Monthly Archives: May 2016

Lupus a Tough Disease to Spot, Treat

MONDAY, May 30, 2016 (HealthDay News) -- Lupus is difficult to diagnose and treat, but scientists are working to learn more about its genetic causes and to develop better treatments.

The autoimmune disease affects between 300,000 and 1.5 million people in the United States, and as many as 24,000 are diagnosed with lupus each year, according to the U.S. Food and Drug Administration.

"With treatment, the disease may quiet down, but it also may relapse eventually. Although it may be controlled with medications, once you get it, you will always have it," Dr. Sarah Yim, a rheumatologist at the FDA, said in an agency news release.

"Technologies have been developed in recent years that can make our medicines more targeted, to address the specific molecule or molecules in the immune system that may be causing the problem," Yim added.

The disease often begins between the ages of 15 and 44, and 10 times more women than men have lupus, according to the American College of Rheumatology.

The underlying cause of the disease is not fully understood. And, it can damage many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain, Yim said.

Treatments include aspirin, corticosteroids, the anti-malarial drug Plaquenil (hydroxychloroquine) and a drug called Benlysta, the first targeted therapy for lupus, she said.

"Older medicines tend to suppress the whole immune system, which works, but it's a little bit like shooting a fly with a cannonball, and can be associated with many undesirable side effects," Yim explained.

While scientific advances over the last several decades have led to people with lupus living longer, more treatment options are needed, according to the FDA.

May is National Lupus Awareness Month.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on lupus.

'Fat Shaming' Begins in First Grade

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, May 25, 2016 (HealthDay News) -- As early as first grade, severely obese children are getting teased, picked on and bullied more than normal-weight kids, a new study finds.

The new research also found that these severely obese youngsters are more likely to be depressed and withdrawn. Obese children may turn to eating to cope with the pain of rejection or skip school to avoid being bullied, the researchers said.

"The social climate at school can exacerbate weight and learning problems because it is so unpleasant," said lead researcher Amanda Harrist, a professor of child development at Oklahoma State University in Stillwater.

For many obese kids, home may not be much better, she said. Other studies have shown that obese children often have families that don't handle their emotions well and make fun of their kids' feelings, Harrist said.

"At school, these kids are teased and picked on, and nobody is playing with them, and they go home and don't get emotional support," she said.

Teachers need to be sensitive to the fact that these kids are being mistreated, Harrist said. But teachers can be biased against obese children, too -- even overweight teachers are sometimes biased, she added.

School programs that focus on accepting people who are different may be one way of overcoming weight bias and improving the school environment for obese kids, Harrist said.

"If teachers are aware of the social and emotional life of overweight children, they can make the school environment a place where these children feel OK about themselves, and give them more chance of succeeding," she suggested.

According to Dr. Scott Kahan, director of the National Center for Weight and Wellness, "Addressing obesity isn't only about healthy foods and physical activity -- we need to deal with these consequences of obesity." Kahan is also a spokesman for the Obesity Society.

From adults to adolescents to young children, there is an incredible amount of stigma, mistreatment and ostracizing of obese people, said Kahan, who was not involved with the new study.

"Weight stigma leads to poor health outcomes -- from physical outcomes, like raising blood pressure and stress -- to emotional health outcomes, like depression, poor quality of life and, ultimately, more weight gain," Kahan said.

For the study, Harrist and colleagues gathered data on nearly 1,200 first graders from 29 rural schools in Oklahoma. Rates of obesity among adults in the counties where the children lived ranged from 28 percent to 41 percent. Most of the students came from low-income white families, but about 20 percent of the kids came from American Indian families.

Obese children are those who weigh more than 95 percent of children their same age, the researchers said. Severely obese children are heavier than 99 percent of kids their age, they added.

The investigators found that the heaviest children suffered most. Severely obese kids were teased more than overweight kids and weren't mentioned by other children as those they wanted to play with, the study authors said.

Severely obese children were often identified as least favorite playmates and were rarely mentioned as a most favorite playmate, the findings showed.

Consequently, severely obese children had more teacher-rated symptoms of depression than overweight and healthy weight children, the study authors said.

Compared with other children, obese and severely obese children were more likely to complain of physical problems, such as pain, and also went to the school nurse more often. These physical problems may be the result of psychological stress, Harrist said.

The report was published online May 25 in the journal Child Development.

"Obesity persists as one of the last bastions of socially acceptable prejudice, in large measure because many people feel the victims of this condition deserve to be blamed for it," said Dr. David Katz. He is director of the Yale University Prevention Research Center and president of the American College of Lifestyle Medicine.

