An essential health resource for current and former smokers

How many smokers will die of smoking-related illnesses?

A recent study addresses this question, and the findings are grim.

For more details, check out this write-up at the Washington Post.


Is it heart disease?

Heart disease is still the #1 killer in the United States, causing roughly 600,000 deaths. The main risk factors are smoking, diabetes, high blood pressure, high cholesterol, age, and family history of heart disease at a young age. Although you can’t control age or family history, the first four risk factors are in our control through a combination of healthy lifestyle choices and, if need be, medication.

Signs of heart disease

One of the big problems that people face is not realizing the signs of heart disease. Most people know that crushing left-sided chest pain could be a heart attack or angina. Some know that left-sided chest pain radiating to the jaw or left arm can also mean heart disease. But many don’t realize that other common symptoms could be signs of heart disease as well. These include:

  • Heartburn or indigestion
  • Nausea
  • Shortness of breath on exertion
  • Dizziness on exertion

Understanding the symptoms

That’s not to say that if a person has any of the above they for sure have heart disease. Indeed, several benign conditions can lead to these symptoms as well. However, if you experience any of these symptoms during exercise, other physical exertion, or when emotionally upset (say after a heated argument) and they occur on a regular basis, then it’s worth checking out, especially if you have any of the risk factors mentioned earlier in the post. Women, the elderly, and diabetics are especially prone to having atypical symptoms, which is a reason heart disease is at times missed.

Lastly, erectile dysfunction (ED) is a marker for heart disease. If you suffer from ED and you’re in your late 30s or older, then it’s worth mentioning to your physician, and being worked up for elevated cholesterol, sugar, blood pressure, and at times for heart disease as well.

Again, I want to emphasize that you shouldn’t be paranoid and assume every symptom that you feel is a heart attack; however, by being vigilant and pragmatic, you ensure that you will be able to receive proper care and prevent any potentially lethal problems.

– Tamir


What smoking does to our lungs – in graphic detail

All of you are aware that smoking damages most of the body, especially the lungs. An experiment loaded to the Internet by Devon Arbelo graphically depicts that damage.

On one side are a set of healthy pinkish lungs from a nonsmoker. As air is introduced, the lungs expand very nicely. On the other side are the blackened lungs from a long-time smoker. First of all, the color itself is off-putting. Secondly, you can see how poorly these lungs expand compared to the lungs from the nonsmoker.

At the bottom of the article are pictures of lungs posted by Ryan Au, a Hong Kong teacher. Again, you can see the color difference between the pink lungs from the nonsmoker compared to the brownish lungs from the smoker. What’s disturbing is that the brown lungs took on this appearance after only 60 cigarettes.

So next time you light up, form a mental image of the video clip and the photos from the above article.



The Onion spoofs big pharma’s approach to mental health, here.

In an effort to alleviate the vague, passing sensation of restlessness and unease that inexplicably afflicts thousands of people each day…


A lifetime of bad choices condensed into less than two minutes

Most of us know that smoking, eating junk food, and avoiding physical activity are all bad for our health. The problem is that each individual cigarette, cookie, or hour on the couch watching TV causes very limited damage – so much so that we barely think about it.

How many of you plan to quit smoking at some future point? How many of you plan to join the gym in the near future? How many of you plan to start a healthy diet next week, after your birthday? We often have some vague future notion of cleaning up our act. However, because we don’t experience the damage being caused to our body at the present time, we often procrastinate or avoid making any changes.

Even when we do try, we often quit too soon; we only see infinitesimal benefits from one day to the next for the maximal effort that we’re exerting, and we feel discouraged. How many of you have quit the gym or returned to a junky diet because the weight loss slowed down drastically? How many of you returned to smoking because you were feeling stressed out and irritable after quitting? I know, I know. There’s always next year.

Rewind the Future

I recently came across a brilliant video entitled “Rewind the Future.” Put out by a group targeting childhood obesity, the video starts off with an obese 32 year old man in the hospital in the midst of a heart attack, and works its way back through his life, showing clips of poor choices such as eating fast food, etc all the way back to when he was a baby being fed french fries by his mother to keep him quiet.

Although the main point of this powerful presentation is to show parents how the poor food choices that they make for their kids leads them to be unhealthy adults, I believe that we can apply this video to other poor choices that we make.

Imagine for a minute, a future you lying on the operating table about to have a large cancerous mass removed from your lungs. Now rewind back through the years to different mental images of you smoking all the way back to that first cigarette.

Similarly, if poor food choices, lack of exercise, or obesity are your main issues, then you can pretty much use the imagery from the video, substituting a future you for the actor.

This video allows us to visualize the ultimate consequences of our poor habits, something that as I mentioned above, is hard to do in the here and now.

– Tamir


Blueberries and beans: Do miracle foods really exist?

Miracle Foods!

Every day we’re hit with headlines describing all sorts of miracle foods, supplements, etc. For example, a common headline might read “Blueberries are good for the brain” or “Beans reduce the risk of colon cancer by 20%.” The headlines always sound amazing yet simple – what better way to improve my health than to add a can of beans to my diet?

