Care Online

Runners have special needs when it comes to pre workout supplements. They are among the very few who need carbohydrates to fuel their high-intensity long-term training. This is why it might be important to know that you will get the ability to work with a solution which allows you great overall results both in terms of energy and in terms of fueling your body with the basic ingredients to keep it going at an optimum level. But most importantly, the Best Pre Workout For Runners needs to come with the energy boost you need to really improve your running results.

What Runners Need in a Pre-Workout Supplement?
Runners have truly special nutritional needs when it comes to daily routines or to official runs like marathons. Since this type of activity demands a larger number of calories you’ll get to see some impressive products with added carbohydrates. These carbs can come from various sources and you can see them in the forms, but you can also see solutions with added fats and added minerals as well. Since you can find different solutions to work with, it is also important to know that you can find many great results when it comes to better hydration and muscle support in form of minerals,

Carbohydrates and Fats in Pre Workouts for Runners
Runners can now choose supplements which are made with carbohydrates or fats. These types of products are great when it comes to added energy sources and they are also easily absorbed by the body. There are a few healthy fats which can also act as energy sources in the right food combinations and this makes them even more appealing to runners. Since there are many great choices to work with, it is also important to know that you can find great results when it comes to better pre workout powder supplements which can last longer and which are most suited to the needs of the runners.

Minerals
There are many pre-workouts which come with minerals and there is a good reason behind this decision. They support muscle function and for runners, they offer the much-needed support for longer training sessions or even for more intense running sessions.
The good news is that they can act to balance the sodium you lose through sweat. At a professional level, you will even see athletes consuming these pre-workouts together with fruits such as bananas to increase potassium intake. It is always worth considering the supplements which allow you to stay safe while training and minerals are among the few additions for this purpose.

Vitamins
In the taxing conditions in which a runner trains, vitamins play an important role. Even if they are not as fast-acting as the other ingredients, they will still build-up in the body and they offer the best solution when it comes to a boosted immunity which can suffer after intense and constant physical activity. This is why it is worth considering the options which at least come with the vitamins for brain function as you will need good focus ability for the duration of your training.

Amino Acids
Amino acids are the foundation to a pre-workout for runners. They are responsible for the added energy as is the case with Citrulline but they can also be responsible with muscle preservation properties as is the case with L-Glutamine. In the end, the decision will be up to you and you will have to find the right formulation in terms of energy output for you.
There are other sources of energy as well. They can come from Taurine or they can even come from Beta Alanine. But their quantities will also largely dictate their overall results. This is why it is important to know that you can find great solutions when it comes to better energy even within the amino acids themselves.
Some amino acids might not be very recommended for runners. Such is the case of L-Carnitine. Since its primary role is to boost fat loss, it is not a solution for runners as they already experience a higher metabolism which burns calories quicker. Even more, running involves the cardiovascular system more than other activities and this is why you might not want to see it as a solution for better muscle retention which is still essential for runners.

Caffeine
Caffeine can also be present in pre-workout for runners, but it will be up to you to decide if you want to use it before your running session. This is why it can be important to know that you can work with solutions which allow you a good overall result in terms of energy even without caffeine. But in some cases, it can definitely come as a major plus.

BHB Ketones
One of the ingredients which are used as an energy source in the absence of glucose and carbohydrates comes with BHB ketones. They are often use on the Ketogenic diet but the runners who are not looking to consume carbohydrates will have to gather energy from other places and BHB ketones can be a good solution for this reason. This is why it is important to know that you can see great results when it comes to energy levels even when you are not having the same glucose levels you might be used to and if you are preparing for a race, it might even be the case that you are trying to reach a certain weight. If you eliminate carbohydrate sources, you can thus fully benefit when it comes to better runs with more energy.

Top 5 Pre Workout Supplements for Runners

1.  Perfect Keto Perform - TOP PICK
2. ONNIT Total Strength + Performance
3.  Optimum Nutrition Amino Energy
4. RARI Nutrition Infinity
5. Legion Athletics Pulse

Dehydration happens when your body doesn't have as much water as it needs. Without enough, your body can't function properly. You can have mild, moderate, or severe dehydration depending on how much fluid is missing from your body.
Causes
It’s normal to lose water from your body every day by sweating, breathing, peeing, and pooping, and through tears and saliva (spit). Usually you replace the lost liquid by drinking fluids and eating foods that contain water. If you lose too much water or don’t drink and eat enough, you can get dehydrated.
You can lose more water than usual with:

• A fever
• Diarrhea
• Vomiting
• Excessive sweating

Peeing a lot (Diabetes and some medications like water pills -- also called diuretics -- can make you pee more often.)

You may not replace the water you lose because:

• You’re busy and forget to drink enough.
• You don’t realize you’re thirsty.
• You don’t feel like drinking because you have a sore throat or mouth sores, or you’re sick to your stomach.

Symptoms

• Thirst
• Dry or sticky mouth
• Not peeing very much
• Dark yellow pee
• Dry, cool skin
• Headache
• Muscle cramps

Signs of severe dehydration include:

• Not peeing or having very dark yellow pee
• Very dry skin
• Feeling dizzy
• Rapid heartbeat
• Rapid breathing
• Sunken eyes
• Sleepiness, lack of energy, confusion or irritability
• Fainting

Symptoms for babies and young children can be different than for adults:

• Dry mouth and tongue
• No tears when crying
• Dry diapers for 3 hours
• Sunken eyes, cheeks, soft spot on the top of the skull
• Sleepiness, lack of energy, or irritability

Severe dehydration is a medical emergency and needs to be treated immediately.

Who’s at Risk?
Anyone can get dehydrated, but the odds are higher for some people:

• Babies and young children are the most likely to have severe diarrhea and vomiting, and they lose the most water from a high fever. The youngest can’t tell you they’re thirsty or get their own drink.
• Older adults have less water in their bodies and often don’t realize they’re thirsty. If they can’t get around very well anymore, they may not be able to get a drink easily.
• People who are ill with a cold or sore throat may not want to eat or drink.
• People with a chronic disease such as type 2 diabetes can pee a lot if the disease is uncontrolled. They also may take medicines such as water pills, which make them go more often.
• People who are active outside in hot and humid weather sometimes can’t cool down effectively because their sweat doesn’t evaporate. This can lead to a higher body temperature and need for more water.

A Collection of Related Diseases:
Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.
Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.
When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.
Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.
Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.
Unlike malignant tumors, benign tumors do not spread into, or invade, nearby tissues. Benign tumors can sometimes be quite large, however. When removed, they usually don’t grow back, whereas malignant tumors sometimes do. Unlike most benign tumors elsewhere in the body, benign brain tumors can be life threatening.

