Salmonella Outbreak Again – Too Often

 

After you eat, you may feel abdominal cramps, a fever, headache, and just feeling lousy over the next few days. That could be a sign you have food poisoning, also known as salmonella.

No, it is not named for the fish. Salmonella, a group of bacteria, is the most common cause of food borne illness, and was named for a doctor named Salmon who discovered it more than 100 years ago. The illness that people get from salmonella infection is called salmonellosis.

Salmonella comes from food contaminated with bacteria, which can happen during food processing or food handling. It only takes a tiny amount of bacteria to cause food-borne illness.

Salmonella can occur in raw, tainted or live poultry, eggs, beef, fish and unwashed fruits and vegetables. People can get salmonella when they are handling food and don’t wash their hands, especially after being in contact with animals, such as chicks or rodents.

It seems like it happens too often. Just yesterday, 92 people from 29 states have been sickened in a salmonella outbreak linked to raw chicken, reported the Centers for Disease Control and Prevention.

At least 21 were so sick they had to be hospitalized. While not specifying the source of the contaminated chicken, the CDC says the “ill people report eating different types and brands of chicken products purchased from many different locations.” The outbreak of what was labeled as Salmonella infantis can be present in live chickens, and many types of raw chicken products, “indicating it might be widespread in the chicken industry,” the CDC says.   Federal officials have shared the information with chicken industry representatives and they are working to reduce Salmonella contamination. The particular salmonella strain may be resistant to to general antibiotics, officials said.

Impacts Millions of People

About one of six people in the U.S. will get some type of food poisoning this year, officials say. The Centers for Disease Control and Prevention estimate 1.2 million illnesses, 23,000 hospitalizations and 450 deaths related to salmonella each year. Food is the major source for most of those illnesses.

Nausea, vomiting and diarrhea are the most common signs of salmonella, but fever and chills often accompany the illness. It can take a week for symptoms of the illness to begin.

One of the most important things you can do if you get salmonella is drink plenty of liquids to replace fluids lost through vomiting or diarrhea.

How salmonella occurs

The most common causes of salmonella usually come from animals. Touching certain birds and lizards can spread the disease. Reptiles, baby chicks and small rodents are among the animals that may carry it.

Foods contaminated with bacteria can occur during food processing or food handling. Salmonella can be lurking in cooked meats, such as chicken or beef. It is also found in seafood, dairy products and lettuce, in packaged and prepared foods. Outbreaks of contamination have ranged the gamut, including raw turkey products, shell eggs, past salads, cereal, pre-cut melon, dried coconut, chicken salad, and raw sprouts.

In some rare instances, water can be contaminated with salmonella.

Kratom, an herbal supplement that the Food and Drug Administration has said is not safe, also has had instances of containing salmonella, the agency said.

When someone is sick

People who get salmonella may develop symptoms of illness anywhere from 12 to 72 hours or nearly a week after infection. The illness usually lasts 4 to 7 days and most people recover without treatment. However, in some people, diarrhea may be so severe that the patient needs to be hospitalized.

An infection could be more serious in infants or people with chronic conditions, according to the National Institute of Allergy and Infectious Diseases. If left untreated, salmonella poisoning can appear in joints and the urinary tract in a condition known as Reiters Syndrome. In some cases that could become permanent.

Use Best Practices in Handling Food

Taking care in handling food is one of the most important preventative practices in preventing salmonella. For instance, take care when making or handling raw eggs or foods such as cookie dough or burgers. You should also make sure raw meat is cooked to the proper internal temperature, or properly refrigerated. You should always wash the food after purchasing.

What You Can Do When Eating

  • Stay hydrated. Liquid intake is important for your body to fight off food poisoning effects. You can have sports drinks that include electrolytes to prevent dehydration, clear sodas, chicken or broth, and decaffeinated tea.
  • Eat foods gentle on your stomach. Such foods would include bananas, potatoes, cereals, honey, gelatin, and oatmeal. – Joe Cantlupe, HealthDataBuzz

 

References:

Rahayu, S, Nurdiana, N, et al. The Effect of Curcumin and Cotrimoxazole in Salmonella Typhimurium Infection in Vivo. 2013. ISRN Microbiology. Article ID 601076, 4 pages.

