Women's health issues are again highlighted in this edition of the RFE/RL Health Report. Correspondent K.P. Foley has reports on a new study that describes the potentially deadly effects of smoking that are unique to women, and on a survey from Kazakhstan which asserts that environmental degradation from the Soviet era is still harming women today.
U.S. Alarmed By Smoking Rates Among Women
Washington, 30 March 2001 (RFE/RL) -- Health experts say that despite the volumes of evidence proving the dangers of smoking, the rate of smoking among adult women has stopped its decline while increasing among teenage girls.
A new report by U.S. public health agencies now presents even more evidence about the devastating health consequences of smoking that are specific to women -- not only in the United States but around the world.
U.S. Department of Health and Human Services Secretary Tommy Thompson released the report on 28 March, telling reporters that the scope of the problem is much greater than previously thought.
"The repercussions from women smoking are having a devastating impact on the health of our society."
The report was prepared by the U.S. Centers for Disease Control and the U.S. National Institutes of Health, with contributions from academic researchers and non-profit foundations. It is the first major update of a report on smoking and women that was prepared in 1980.
Thompson said some of the findings in the report are alarming.
"Nearly 165,000 women die prematurely each and every year because of smoking. That's one every three and a half minutes."
It was nearly 40 years ago when the U.S. Surgeon General, the nation's chief public health officer, issued the first government report on the health dangers of smoking. The current Surgeon General, David Satcher, noted that smoking was primarily a men's health concern at that time. He says that is no longer true.
"For a long time smoking was considered by and large a men's issue, but today women account for about 40 percent of all U.S. deaths from smoking."
For example, Satcher said that lung cancer has surpassed breast cancer as the leading cause of cancer deaths in women. The new report said that since 1950, lung cancer death rates among women have increased by 600 percent.
While smoking is dangerous for men and women alike, the addiction to tobacco poses several more hazards unique to women.
The report noted, for example, that smoking is "consistently associated with an increased risk for cervical cancer. Pregnant women who smoke risk damaging the lungs of their babies, said the report, and mothers who use tobacco in their homes may harm the lungs of their children by exposing them to toxic smoke.
Other issues of concern to women include findings that women who smoke have a greater chance of suffering hip fractures than women who never smoked, that women who smoke may have a greater risk of developing crippling rheumatoid arthritis and that women who smoke are at greater risk for severe vision problems, including cataracts.
Satcher said that the decline in smoking among women that was evident in the 1980s had stopped, a trend he called troubling. He also said that more teenage girls than ever before are smoking. In total, he said about 22 percent of all American women smoke. Satcher said that worldwide, smoking among women is increasing.
"Looking beyond our national borders, because public health is in fact global, we see that smoking rates among women are increasing rapidly but they vary greatly from as low as seven percent in some developing countries to as high as 25 percent in some developed countries."
The World Health Organization has reported that smoking rates among women have risen rapidly in Eastern Europe and the former Soviet Union since the collapse of communism.
Satcher said the global increases in smoking, "are directly tied to aggressive, Western-style marketing campaigns."
The report calls for implementation of a number of steps to curb smoking among women. These include campaigns to increase public awareness about the "devastating impact," of smoking on women's health, efforts to expose and counteract the tobacco industry's targeting of women, and employment of proven tobacco-control strategies in the 50 states.
Thompson went a step further. He called for regulation of the tobacco industry by the U.S. Food and Drug Administration. This would give that agency the power to control the manufacture and distribution of cigarettes and authority to sharply restrict tobacco advertising. Such a move would require legislation by the U.S. Congress.
(More information on women and smoking at www.cdc.gov/tobacco )
U.S. Studying New Methods For Alcoholism Treatment
There are an estimated eight million alcoholics in the United States. Government statistics say that each year, alcoholism contributes to 100,000 premature deaths and drains the national economy of more than $185 billion from medical care expenses, lost productivity, and other costs.
The U.S. National Institute on Alcohol Abuse and Alcoholism has just begun a nationwide test to determine how well various alcoholism treatment programs work. The director of the Institute, Enoch Gordis, says the evaluation comes at a time when doctors and others involved in alcoholism treatment have higher expectations for success because of advances in genetics, neuroscience, and other treatment research.