"This quite sad study shows that even young children are subject to obesity bias, which quite literally adds insult to injury," he said.

Fixing obesity bias can start with any of us, beginning with compassionate understanding, Katz said.

"When we stop blaming the victims of the obesity epidemic, our children will learn to do likewise," he said. "We will still have miles to go to undo the injury of obesity, but we can stop adding the insult any time we decide."

More information

For more on childhood obesity, visit the U.S. Centers for Disease Control and Prevention.

Stool Transplant Soothes Tough-to-Treat Colitis in Study

By Maureen Salamon
HealthDay Reporter

MONDAY, May 23, 2016 (HealthDay News) -- Stool transplants helped ease debilitating symptoms and heal the colons of tough-to-treat ulcerative colitis patients, new research shows.

Australian scientists said the findings could pave the way for such transplants to be used on a more widespread basis. Transferring fecal matter from healthy donors into these patients alters the composition of their gut bacteria, circumventing one of the drivers of ulcerative colitis, experts said.

"We were not completely surprised by the study findings, as . . . smaller studies along with unpublished experience suggested repeated fecal microbiota transplantation may be an effective treatment for ulcerative colitis," said study author Dr. Sudarshan Paramsothy, a gastroenterologist at University of New South Wales. "This study shows that [stool transplant] is a very promising therapeutic option for ulcerative colitis patients."

Up to 700,000 Americans suffer from ulcerative colitis, a chronic disease believed to stem from an abnormal immune system response, according to the Crohn's and Colitis Foundation of America. The condition causes the lining of the colon to become inflamed and develop tiny, open ulcers. Symptoms include bloody stools, abdominal pain and persistent diarrhea.

Currently, stool transplants -- which experts acknowledge come with a "yuck" factor -- are standard treatment only for virulent Clostridium difficile gastrointestinal infections. These infections can be life-threatening.

Across three Australian study sites, Paramsothy and his team analyzed 81 ulcerative colitis patients whose disease had proved resistant to standard treatments such as steroids or anti-inflammatory medications.

Participants were randomized into two groups, with 41 receiving repeated fecal transplants over eight weeks and the rest receiving a placebo.

The fecal matter used for transplantation had been derived from at least three donors per participant, to minimize the chances that a single donor's gut bacteria could skew results.

Donor stool was homogenized and filtered, then frozen for storage prior to infusion as a liquid "slurry" enema directly into the rectum, Paramsothy said. Multiple donations were needed to supply the 40 infusions required for each participant receiving stool transplants, who administered their own infusions after the first treatment.

"There is a risk of infection transmission whenever a biological product is [used]," he said, "but this can be minimized by comprehensive screening of history [and] stool and blood testing for known pathogens."

After eight weeks, 27 percent of stool transplant recipients achieved the study's primary goal, which was patients reporting no ulcerative colitis symptoms and doctors determining through endoscopic examination that the lining of the colon had healed or significantly improved. Only three of the 40 patients, or 8 percent, in the placebo group had achieved this goal.

When researchers counted only those patients who reported being symptom-free, without colon observation, they found that 44 percent of stool transplant patients reached this milestone, compared to 20 percent in the placebo group.

The study is to be presented Monday at Digestive Disease Week, in San Diego. Research presented at scientific conferences typically hasn't been published or peer-reviewed, and results are considered preliminary.

Still, a U.S. expert said he found the results remarkable.

"I was most impressed . . . and I think we need to pay attention to this study," said Dr. R. Balfour Sartor, director of the Broad Research Medical Program for the Crohn's and Colitis Foundation of America. "There's a 'yuck' factor with stool transplants, although it's quite trendy these days. The clinicians, the patients and the government agencies have to be convinced it's safe and effective, and this study is probably the best example it can be for ulcerative colitis."

But more research is still needed to determine the treatment's long-term effects in ulcerative colitis patients, Paramsothy and Sartor agreed.

"What's not shown here is the staying power -- how long do these patients remain in remission after the eight weeks of therapy is over?" Sartor asked. "One of the defects of the current study is we don't know what happened after the fecal transplants stopped."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases offers more about ulcerative colitis.

Blood Pressure Swings Linked to Faster Decline in Mental Skills

By Steven Reinberg
HealthDay Reporter

MONDAY, May 23, 2016 (HealthDay News) -- Fluctuations in blood pressure may be linked to faster declines in thinking skills among seniors, a new study suggests.