Differences between Cancer Cells and Normal Cells
Cancer cells differ from normal cells in many ways that allow them to grow out of control and become invasive. One important difference is that cancer cells are less specialized than normal cells. That is, whereas normal cells mature into very distinct cell types with specific functions, cancer cells do not. This is one reason that, unlike normal cells, cancer cells continue to divide without stopping.
In addition, cancer cells are able to ignore signals that normally tell cells to stop dividing or that begin a process known as programmed cell death, or apoptosis, which the body uses to get rid of unneeded cells.
Cancer cells may be able to influence the normal cells, molecules, and blood vessels that surround and feed a tumor—an area known as the microenvironment. For instance, cancer cells can induce nearby normal cells to form blood vessels that supply tumors with oxygen and nutrients, which they need to grow. These blood vessels also remove waste products from tumors.
Cancer cells are also often able to evade the immune system, a network of organs, tissues, and specialized cells that protects the body from infections and other conditions. Although the immune system normally removes damaged or abnormal cells from the body, some cancer cells are able to “hide” from the immune system.
Tumors can also use the immune system to stay alive and grow. For example, with the help of certain immune system cells that normally prevent a runaway immune response, cancer cells can actually keep the immune system from killing cancer cells.

How Cancer Arises
Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.
Genetic changes that cause cancer can be inherited from our parents. They can also arise during a person’s lifetime as a result of errors that occur as cells divide or because of damage to DNA caused by certain environmental exposures. Cancer-causing environmental exposures include substances, such as the chemicals in tobacco smoke, and radiation, such as ultraviolet rays from the sun. (Our Cancer Causes and Prevention section has more information.)
Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.
In general, cancer cells have more genetic changes, such as mutations in DNA, than normal cells. Some of these changes may have nothing to do with the cancer; they may be the result of the cancer, rather than its cause.

"Drivers" of Cancer
The genetic changes that contribute to cancer tend to affect three main types of genes—proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.
Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.
Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.
DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes. Together, these mutations may cause the cells to become cancerous.
As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Because of this, cancers are sometimes characterized by the types of genetic alterations that are believed to be driving them, not just by where they develop in the body and how the cancer cells look under the microscope.

When Cancer Spreads
A cancer that has spread from the place where it first started to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that spreads to and forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.
Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.
Treatment may help prolong the lives of some people with metastatic cancer. In general, though, the primary goal of treatments for metastatic cancer is to control the growth of the cancer or to relieve symptoms caused by it. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.


Tissue Changes that Are Not Cancer
Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored:
Hyperplasia occurs when cells within a tissue divide faster than normal and extra cells build up, or proliferate. However, the cells and the way the tissue is organized look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation.
Dysplasia is a more serious condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form.
Some types of dysplasia may need to be monitored or treated. An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.
An even more serious condition is carcinoma in situ. Although it is sometimes called cancer, carcinoma in situ is not cancer because the abnormal cells do not spread beyond the original tissue. That is, they do not invade nearby tissue the way that cancer cells do. But, because some carcinomas in situ may become cancer, they are usually treated.

Types of Cancer
There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in cells of the lung, and brain cancer starts in cells of the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.
You can search NCI’s website for information on specific types of cancer based on the cancer’s location in the body or by using our A to Z List of Cancers. We also have collections of information on childhood cancers and cancers in adolescents and young adults.

Here are some categories of cancers that begin in specific types of cells:

• Carcinoma

Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope.
Carcinomas that begin in different epithelial cell types have specific names:
Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.
Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.
Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.
Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

• Sarcoma

Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).
Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, liposarcoma, and dermatofibrosarcoma protuberans.

• Leukemia

Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections.
There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid).

• Lymphoma

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.
There are two main types of lymphoma:
Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells.
Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

• Multiple Myeloma

Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all through the body. Multiple myeloma is also called plasma cell myeloma and Kahler disease.

• Melanoma

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.
Brain and Spinal Cord Tumors
There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Other Types of Tumors:
There are few types of tumors, so they are all described below

Germ Cell Tumors:
Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.
Neuroendocrine Tumors:
Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.
Carcinoid Tumors:
Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

“Hey Steve, I want to start eating healthy, but I don’t like vegetables.  Can you help me eat healthier without having to eat vegetables?  Actually, I love corn, so can you tell me how to make more foods with corn?”

“Hey man, hate to break it to you…but corn is actually a grain.”

“Well shit.”
I’ve had some variation of this conversation with more people than I can count.  Many people like the IDEA of eating healthy, but eating vegetables feels like Superman eating a bowl full of Kryptonite (hey, they’re both green!).
Whether it’s the taste, texture, or just the mental block, veggies consistently prove to be a challenge for many Rebels.  Considering we recommend filling up at least half of your plate with vegetables, this is a serious problem.
I didn’t start eating vegetables regularly until I was probably 22….and even then it was a challenge. If you are like I was, fear not!
By the end of today, I’m going to have you excited to eat vegetables, and ready to take the NF Veggie Challenge.
If you’re someone who doesn’t eat vegetables because you don’t like them, don’t know how to buy them, or don’t know how to make them, this article is for you. We’re going to change that today.
Finding vegetables that you are excited to eat (and actually enjoy) is a cornerstone to having success on the diet we regularly recommend to our Rebels, the Paleo Diet. Enter your email in the box below and we’ll walk you through everything you need to know to get started.

Why vegetables rule!

You’ve probably been told since you were a toddler to “Eat your vegetables! They’re good for you.”
Do you really know WHY they’re good for you?  Let me jump into a few reasons why vegetables kick ass.

• Vegetables are nutrient dense. It should be no surprise that Popeye turned to a vegetable when he needed a powerup. Think of vegetables as one of our body’s most efficient fuel sources: they are packed full of vital macro and micronutrients. Just take a look at our article on how to eat healthy on a budget – it should be no surprise that vegetables are an important part of efficiently eating healthy! Simply put: vegetables are the backbone of any solid diet.
• They fill you up, without “filling you up.”  Ever seen what 200 calories worth of broccoli looks like? It’s the size of a grocery bag compared to 200 calories of a doughnut or other treats.  If you are feeling hungry but don’t want to overeat, choose a vegetable. Kind of hard to overeat when you’re eating carrots or celery!

• Veggies keep your body operating at max efficiency! Vegetables are a great way to keep your…um…indoor plumbing…functioning properly.  Adding a vegetable or two to each meal is a great way to keep things working right! Seriously: if you’re someone who doesn’t eat many veggies, you will notice a considerable difference after adding veggies to your diet regularly.

