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You Don't Have to Smoke to Get Lung Cancer

SATURDAY, Jan. 22, 2022 (HealthDay News) -- Tobacco use is far and away the leading cause of lung cancer, but non-smokers are also at risk, experts say.

People who smoke have the highest risk, and smokeless tobacco is also a threat. About 90% of lung cancer cases could be prevented by eliminating tobacco use, according to the World Health Organization.

"There are many other risk factors, and risk factors we don't know," said Dr. Aaron Mansfield, an oncologist who specializes in treating lung cancer at the Mayo Clinic in Rochester, Minn. "All you need to be at risk of developing lung cancer is a lung."

Exposure to secondhand smoke can increase the odds of developing lung cancer. Other risk factors include a family history of lung cancer and exposure to radon gas, asbestos and other cancer-causing substances.

Some lung cancer patients don't have any obvious risk factors.

If you do smoke, however, you can reduce your lung cancer risk by quitting.

Dr. J. Taylor Hays is associate director of the Mayo Clinic Nicotine Dependence Center. He said, "Even if you're in your 60s or 70s, we know that by quitting smoking you add years of life, and reduce the chronic health impacts and symptoms that occur from smoking."

Hays added that even people who have had chronic bronchitis and other diseases quickly benefit from smoking cessation.

"They see within months to years significant reduction in symptoms, significant improvement in shortness of breath, and the ability to function without symptoms," he explained in a Mayo news release.

Symptoms of lung cancer include shortness of breath and persistent cough, chest pain, coughing up blood, weight loss, bone pain and headache.

These symptoms often appear only when the cancer has spread into other areas of the body.

"One of the problems with lung cancer is that by the time a patient is diagnosed with lung cancer ― 80% of the time ― the lung cancer has spread," said Dr. Karen Swanson, a pulmonologist and critical care specialist at the Mayo Clinic in Phoenix. "Unfortunately, when tumors grow within our lungs, it's not something our bodies can sense or feel. So we miss it at its earliest stages, unless we screen."

Screening with an annual low-dose CT scan is recommended for those who are at high risk.

"Patients should talk to their primary care provider about lung cancer screening, especially if they have any history of smoking," Swanson said.

Feb. 4 is World Cancer Day.

More information

The U.S. National Cancer Institute has more on lung cancer screening.

SOURCE: Mayo Clinic, news release, Jan. 19, 2022

Three New Studies Confirm Power of Booster Shots Against Omicron

FRIDAY, Jan. 21, 2022 (HealthDay News) -- Booster shots are keeping the Omicron variant from landing millions of Americans in hospitals, emergency rooms and urgent care clinics across the country, three new government studies show.

In one study, published Friday in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (MMWR), a third dose of either the Pfizer or Moderna vaccines was 90% effective at preventing hospitalization, and at least 82% effective in preventing a trip to the emergency room or urgent care. The study included a three-week period when the Omicron variant took over the United States.

"The good news is that for people who received a third booster dose, the effectiveness of three doses is very high and protects against moderately severe and severe disease," study author Mark Thompson, told the Washington Post. "This is among the first data that really shows the actual level of protection in the United States."

A second study led by CDC epidemiologist Amelia Johnson and also published Friday in the MMWR found that booster shots also protected Americans, particularly those over 50, from COVID-related deaths.

Meanwhile, a third report published Friday in the Journal of the American Medical Association found that among Americans tested for COVID-19 in December 2021, three doses of an mRNA vaccine offered greater protection against cases of symptomatic COVID-19 infection than being fully vaccinated (with two doses) or unvaccinated did.

"These findings suggest that receipt of three doses of [an] mRNA vaccine, relative to being unvaccinated and to receipt of two doses, was associated with protection against both the Omicron and Delta variants," wrote researchers led by Emma Accorsi, of the CDC's COVID-19 Response Team.

Experts welcomed the new reports.

