Texting Can Save Lives?

http://t.cdc.gov/ecards/message.aspx?cardid=573&category=157

Following up on yesterday's Great American Smokeout..., an interesting study was published this year looking at the effectiveness of TEXTING support to help people quit smoking. This was an analysis of several other studies, including over 9000 total participants. Text messages were used either exclusively or as a supplemental part of smoking cessation programs. Although the results were not fully consistent between the individual studies, ultimately the data is encouraging to support use of this ever-present appendage to aid people in quitting smoking.

In fact, the National Cancer Institute has a texting support program for smokers wanting to quit. Smokefree TXT is designed to be a 24/7 support system offering advice, encouragement and tips for tobacco users trying to kick their habit.

More and more, we are finding ways to use technology to help our health. This picture above is from the free e-card collection at the Center for Disease Control (CDC). Use the link above to check out the wide range of health reminders that you can share with your friends and family! Everything from flu shot reminders, to cancer screenings (think mammograms, pap tests and colonoscopies) to yes, quitting smoking.

BOTTOM LINE: Every bit of contact and support that we can give our friends to help them quit smoking is worthwhile- even texting!

Cell Phone DANGER

Last week, the buzz in much of medical media centered around cell phone use and risk of cancer, because an early release of a study published in an oncology medical journal noted that cell phone users had a 40% INCREASE in gliomas, which are a type of brain tumor. To put it in perspective, though, the baseline glioma risk in the general population is 1 in every 200,000 adults. The potential cell phone increase would increase that risk to 1 in 120,000. However, given the 5 BILLION cell phone users worldwide, everyone is understandably concerned with whether or not they can cause cancer in humans. The World Health Organization International Agency for Research on Cancer (WHO/IARC) has indeed now classified these radiofrequency electromagnetic fields as "possibly carcinogenic to humans (Group 2B)". Of course, these fields can come from microwaves, tv's, and radars, as well as cell phones.

When are the phones considered dangerous? When the phone is used on the same side for 30 minutes/day for > 10 years. (Lancet Oncology; July, 2011). Previous studies showed no increased risk if you alternate ears as you talk on the phone, and the jury is still out regarding blue-tooth and other wireless devices.

What is my level of concern? As usual, I think overuse of nearly anything can be harmful to your health, whether it's chocolate, french fries, wine or cell phones. I know that cell phones are causing far more harm RIGHT NOW as people chat on the phone nonstop as they drive, and heaven forbid, TEXT. I was nearly hit in a parking garage today by a driver busily texting as she negotiated the tight ramps. Apparently simply dialing your phone while driving TRIPLES your risk of a car accident, and texting increases that risk by a factor of 28!!

As a side note, my kids know that I am always looking for pictures for this blog. We were driving the other day, and a young woman passed us (in the right hand lane, mind you!) while she was looking at her cell phone AND smoking a cigarette. Immediately everyone in our car (EXCEPT THE DRIVER) reached for a phone or camera to grab her picture as the health "DON'T", and the kids launched into "my" speech about driving safety. She sped away before we caught her picture, so this is me POSING as the driving "DON"T".

BOTTOM LINE: PLEASE, leave your CELL PHONE in the BACK SEAT (or your purse, or the trunk- whatever is safely out of reach) when you drive, so you wont be even tempted to look at your latest text, none the less, respond.

Did U 4Get? Medication Reminders

Ah, texting- the new language of our youth! As we embrace technology, I believe there will be many beneficial uses of the tiny screens upon which our culture is becoming increasingly dependent. There are multiple "apps" out there, for example, that help people track behavioral changes such as exercise, or count days without junk food (or soda, or alcohol, or cigarettes or candy bars!) In my practice, I have seen these simple electronic tools really help my patients improve their health.

Along those lines, there is an interesting study recently published in the medical journal Obstetrics and Gynecology, entitled Using daily text-message reminders to improve adherence with oral contraceptives: a randomized controlled trial. This was a small, short study with just less than one hundred young, high school female graduates followed over three months. The women were randomized to receive a daily text message reminding them to take their birth control pill, and their compliance was both self-recorded and externally monitored.

The results surprised me, frankly. I would have thought simply participating in such a study, none-the-less receiving a DAILY reminder would have yielded near perfect compliance. Unfortunately, what was seen was that BOTH groups missed a significant number of pills each month (4.9+/-3.0 for the text-message group and 4.6+/-3.5 for the control group.) It's possible the difference in the groups was small because women in both groups used additional reminders such as alarms on their cell phones.

The other disappointment is that the girls' self-reporting of missed pills was markedly below their true number of missed pills, which strongly suggests that they could be underestimating their true risk of becoming pregnant if they are sexually active.

BOTTOM LINE: While technology may be able to help us towards healthy lifestyles, daily text medication reminders may not be an effective tool (at least in this setting.) Physicians need to emphasize (and patients need to implement!) strict compliance with oral contraceptive pills.

Prevent Accidents: Hang up the Phone!

This week a perspective in the New England Journal of Medicine encouraged doctors to ask their patients about driving habits- and not simply about driving home after having wine with dinner. The issue here is all about texting or talking on cell phones while you are driving. Oh sure, you ONLY check your texts/emails when you are stopped at a light, right? Well, maybe if the traffic is really slow…What about simply talking on the phone- is that really a problem?

We know that driving while distracted by a phone conversation or texting is similar to driving while intoxicated. Both situations can cause you to react more slowly when an unexpected driving hazard emerges, or perhaps to never see the hazard until it’s too late. More and more studies are showing the dangers inherent with this distraction, and the hands-free phones do not appear to offer much (if any) improvement. There are more document accidents from talking on the phone than from texting, but this is likely due to the widespread use of cell phones (compared with texting.)

When teens are learning to drive, they are encouraged to put their phones in their backpacks or purses, and then place those items in the back seat. I believe we should all follow that advice. Move it to the trunk if you need to, but remove the temptation!
BOTTOM LINE: To quote a rude but accurate bumper sticker, “Shut up and DRIVE!”