• They can be delicious!  Sure, a point of debate…but as a former veggie hater, I am now firmly on Team Vegetable.  A plate full of veggies used to make me want to gag, and now I’m thrilled at the idea of a plate covered in a cornucopia (what a great word, right?) of multicolored plants

• I figured any vegetable, even if I didn’t like it, and even if I only ate a small bite, was better than nothing.
• If I found a vegetable I DID like, I could learn to prepare it the same way and eat more at home.

US infant mortality high even for full-term babies
WASHINGTON: Infant mortality rates for full-term babies vary across the US, but all states are worse than several European countries, a new study suggests.
Previous research has found babies more likely to die in the US than in other developed and affluent nations, but the current study offers fresh evidence that this is true even for infants born at the very end of pregnancy when they should have excellent survival odds.
Across the US, infant mortality rates for full-term babies were 50% to 200% higher than in Austria, Denmark, Finland, Norway, Sweden, and Switzerland, the study found.

The two main reasons for the higher US mortality were “congenital malformations, which patients cannot really do much about other than ensuring adequate screening during pregnancy, and high risk of sudden unexpected deaths in infancy, which should largely be preventable through appropriate sleeping arrangements,” said study co-author Neha Bairoliya of the Harvard Center for Population and Development Studies in Cambridge, Massachusetts.

Bairoliya and colleagues studied more than 10 million US infants born between 2010 and 2012 at full-term, that is, between 37 and 42 weeks gestation.
Out of every 5,000 full-term births, 11 babies died before the age of one, researchers report in PLoS Medicine.

Overall, more than 7,000 full-term babies die each year in the US, and researchers estimate that infant mortality could be reduced by about 4,000 deaths if all states achieved the mortality levels of the best-performing state for each cause of death.

At the state level, infant mortality rates ranged from 6.45 deaths for every 5,000 full-term births in Connecticut to nearly 19 deaths for every 5,000 in Mississippi.

Every state was worse than the six European countries in the analysis, which had an infant mortality rate of slightly over 6 deaths for every 5,000 full-term births.

Birth defects, or congenital malformations, accounted for 31% of US infant deaths during the study. So-called perinatal complications, or medical problems babies developed shortly before or after birth, accounted for another 13% of fatalities.

The biggest cause was sudden unexpected death in infancy (SUID), which includes sleep-related fatalities and accounted for 43% of infant mortality cases.

“While we do not have data on actual sleeping arrangements from our study, other data sources suggest that a substantial number of babies continue to sleep on their tummy,” Bairoliya said by email. “We also found a shockingly large number of babies dying from suffocation, which suggests that parents either use covers that are not safe, or let children sleep in their own beds.”

Babies are safest sleeping on their backs in their own cribs without any pillows, toys, blankets or other loose bedding, according to the American Academy of Pediatrics. If babies do sleep in parents’ beds, parents should have a firm mattress, remove soft objects such as pillows, and move the bed away from the wall.

The study wasn’t a controlled experiment designed to prove whether or how infant sleep practices or other parenting behaviours in the US might explain higher infant mortality rates here. Researchers also used death certificates, which don’t provide a complete picture of any medical conditions that might have contributed to babies’ deaths.

It’s also hard to say exactly why infant mortality rates are so much lower in Connecticut than in Mississippi, although researchers say this may be more due to mothers’ education and income levels rather than disparities in health care after birth.

Different approaches to parental leave and infant sleep in the US and Europe may help explain why babies have better survival odds elsewhere, said Michael Gradisar, a psychology researcher at Flinders University in Adelaide, Australia, who wasn’t involved in the study.

“Once a baby is born in the US, the odds of that baby dying in its first year from poor sleeping arrangements (sleeping position, co-sleeping) is higher than the best European countries, especially in Scandinavia,” Gradisar said by email. “There are also clear links between paid parental leave, which is higher in Scandinavian countries, and lower infant mortality risk in the first year of life.”

Volusia and Flagler counties are trying to combat high fetal and infant mortality rates.
Dixie Morgese, executive director of The Healthy Start Coalition of Flagler and Volusia Counties said a report from 2016 found that more than eight out of every one thousand births resulted in death.
She said the three leading causes of fetal and infant death are sleeping in a person’s arms, falling into a pool or pond and physical harm or trauma.
Morgese said, that homelessness plays a factor into these mortality rates. She said, if a family is homeless and living out of their car with a young child it is not useful to give them a pack-and-play because they are not able to set it up.

According to Morgese, helping these families get into safe living conditions will impact these rates.
Morgese says an important step in reducing these rates is listening to parents.
“And the other part of the process is listening to families,” said Morgese. “We are all experts in what we do, but families are experts about their own families.”
She said they will hold a listening session with families next month at the Volusia county health department.
The Healthy Start Coalition of Flagler and Volusia Counties is a non-profit organization which aims to help young children, pregnant women and families with community resources.

Students at the middle and high school in Glasgow are gearing up to raise awareness about the dangers of tobacco use as part of Kick Butts Day on Wednesday, March 21. Kick Butts Day is an annual day of youth activism and leadership against tobacco use, sponsored by the Campaign for Tobacco-Free Kids. Thousands of events are taking place across the country to stand up to corporate tobacco companies, which target youth as “replacement smokers” as their current customers quit or die.

This year, Kick Butts Day is focusing attention on the progress the U.S. has made in reducing youth smoking and the actions needed to create the first tobacco-free generation. Since 2000, the national smoking rate among high school students has fallen by 71 percent (from 28 percent in 2000 to 8 percent in 2016). However, the fight against tobacco is far from over.

• Nationwide, tobacco companies spend $8.9 billion a year, over one million dollars every hour, to market tobacco products. In Montana alone, tobacco companies spend $28.9 million annually on marketing efforts, often in ways that appeal to kids.

• Tobacco use is still the number one cause of preventable death in the U.S., killing over 480,000 people and costing about $170 billion in health care expenses each year (1,600 lives and $440 million in health care bills in Montana.)

• E-cigarettes have become the most popular tobacco product used by kids. Nationwide, 11.3 percent of high school students use e-cigarettes compared to eight percent who smoke cigarettes. The latest trend with teens is JUUL, an e-cigarette that looks like a computer flash drive and comes in flavors like mango and fruit medley. The fact that 13.1 percent of Montana high school students smoke cigarettes and 29.5 percent are e-cigarette users proves that Big Tobacco’s marketing strategies are effectively reaching youth under 18.