Healthline. What to Eat After Food Poisoning. Retrieved from: https://www.healthline.com/health/food-nutrition/what-to-eat-after-food-poisoning

Teatulia. What is Ginger? Retrieved from: https://www.teatulia.com/tea-varieties/what-is-ginger-tea.htm

Michael and Lesley Tierra’s East West School of Planetary Herbology. Salmonella in Species and the Herbal Treatment of Food Poisoning. Retrieved from: https://planetherbs.com/blogs/michaels-blogs/salmonella-in-spices-and-the-herbal-treatment-of-food-poisoning/

 

WebMD. Andrographis. Retrieved from:https://www.webmd.com/vitamins/ai/ingredientmono-973/andrographis

 

National Institutes of Health. NIH Scientists describe how salmonella bacteria spread in humans. Retrieved from:

https://www.nih.gov/news-events/news-releases/nih-scientists-describe-how-salmonella-bacteria-spread-humans

 

Food and Drug Administration Administration. 2018. FDA warns companies selling illegal, unapproved kratom products marketed for opioid cessation, pain treatment and other medical use. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm608447.htm

https://www.cdc.gov/salmonella/index.html

 

Based on my article from https://www.hcpnow.com/feeling-lousy-could-be-food-poisoning/

The Joy of Athletic Repetition: Just Hitting Tennis Balls Against A Wall

Sometimes, there’s just no one to play with.

Or maybe I just don’t feel like playing with others.

It may be cold or windy. So I take my tennis racket and go inside, yes, a racquetball court nearby. I warm up slowly, and then hit ball after ball against the walls. I can imagine how high the net is when there is none. I can picture my opponent on the other side, when there is none. I can smash, slice, hit lobs, hit soft overheads.

I can hit ball after ball after ball: over and over.

It’s meditative. The mind is still, oddly enough, with the sound that echoes off the walls. It’s relaxing and yet a tough workout as I sprint back and forth inside the small court.

The court is a cinderblock rectangle. In my head, it’s Wimbledon.

I’ve done this for years. I feel lucky to do this. When the winter comes, the court feels warm inside, though no heat is on. I notice sometimes the spout outside is frozen and the water is solid ice. I don’t look forward to that.

Hitting the balls. One after another. I’ve done this before, I think. A variation of it.

A long time ago.

Yes. Decades ago, as a 10-year-old, I made believe I was Whitey Ford or Sandy Koufax and go into a windup and throw, throw tennis balls against the outside brick wall of the apartment building where I grew up.

In my head, I had a lineup of baseball players I made up. I would pitch. Sometimes they blasted a home run in my imagination. More often, they struck out.

The repetition. The tranquility and joy of it. Yes.  – Joe Cantlupe

 

 

 

Millions Paid to Ohio Medicaid Contractors On Behalf of …..(Oops!)…Deceased Beneficiaries, Feds Say

Ohio officials mistakenly  made more than $90.5 million payments to contractors for medical services under Medicaid on behalf of  beneficiaries who had died, federal officials say in an investigative report.

That was found in a random sample of 100 so-called capitation payments made to Medicaid Managed Care Service Organizations.  Ohio eventually recovered 37 payments, but did not recover the remaining 63 — which amounted to at least  $51.3 million in unapproved payments, according to the federal Health and Human Services Inspector General’s Office. That amount includes $38 million in federal funds.

“Ohio did not always identify and process Medicaid beneficiaries’ death information. Although Ohio’s eligibility systems regularly interfaced with Federal data exchanges that identify dates of death, county caseworkers did not always receive notification that beneficiaries had died,” the report said.

“We confirmed that all beneficiaries associated with the 100 capitation payments in our stratified random sample were deceased,” it added.

Not that this hasn’t happened before in the U.S.

Since 2016, Florida, Texas and Tennessee have made payments after beneficiaries’ deaths, according to HHS.- Joe Cantlupe, HealthDataBuzz

 

Opioids: Too Many Prescriptions And Lots of Unused Medications, Too

A HealthDataBuzz series: Our Daily Lives – Things That Impact Our Everyday Health

While there is an opioid crisis in this country, there is an almost stunningly routine part of the massive problem: too often medications prescribed for patients after surgeries, for instance, aren’t used after they picked them up. The pills are left in the house, and may be taken accidentally — or not – by someone else. And that someone else may be a child.