Miracle Foods?

However, once you dig deeper, you’ll realize that many of these studies are much less relevant than what they seem when reading the headline.

Let’s take the hypothetical beans example from above. Beans are high in fiber, and yes, a high fiber diet may decrease the risk of certain cancers. But if you look at the overall numbers with respect to the contribution that beans make towards that reduction in cancer, risk reduction is almost meaningless.

First of all, the chance of any given person developing colon cancer in a given year is quite low. Second, there are many different factors that increase a person’s risk of developing colon cancer. Third, in a day and age when many people undergo screening tests for colon cancer (e.g. colonoscopy), the risk of developing cancer becomes even lower.

Let’s look at what the numbers really show

When you finally crunch the numbers, the benefit is practically nil. Although beans MAY reduce the risk of colon cancer by 20%, this is what’s called a relative risk reduction. Basically, when comparing people who don’t eat beans to those who eat the most beans, the latter will have a 20% lower risk of developing colon cancer. Sounds good, right? But what really matters is the absolute risk reduction. For example if 1 out of 200,000 people who don’t eat beans will develop colon cancer in the next year, then by eating a lot of beans, the risk goes down to 1 out of 250,000. Suddenly, this doesn’t seem like much. Although the numbers I used were hypothetical, they drive home the point.

Even worse is that sometimes the relative risk reduction will be meaningless. A recent study in JAMA Neurology showed a 6.5% worsening decline in cognitive function over 20 years between people who had untreated high blood pressure during middle age compared with their peers who had normal blood pressure. Yes, technically that’s a significant difference. However, 6.5% is nothing to get too excited about (however, it’s important to treat high blood pressure to prevent heart disease, strokes, kidney disease, etc.).

Research design

Another type of study you often come across is one that tests specific markers in the blood, and extrapolating benefits with respect to diseases based on these markers.

For example, let’s say a certain substance in the blood (we’ll call it substance A) is correlated to the development of heart disease. The researchers then give a group of volunteers a certain food or vitamin, and measure the concentrations of substance A in the blood. If they go down, then voila! The food that was studied is purported to fight heart disease. Again, life isn’t so simple. Often, things found in the blood may be markers of heart disease, but don’t necessarily cause heart disease. Reducing those markers does nothing to slash a person’s risk of suffering a heart attack. To show benefit, we need a study comparing heart attack rates in people who ate a certain food or took a certain medication or vitamin to those who didn’t.

What’s the bottom line?

If you enjoy beans or blueberries or any other healthy food, then by all means, indulge. And yes, you’re probably getting some health benefits. However, if you don’t enjoy those foods, then eat other healthy foods that you do enjoy. The small incremental risk reduction from any one food is minute.

If you want to reduce your risk of dying young and developing different diseases, then improve your lifestyle as a whole. Don’t smoke. Exercise every day and stay active. Follow a healthy diet rich in fresh fruits, vegetables, healthy fats, protein, and low in processed carbs and fats. Cut down on your stress. Focusing on the big picture will keep you on the road to good health much much more than beans or blueberries.

– Tamir


Even a little exercise counts

As any of you who have read our book and follow our blog know, we heavily push exercise as one of the best ways to stay healthy. However, the reality is that we’re often short on time and/or lazy. Even though 150+ minutes of moderate intensity exercise is what’s recommended, many of us unfortunately don’t even come close to that.

Well, I have some good news for those of you who fit into that category. A new study published in the Journal of the American College of Cardiology shows that as little as 5-10 minutes a day of running had tremendous health benefits, reducing the risk of death from heart disease by nearly half and from any cause by 30%. This translated to an extra 3 years of life. The study looked at data from over 55,000 adults ages 18-100 of which about a quarter were runners, and compared their health and longevity to non-runners.

What was even more amazing was that running more than 51 minutes a week did not seem to add any additional health benefits, and that the running didn’t have to be at a very fast pace (even less than 6 miles an hour showed benefit).

The take home message is that for a very small investment in time and effort (5-10 minutes a day, which even the busiest people have), people can achieve a remarkable reduction in heart disease and overall mortality.

Whether other forms of exercise when performed briefly have the same benefits is unknown at this time; however, there’s no reason to believe that there would be no improvements in health. Nevertheless, if possible, it seems that incorporating some running into your overall fitness routine may be a good idea.

Obviously, if you haven’t exervised before (or ever) or are otherwise in poor shape or have health issues, then start with walking, and speak to your physician before embarking on a more strenuous routine.

– Tamir


A link between cycling and prostate cancer?

In our book and blog – we heavily promote exercise as one of the best ways (along with a healthy diet and quitting smoking) to prevent many different diseases, including heart disease, diabetes, strokes, and certain cancers in addition to improving quality of life and increasing life expectancy.

However, we mention that often doing just one type of exercise, or exercising too much (e.g. marathon running) can at times lead to injury and in the case of doing too much can actually damage the heart and weaken the immune system.