As a means of counteracting these statistics, reACT was formed under the guidance of the Montana Tobacco Use Prevention Program as a teen-led movement against Big Tobacco.

On Kick Butts Day, kids and health advocates are calling on elected officials to implement proven strategies that make up a “roadmap to a tobacco-free generation.” These strategies include tobacco tax increases, comprehensive smoke-free laws, raising the tobacco sale age to 21, well-funded tobacco prevention programs and banning the sale of flavored tobacco products.

“On Kick Butts Day, kids are celebrating the progress we’ve made to reduce tobacco use and building momentum to get us across the finish line,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “Elected leaders in every state can help create the first tobacco-free generation by supporting proven strategies to prevent youth tobacco use.”

Valley County reACT members will be contributing to national tobacco use prevention efforts this Wednesday by hanging a “Be The First” pledge banner during lunch at both the Middle and Glasgow High School, encouraging their peers to sign it as part of their mission to become the first tobacco-free generation.

Many adolescent users of one or more specific tobacco product type do not self-identify as tobacco users, according to a study published online in Pediatrics.
Israel Agaku, DMD, MPH, PhD, from the US Centers for Disease Control and Prevention in Atlanta, and colleagues examined tobacco-related self-identity and risk perceptions among 20,675 US sixth to 12th graders. Adolescents were classified as not self-identifying as tobacco users if they reported past 30-day use of a specific tobacco product or 2 or more products, but denied having used "any tobacco product" in the past 30 days.

Those denying having used any tobacco products included single-product users of roll-your-own and/or pipe tobacco (82.2%), electronic cigarettes (59.7%), cigars (56.6%), and cigarettes (26.5%). The researchers found that the odds of denying any tobacco product use were increased among those without vs those with symptoms of nicotine dependence (adjusted odds ratio, 2.16) and for those who access their tobacco products via social sources vs those who bought them (adjusted odds ratio, 3.81). Of those who believed "all tobacco products" were harmful, single product users of e-cigarettes, hookah, smokeless tobacco, and cigarettes believed their own product was not harmful (74.6%, 56.0%, 41.8%, and 15.5%, respectively).

The US Centers for Disease Control and Prevention (CDC) today said that 13 people from eight states have been sickened in a Salmonella Typhimurium outbreak linked to dried coconut and that products from a second company have been implicated in the event and have been recalled.
Earlier reports had said the source of the outbreak was Natural Grocers Coconut Smiles Organic dried coconut, which is sold at Natural Grocers stores. Today's announcement from the CDC said International Harvest, Inc., has recalled bags of Organic Go Smile! Raw Coconut and bulk packages of Go Smiles Dried Coconut Raw.

The CDC is urging people who bought the products to throw them away or return them to the place of purchase, even if some it was eaten and no one got sick.
Three of 13 patients hospitalized
The 13 people infected in the outbreak are from California, Colorado, Connecticut, Idaho, Missouri, Oregon, Texas, and Utah. Whole-genome sequencing on bacteria isolated from sick patients shows that the Salmonella samples are closely related. Illness onsets range from Sep 2, 2017, to Feb 26. Ages range from 1 to 73 years, and two thirds of the patients are female.
Three people have been hospitalized, but no deaths have been reported.
Of 11 samples from patients, only 1 isolate contained resistance genes for ampicillin and azithromycin. Susceptibility testing by the CDC National Antimicrobial Resistance Monitoring System (NARMS) found 2 isolates with no resistance, but 1 with resistance to streptomycin, which isn't likely to affect antibiotic choice to treat most people, though some infections might require a different antibiotic.
Second company recalls products
The first International Harvest product that is subject to the recall was sold online and in stores in 9-ounce bags with sell-by dates from Jan 1, 2018, through Mar 1, 2019. The recalled bulk product was sold in 25-pound cases labeled with batch/lot numbers OCSM-0010, OCSM-0011, and OCSM-0014.

In its Mar 16 Food and Drug Administration (FDA) recall notice, the company said the recall was prompted by FDA lab tests that identified Salmonella in the product. The recall involves 14,620 pounds of bulk and 24,270 bags of its products. The products were directly distributed to 14 states: New York, New Jersey, Connecticut, California, Colorado, Oklahoma, Georgia, Vermont, Illinois, Florida, Maine, Washington, New Hampshire, and Utah.
International Harvest said it was working with the FDA to find the root cause of the problem, and it urged retailers who sold the bulk coconut to clean and sanitize the containers used to hold the product.

Outbreak strain in coconut samples
Today's CDC report also provided new details on epidemiologic and lab investigations. Interviews with 8 sick people found that 7 had eaten dried coconut from grocery stores, and of those, 4 had bought the products at different Natural Grocers stores. Interviews with patients is ongoing.
FDA and state health departments have been testing leftover dried coconut from patients' homes, Natural Grocers stores, and a Natural Grocers' distribution center. FDA tests turned up the outbreak strain in unopened samples of Natural Grocers Coconut Smiles Organic collected from a store. Also, the outbreak strain was found in an opened leftover sample from a sick patient's home.

The FDA's tests on packaged and bulk coconut from International Harvest also found the outbreak strain.

The CDC is urging the public to avoid eating certain brands of dried coconut because they are linked to a multi-state outbreak of Salmonella poisoning that has been ongoing since September 2017.
This outbreak is unrelated to the Salmonella outbreak linked to frozen shredded coconut announced in January

“CDC recommends people not eat recalled International Harvest Inc. brand Go Smile! Raw Coconut, Go Smiles Dried Coconut Raw or recalled Natural Grocers Coconut Smiles Organic,” according to an outbreak notice posted today by the Centers for Disease Control and Prevention.

Retailers and restaurants should not sell or serve recalled dried coconut products, the CDC said.

“Even if some of the recalled dried coconut was eaten or served and no one got sick, throw it away or return it to the place of purchase,” the CDC notice said, adding that sanitizing procedures should be implemented.“Put it in a sealed bag in the trash so that children, pets, and other animals can’t eat it. Wash and sanitize drawers or shelves in refrigerators and freezers where recalled coconut was stored.

“If you aren’t sure if your dried coconut was recalled, do not eat it and throw it away.”
Thirteen people from eight states are confirmed to be infected with the outbreak strain of Salmonella Typhimurium that has been found in the implicated brands of dried coconut. Three of the victims have required hospitalization because of severe symptoms. No deaths had been confirmed as of today.
Of the victims for whom complete information is available, 88 percent reported eating dried coconut purchased at grocery stores before they became sick. Of the seven people who reported eating dried coconut before becoming ill, four said they purchased the product at different Natural Grocers store locations.