"Data from other countries have also shown significant benefit of getting the booster, but this is really showing it in the U.S.," Akiko Iwasaki, an immunologist at Yale University, told The New York Times. "These numbers should be very convincing."

"We should be celebrating this," Eric Topol, a molecular medicine professor at Scripps Research, told the Post. While vaccines and booster shots are "not holding up against Omicron infections, they are holding up the wall against severe disease … and that's phenomenal," he said. "A booster is essential for preventing severe disease, hospitalization and deaths."

Still, less than 40% of Americans have gotten booster shots, according to the latest CDC data.

The three studies released Friday follow the CDC's posting of other new data on Thursday that showed the risk of hospitalization for COVID-19 among older Americans is far higher for those who are unvaccinated than for those who are fully vaccinated and have had a booster shot.

The differences were stark: In December, unvaccinated people 50 and older were 17 times more likely to be hospitalized with COVID-19 than those who had completed the initial immunization series, but hadn't yet received a booster, according to statistics published Thursday on the CDC's website.

Among those aged 50 to 64, unvaccinated people were 44 times more likely to be hospitalized with COVID-19 than those who were fully vaccinated and had a booster shot, the data showed.

The risk difference was even greater among seniors. Among Americans over 65, the chances of hospitalization for COVID-19 was 49 times higher for those who were unvaccinated than for those with full vaccination and a booster.

The findings suggest that booster shots provide older Americans with a significant added level of protection. The CDC now recommends booster shots for everyone aged 12 and older, to be given five months after getting two doses of the vaccines made by Pfizer and Moderna, or two months after a single dose of the Johnson & Johnson vaccine.

What remains to be seen is whether the power of the booster shots will last, Natalie Dean, a biostatistician at Emory University, told the Times.

"We just have to recognize that all these estimates of Omicron third-dose protection are going to be people who are pretty recently boosted," she said. "We do wonder [about] the durability of boosters themselves."

More information

Visit John Hopkins for more on COVID booster shots.

SOURCES: Morbidity and Mortality Weekly Report, Jan. 21, 2022; Journal of the American Medical Association, Jan. 21, 2022; U.S. Centers for Disease Control and Prevention website; Jan. 20, 2022; Washington Post; The New York Times

After Heart Attack, Cardiac Rehab Begins Road to Recovery

FRIDAY, Jan. 21, 2022 (HealthDay News) -- Your heart is in an incredibly vulnerable state if you've suffered a heart attack or are fighting heart failure, and cardiac rehabilitation could be an important part of your recovery.

Unfortunately, not enough older folks appear to be taking advantage of this life-saving therapy.

Fewer than one in 10 eligible Medicare beneficiaries get recommended heart failure rehab treatments, the American Heart Association recently noted.

"Based on the current data, more than 90% of people with heart failure will not receive a treatment that could improve their health and survival," said Dr. Vinay Guduguntla, a third-year internal medicine resident at the University of California, San Francisco.

Cardiac rehabilitation is a comprehensive supervised program that includes:

  • Regular physical activity.
  • Education about eating healthy, taking medicine as prescribed, and dropping bad habits like smoking.
  • Counseling to help relieve stress and improve mental health.

It's for anyone recovering from a heart attack or heart failure, according to the U.S. Centers for Disease Control and Prevention. You also might benefit from cardiac rehab if you've had a heart problem that required surgery or medical care.

A team of people could eventually become involved in your cardiac rehab, including doctors, nurses, exercise and nutrition specialists, physical therapists and counselors.

Cardiac rehab usually lasts about three months, but can range anywhere from two to eight months, the CDC says.

Studies have found that cardiac rehabilitation decreases the chance that you will die in the five years following a heart attack or bypass surgery by about 35%, the CDC says.

Another recent study, presented at the European Society of Cardiology's annual meeting, estimated that heart attack survivors can gain more than seven healthy years of life if they stick to the tenets promoted by cardiac rehab.