Among older patients, those whose systolic blood pressure -- the top number in a blood pressure reading -- varied between doctor's visits showed more rapid mental deterioration and loss of verbal memory than those whose blood pressure stayed within normal ranges, researchers found.

Variability in the bottom number -- diastolic blood pressure -- was also associated with faster decline of mental ability among those aged 55 to 64, but not among people aged 65 and older, the study authors added.

"The relevance of blood pressure variability between doctor's visits has been dismissed until recently," said study author Bo Qin, a postdoctoral associate at Rutgers Cancer Institute, in New Brunswick, N.J.

"However, over the past six years, evidence has accumulated that blood pressure variability over monthly or yearly visits may lead to greater risk of stroke and some additional health problems," she said.

This study suggests that it may not be a random phenomenon or an unimportant measurement related to use of blood pressure medications, "but may instead provide information relevant for prognosis," Qin said.

According to Qin, this study cannot prove that fluctuations in blood pressure cause declines in mental ability, but it adds to mounting evidence that these changes in blood pressure may have health consequences.

"Higher long-term variability in blood pressure readings predicted faster declines of mental function among older adults," Qin said. "Controlling blood pressure instability may be a potential strategy in preserving mental function among older adults," she suggested.

The report was published online May 23 in the journal Hypertension.

For the study, Qin and colleagues collected data on nearly 1,000 adults aged 55 and older who took part in the China Health and Nutrition Survey over five years.

Blood pressure was calculated from three or four visits to health professionals. Participants also completed a series of mental quizzes, such as word recall and counting backwards.

"Although the study was done in China, the same results apply in the U.S.," said Dr. Gisele Wolf-Klein, director of geriatric education at Northwell Health in Great Neck, N.Y.

"The correlation of fluctuation in blood pressure and dementia is known to be linked to circulatory problems -- specifically to high blood pressure," she said.

But high blood pressure and low blood pressure may both be damaging to the brain, she added. The goal is to try to achieve a stable blood pressure rather than have huge variations. "You want good, solid, stable, average numbers," Wolf-Klein said.

Keeping blood pressure within normal ranges may help "prevent dementia and may even benefit patients who are losing their mental abilities," she said.

More information

Visit the American Heart Association for more on high blood pressure.

Sex, Breast Milk May Have Helped Spread Ebola in Africa

THURSDAY, May 19, 2016 (HealthDay News) -- The Ebola virus was transmitted by semen and breast milk during the latter stages of the outbreak in Sierra Leone, a new study shows.

Researchers from the United Kingdom identified several instances of unconventional transmission of the deadly disease, including a mother who may have passed it to her baby through breast-feeding. In another instance, an Ebola survivor sexually transmitted the virus a month after being released from quarantine.

"Close contact with an infected individual is still by far the most common way for Ebola to spread, but this study supports previous research suggesting that the virus can persist in bodily fluids for a long time after recovery," said Jeremy Farrar, director of Britain's Wellcome Trust, which funded the study.

"These unusual modes of transmission may have contributed to isolated flare-ups of infections towards the end of the epidemic," said Farrar in a news release from the organization.

The recent West African outbreak of Ebola, the largest in history, killed more than 11,000 people and infected more than 28,000, according to the U.S. Centers for Disease Control and Prevention. Cases were concentrated in Guinea, Liberia and Sierra Leone.

The study does not suggest that unconventional transmission of Ebola was more common than previously believed.

However, the study authors said their findings suggest that rapid sequencing of viral genomes (determining a virus' genetic code) during an epidemic could enable public health officials to quickly trace new cases back to their source. This could prove important in bringing future outbreaks under control, the researchers said.

The study "shows how important it is to carry out genome sequencing within the affected countries, and for the data to be shared in a rapid and open way as part of the epidemic response," Farrar said. "Strengthening laboratory and surveillance facilities where they are currently lacking will also aid early detection, making the world better prepared for infectious disease outbreaks."

The study was published May 18 in the journal Virus Evolution.

More information

The U.S. Centers for Disease Control and Prevention has more on Ebola.

Giving the 'Green Light' to Migraine Relief

TUESDAY, May 17, 2016 (HealthDay News) -- A new study sheds light -- literally -- on a potential means of easing migraine pain.

Researchers in Boston exposed 69 migraine patients to different colors of light. They found that while blue light exacerbated headache pain, a narrow spectrum of low-intensity green light significantly reduced light sensitivity.

In some cases, this green light also reduced migraine pain by about 20 percent, the researchers found.

They noted that migraine headache affects nearly 15 percent of people worldwide, and a frequent symptom of migraine is light sensitivity, also known as photophobia.

