Rates among their female counterparts hovered at 34% for all years.

According to the CDC, smoking rates among teens could be cut in half within the decade, meeting the Healthy People 2010 objectives for youth tobacco use, if the nation's fully implemented anti-smoking approaches prove to be effective. Currently, less than 5% of schools nationwide are implementing the major components of the CDC's Guidelines for School Health Programs to Prevent Tobacco Use and Addiction.

The U.S. Surgeon General's report "Reducing Tobacco Use" concludes that effective educational programs could postpone or prevent smoking in 20% to 40% of American adolescents.

Findings indicate how some exposures may protect against asthma risk

Research published in the Aug. 24 New England Journal of Medicine adds a new twist to the perplexing issue of increasing asthma rates among young children in the United States.

The report, authored by Sandra C. Christiansen, MD, of Scripps Research Institute in La Jolla, Calif., begins with a premise that most parents believe: Children who attend day care or who have older siblings are more likely to get sick. However, emerging science indicates that, at the same time, this exposure may actually reduce the risk of asthma.

Specifically, Dr. Christiansen wrote that "protection against the development of asthma or frequent wheezing in children ages 6 to 13 was linked to either day-care attendance during infancy or the presence of older siblings in the home." Children with these exposures usually were more likely to have episodes of wheezing at age 2. But, she added, "this increased wheezing was found to be correlated with a subsequent reduction in the relative risk of asthma."

This correlation, according to the article, likely reflects the relationship between certain exposures and the developing immune system. Still, wrote Dr. Christiansen, "for those of us who share the furtive guilt of having left marginally ill toddlers at day care, these findings also offer a sense of relief. We were perhaps only doing our part to restore the Th1-Th2 balance and to stem the rising tide of asthma and allergic disease."

New drug shows promise for early-onset alcoholics

Ondansetron, a selective serotonin blocker, may be an effective treatment for alcoholics who started problem drinking before age 25, according to research published in the Aug. 23/30 JAMA.

The study from the University of Texas looked at more than 200 late- and early-onset alcoholics and combined medication with behavioral therapy over an 11-week period.

Early-onset alcoholics were abstinent 40% more often than those taking the placebo. The drug did not seem to help those who became alcoholics after age 25.

Physicians who treat alcoholics said the research was promising but that it was too early to start using the drug in clinical practice. "There's a lot of theory that supports that it might work," said Michael F. Fleming, MD, professor of family medicine at the University of Wisconsin, Madison. "But it's too early to tell."

Diabetes rates rising

Diabetes incidence shot up over the past decade -- increasing across all demographic categories. The most dramatic rise -- 70% -- came among people aged 30 to 39. Overall, diabetes rates jumped by about one-third.

These findings, published in the September Diabetes Care, were based on telephone surveys in which 150,000 people 18 or older were asked if a doctor had told them they had diabetes.

Experts consider this jump to be a serious public health problem. They also link the unprecedented numbers to America's trend toward obesity.