Unfortunately, researchers have found that women are less likely than men to start or complete cardiac rehab, possibly because they aren't being offered the option, the CDC suggested.

Older adults also are less likely to undertake cardiac rehabilitation, according to the CDC. They might feel that they're too old to be physically active, especially if they suffer problems like arthritis that make exercise more difficult.

If you've had recent heart problems, the CDC recommends that you talk to your doctor about cardiac rehabilitation. Many insurance plans cover it, including Medicaid and Medicare.

"I'm an enormous fan of cardiac rehab," said Dr. Donald Lloyd-Jones, past president of the American Heart Association.

After a heart attack, he explained, people can be fearful about exercise, depressed, or feel like it's "too late" to do anything about their cardiovascular health.

"Cardiac rehab gets patients into a monitored setting where they can learn to trust their bodies again," Lloyd-Jones said.

More information

The American Heart Association has more information about cardiac rehabilitation.

SOURCES: U.S. Centers for Disease Control and Prevention, news release; American Heart Association, news release, Nov. 8, 2021;

COVID Vaccine Won't Affect Fertility, But Getting COVID Might

FRIDAY, Jan. 21, 2022 (HealthDay News) -- One less excuse to avoid that COVID vaccine: The shots don't affect fertility in either men or women, new research shows, but coronavirus infection could cause short-term fertility problems in men.

"Many reproductive-aged individuals have cited concerns about fertility as a reason for remaining unvaccinated," said lead study author Amelia Wesselink. She is research assistant professor of epidemiology at Boston University School of Public Health.

"Our study shows for the first time that COVID-19 vaccination in either partner is unrelated to fertility among couples trying to conceive through intercourse. Time-to-pregnancy was very similar regardless of vaccination status," Wesselink said in a university news release.

For the study, Wesselink's team analyzed data from more than 2,100 American and Canadian women and their male partners in an ongoing study of women trying to conceive.

The women provided demographic, lifestyle and medical information about themselves and their partners from December 2020 to September 2021, and were followed through November 2021.

The researchers found that the Pfizer-BioNTech, Moderna and Johnson & Johnson vaccines had no effect on male or female fertility.

However, men infected with COVID-19 may have a temporary decline in their fertility, the investigators found.

The report was published Jan. 20 in the American Journal of Epidemiology.

The findings support previous research linking COVID-19 infection in men with poor sperm quality and other reproductive dysfunction. The researchers said the findings should ease concerns about COVID-19 vaccines and fertility prompted by anecdotal reports of women having menstrual cycle changes after getting their shots.

"These data provide reassuring evidence that COVID vaccination in either partner does not affect fertility among couples trying to conceive," said study senior author Lauren Wise, a professor of epidemiology at Boston University.

"The prospective study design, large sample size, and geographically heterogeneous study population are study strengths, as was our control for many variables such as age, socioeconomic status, preexisting health conditions, occupation and stress levels," she explained.

More information

The U.S. Centers for Disease Control and Prevention has a list of myths and facts about COVID-19 vaccines.

SOURCE: Boston University School of Public Health, news release, Jan. 20, 2022

Exposing Kids to Safe Levels of Peanut When Young Might Prevent Allergy

FRIDAY, Jan. 21, 2022 (HealthDay News) -- Some kids might be able to get over their peanut allergy if they start immunotherapy while they're still toddlers, a major new clinical trial reports.

In the trial, a group of 1- to 3-year-olds with severe peanut allergies were safely fed gradually increasing daily doses of a peanut protein flour to help accustom their immune systems to the allergen.

About one in five wound up able to eat a handful of peanuts without an allergic reaction, even after they'd been off their therapy for six months, researchers reported Jan. 22 in The Lancet.

"We believe that this shows that if we can identify children with peanut allergy and intervene early with an oral treatment protocol, there is a chance we could really change their trajectory for severe allergic reaction and even potentially get kids into remission where they, down the road, would not be peanut allergic," said lead researcher Dr. Stacie Jones. She is a professor of pediatrics in allergy and immunology at the University of Arkansas for Medical Sciences and Arkansas Children's Hospital, in Little Rock.