Alcoholism is a condition characterized by what Gordis calls "an abnormal appetite for alcohol that leads to significant impairment." He recently told reporters that when alcohol begins to interfere with a person's life, that is cause for alarm.
"We generally recognize drinking problems not from the amount of drinking that's being done -- although that's a clue as well -- but from the troubles in life which the drinking is causing. Anytime alcohol is interfering with a person's function in life, there's a signal that there's maybe some role for alcohol in causing these troubles. And, it can be either alcohol abuse or it may be alcoholism -- where the more extensive treatment is necessary."
Alcoholism, said Gordis, is really an addiction.
"When you're an alcoholic or you have the alcohol-dependence syndrome, you're hooked on alcohol in such a way that the desire for the drink and seeking the drink and wanting it very much dominate your whole life. So, other things which normally give people joy -- or other things, such as their responsibilities -- are interfered with. So, 'alcoholism' really is an addiction to alcohol."
Gordis noted that 50 percent of people who receive treatment for alcoholism start drinking again and only a minority achieve a long-term sobriety. He said this is why "identifying an developing effective treatments is the first priority of alcoholism research."
Over the next 24 months, the Institute will randomly recruit 1,375 people from eleven treatment research centers across the country who meet the clinical definition of alcohol dependence. The participants will be divided into groups that receive behavioral treatment combined with an anti-alcohol medication, and a group that receives counseling along with a sham medical treatment using a placebo.
The project, called the "Combining Medications and Behavioral Interventions (COMBINE)" study is designed to test the effectiveness of counseling used in conjunction with a medication called naltrexone and one called acamprosate. Naltrexone blocks the euphoric affects of alcohol. Acamprosate is supposed to ease the discomfort that comes with alcohol withdrawal.
NGO Says Women's Reproductive Health Worsening In Kazakhstan
A Kazakh non-governmental organization in Islamabad says the reproductive health of women in Kazakhstan is getting worse, particularly in the northeastern Semipalatinsk region.
A survey conducted by the group Women of Kazakhstan, which was funded by the U.S. Embassy, concluded that environmental problems were significant contributors to reproductive health difficulties. The group noted, for example, that the Semipalatinsk region was the site of more than 40 years of nuclear weapons testing by the Soviet Union.
The survey was reported by the United Nations Office for the Coordination of Humanitarian Affairs. The Kazakhstan study included interviews with approximately 1,500 women between the ages of 18-25 years. They live in the Taraz, Semi, and Atyrau regions which reportedly have suffered acute environmental damage.
The survey results said that more than ten percent of the respondents at Semipalatinsk had children with birth defects detected in the womb. That compared with rates of four percent in both Almaty and Astana. In addition, the survey said that more than 20 percent of pregnancies in Semipalatinsk ended in still-birth.
According to the UN's World Health Organization, the maternal mortality rate in Kazakhstan has been rising and more than half of pregnant women suffer from anemia. The WHO says the child mortality rate is persistently high, as are the rates of abortion and sexually transmitted diseases.
(More information on the survey at http://www.reliefweb.int/IRIN/asia/asiafp.phtml)
Russian Abortions, Maternal Mortality Among World's Highest
A senior Russian health official reports that Russia has one of the highest rates of abortion and maternal mortality in the world. Chief Russian gynecologist Vladimir Serov said in Moscow last week that about 2.1 million abortions are performed each year. He said complications arising from the procedure resulted in 250 deaths and left 350 women crippled last year.
Serov said the abortion rate exceeds the country's 1.7 million annual births. He added that almost seven million couples are rendered childless as a result of abortions and sexually transmitted diseases each year. Lyubov Yerofeyeva, the head of the Russian Demographic Fund, called on the government to resume subsidies for family planning centers and for education on contraception.
On a more positive note, health officials reported that infant mortality decreased by four percent in Russia last year. Last year, 15.8 babies died for every 1,000 born, down from 16.4 per 1000 in 1999.