Not only do many people take only some or none of the prescribed pills, but more than 90 percent fail to dispose of the leftovers in the recommended way, which may be potentially hazardous to others, never mind hurting the environment.

That was found in an extensive Johns Hopkins Medicine study also showed that physicians were prescribing too many opioids, which has become well-known. The researchers said they highlighted in the report the need for more personalized pain management to avoid over prescribing opioids, and reduce risks linked to improperly stored opioids in the home.

Drug Accidents

The opioid crisis revolves around medications often prescribed for painkillers that have led to too many overdose deaths., as nearly everyone knows. From 1999 to 2016, more than 200,000 people died in the U.S. from overdoses related to prescription opioids.

Accidental drug overdoses are also too common in the U.S. From 2006 to 2011 unintentional poisonings from prescription opioids alone accounted for 138,603 trips to the emergency room, according to Consumer Reports. 

Too Much Prescribing, And Sending Home?

Various studies have shown that opioid painkillers are prescribed often after surgery, yet one of three patients who were evaluated in a Mayo Clinic study didn’t take a “single pill.”

“That showed us there’s an opportunity to prescribe a certain select group of patients zero opioids,” said Elizabeth Habermann, scientific director for surgical outcomes at the Mayo Clinic in a statement to HealthDay. Instead, patients should be able to take care of their pain with non-opioid medications, such as anti-inflammatory drugs that are considered over-the-counter, and not prescribed.

One of the problems is that physicians write too many prescriptions for patients to use at home after their hospitalization — simply because they don’t know exactly how much is needed, the researchers found.

“There’s a lot we don’t know about how much pain medication people really need or use after common operations,” said Mark Bicket, MD, an assistant professor of anesthesiology and critical care at Johns Hopkins University School of Medicine and the paper’s first author in the report published in the Journal of the American Medical Association Surgery in a press station.

The studies say that non-opioid drugs like acetaminophen and naproxen can often suffice for moderate post-operative pain. Prescribers should spend more time assessing post-operative pain and prescribe smaller amounts of opioids or alternatives as appropriate.

“If we can tailor the amount of opioids prescribed to the needs of the patients, we can ensure patients receive appropriate pain control after surgery yet reduce the number of extra oxycodone and other opioid tablets in many homes that are just waiting to be lost, sold, taken by error or accidentally discovered by a child,” says Bicket.

Some of the surgeries involved in the unused opioid medications were orthopedic, urology, Cesarean section, dental and general. The researchers said that 67 to 92 percent of the patients reported unused opioids. Some of the patients never filled their prescriptions, or did so and didn’t take the opioids.  Overall, 42 to 71 percent of prescribed pills were unused among more than 800 patients, according to the study.

Unused and Discarded Medications

The problem, too, is what happens to these drugs when they aren’t used? They wind up left homes, “inviting abuse and the potential for addiction,” according to the report.

In 2017, a national survey by Consumer Reports found that one-third of Americans hadn’t cleaned out a medicine cabinet in the past year, and nearly one-fifth hadn’t done so in five years. Occasionally, patients stopped using the drugs because they had adequate alternative pain control, or because of the opioid-related side effects.

When it came to storing the drugs, most patients took inadequate measures, studies showed.

Take the Proper Disposal Steps

When medicines are no longer needed, they should be disposed of promptly. Consumers and caregivers should remove expired, unwanted and unused medications from their homes as quickly as possible.

Experts say don’t leave medications in your medicine cabinet for a lengthy period or give them to friends or throw them away.

While medications are ready to be disposed, some types of prescription drugs can be disposed of in your household trash. But the Food and Drug Administration says opioids are too dangerous to go out with your garbage. Drugs may go into the wrong hands and be fatal.

In some cases, flushing unused opioid medication is OK when the medication cannot be safely or securely stored. That would include oxycodone, hydrocodone, fentanyl and many other opioids. – Joe Cantlupe

Also published in HCPnow.com

References:

Johns Hopkins Medicine. Study Adds to Evidence That Most Prescribed Opioid Pills Go Unused. 2017. Retrieved from: https://www.hopkinsmedicine.org/news/media/releases/study_adds_to_evidence_that_most_prescribed_opioid_pills_go_unused_

Dennis Thompson. HealthDay. Addictive Opioids Still Overprescribed After Surgery: Study. Retrieved from:   https://consumer.healthday.com/bone-and-joint-information-4/opioids-990/addictive-opioids-still-overprescribed-after-surgery-study-733107.html