The earlier the child started the therapy, the better their chance of losing their allergy, the researchers found. About 71% of the 1-year-olds went into remission, compared with 35% of the 2-year-olds and 19% of the 3-year-olds.

Currently, the only immunotherapy approved by the U.S. Food and Drug Administration (FDA) for peanut allergies — a peanut-derived powder called Palforzia — is approved for treatment of kids 4 to 17, Jones said.

Jones and her colleagues suspected that children much younger than that might benefit from immunotherapy. At that stage, "the immune system is very dynamic, has a lot of plasticity," Jones said.

For the study, the researchers recruited nearly 150 young children at five academic medical centers across the United States, and assigned two-thirds to undergo peanut immunotherapy while the rest received an inactive placebo.

The toddlers were all highly allergic to peanuts, and often also had other food allergies or immune conditions like asthma or eczema, Jones noted.

"At their initial food challenge to get into the study, they reacted to the equivalent of 25 milligrams of peanut, which is about a tenth of a peanut," Jones said.

Even at that age, symptoms of peanut allergy are usually quite dramatic, according to the American College of Allergy, Asthma, and Immunology (ACAAI).

The most severe reaction is anaphylaxis, a whole-body immune response that can include impaired breathing, swelling in the throat, a sudden drop in blood pressure, pale skin, blue lips, fainting or dizziness, the ACAAI says.

Less intense reactions still could include hives, difficulty breathing or vomiting, sometimes within seconds to minutes of eating peanut, Jones said.

During an initial 30-week period, the kids in the treatment group were fed ever-growing doses of peanut flour mixed into foods like applesauce or pudding, until they reached a maximum target dose of 2 grams (equivalent to about six peanuts). They then continued to eat a daily dose of peanut flour for the next two years.

At the end of the two years, the children underwent a food challenge to test the status of their peanut allergy.

"We found that of the children that started the study, 71% reached the desensitization endpoint," Jones said. "They went from being able to consume only about a tenth of a peanut as a group, up to 5 grams, or 16 peanuts."

The clinical trial stopped the kids' treatment at that point and asked them to avoid peanut for six months. They were then brought back for a second food challenge to see how long the effects of their therapy had lasted.

About 21% of the children still could eat 5 grams of peanut during the second challenge without having an allergic reaction, compared with only 2% of kids in the placebo group, according to the study.

"Even the ones that didn't tolerate the 5 grams, 40% of them were able to tolerate almost half that or a little less," Jones said. "It implies if we understood this better we really might be able to help kids outgrow their allergy and introduce that food into their diet."

Although nearly all the children who received peanut flour had at least one dose-related allergic reaction during treatment, most were mild to moderate, the study authors said. Twenty-one kids received the rescue drug epinephrine for 35 moderate reactions to peanut flour during the treatment period.

Starting immunotherapy at such a young age "can shorten the gap of how long someone must live with peanut avoidance as their main management style," said pediatric allergist Dr. Matthew Greenhawt, who wrote an editorial that accompanied results of the clinical trial.

"This would make most kids immediately eligible to start therapy very close to the time of diagnosis, which is important now with a push to introduce peanut in the first year of life leading to earlier diagnosis in some children," said Greenhawt, director of the Children's Hospital Colorado Food Challenge and Research Unit in Aurora, Colo. "As well, this can help increase the number of peanut allergic children who could be treated before starting school."

However, Jones warned that at this point "we don't think this is ready for prime time. We think more study needs to occur with better age-stratified groups of children treated to really understand the impact of this."

More information

The American College of Allergy, Asthma, and Immunology has more about peanut allergy.

