May 2010

Anti-tobacco campaign

People are once again asked to think before they light up during anti-tobacco campaign month. Smoking is the single biggest cause of cancer in the world and over 44 000 South Africans die from tobacco-related diseases annually. Many more become ill from using tobacco products and inhaling second-hand smoke.

According to the Cancer Association of South Africa (CANSA), smoking is the main cause of lung cancer – which has one of the lowest survival rates of all cancers. Smoking also increases the risk of many other cancers including cancers of the mouth, larynx (voice box), oesophagus (food pipe), liver, pancreas, stomach, kidney, bladder and cervix. The good news is that most of these deaths are preventable by giving up smoking in time.

Stiffening of the arteries

It is already a well-known fact that smoking is bad for the heart, and researchers now have discovered one reason why: continual smoking causes progressive stiffening of the arteries.

In fact, smokers' arteries stiffen with age at about double the speed of those of non-smokers, Japanese researchers have found.

Stiffer arteries are prone to blockages that can cause heart attacks, strokes and other problems. Smokers’ large- and medium-sized arteries stiffened at twice the rate of non-smokers’, according to the report in the Journal of the American College of Cardiology by the team from Tokyo and the University of Texas in Austin.

That's no big surprise, said Dr William B. Borden, a preventive cardiologist and assistant professor of medicine at Weill Cornell Medical Centre in New York City, noting that there is definitely a dose-response relationship. "The more smoking, the more arterial stiffening there is per day."

The study authors measured stiffening by years, not by day, but the damaging effect of smoking was clear over the long run.

Australia’s progressive new campaign

Countries like Australia have taken a more hard-line view of tobacco advertising, becoming the first country to ban branding on cigarette packaging at the end of April and raising the price of tobacco products with 25%.

According to Prime Minister Kevin Rudd, plain packaging will be introduced within the next 18 months. Under Australia’s proposal, packets will display only health warnings and basic product information. In the process Rudd is intensifying a four-decade long campaign to convince Australians of the risks associated with smoking, the biggest preventable cause of disease and premature death.

Rudd is expecting that the world’s large tobacco companies will be up in arms, a fight he is well prepared for. “The big tobacco companies are going to go out there and whinge, whine, complain, consider every kind of legal action known to man — that’s par for the course,” Rudd said on Sky News. “We, the government, will not be intimidated.”

Imperial Tobacco said it might take legal action. “Introducing plain packaging just takes away the ability of a consumer to identify our brand from another brand,” Cathie Keogh, a spokeswoman, said. “We will fight to support protecting our international property rights.”

Sources: Business Day, Health24, Bloomberg, CANSA

Health Calendar: May

Anti-Tobacco Campaign Month
International Multiple Sclerosis Month

8 World Red Cross Day
10 World Move for Health Day
12 World Chronic Fatigue and Immune Dysfunction Syndrome
12 International Nurses Day
16 Candlelight Memorial Day
24 - 30 Child Protection Week
28 International Day of Action for Women’s Health
31 World No Tobacco Day

A cancer causing habit

Epicentre News Desk:

Shortage of flu shots

Getting your hands on a flu shot this winter will prove difficult is you do not fall within one of the risk groups earmarked for the national flu vaccination programme.

South Africa’s private health care sector has run out of stock and all remaining flu vaccines will be distributed by the Department of Health to people manning our airports and harbours, as well as general high risk groups that include health care workers, HIV and AIDS patients, pregnant women and people suffering from lung or chronic diseases.

Private health sector has run out

Dr Frew Benson, of the National Institute for Communicable Diseases (NICD), confirmed that there were no flu vaccines in the private health sector. According to Benson some manufacturers had switched their focus to producing vaccine for the H1N1 flu virus (the so called ‘swine flu’) last year in response to the pandemic and there had been in increased demand for flu vaccines because people were frightened by the swine flu outbreak. All these factors have contributed to the shortage that we are now facing.

Coupled with the decrease in production and the increase in demand, the national department of health embarked on an immunisation campaign for the public sector at the beginning of April. This further depleted the already dwindling stock.

Different strains

This year’s flu vaccine contains three different influenza strains, including the influenza A H1N1 strain commonly known as the swine flu strain. At the moment government facilities do not experience problems, but the risk groups will definitely take preference, according to Mandla Fidu, spokesperson for the Gauteng Health and Social development department.

Source: IOL

The Epicentre Health Management Programme

Employee Health Management (EHM) is the strategic and coherent management of the health of the organisation's most valued asset - the people working there. EHM includes all activities undertaken by the organisation to promote healthy living among the employees.