U.S. Food and Drug Administration. Disposal of Unused Medicines: What You Should Know. Retrieved from: https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm

Consumer Reports. 2018. Retrieved from: https://www.washingtonpost.com/national/health-science/many-people-fail-to-get-rid-of-unneeded-and-expired-drugs/2018/07/20/0c87e024-65d6-11e8-a768-ed043e33f1dc_story.html?utm_term=.97b069f7190e

Mayo Clinic. 2018. How to use opioids safely.

https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-to-use-opioids-safely/art-20360373

Salynn Boyles. Study: Trash Old, Unused Drugs. WebMD. Retrieved from: https://www.webmd.com/women/news/20120518/study-trash-old-unused-drugs#1

With All This Going On…Are There Moments When You Are….Dare I Say It? …Bored (but continue reading)

One of a HealthDataBuzz series: Our Daily Lives — Things That Impact Our Everyday Health

It certainly can be a busy time, with work, kids, family and friends, commuting, to-do-lists and the constant barrage of news to absorb.

And I mean constant.

Amidst it all, there are simple tasks that have to be accomplished. Washing the dishes, throwing out the trash, cleaning the house or apartment, mowing the lawn or wondering when you won’t be stuck in traffic. And while doing those tasks, there is something else that may draw your attention: you are bored.

Bored. Let that sink in. During those times you are bored you may feel anxious about it, because we are so stimulated that you may feel guilty about not being engaged in something. You may decide then to quickly check emails on a smartphone, watch TV. The feeling of uncertainty may make you feel even more stressed.

Leading to Creativity

But oddly enough, there have been recent studies, books and other research that shows boredom may spur your inner creativity. Boredom actually encourages people to explore and push toward new ideas, in some respects because there is something lacking at the current time. In addition, it opens the door for daydreaming, and may add positive connections.

The recent studies contradict earlier reports from years ago that people who were bored had been prone to being easily frustrated by doing something challenging.

Manuosh Zomerodi, a journalist who has written a book on the issue, “Bored and Brilliant,” said in a Ted Talk

her conversations with neuroscientists and cognitive psychologists showed that when you are bored you ignite something in the brain – the “default mode.”  She describes what’s happening inside the brain like being on “autopilot.” While someone may be doing laundry, or walking, she says, “the brain actually takes the seeming down time to be really busy.”

When it appears you are doing mundane tasks, the brain is “really busy,” she says.

“Once you start daydreaming and allow your mind to really wander, you start thinking a little bit beyond the conscious, a little bit into the subconscious, which allows sort of different connections to take place,” said Zomerodi. “ It’s really awesome actually.”

Reseacher Andreas Elpidorou of the University of Louisville writes in a journal article that boredom is a helpful motivator for people, and possibly helps them to pursue other goals or a path they would normally go.

“Despite its impressive historical backing, the view that boredom is entirely negative should be rejected,” Elpidorou writes. “Boredom helps to restore the perception that one’s activities are meaningful or significant. It acts as a regulatory state that keeps one in line with one’s projects. Boredom is both a warning that we are not doing what we want to be doing and a ‘push’ that motivates us to motivates us to switch goals and projects.”

Researchers also found in several studies  the creative power of boredom. Boredom during passive activities, like reading reports or some drawn-out meetings, heightens the “daydreaming effect” on creativity, the more passive the boredom, the more likely the daydreaming and the more creative you could be afterward,” the researchers said.

So what should you do?

Well, if you find you are doing some boring tasks, do them first, but while you are accomplishing them, let your mind just  embrace dreaminess.

“So don’t feel guilty about a little boredom, let your mind wander, embrace the state of boredom because feelings and emotions highly affect the things you think about,” Zomerodi writes.

Don’t Overdue It

Like many things, if you get bored too often, that’s probably no good. If you are easily bored, there may be signs that you are more prone to depression, or engage in addictive behaviors, which may be a mistaken attempt to cope with their feelings.