SOURCES: Stacie Jones, MD, professor of pediatrics and chief, allergy and immunology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock; Matthew Greenhawt, MD, director, Children's Hospital Colorado, Food Challenge and Research Unit, Aurora, Colo.; The Lancet, Jan. 22, 2022

AHA News: Worried About Her Health, She Lost 163 Pounds – And Inspired Her Husband to Drop 55

FRIDAY, Jan. 21, 2022 (American Heart Association News) -- A few weeks before Thanksgiving, Ken and Morgan House of Newington, Connecticut, spent a week at one of her favorite places – Disney World. They walked to all the theme parks, went on countless rides and shared healthy meals.

Every day, Morgan would smile broadly at Ken and shoot him an expression that said, "Do you even believe this?"

The last time the Houses were there, Morgan weighed 357 pounds. Ken weighed 280.

While they enjoyed the trip, Morgan couldn't walk for more than 10 minutes without needing to take a break, her knees hurt and she didn't fit on some of the rides, including Avatar Flight of Passage, one of her favorites.

That was in January 2020.

In November 2021, Morgan weighed 194 pounds. Ken weighed 225.

"I wasn't struggling to get in and out of rides," Morgan said. "I wasn't struggling to walk. In fact, I was doing 15,000 to 20,000 steps a day without batting an eye."

One day, she cried with gratitude exiting Flight of Passage.

The tears of joy were as much about conquering her lifelong struggle as they were about enjoying that ride.

"Being overweight prevented me from being my best self, my confident self," she said. "You internalize how society views you as a fat person."

In high school, she began what would become years of trying various diets and workout plans. Her weight yo-yoed, always ending higher.

In her 20s, she started getting migraines and was diagnosed with fibromyalgia, a condition marked by pain. Later, she developed sleep apnea and prediabetes.

Doctors recommended bariatric surgery. Morgan saw that as a last resort. She wanted to continue trying to lose the weight on her own.

In her 30s, her struggles continued. Between pain from the fibromyalgia and a lack of activity, "I kind of spiraled," she said.

"Once my weight got to a certain point, I had depression, anxiety and felt out of control," she continued. "My life was feeling unmanageable."

Morgan was in her early 20s when she met Ken. They married five years later.

"She was always beautiful to me, and I've always loved her," Ken said. "But I saw the weight as impacting her quality of life and self-esteem."

A few years ago, a doctor encouraged Morgan to learn more about gastric bypass surgery. It's not enough to want the operation; patients must meet certain guidelines to qualify. These include a willingness to make permanent lifestyle changes.

"I thought, 'This is a tool that can physically help me,'" Morgan said. "It was very scary, and I had a lot of emotions, but it also felt promising."

Ken, meanwhile, was having his own middle-age wakeup call. He'd long been on medication for high blood pressure.

"I always knew I was too heavy, but it just didn't bother me," he said. "Then my physician told me I was a ticking time bomb for stroke and heart attack because of my blood pressure, heart rate and metabolic panel."

He was also developing sleep apnea. He'd wake up in the middle of the night feeling like he was drowning. He feared leaving behind Morgan and his daughter from a previous relationship.

"I want to be there for both of them," he said.

Ken vowed to walk 10,000 steps a day. He aimed to limit his daily diet to 2,000 calories.

As he began slimming down, Morgan received the OK for the bariatric surgery. She underwent the procedure in September 2020, then began adjusting to her new life.

"I might think, 'Oh, I can't fit between that chair and the wall' – when, in fact, now I can," she said. "It's a weird feeling."

Another weird feeling: Adjusting to people treating her differently just because there's less of her. It makes her angry.

"At 357 pounds, I felt invisible," she said. "Then when you're the same person but 163 pounds lighter, you're suddenly visible."

The weight loss has made them healthier.

Ken said his sleep apnea is gone and he's in the best shape of his life. Morgan is especially excited about walking long distances without knee pain.

She's looking forward to their Disney-themed vacation for her 40th birthday on Jan. 28.

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email editor@heart.org.