However, illnesses that occurred after Jan. 25 might not yet be reported to the CDC because of the time it takes between when a person gets sick and when the illness is reported to local, state and, ultimately, federal public health officials. Please see the CDC’s “Timeline for Reporting Cases of Salmonella Infection” for more details.
Illnesses started on dates ranging from Sept. 22, 2017, to Feb. 26, 2018. Ill people range in age from 1 to 73, with a median age of 40. Sixty-seven percent are female.

FDA’s role in the investigation
The Food and Drug Administration has been working with state officials to pinpoint the source of the outbreak. They collected leftover dried coconut from ill people’s homes, as well as dried coconut from Natural Grocers store locations where people who got sick shopped and from the Natural Grocers’ Distribution Center.
FDA testing identified the outbreak strain of Salmonella Typhimurium in an unopened sample of Natural Grocers Coconut Smiles Organic collected from Natural Grocers.

The outbreak strain was also identified in an opened, leftover sample of Natural Grocers Coconut Smiles Organic collected from a sick person’s home.
In addition, FDA collected dried coconut from International Harvest Inc. The outbreak strain of Salmonella Typhimurium was identified in samples of International Harvest Brand Organic Go Smile! Dried Coconut Raw and Go Smiles Dried Coconut Raw.

Soon after the Centers for Disease Control and Prevention (CDC) issued a final update for a recent multistate Salmonella outbreak linked to frozen shredded coconut, they announced yet another investigation into a new multistate Salmonella outbreak which has been linked with dried coconut.
The CDC reports that a total of 13 individuals have already fallen ill across 8 different states; 3 of the individuals have required hospitalization.
On March 16, 2018, International Harvest, Inc. of Mount Vernon, New York, announced a recall of over 14,000 pounds of bulk and more than 24,000 bags of Organic Go Smile! Raw Coconut product, due to its potential to be contaminated with Salmonella, a bacteria that is estimated to cause upwards of 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths on an annual basis in the United States alone.

Subsequently, on March 19, 2018, Vitamin Cottage Natural Food Markets, Inc., a natural grocery chain located in Lakewood, Colorado, also issued a recall of Natural Grocers brand 10-ounce Coconut Smiles Organic product.
Illnesses started as far back as September 22, 2017 and have run through February 26, 2018, with those who have fallen ill ranging in age from 1 to 73 years; the majority, or 67%, of infected individuals are female. Whole genome sequencing of bacteria isolated from infected individuals found that the isolates were closely related genetically, which suggests a higher likelihood that the infected individuals share a common source, according to the CDC.
In an effort to identify the source of the outbreak, health officials interviewed 8 of the individuals who fell ill. Seven out of the 8 reported having eaten dried coconut that they purchased at grocery stores. In fact, 4 of the 7 individuals reported purchasing the coconut products at different Natural Grocers store locations.
The investigators collected samples of coconut product from the homes of those who fell ill, Natural Grocers store locations where the individuals purchased their products, as well as the Natural Grocers’ Distribution Center. Testing conducted by the US Food and Drug Administration found the outbreak strain in an unopened sample collected from Natural Grocers as well as the samples collected from the individuals’ homes. They also collected samples from International Harvest, Inc., and the outbreak strain, Salmonella Typhimurium, was identified in those samples as well.
Whole genome sequencing analysis suggested that 10 of the 11 isolates collected from the individuals did not predict resistance to available medications; however, 1 did show resistance genes for ampicillin and azithromycin. Standard antibiotic susceptibility testing analysis found 1 isolate with resistance to streptomycin.
“This resistance is unlikely to affect the choice of antibiotic used to treat most people, but some infections may be difficult to treat with antibiotics usually prescribed and may require a different antibiotic,” according to the report.
This is not the only Salmonella outbreak that has sprung up in the United States recently—a multistate outbreak linked to kratom, an opioid substitute, has caused 87 illnesses throughout 35 states, and another multistate outbreak linked to chicken salad has caused 170 illnesses throughout 7 states.

Shampoos and scalp products are available over the counter at most stores and pharmacies. These can control seborrheic dermatitis, but they cannot cure it.

Shampoos and scalp preparations
Before using an anti-fungal shampoo, individuals should carefully try to remove any scaly or crusty patches on the scalp, as far as possible, This will make the shampoo more effective.
Dandruff shampoo is available to treat dandruff in the beard.
Ingredients to look out for
Most anti-dandruff or anti-fungal shampoos contain at least one of the following active ingredients:

• Ketoconazole: An effective anti-fungal. Shampoos containing this ingredient can be used at any age.
• Selenium sulfide: This reduces the production of natural oils by glands in the scalp. It is effective at treating dandruff.

• Zinc pyrithione: This slows down the growth of yeast.
• Coal tar: This has a natural anti-fungal agent. Dyed or treated hair may become stained by long-term usage. Tar soaps may also make the scalp more sensitive to sunlight, so users should wear a hat when outside. Coal tar can also be carcinogenic in high doses.
• Salicylic acids: These help the scalp get rid of skin cells. They do not slow down the reproduction of skin cells. Many "scalp scrubs" contain salicylic acids. Treatment can sometimes leave the scalp dry and make skin flaking worse.
• Tea-tree oil: Derived from the Australian Tea Tree (Melaleuca alternifolia), many shampoos now include this ingredient. It has long been used as an anti-fungal, an antibiotic, and an antiseptic. Some people are allergic to it.

The best strategy is to select a shampoo containing one of these ingredients and shampoo the hair every day until the dandruff is under control.
After this, they can be used less frequently.
Alternating dandruff shampoo with regular shampoo may help. A specific shampoo may stop being as effective after some time. At this point, it may be a good idea to switch to one with another ingredient.
Some shampoos should be left on the scalp for around 5 minutes, as rinsing too quickly will not give the ingredient time to work. Others should be rinsed at once. Users should follow the instructions on the container.

Dandruff is a condition of the scalp that causes flakes of skin to appear. It is often accompanied by itching.
The exact cause is unknown, but various factors increase the risk. It is not related to poor hygiene, but it may be more visible if a person does not wash or brush their hair often.
Dandruff can be embarrassing and hard to treat, but help is available.
Causes
The exact causes of dandruff are unknown.
One theory is that it is linked to hormone production, as it often begins around the time of puberty.
Here we look  more possible factors.