REFERENCES:

HuffPost. Wellness. 2015. 8 Ways to Harness the Power of Boredom. Retrieved from: https://www.huffingtonpost.com/2015/01/18/boredom-hacks_n_6479468.html

Vivian Giang. Fast. Company. The Science Behind How Boredom Benefits Creative Thought. 2015. Retrieved from: https://www.fastcompany.com/3042046/the-science-behind-how-boredom-benefits-creative-thought

Manoush Zomorodi. TedTalk. 2017. Retrieved from: https://www.ted.com/talks/manoush_zomorodi_how_boredom_can_lead_to_your_most_brilliant_ideas#t-151506

Now I Know. The Power of Being Bored. 2017.

http://nowiknow.com/the-power-of-being-bored/

Eipidorou, A. The bright side of boredom. Frontiers in Psychology. 2014. https://doi.org/10.3389/fpsyg.2014.01245.

David Burkus. The Creative Benefits of Boredom. 2014. Harvard Business Review.  Retrieved from: https://hbr.org/2014/09/the-creative-benefits-of-boredom

A Fast Way To Health Problems? Fast Food

You know it: Too often, we are living in a buzz fast world.  And when it’s time to eat something, Americans often  opt for the quick way to try to satisfy hunger: now, ready, set: fast food.

Go to a nearby fast food establishment and you’ll see a line of cars outside as patrons wait to give orders, without stepping out of their cars. And many fast food restaurants are open day and night, 24 hours.  How many young adults have that craving for food at any hour? And where do they go? Fast food.

Over 36 percent of adults – 84.8 million – in the United States consume fast food on any given day, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics data brief that covered 2013 to 2016. Among adults, a higher percentage of men, (37.9 percent) than women (35.4 percent) consumed fast foods.  That could include the usual staple of fare, such as burgers – and bigger burgers – and French fries and even larger fries, among other fried foods.

“Fast food is definitely a part of the American diet and has been associated with high caloric intake, and poor diet quality,” the CDC says in a new report. “There are many reasons why people go and get fast food: time, convenience, and price.”

Fast food, however, isn’t considered healthy because there is often too much sodium, calories, fat, cholesterol, and sugar associated with it. When too much fast food is eaten, it can be linked with an increased risk of obesity, Type 2 diabetes, heart disease and other health problems.  Some people also may want to avoid fast foods such as hamburgers or sandwiches, if they are trying to maintain a relatively low-carb diet.

The CDC issued its report because fast-food is so much a part of how Americans eat. “We focused on fast food for this report because fast food has played an important role in the American diet in recent decades,” said Cheryl Fryar, a health statistician at CDC and a first author of the report in a statement. “Fast food has been associated with poor diet and increased risk of obesity.”

Among adults who consumed fast food, the most commonly reported times for when they did so were lunch, (43.7 percent) and dinner, (42 percent) followed by breakfast, 22.7 percent, and snacks, 22.6 percent.

Men were more likely to eat fast food at lunch, and women as a snack.

Young People Like Fast Food – And the More Well-to-Do

In the CDC study, there are some interesting revelations. Mostly, younger people opt for fast foods – and that may be no surprise! – and those people with higher incomes eat more fast food, and that may be surprising.

    • The percentage of adults who consumed fast food decreased with age, the CDC said. While nearly 45 percent of those aged 20 to 39 were among the adults who consumed fast food on a given day, 37.7 percent aged 40 to 59, and 24.1 percent for those 60 and over. That age pattern was observed for both men and women.
    • The percentage of adults who consumed fast food increased with “increasing family income,” the CDC says, with more than 31 percent of lower income people, 36.4 percent of middle-income, and 42 percent of higher income adults consumed fast food on a given day.

Some healthy alternatives

Hungry consumers don’t need to be bogged down in simply fast food choices if they are in a hurry or on the run. There are various alternatives, including low fat cheese sticks, yogurt, cut vegetables, or fruits, such as bananas and grapes.

If you want that burger, maybe put aside the bun, which generates higher calories. And replace the fries or potatoes chips with salad or fruit. And ask for meat that is grilled, or without the skin.

Just Don’t….Light Up!

One of a HealthDataBuzz series: Our Daily Lives — Things That Impact Our Everyday Health

Check it out. Restaurants. No smoking. Big buildings. No smoking inside. Not many people, it seems, are taking quick puffs from a cigarette. When you drive on the highway, in the next lane of cars, not many windows are rolled down, to allow curls of smoke to go up. Indeed, tobacco control efforts have contributed to a decline in U.S. cigarette consumption by nearly 25 percent since 1968.