By Diane Daniel

COVID Rapid Test Makers Struggling to Meet Demand

FRIDAY, Jan. 21, 2022 (HealthDay News) -- Shortages of both supplies and workers are wreaking havoc on the efforts of COVID at-home test makers to deliver enough of the tests to Americans, even as the federal government pledges to provide 500 million free, at-home kits.

Like many other businesses, test kit manufacturers "have too many of their staff out with COVID. Thus, even if they have the physical capacity for production, they don’t have the staff," Mara Aspinall, from Arizona State University, and colleagues wrote in a newsletter, NBC News reported.

She estimated that the current total monthly capacity of U.S. rapid at-home test kit manufacturing is 260 million units per month, which is expected to rise to 355 million by February and 526 million by March.

The government's order for the free test kits is in addition to existing supply and doesn't interfere with existing orders, said a senior White House official, who added that four new rapid tests with high-volume production capacity have been authorized since September, NBC News reported.

On Jan. 13, the Department of Defense announced the awarding of contracts to three companies, Abbott, Roche Diagnostics and iHealth labs, for 380 million test kits, in an “effort that supports the president’s plan to deliver 500 million free at-home COVID-19 tests."

Abbott has plans to “build two new U.S. manufacturing facilities, hired thousands of people for new jobs that pay American wages, and we continue to invest in automation to allow us to scale further,” Kim Modory, Abbott’s senior director of public affairs for diagnostics, told NBC News.

Abbott is currently producing 70 million tests a month. It is building up the ability to manufacture an additional 30 million to be added to support government, school and more retail efforts, Modory added.

Meanwhile, Roche spokeswoman Michelle Johnson said the company will start deliveries in January and by March provide “tens of millions” of test kits. The company has invested $500 million globally to boost instrument and test machine capacity. Still, “like other companies, we’ve experienced our share of supply challenges,” she said.

One of those other companies includes San Diego-based Quidel, which currently produces more than 40 million tests a month and plans to increase that to 70 million by February. Unfortunately, 10% of its workforce is currently quarantined.

“With Omicron, it’s gone crazy. The demand far exceeds what we’re doing,” Quidel CEO Douglas Bryant told NBC News. “The biggest challenge is actually enough people to do the work."

Bryant said the company has found it difficult to reach its target of hiring 400 workers for a new production facility and finding enough trucks to make deliveries, NBC News reported.

Supplies are also an issue: Demand for high-quality nitrocellulose membrane, the off-white fabric that forms the COVID test strip, has soared during the pandemic.

Some manufacturers cited difficulties sourcing sufficient nitrocellulose supplies a an obstacle to production earlier this year, a senior administration official told NBC News.

"We acted to alleviate" the bottleneck, the official said.

In a statement, Rachel Bloom-Baglin, a spokesperson for MilliporeSigma, a supplier of nitrocellulose to major U.S. rapid test kit makers, told NBC News that “raw material availability to make nitrocellulose membrane is readily available, but the world does not have enough membrane manufacturing capacity to turn the raw materials into finished goods, which are then used by our customers to manufacture rapid antigen tests."

The company makes the product at a facility in Cork, Ireland. Although the company completed an expansion of the plant that doubled its capacity, even that did not meet the soaring demand.

On Dec. 29, the Department of Defense awarded a $136.7 million contract to MilliporeSigma for the construction of a new facility in Sheboygan, Wisconsin, over a three-year timespan, NBC News reported.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on COVID tests.


Many Marijuana Vendors Aim Advertising at Kids: Study

FRIDAY, Jan. 21, 2022 (HealthDay News) -- Some recreational pot shops are using tricks from the old playbooks of alcohol and tobacco companies to target underage users on social media, a new study reports.

Despite state laws restricting such marketing, researchers found marijuana retailers on social media promoting their wares with posts that:

  • Featured cartoon characters like Snoopy, SpongeBob SquarePants, and Rick and Morty.
  • Presented store-branded merchandise like caps and T-shirts.
  • Offered discounts and deals, like a Memorial Day sale or a regular Friday special.

