News in brief - July 12, 2004

Number of teens smoking is down - GAO scores pain meds on Internet in test - AMA calls for development of return-to-work guidelines - Direct-to-consumer genetic testing restrictions necessary

Number of teens smoking is down

Increased cigarette taxes and anti-smoking campaigns could have been factors in a dramatic decrease in smoking among high school students, according to the Centers for Disease Control and Prevention.

Smoking levels have dropped to 22% among high school students in 2003, compared with 36% in 1997, and are at the lowest level since the CDC began tracking these rates in 1975.

The agency attributes the increased price in cigarettes -- by 90% from December 1997 to May 2003 -- and exposure to smoking-prevention campaigns as reasons for the decline among male and female students.

Researchers also found that the percentage of high school students who smoke is, for the first time in 20 years, lower by about 1% than the percentage of adults who smoke. Reducing the number of students who smoke is important, since many adults say they began smoking as teens.

GAO scores pain meds on Internet in test

The General Accounting Office, regarded as the nation's watchdog agency, had no trouble obtaining the controlled substance hydrocodone from eight online pharmacies without having been seen by the physicians who wrote the prescriptions.

The GAO reported its findings to the Senate's permanent subcommittee on investigations in a June 17 report.

A prescription for the powerful pain reliever was sent to a GAO investigator posing as a patient by five Internet pharmacies after they received an order and credit card payment information. Three other suppliers called and asked questions about prior use of the drug before sending the prescriptions.

The online price of the drug was about 10 times higher than its normal retail price.

The GAO concluded that the "Web sites appear to purposely cater to hydrocodone customers who are willing to pay a substantial markup for the painkillers because they do not have prescriptions."

AMA calls for development of return-to-work guidelines

Physicians need evidence-based guidelines to assist their efforts to get their patients back on the job after significant illness, according to a Council on Scientific Affairs report accepted at the AMA Annual Meeting in Chicago last month.

The recommendation came in the wake of the recognition that physicians are doing much to assist their patients' return to full functionality but have little guidance on exactly what that means. Several specialty societies have consensus statements based on expert judgment, but the science on the issue is scant.

"We're in a situation where the literature hasn't caught up with the experience of practitioners," said Scott D. Deitchman, MD, a CSA member.

The AMA also recognized that physicians can facilitate return to work, and it might convene a Federation task force on the issue.

Approximately 21 million people annually report a condition that affects their ability to work.

Direct-to-consumer genetic testing restrictions necessary

Patients should not be able to access genetic testing without the consultation of a qualified health care professional, according to policy adopted at the American Medical Association Annual Meeting in Chicago last month.

The call for such restrictions is a response to the growing number of such tests being made available directly to consumers. The AMA favors state restrictions of the tests' availability because of the belief that misinterpreted tests could lead patients to take actions that they might regret.

A positive test result for genes related to breast cancer could lead a patient to seek a prophylactic removal of breasts and ovaries, which might not actually be necessary. A negative test could lead patients to believe that they are not at risk when in fact they are.

"In the past 10 years, genetics has expanded significantly, and as a result there has been a proliferation of many new laboratory tests," said Raymond Lewandowski, MD, delegate from the American College of Medical Genetics. "However, selection of the tests and interpretation of the results is often a complicated process."