Decades of education and research reduced much of the smoking, and the impact is saving millions of lives.

The good news ends there.

Despite the enormous progress in reducing smoking, tobacco use is still the leading cause of preventable death in the U.S. and posses a terrible toll on families, businesses and government.

Despite the enormous progress in reducing smoking, tobacco use is still the leading cause of preventable death in the U.S. and posses a terrible toll on families, businesses and government.

Tobacco kills more than 480,000 people annually from their own smoking or exposure to second-hand smoke – “more than AIDs, alcohol, car accidents, illegal drugs, murders and suicides combined,” the government says.  About 15.5 percent of all adults, and 17.5 percent of males and 13.5 percent of females were current smokers in 2016.

One of the major problems is the addiction caused by the nicotine in cigarettes.

This week, pharmacologist Lynn Hull of the FDA Center for Tobacco Products, noted:

“Making all cigarettes minimally addictive could significantly reduce the morbidity and mortality caused by smoking,” she said, according Seeking Alpha.  It said “Hull seemed to indicate with her comments that the agency may be looking at implementing reduced nicotine standards as soon as 2020.”

Cigarette smoking impact

Cigarette smoking is seen as the greatest preventable cause of premature death in the U.S. In fact, cigarette smoking accounts for one out of five U.S. deaths: 87 percent of lung cancer deaths and at least 30 percent of all cancer deaths each year. People who quit smoking before age 50 reduce by half their risk of dying in the next 15 years. The World Health Organization estimates 1.27 billion tobacco users worldwide, and says that one billion people may die in this century if the global tobacco consumption remains at current levels. The problem doesn’t involve not only smoking, but also secondhand smoke – just being around smokers – that harm children and adults in homes, work and public places.

The smoking habit. 

 Smoking is a physical and psychological habit that is hard to erase. Withdrawal symptoms include irritability, fatigue, headache or a feeling like the flu. The big culprit is nicotine. Besides being highly addictive, nicotine has consistently been linked to being carcinogenic. There are many nicotine preparations that do not involve tobacco, but research shows they are still harmful.  There are e-cigarettes, e-hookahs, mods, vape pens, all nicotine based, nicotine gums, and patches, often marketed as remedies or alternatives to cigarette smoking,  but still pose a significant health risk. Too often, young people are attracted to these cigarette alternatives. One in six high school students reported using e-cigarettes in the past month.

“The overwhelming amount of death and disease attributable to tobacco is caused by addiction to cigarettes – the only legal consumer product that, when used as intended, will kill half of all long-term users,” FDA Commissioner Scott Gottlieb, MD, said in a statement. “Unless we change course, 5.6 million young people alive today will die prematurely later in life.”

Do you have the will?

The brain will try to make excuses to have you smoke again. Experts advise you to train your subconscious mind to prevent you from getting back to smoking.

Stay away from herbal cigarettes, experts say

Because many people are concerned about smoking “regular” cigarettes, some turn to “herbal” cigarettes, made of a mixture of different herbs that contain no tobacco or nicotine.  A study that examined the issue said, “our findings showed that herbal cigarettes did not deliver less carcinogens than regular cigarettes.” — Joe Cantlupe

REFERENCES:

Mishra, A, Chaturvedi, P, et al.Harmful effects of nicotine 2015. Indian Journal of Medical and Paediatric Oncology. 2015. 24-31. Doi: 10.4103/0971-5851.151771.

Kitikannakorn, N, Chalyakunapruk, et al. An overview of the evidences of herbals for smoking cessation 2013. Complementary Therapies in Medicine. Vo. 21, Issue 5, pages 557-564. 

Lee, H, and Lee, J. Effects of medicinal herb tea on the smoking cessation and reducing smoking withdrawal symptoms. 2005. American Journal of Chinese Medicine. 2005;33(1): 127-38.

Diane Joswick, L.Ac, MSOM. Quit Smoking with Acupuncture. From Acufinder.com .

https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=119

https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

E-cigarettes and lung health. American Lung Association From: http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html

Diane Joswick, L.Ac, MSOM. Quit Smoking with Acupuncture. From Acufinder.com .

https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=119

https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

E-cigarettes and lung health. American Lung Association From: http://www.lung.org/stop-smoking/smoking-facts/e-cigarettes-and-lung-health.html