"Those types of restricted content basically come from evidence around ways that tobacco and alcohol companies used to appeal to youth," said lead author Dr. Megan Moreno, division chief of general pediatrics and adolescent medicine at the University of Wisconsin-Madison.

"For example, discounts and promotions are actually ways to draw in youths to use your products because they're very price-sensitive, and branded content is a way to draw in young people because they want the hats and the T-shirts," she said.

For this study, Moreno and her colleagues decided to examine how pot shops were using social media to market their goods, looking specifically at four of the "early adopter" legalization states: Washington, Oregon, Colorado and Alaska.

"The one remaining Wild West of marketing is still social media, and one of the issues with social media is that these platforms are most highly frequented by youth," Moreno said. "Essentially, we were wondering what's happening in a lightly regulated environment that's populated by youth, and how are cannabis companies leveraging that."

For the study, the researchers evaluated one year of publicly displayed posts on Facebook and Instagram from companies located in the four states.

One piece of good news — of 80 recreational weed retailers identified by the researchers, only 16 had a presence on both social media sites, and two of those companies deleted their pages during the study period. Researchers wound up with 2,660 posts from 14 businesses.

About 35% of the posts featured discounts or promotions, even though such marketing is restricted, the study reported. About 7% of posts used pop culture references; 6% featured store-branded products; and 6% appealed to youth through the use of cartoon characters.

About 12% of the social media posts also promoted the idea that you should use marijuana products until you're very impaired.

"In alcohol advertising, you don't often see ads that say things like, 'Hey, use our products so you can get drunker. Use our product so you can achieve a better buzz,'" Moreno said. "That's absolutely not allowable in alcohol literature, but we see a lot of that content in the cannabis literature, saying things like 'Use our product to get higher, use our product to reach that higher place we know you want to go' — really pushing people toward the idea that you should use until you feel impaired."

Linda Richter, vice president of prevention research and analysis with the Partnership to End Addiction, noted that this is all happening in states with "some of the most robust youth protection provisions in their recreational, or adult use, marijuana laws."

Because of that, she said, "the findings are likely quite conservative regarding the extent to which cannabis businesses stray from state marketing restrictions and requirements, such that the actual state of affairs is probably worse and more damaging to teens than reflected in this study."

Richter added that "there's little doubt, based on years of research on tobacco and alcohol advertising and more recent research on marijuana, that advertising and marketing that has youth appeal or that exposes young people to the positive aspects of marijuana have a significant impact on teens' attitudes and behaviors around marijuana use."

Such tactics have been strongly associated in research studies with "reduced perceptions of the risks of marijuana, more acceptance of marijuana use as normal, and more intentions to use marijuana among young people," Richter said.

The social media posts also did a poor job including messages required by law in marijuana marketing, the researchers found. For example, only one-quarter of posts said pot can only be used by those 21 or older, and a similar percentage urged readers to avoid driving impaired.

One problem is that regulations surrounding marijuana marketing vary from state to state, Moreno said. Of the four states, only Alaska and Washington prohibit sales and promotions, for example, while only Washington prohibits store-branded merchandise.

Until recreational pot is legalized at the federal level, it's unlikely that you'll see uniform laws or regulations governing the marketing of these products, said Paul Armentano, deputy director of NORML, an advocacy group promoting reform of marijuana laws.

"Any potential standardization of rules and regulations governing the marketing of cannabis products is likely impossible in a legal environment where cannabis remains federally illegal, thus leaving the creation and imposition of such standards up to the individual states and localities for the foreseeable future," Armentano said.

Moreno said states should consider banning marijuana marketing from social media, considering that youth comprise about 70% of the audience for a site like Instagram.

If not that, she said states ought to require that social media platforms restrict pot marketing to people of legal age.

