The official MedZine Blog

Also this week MedZine brings you the latest medical news on various medical specialisms. In this editorial some striking studies are highlighted.  This week we have selected two studies, both featuring serious concerns. The first is the worry of people who consider to stop smoking. Won't the weight gain after quiting outweigh the cardiovascular benefits of quiting? The other concern we want to highlight is that of doctors about the tendency to precribe memory-enhancing drugs to healthy children whose brains are still developing. While the first are probably unwarranted, the second concerns might need serious consideration.

Weight gain after smoking

It is a question that troubles a lot of people that consider to stop smoking: do the health effects of any weight gained after quitting outweigh the known cardiovascular benefits of smoking cessation?
A report in the March 13 issue of JAMA concludes that these people don't need to worry. According to the analysis from the Framingham Offspring Study – a long-term study that follows children of participants in the original Framingham Heart Study –  the benefits of stopping smoking far exceed any weight-gain associated risk.

The investigation analyzed data from participant visits conducted from the mid 80s into the mid-2000s. Based on information gathered at each exam, participants were categorized as never smokers, current smokers, recent quitters – who had stopped smoking since their last exam – and long-term quitters. A general trend toward weight gain was seen across all study participants. Smokers, never smokers, and long-term quitters gained an average of 1 to 2 pounds between study visits, while recent quitters had gained an average of 5 to 10 pounds since their previous visit.
But no matter how much weight the recent quitters gained, the risk of cardiovascular events in the six years after quitting dropped in half for participants without diabetes. A similar drop in the incidence of cardiovascular events was seen in participants with diabetes, but it did not reach statistical significance, probably because less than 15 percent of the overall group was known to have diabetes.
James Meigs, MD, MPH, of the General Medicine Unit at Massachusetts General Hospital (MGH) and senior author of the JAMA report, says that 'among people without diabetes, those who stopped smoking had a 50 percent reduction in the risk for heart attack, stroke or cardiovascular death, and accounting for any weight increase didn't change that risk reduction. In patients with diabetes – among whom weight gain is a particular concern – we saw the same pattern of a large risk reduction regardless of weight gained.' Meigs further states that 'we now can say without question that stopping smoking has a very positive effect on cardiovascular risk for patients with and without diabetes, even if they experience the moderate weight gain seen in this study.'

Attention-boosting drugs for healthy kids

In the March 13 online issue of the journal Neurology, doctors at Yale School of Medicine have called upon their fellow physicians to limit or end the practice of prescribing memory-enhancing drugs to healthy children whose brains are still developing. The statement was written to address the growing trend in which teens use "study drugs" before tests and parents request attention deficit hyperactivity disorder (ADHD) drugs for children who don't meet the criteria for the disorder. The doctors are members of the American Academy of Neurology (AAN). The AAN spent several years analyzing all of the available research and ethical issues to develop this official position statement on the topic.

William Graf, M.D., professor of pediatrics and neurology at Yale School of Medicine and first author of the statement says that 'doctors caring for children and teens have a professional obligation to always protect the best interests of the child, to protect vulnerable populations, and to prevent the misuse of medication.' According to Graf 'the practice of prescribing these drugs for healthy students is not justifiable.'
Graf and a group of child neurologists express their worries about a number of reasons why doctors shouldn't prescribe neuroenhancers to children. Among these are the long-term health and safety of neuroenhancers, which has not been studied in children and the fact that kids and teens may lack complete decision-making capacities while their judgments and cognitive abilities are still developing. Other issues are maintaining doctor-patient trust and the risks of over-medication and dependency.

Source: Eurekalert