An Employee Health Management Strategy is a formal plan that outlines the organisation's EHM programme goals and ties them to business objective.

The effects of cost containment

Cost containment is of course a key component of all EHM strategies, with a focus on:

•    Death and disability benefits - HIV has reduced life expectancy to below 50 years of age. The increased disability costs and mortality have a direct impact on the cost of group life and retirement funds.

•    Medical costs - Medical aid costs escalate by an average of between 7-10% annually and organisations are trying to find new ways in which they can cap this expenditure.

•    Primary Health - Another costs containment strategy has been the removal of primary health care from the organisation's clinic portfolio and instead only focusing on occupational health.

•    Outsourcing employees – This can cut salary costs by as much as 20% as outsourced employees normally do not enjoy any company benefits.

Cost containment strategies do not remove the employee health risk, instead they simply manage to shift the cost from the employer to the employee.

Increased cost

As the health safety nets are removed, there is actually an increase in cost with regards to:

•    Staff turnover – Company benefits create a barrier for staff turnover. Direct costs related to staff turnover include the replacement and transitional costs. Indirect costs relate to the loss of production, reduced performance levels, unnecessary overtime and low morale.

•    Absenteeism – Without access to onsite medical services or booked doctor visits, employees will either leave medical conditions untreated or take time off work to wait in long queues in public sector institution for services. This translates into increased absenteeism. The costs of absenteeism are estimated at twice an employee salary.

•    Presenteeism – When an employee is present but unable to work, it translates into significant costs. With no sick leave benefit, employees are forced to work when they are not medical fit to do so.

Increasing physical, mental and social health of employees

Increasing the physical, mental and social health of employees will reduce absenteeism, presenteeism and staff turnover and counteract the effects of reduced staff benefit costs. Programmes can be tailored to the specific needs of the employees to ensure the most benefit.

It is estimated that 75% of health problems are caused by the behavioural choices of employees. Employees can improve their health significantly if they eat healthier, exercise more and stop smoking, according to the World Health Organisation (WHO). This will in turn effectively prevent 80% of premature heart disease, 80% of premature stroke, 80% of type 2 diabetes and 40% of cancers.

How To: quit smoking

…tobacco is the only legally
available consumer product
which kills people when it is used
entirely as intended.
The Oxford Medical Companion (1994)

When you stop smoking, the benefits are immediately clear: only 20 minutes after a smoker’s last cigarette, blood pressure and heart rate start to return to normal. Yet millions of smokers find it difficult, if not impossible, to quit.

The reason is nicotine addiction, but there are many factors involved in smoking addiction that makes quitting a complex and challenging process.

Options for quitting include:

1. Nicotine replacement therapy (NRT)

The first few days are by far the hardest and NRT can be regarded as a temporary solution that helps smokers get past the first hurdle on their journey to long-term smoking cessation.

Always carry a batch of gum or another type of NRT with you as the urge could come at any time.

2. Zyban

The antidepressant Zyban (bupropion) seems to increase levels of dopamine and norepinephrine in the brain, leading to an enhanced feeling of pleasure.

Longer-term treatment of bupropion may prevent relapse, but more research on the long-term benefits of Zyban is necessary before definite conclusions can be drawn. Zyban is only available on prescription and can not be used by people with, among others, kidney problems, heart problems and diabetes.

3. Combination therapy

Combination therapy, which involves counselling, the simultaneous administration of NRT (patches and/or gum) and/or the drug Zyban, seems to be an effective solution for many smokers. Preliminary research results indicate a 50 percent six-month success rate for combination therapy.

4. Behavioural changes

Many experts believe that a replacement method such as NRT does not address the core psychological factors involved in smoking addiction.

For this reason the focus for long-term smoking cessation should be on behavioural changes that address the smokers’ emotional bond with their cigarettes.

5. Kicking the habit on your own

Quitting all by yourself is not easy, but not impossible.
The biggest reason for relapse, in general, is that quitters feel anxious about being without their cigarettes. Other reasons include missing the pleasure of smoking, feeling pressurised by family members or friends who smoke, or feeling addicted.

Research suggests that stress management techniques, like exercise or yoga, can play an important role in long-term success, whether you want to stop by yourself or join a programme.

Source: Health24

- Programme set-up, Training & Policy Development	- Education & Awareness
- Peer Education Training, Toolkits & Coaching	- VCT & Health assesment interventions
- Employee support programmes	- Research