"The alcohol industry has actually done a fantastic job with this," Moreno said. "If you are on Instagram and you are under 21, you can't even find or access any alcohol content that is put out by alcohol companies. That's called age gating, meaning the content doesn't even appear unless you're of age."

States also could step up enforcement of their existing rules around pot marketing, with stiff fines to discourage violators, she said.

"Many companies and many policymakers are still trying to navigate how to treat social media. I think there's a view that it's not real or not real life or it doesn't really count or that it's ephemeral," Moreno said.

"I think now is a good time for us to think about how pervasive and influential that content is, as we think about the different ways it's touched our life in COVID and politics and all sorts of different ways," she added. "I think it's time to realize that what happens on social media is real life. It's taken us a while as a society to figure out that we can regulate it as real life."

Such regulations are part of the strength of an above-board and legal pot marketplace, Armentano said, adding that NORML supports restrictions that bar ads in public spaces or marketing that targets young people.

"In licit marketplaces, licensed players are motivated to abide by regulations — such as limitations on the manner with which products may be advertised and marketed — whereas in illicit unregulated markets, participants are not compelled to play by any rules," he said. "Unlicensed, illicit players have no qualms marketing their products to young people, possess no incentive to check ID for proof of age, and possess few if any motivations to change their behaviors."

The new study was published online Jan. 19 in the Journal of Studies on Alcohol and Drugs.

More information

The Truth Initiative has more about legalized marijuana and youth.

SOURCES: Megan Moreno, MD, MPH, division chief, general pediatrics/adolescent medicine, and vice chair, digital health, University of Wisconsin-Madison; Linda Richter, PhD, vice president, prevention research and analyst, Partnership to End Addiction, New York City; Paul Armentano, deputy director, NORML, Washington, D.C.; Journal of Studies on Alcohol and Drugs, Jan. 19, 2022, online

COVID Boosters Keep Older Americans Out of Hospitals: CDC

FRIDAY, Jan. 21, 2022 (HealthDay News) -- The risk of hospitalization for COVID-19 among older Americans is far higher for those who are unvaccinated than for those who are fully vaccinated and have had a booster shot, new government data shows.

The differences were stark: In December, unvaccinated people 50 and older were 17 times more likely to be hospitalized with COVID-19 than those who had completed the initial immunization series, but hadn't yet received a booster, according to statistics published Thursday on the U.S. Centers for Disease Control and Prevention's website.

Among those ages 50-64, unvaccinated people were 44 more times to be hospitalized with COVID-19 than those who were fully vaccinated and had a booster shot, the data showed.

The risk difference was even greater among seniors: Among Americans over 65, the chances of hospitalization for COVID-19 was 49 times higher for those who were unvaccinated than for those with full vaccination and a booster.

The findings suggest that booster shots provide older Americans with a significant added level of protection, according to The New York Times.

This is the first real-world data on the impact of COVID vaccine boosters in the United States, and adds to research from other countries showing that boosters reduce the risk of severe illness and hospitalization, especially among older adults, the Times reported.

When weighing booster shots for all American adults, scientific advisers to the U.S. Food and Drug Administration and the CDC repeatedly bemoaned the lack of booster shot data specific to the United States, the Times said. At that time, they only had data from Israel to analyze.

But there are differences between the two countries -- most notably in the way Israel defines severe illness — that made it hard to assess the relevance of Israeli data for Americans, the advisors said at the time.

The CDC now recommends booster shots for everyone ages 12 and older, to be given five months after getting two doses of the vaccines made by Pfizer and Moderna, or two months after a single dose of the Johnson & Johnson vaccine.

On Friday, the agency is expected to release more recent data on the effectiveness of vaccines and boosters against the Omicron variant, the Times reported.

More information

Visit John Hopkins for more on COVID booster shots.

SOURCE: U.S. Centers for Disease Control and Prevention website, Jan. 20, 2022; The New York Times

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