Military cyclists in pace line.jpg

A recent study published in the Journal of Men’s Health shows a correlation between too much cycling and a risk of developing prostate cancer in men over 50. Data from over 5,000 men was analyzed; those who cycled more than 8.5 hours a week were over 6 times likely to report having prostate cancer. Those who cycled over 3.75 hours but less than 8.5 hours a week had an almost 3 fold increase.

The design of this study is such that it doesn’t per se prove that excessive cycling causes prostate cancer. For example, it’s possible that men who cycle more end up having more urological complaints stemming from sitting on a hard narrow seat for too long which leads to medical investigations that uncover cancer. However, the study did show that cyclists were no more likely to contact their primary care physicians than those who did not cycle. Furthermore, excessive cycling has been previously linked to testicular cancer as well as prostatitis (inflammation of the prostate), so that it’s at least plausible that the repeated trauma to the region of the prostate that happens during long bouts of cycling can lead to the development of prostate cancer.

The bottom line is that for now, it isn’t known for sure if too much cycling does cause prostate cancer. However, since it’s possible, and given that the magnitude of the potential harm (over a 6 fold increase in those that cycled the most) is huge, it probably is a good idea to cycle less than 3.5 hours a week and otherwise vary your workouts by incorporating other types of exercise.

– Tamir


Junk Food: The New Smoking

As much as cigarettes have become more and more socially unacceptable over the past few decades, a new dangerous trend is replacing them – excessive junk food consumption.

Now, before you cringe and compare me to New York City’s ex-mayor Bloomberg with his bans on trans fats and oversized sodas, hear me out.

Overconsumption of junk food

It would be unacceptable to give children cigarettes as rewards for doing well in school – yet it’s completely ok to shower them with candies, slurpees, sodas, etc. At most business lunches, there are probably more unhealthy choices than healthy. Heck – I’ve attended lectures on diabetes and obesity where an abundance of pastries, cookies, and donuts were served. TV is full of ads for junk food, sodas, etc. And let’s be honest – in this day and age, someone is much more likely to go up to a person smoking a cigarette and chide them than to someone drinking a large soda while munching on a hot dog and fries.

I know what you’re thinking – smoking is much more dangerous then eating junk food; furthermore it’s addictive. While those arguments are certainly true, what I don’t understand is why junk food consumption for the most part is completely acceptable. As a result, we’re seeing the amount of obesity in both children and adults reach an all time high. The obesity-related illnesses such as diabetes, heart disease, stroke, liver disease, and certain cancers are threatening to reverse some of the gains that we’ve made in life expectancy.

The solutions isn’t to ban junk food…

I am not here to suggest banning junk food completely – such an idea is unrealistic and unnecessary. What I do propose is for us to take a long hard look at what we’re eating and what we’re feeding our children, and make small changes. Perhaps we can demand more healthy choices at school and at the workplace. Certainly, whatever is in our control currently should be optimized. Don’t add a third junky item to your child’s lunch bag – provide an apple or carrot sticks. Encourage your children to drink more water instead of sugar laden beverages – and do the same yourself.

I have a feeling that years from now we will look back with dismay at how an entire generation of people was being poisoned with horrible food much in the same way that we look back at how cool and acceptable smoking was for so many years.

– Tamir


Cigarettes today are more harmful than 50 years ago

A new study published by the Campaign for Tobacco-Free Kids explains the disturbing findings that came out last year in the Surgeon General’s Report on smoking. The report stated that in spite of the fact that the average smoker is smoking fewer cigarettes today, they’re at a higher risk of developing lung cancer and emphysema!

Why would that be? It seems that Big Tobacco has over the years engineered cigarettes into more palatable, more addictive products in a bid to get new smokers hooked. Since over the decades smoking has become less attractive and the industry has faced more regulation (e.g. warning labels on packs, a ban on advertising on TV), it’s essential for the tobacco companies to find other ways to reel in and keep new smokers.

Among the alterations in today’s smokes:

  • Increased nicotine levels to make the cigarette more addictive.
  • Increased ammonia levels which makes the cigarettes “smoother” as well increase the absorption of nicotine.
  • Increased sugar levels, which again, makes the cigarette easier to smoke as well as increases the absorption of nicotine through a byproduct of the burnt sugar called aldehyde.
  • Levulinic acid which once again makes the cigarettes easier to inhale through decreasing their harshness.
  • Bronchodilators which are chemicals that open up the airways, making it easier to inhale the tobacco deep into the lungs.
  • Menthol found in menthol cigarettes which cools the throat making it easier to smoke.
  • Increased nitrosamine levels which cause cancer. This is due to the specific tobacco blends being used in the U.S.
  • Ventilation holes in the cigarette filter which causes smokers to inhale more deeply, resulting in the tobacco smoke ending up deeper in the lungs.

There you have it – a more carcinogenic cigarette that’s inhaled deeper and is more addictive.

– Tamir