• Seborrheic dermatitis

Dandruff involves flakes of skin that collect in the hair.
People with seborrheic dermatitis have irritated, oily skin, and they are more likely to have dandruff.
Seborrheic dermatitis affects many areas of the skin, including the backs of the ears, the breastbone, eyebrows, and the sides of the nose.
The skin will be red, greasy, and covered with flaky white or yellow scales.
Seborrheic dermatitis is closely linked with Malassezia, a fungus that normally lives on the scalp and feeds on the oils that the hair follicles secrete.
It does not usually cause a problem, but in some people it becomes overactive, causing the scalp to become irritated and to produce extra skin cells.
As these extra skin cells die and fall off, they mix with the oil from the hair and scalp, forming dandruff.

• Not enough hair brushing

Combing or brushing the hair regularly reduces the risk of dandruff, because it aids in the normal shedding of skin.

• Yeast

People who are sensitive to yeast have a slightly higher chance of dandruff, so yeast may play a part. Dandruff is often worse during the winter months and better when the weather is warmer.

This may be because ultraviolet-A (UVA) light from the sun counteracts the yeast.

• Dry skin

People with dry skin are more likely to have dandruff. Cold winter air combined with overheated rooms is a common cause of itchy, flaking skin. Dandruff that stems from dry skin tends to have smaller, non-oily flakes.

• Shampooing and skin care products

Certain hair care products can trigger a red, itchy, scaling scalp. Frequent shampooing may cause dandruff, as it can irritate the scalp.

Some people say not shampooing enough can cause a buildup of oil and dead skin cells, leading to dandruff, but evidence is lacking that this is true.

• Certain skin conditions

People with psoriasis, eczema, and some other skin disorders tend to get dandruff more frequently than others. Tinea capitis, a fungal infection also known as scalp ringworm, can cause dandruff.

• Medical conditions

Adults with Parkinson's disease and some other neurological illnesses are more prone to dandruff and seborrheic dermatitis.
One study found that between 30 and 83 percent of people with HIV have seborrheic dermatitis, compared with 3 to 5 percent in the general population.
Patients who are recovering from a heart attack or a stroke and those with a weak immune system may be more prone to dandruff.

• Diet

Not consuming enough foods that contain zinc, B vitamins, and some types of fats may increase the risk.

• Mental stress

There may be a link between stress and many skin problems.

• Age

Dandruff is more likely from adolescence through middle age, although it can be lifelong. It affects men more than women, possibly for reasons related to hormones.

A blood-filled pimple usually develops because a person has picked, squeezed, or popped a regular pimple.
Luckily, there are many ways to treat acne or other types of pimples and prevent them from turning into blood-filled pimples.
Up to 80 percent of 11- to 30-year-olds will experience pimples or acne at some stage.
In this article, learn more about the different types of pimples and the treatment options available.
Causes
Young man in front of mirror squeezing spot on chin causing a blood pimple.
Squeezing a pimple may cause it to fill with blood.
Blood-filled pimples occur after someone has squeezed or popped a pimple
Squeezing a pimple forces out a yellow liquid called pus. The trauma caused by the squeezing can also cause blood vessels underneath to burst, causing the pimple to fill with blood.
Regular pimples occur when the skin's pores become clogged with bacteria, sweat, or dirt. More severe acne can be due to hormonal changes in adolescents and adult women
Treatment
Most of the time, blood-filled pimples will heal on their own if they are left alone. If someone squeezes the pimple before it heals, they may spread bacteria to other parts of the face and body.
It is essential to keep the area around the pimple clean and wash twice daily, using a gentle cleanser or soap and water.
Blood-filled pimples that recur or persist may need to be treated with:
Over-the-counter treatments
There are many over-the-counter treatments for different types of pimples and acne, including blood-filled pimples:
Topical retinoids. These vitamin A-based medications reduce oil production in the skin and help prevent clogged pores. Stronger versions are available by prescription.
Salicylic acid. This ointment removes dead skin cells. It typically works best on acne without inflammation, such as blackheads and whiteheads.

Prescription medications

• Antibiotics. Usually taken daily as a pill, antibiotics kill the bacteria that are causing outbreaks. People can apply topical antibiotic ointments and liquids directly to the skin.
• Birth control pills. In women and teenagers, fluctuating hormone levels can contribute to acne development. Some women and girls may be prescribed birth control pills to regulate hormones and clear up their skin.
• Isotretinoin. This is a prescription oral retinoid that people typically take for approximately 4 to 5 months. It effectively treats acne in many people, sometimes permanently. However, it can cause serious side effects and is usually only given to people with severe cystic acne.

Pimples and boils are troublesome skin problems that can sometimes cause similar symptoms.
Pores are tiny openings in the skin that allow oil to seep out and keep the skin soft. A pimple is a result of a pore becoming clogged.
A boil, or furuncle, is a pus-filled lump caused by bacterial infection. It can appear red and swollen.
While a person can treat both boils and pimples at home, boils can sometimes turn into a severe infection known as a carbuncle.
Learn more about the difference between boils and pimples in this article.
Causes
A pimple is often the result of excess oil production or a buildup of dead skin cells and bacteria. People may be more likely to develop pimples during puberty, when the body makes more hormones that can cause excessive production of oil.
Sometimes a bacteria type called Propionibacterium acnes can infiltrate the skin and cause further redness, pain, and irritation.
Pimples most commonly occur on the face, but can also appear on the back or neck. They have many forms, including blackheads, whiteheads, and papules. Some may be pus-filled, so they may closely resemble boils.
Staphylococcus aureus bacteria usually live on the surface of the skin, but can reach the inner layers via a cut, bug bite, or infected hair follicle. This infiltration can result in a boil.
Boils are most likely to appear on the sweatiest areas of the skin. These include the:

• armpits
• buttocks
• face
• neck
• thighs

Boils start out as a small, round bump, which is usually swollen and red. Over several days, the bump will fill with pus. As the bump grows, pressure on the skin increases, eventually causing the boil to rupture and drain.

Diagnosis
A doctor can often diagnose a boil or a pimple with a visual examination. The doctor will ask about symptoms, when the person first noticed the bumps, and whether they have tried any treatments.
Additional symptoms, the location of the bumps, and the condition of the surrounding skin help a doctor to diagnose pimples or boils. Invasive testing is usually not required.

Treatments
Treatments for boils and pimples differ. Below, find some of the most common techniques.

