Friday, February 21, 2014
This and that from the BMJ
Yes yes, America is the Greatest Nation on Earth, a Beacon to All the Nations, with better Pizza than Italy and better marijuana than Mexico. That said, we don't have the greatest medical journal, in my opinion. BMJ gets the honor because for them, medicine is just as much about society as it is about biology. A few tidbits from this week that caught my eye:
Switzerland, which has the second most costly health care in the world because it essentially has Obamacare, which is better than whatever it was we had before but not by much, is considering dismantling its screening mammography program. That's because their medical board can read and has gotten the 4-1-1 that it is very unclear that screening mammography does more good than harm. It certainly costs a boatload of money. And, of course, we get the fully predictable howls of outrage from the radiologists and oncologists. How are they going to pay for their Rolexes and giant wooden trumpets? My guess - not going to happen. But we shall see.
Australia now requires "plain" tobacco packaging, which means no branding and also isn't exactly plain because it does have to carry the quitline number. Result? A 78% increase in calls to the quitline. Don't know yet into how much quitting, or how much less starting, that leads to, but it can't be bad. Of course, the Supreme Court won't allow that here because Freedom. Like being addicted to tobacco is Freedom.
Children who live near a lot of fast food outlets are more likely to be obese. Now, this could be an error of causal inference. Presumably those are more socioeconomically underprivileged areas. Still, intriguing enough to be worth further study.
This meta-analysis finds that people who quit smoking end up being happier with less diagnosed psychiatric disorders. The authors attribute this to not continually going through incipient nicotine withdrawal but it could be simpler than that: you have more money in your pocket, you're less worried about lung cancer and heart attacks, you don't have to keep ducking out of the office into the rain and freezing cold, and you're free baby, you're in control, you beat this thing, you rock. Yay!
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2 comments:
Re: quitting smoking and psychiatric disorders.
Is it possible we are reversing the causal arrow here? It has always seemed to me that nicotine (like many substances) is a self-medication for another problem. Given that it might be more accurate to say that people without psychiatric disorders may be more likely to quite smoking.
That may be true, but this is a before and after comparison of people who do, in fact quit. It's not comparing quitters to non-quitters, it's saying that after people quit, they feel better.
So if they had been self-medicating, it wasn't working.
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