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Smokers May Have Other Risky Habits


One risky health behavior may lead to another, says the researcher involved in a new National Center for Health Statistics survey of 33,000 smokers and nonsmokers.

"Smokers surveyed tend to have poorer health behaviors than nonsmokers," said Charlotte Schoenborn, a health statistician for the government survey, which was released Friday. To wit: The smokers were more likely than nonsmokers to sleep less than six hours a day, to skip breakfast, to be physically inactive and to be heavy drinkers, she said.

Men who smoke heavily shouldn't rely on the habit as a weight-control aid, survey findings suggest. About 27.2% of the men who smoked more than 35 cigarettes a day were overweight, compared with 28.1% of those who never smoked. About 19% of men who smoked 15 a day or fewer were overweight.

Of the women surveyed, 24.9% of those who never smoked were overweight, while 19.7% of heavy smokers and 19.3% of those smoking 15 a day or fewer had excess pounds. "Unfortunately, the evidence shows that women smokers and men who smoke lightly (under 25 a day) are less likely to be overweight than the general population," said Schoenborn. "But I don't think the benefits of reduced weight outweigh the risks of smoking."

Overall, smokers snack less than nonsmokers, the survey also found, but heavy smokers snack more than either nonsmokers or light smokers.

Fast Food but Fewer Calories

Giving up fast food is probably unthinkable for the estimated one in five Americans who eat it on any given day.

But eating defensively can minimize the nutritional flaws of fast fare, says a report in this month's Consumer Reports.

Among the suggestions:

--Choose a roast beef sandwich over a hamburger--it's often leaner.

--Don't assume chicken and fish are always better nutritional choices than red meat. Deep-frying can make their fat and calorie content rival those of burgers.

--Hold the mayo to save calories and fat. (A tablespoon has about 101 calories and 11.2 grams of fat.)

--Substitute milk or a diet soda for a shake.

--Bypass the "extra crispy" chicken to cut down on fat intake.

--Split an order of fries with a friend.

--Choose a baked potato without toppings.

--Opt for a salad. But skip the pasta and potato salads, croutons and taco chips to cut down on fat and calories.

Less Painful Injections

Adding a bit of sodium bicarbonate (baking soda) to local anesthetics can reduce the pain of the injection, according to a UC San Francisco anesthesiologist.

"It works mainly by neutralizing the acidity of the local anesthetic," said Dr. Warren McKay, head of the UCSF Pain Management Center. The acidity of the anesthetics is the major reason for pain on injection, McKay suspects. (Manufacturers make anesthetics acidic to increase shelf life, among other reasons, McKay said.)

The applications of McKay's idea are numerous, since many office surgeries (such as the removal of warts and some skin cancers) and dental procedures require local anesthetics.

In his study of 24 patients, done while he was at Boston's Brigham and Women's Hospital and Harvard Medical School, McKay and his colleagues found that the sodium bicarbonate had another advantage besides pain reduction. It also made the anesthetic work faster, longer and more efficiently, probably because its acidity was lowered closer to the level of the acidity of the body and blood.

Vasectomy Checkups

Failure should be considered as one of several possible complications of vasectomy, the male sterilization surgery, says a Canadian physician in a recent report in the Journal of the American Medical Assn.

In a report titled "The Lurking Sperm," Dr. Philip M. Alderman, a British Columbia urologist, said he discovered 97 failures--five found after pregnancy had occurred--in 5,331 patients who underwent at least two postoperative semen tests.

But not everyone thinks failure is an inevitable complication. In an editorial accompanying the report, Dr. Stanwood S. Schmidt, a UC San Francisco urology research associate and Eureka urologist, disagreed with Alderman's view, claiming he has seen no failures in 5,000 consecutive patients.

Schmidt and others say it is the type of surgical method that makes the difference. He recommends cutting the vas deferens (the sperm-carrying duct), cauterizing the ends and then making a tissue barricade between the cut ends. The last step, he explained in a telephone interview, is akin to building a firewall. "Mother Nature isn't going to let it connect up again." (In the series of vasectomies reviewed by Alderman, none included the tissue barricade, he noted.)

Preventive checkups are a good idea for any vasectomized man, but especially for those who neglected to return for two postoperative semen checks, said Dr. Cappy Rothman, a Century City urologist and clinical instructor of urology at the UCLA School of Medicine. "I think it's prudent for a man to go back every six months to a year (to be sure the vasectomy has worked)," he said.

Serious Leg Cramps

Leg cramps can be an uncomfortable nuisance, sometimes the benign result of overexertion. More often than not, they can be relieved simply by walking, forcing the muscle to relax.

But leg cramps aren't always a minor health problem and shouldn't always be self-treated or ignored, warn experts.

"Leg cramps can be caused by a chemical imbalance or a deficiency such as calcium or potassium," said Dr. Andrew Roth, a Beverly Hills orthopedic surgeon on staff at Cedars-Sinai Medical Center. "Sometimes (medication with) quinine works beautifully."

But leg cramps can also result from spinal stenosis (an arthritic narrowing), narrowing of the arteries to the legs or other conditions, said Roth, who offered this advice: If a leg cramp doesn't go away in a few days, seek medical help. If it is more than mildly painful, see a doctor as soon as possible. And don't experiment with over-the-counter remedies.

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