Pimples
For most people, a thorough skincare routine can help to reduce the incidence of pimples. However, it can take 6 to 8 weeks for a pimple to completely heal.
A skincare routine for pimples should include:
washing the skin in the morning and evening with warm, not hot, water and a mild cleanser
using a product containing benzoyl peroxide or salicylic acid, to reduce oil and buildup of dead skin cells in the pores
applying a gentle moisturizer to reduce any dryness that may have resulted from acne treatment
exfoliating once or twice a week with a gentle scrub to prevent dead skin cells from collecting
avoiding squeezing or popping the pimple, as this can invite bacteria into the skin and lead to scarring
If pimples do not go away with home remedies, a person may wish to speak to a dermatologist, a doctor who specializes in managing skin conditions.

Boils

Applying a warm compress to a boil will help to reduce pain and may encourage the boil to drain. If the boil is in a hard-to-reach area, a person can try resting in a hot bath instead.
Over-the-counter pain relievers such as acetaminophen or ibuprofen can also reduce discomfort.
A doctor may prescribe an antibiotic ointment designed to fight the bacteria inside the boil. Or, they may prescribe oral antibiotics to prevent the infection from spreading to the blood stream.
In some cases, a doctor will surgically drain the boil and apply topical antibiotics to the area, to combat the infection.
A boil and the skin around it should be kept clean and dry. A person should wash their hands with soap and water after touching a boil, to avoid spreading the infection. Sharing personal care items, such as towels, razors, or makeup brushes can also pass the infection from person to person.

Women's bodies are always changing. Sometimes changes that seem normal can be signs of cancer, though.
The key is to pay attention to your body so you can notice when something's different, says Robyn Andersen, PhD, of the Fred Hutchinson Cancer Research Center in Seattle. "New symptoms indicate something has changed in your body, and you want to know what that means."
So, what should you watch for?



1. Breast changes:

Most breast lumps aren't cancer, but your doctor should always check them. Let her know about these changes, too:

• Skin dimpling or puckering
• Nipples that turn inward
• Nipple discharge
• Redness or scaling of your nipple or breast skin

To look for the cause of your symptoms, your doctor will do a physical exam and ask you questions about your medical history. You may also have tests like a mammogram or a biopsy, when doctors remove a tiny piece of tissue for testing.

2. Bloating

"Women are natural bloaters," says Marleen Meyers, MD, an oncologist at NYU Langone Medical Center. "It's OK to wait a week or two to see if it goes away."
If your symptoms don't get better with time, or if they happen with weight loss or bleeding, see a doctor. Constant bloating could be a sign of cancer, including breast, colon, gastrointestinal, ovarian, pancreatic, or uterine. Depending on other symptoms, you will undergo tests which could include a pelvic exam as well as blood tests, a mammogram, a colonoscopy, a CT scan or an ultrasound, to look for the cause of the problem.

3. Between-Period Bleeding

If you’re still getting periods, tell your doctor if you’re spotting between them. Bleeding that’s not a part of your usual monthly cycle can have many causes, but your doctor will want to rule out endometrial cancer (cancer of the lining of your uterus).
Bleeding after menopause is never normal and should be checked right away.

4: Skin Changes

A change in the size, shape, or color of a mole or other spot, as well as development of new spots, are common signs of skin cancer. See your doctor for a thorough exam and perhaps a biopsy. This is one time you don't want to wait, Meyers says.

5. Blood in Your Pee or Stool

Talk to your doctor if you're bleeding from a part of your body that normally doesn't, especially if the bleeding lasts more than a day or two, Meyers says.
Bloody stool is often from hemorrhoids, but it can also be a symptom of colon cancer. Bloody urine is usually the first sign of cancer of the bladder or kidneys, says Herbert Lepor, MD, a urologist at NYU's Langone.

Effects of tobacco
The effects of any drug (including tobacco) vary from person to person. How tobacco affects a person depends on many things including their size, weight and health, also whether the person is used to taking it. The effects of tobacco, as with any drug, also depend on the amount taken.
In Australia, tobacco use is responsible for approximately 15,000 deaths each year. In 2004–2005 approximately three-quarters of a million hospital bed-days were a result of tobacco use. (Collins & Lapsley, 2008)
There is no safe level of tobacco use. Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.

Immediate effects
Low to moderate doses
Some of the effects that may be experienced after smoking tobacco include:

• initial stimulation, then reduction in activity of brain and nervous system
• increased alertness and concentration
• feelings of mild euphoria
• feelings of relaxation
• increased blood pressure and heart rate
• decreased blood flow to fingers and toes
• decreased skin temperature
• bad breath
• decreased appetite
• dizziness
• nausea, abdominal cramps and vomiting
• headache
• coughing, due to smoke irritation.

Higher doses
A high dose of nicotine can cause a person to overdose. This means that a person has taken more nicotine than their body can cope with. The effects of very large doses can include:

• an increase in the unpleasant effects
• feeling faint
• confusion
• rapid decrease in blood pressure and breathing rate
• seizures
• respiratory arrest (stopping breathing) and death.
• 60 mg of nicotine taken orally can be fatal for an adult

Long-term effects
Tar in cigarettes coats the lungs and can cause lung and throat cancer in smokers. It is also responsible for the yellow–brown staining on smokers’ fingers and teeth.

Carbon monoxide in cigarettes reduces the amount of oxygen available to the muscles, brain and blood. This means the whole body—especially the heart—must work harder. Over time this causes airways to narrow and blood pressure to rise, which can lead to heart attack and stroke.

High levels of CO, together with nicotine, increase the risk of heart disease, hardening of the arteries and other circulatory problems.

Some of the long-term effects of smoking (Quit Victoria, 2010) that may be experienced include:

• increased risk of stroke and brain damage
• eye cataracts, macular degeneration, yellowing of whites of eyes
• loss of sense of smell and taste
• yellow teeth, tooth decay and bad breath
• cancer of the nose, lip, tongue and mouth
• possible hearing loss
• laryngeal and pharyngeal cancers
• contributes to osteoporosis
• shortness of breath
• coughing
• chronic bronchitis
• cancer
• triggering asthma
• emphysema
• heart disease
• blockages in blood supply that can lead to a heart attack
• high blood pressure (hypertension)
• myeloid leukaemia, a cancer that affects bone marrow and organs that make blood
• stomach and bladder cancers
• stomach ulcers
• decreased appetite
• grey appearance
• early wrinkles
• slower healing wounds
• damage to blood vessel walls
• increased likelihood of back pain
• increased susceptibility to infection
• lower fertility and increased risk of miscarriage
• irregular periods
• early menopause
• damaged sperm and reduced sperm
• impotence.

Other effects of tobacco use
Passive smoking
Passive smoking occurs when a person who is not smoking breathes in the smoke from people who are smoking. Passive smoking can irritate the eyes and nose and cause a number of health problems such as heart disease and lung cancer. Tobacco smoke is especially harmful to babies and young children.

Using tobacco with other drugs
Nicotine can affect the way the body processes many different drugs. This can affect how these drugs work. For example, nicotine can decrease the effectiveness of benzodiazepines. Smoking while taking the contraceptive pill increases the risk of blood clots forming.

Check with your doctor or other health professional whether nicotine might affect any medications you are taking.

Pregnancy and breastfeeding
Read about the effects of tobacco use on pregnancy and breastfeeding.
Many drugs can cross the placenta and affect an unborn child.
In general, using drugs when pregnant can increase the chances of going into labour early. This can mean that babies are born below the normal birth weight.
If a mother uses drugs while breastfeeding, they may be present in her milk, and could affect the baby.
Check with your health professional if you are taking or planning to take any drugs during pregnancy, or while breastfeeding.

Tolerance and dependence
People who use tobacco regularly tend to develop a tolerance to the effects of nicotine. This means they need to smoke more tobacco to get the same effect.
They may become dependent on nicotine. Dependence can be psychological, physical, or both. People who are dependent on nicotine find that using the drug becomes far more important than other activities in their life. They crave the drug and will find it very difficult to stop using it.
People who are psychologically dependent on nicotine may find they feel an urge to smoke when they are in specific surroundings or socialising with friends.
Physical dependence occurs when a person’s body adapts to the nicotine and gets used to functioning with the nicotine present.

When it comes to our oral health, it seems many of us can 'try harder'.
That's the take-home message from a new report card looking at Australia's dental health.

The country's first comprehensive Oral Health Tracker found only half of all Australians brush their teeth twice a day, 90 per cent of adults have some form of tooth decay, and more than one-third of five-year-olds had decay in their baby teeth.
Risky alcohol consumption, smoking habits and diets high in sugar are contributing to poor oral health, with almost three-quarters of children found to eat too much sugar.
You might know there's a dental downside when it comes to sweet treats, but it's not just chewy lollies and fizzy soft drinks that are enemies of your pearly whites.

Did you know chips, ice, dried fruit and popcorn can also cause havoc in your mouth?

Dr Peter Alldritt, dentist and consultant to the Australian Dental Association's oral health committee, shares common food and drink items that many of us aren't aware are potential troublemakers in the tooth department.

Diet soft drinks
They're tempting if you're looking for something sweet to sip on without the kilojoule hit of regular soft drinks.

But while there's no sugar to cause tooth decay, as is the case with regular soft drinks and even fruit juice, diet soft drinks still have high acid levels that can erode tooth enamel.
This can lead to exposure of the inner tooth layer, causing pain and sensitivity, and it can also cause cavities.
And don't brush right after drinking as the acid can soften enamel, making it easier to brush away.
If you must drink diet drinks, swish your mouth with water afterwards to wash the acid away. You could also sip them through a straw to minimise contact with your teeth.

Potato chips

They might start out crunchy but once chewed, they turn into a soft mess that can lodge and linger in the tiniest crevices on and between your teeth.
What's more, while we think of them as savoury, most chips are actually quite high in sugar Dr Alldritt says, which means their tendency to stick around on your teeth is even more of a problem.

Ice
Do you get to the end of your ice-chilled drink and find those remaining ice cubes irresistible? Plenty of us do. But while sucking them is fine, biting them is not.
Ice is so hard that biting it can easily chip off enamel or crack your teeth.
If you can't trust yourself to stop at sucking an ice cube, don't put it in your mouth in the first place. Finish your drink and move it away from temptation.

Dried Fruit
Fruit is healthy and packed with vitamins and other nutrients. But suck the moisture out of it and you're left with a sticky product made up of concentrated sugar entwined with bits of fibre that make it stick to the surface of your teeth.
Also, some dried fruits, such as dried mangoes and craisins (dried cranberries), often have extra sugar added to boot.
Eat dried fruit in moderation and brush well afterwards. But generally fresh fruit is a better choice.

Popcorn and corn on the cob
It's made from popped corn kernels, so it can't be too bad, right?
Except when the popcorn is coated with coloured sugar dust or sticky toffee. Then it's a "sugar bomb", Dr Alldritt says.Popcorn with no added sugar is dentally speaking, not a bad snack. That's as long as you take care to floss out any bits that wedge between your teeth and don't bite on any unpopped kernels, which can cause cracks and breaks in teeth.
Biting into corn on the cob should also be approached with caution if you have crowns or large fillings on your front teeth, as the focused pressure may damage these. (You can always cut the kernels off the cob to eat them.)

Sports drinks
Sports drinks along with energy drinks are highly acidic and many are also high in sugar.
An acid attack that can erode the enamel on your teeth generally lasts for around 20 minutes. Every time you take a sip of the drink, the acid damage begins all over again.
Bear in mind too that unless you're having a fairly long and intense workout, you probably don't need the extra fuel and electrolytes a sports drink provides anyway.

Muesli bars
They look healthy with all those nuts, grains and oats. But the substance holding all that together into a bar is generally sugar, Dr Alldritt says.
The sugar makes every bite sticky, and it hangs around the grooves of your teeth a long time.




Wine
Wine — especially sparkling and white wine — contains erosive acid, which can soften the protective hard enamel on teeth.
This acid can also leave teeth more vulnerable to staining, which can be a problem for those who enjoy red wine along with other heavily pigmented foods and drinks such as curries, coffee and tea.
Alcohol, in general, causes dehydration, which means your mouth will have less of the saliva that protects your teeth from decay.
It's worth noting that heavy alcohol consumption is a risk factor for oral cancer.

Low-fat yoghurts
We tend to think of dairy foods as good for our teeth, but the low-fat varieties often contain a lot of added sugar.
"The only way they can make yoghurt tasty with so much fat taken out of it is to bump up the sugar content," Dr Alldritt says.
"Often the amount [of sugar] they add is outrageous. The result is a product that's a disaster for teeth."
Some low-fat yoghurts have less sugar than others though, so check the labels. You could also consider choosing natural yoghurt and adding fresh fruit yourself for a bit of sweetness.

Bottled water
Bottled water is very popular. But when it comes to your teeth, the water that comes out of your tap is almost certainly a better choice.

In fact, the Australian Dental Association says tap water should be the primary drink of choice for all of us.That's because in most areas of Australia, tap water contains fluoride — a natural mineral that strengthens tooth enamel and protects against decay.Bottled water in comparison does not contain the amount of fluoride needed to protect your teeth. Choosing tap water will also save you a bundle.