"Although photophobia is not usually as incapacitating as headache pain itself, the inability to endure light can be disabling," study author Rami Burstein, of Beth Israel Deaconess Medical Center in Boston, said in a medical center news release.

"More than 80 percent of migraine attacks are associated with and exacerbated by light sensitivity, leading many migraine sufferers to seek the comfort of darkness and isolate themselves from work, family and everyday activities," he added. Burstein directs the medical center's Comprehensive Headache Center.

Two experts said the treatment may have merit.

"Certainly Dr. Burstein's work suggests that more research should be done, as this is a potentially beneficial new avenue for treatment," said Dr. Noah Rosen, who directs Northwell Health's Headache Center in Great Neck, N.Y.

He pointed out that "light therapy has been used successfully in other conditions such as certain dermatologic issues and seasonal affective disorder [SAD]."

Dr. Gayatri Devi is a neurologist at Lenox Hill Hospital in New York City.

He said the success in some patients with light therapy "implicates the thalamus -- a brain 'relay station' between the sensory organs, including the eyes and the cortex of the brain -- as the area where migraine-related photophobia is amplified."

For his part, Burstein said he's now trying to develop an affordable light bulb that emits narrow-band green light at low intensity, as well as sunglasses that block all but the narrow band of green light.

Rosen stressed, however, that more study may still be needed.

"In general, it seems a safe treatment but one that is limited by cost, access and whether its use on a regular basis would decrease disability," he said.

The findings were published May 17 in the journal Brain.

More information

The American Academy of Family Physicians has more about migraines.

COPD Discovery Might Improve Treatment

SUNDAY, May 15 2016 (HealthDay News) -- Researchers say they've found a new way to predict how chronic obstructive pulmonary disease will progress, a discovery they believe could improve COPD treatment.

Their research might help doctors determine which patients are less likely to respond to standard treatment and are at higher risk for disease advancement, the study authors explained.

COPD -- chronic obstructive pulmonary disease -- is a chronic lung disease that makes it tough to breathe. It includes chronic bronchitis and emphysema, according to the American Lung Association.

The new discovery concerns something called neutrophilic airway inflammation, which is associated with COPD. Neutrophils are white blood cells that are important for fighting infection.

Scientists said that a type of neutrophil behavior called neutrophil extracellular trap (NET) formation in the lungs of COPD patients appears to reduce their ability to destroy bacteria.

"We have known for many years that neutrophils should be able to fight infection, but we haven't fully understood why they don't work in COPD," said study author Dr. James Chalmers, from the University of Dundee in Scotland.

"Some recent studies described the presence of NETs in the COPD lung, so we wanted to know whether there was any relationship between NETs and outcomes in COPD patients," he said in a news release from the American Thoracic Society.

For the study, the researchers collected blood and sputum samples from 141 patients at the end of acute COPD flare-ups.

The researchers found the amount of NET formations in participants' lungs was directly related to the severity of their lung disease and their risk for COPD flare-ups that didn't respond to treatment with corticosteroids.

NETs result in more infections as well as worse lung function and quality of life, the study authors concluded.

"This marker may help us identify patients at higher risk of disease progression," said Chalmers. "And it identifies a subset of patients who may need treatments other than corticosteroids. Our data show that inhaled steroids may even exacerbate NETs, so we need to identify new COPD treatments and discover whether inhibiting NET formation will result in improved clinical outcomes for patients with COPD."

The researchers plan to continue their investigation, examining why NET formation occurs and whether it can be prevented or treated.

"While our new research is at an early stage, we hope that detecting NETs may be a biomarker that can identify patients at risk of deterioration, and that we can work toward testing whether inhibiting NET formation would be a beneficial treatment in COPD," Chalmers said.

The findings were to be presented Sunday at the American Thoracic Society's annual meeting, in San Francisco. Research presented at meetings usually is regarded as preliminary until published in a peer-reviewed medical journal.

More information

The American Lung Association provides more information on COPD.

Out-of-Pocket X-Ray, CT Scan Costs Vary Widely

By Alan Mozes
HealthDay Reporter

SUNDAY, May 15, 2016 (HealthDay News) -- The out-of-pocket price for a standard chest X-ray, CT scan or ultrasound can vary by hundreds of dollars, depending on where the imaging is done, new research reveals.

And uninsured patients trying to get the cost in advance may face an uphill battle, investigators caution, with hospitals slower to respond than stand-alone imaging centers.

How slow? Calls made to six hospitals and five private imaging centers in the Philadelphia region got answers from half of the hospitals within five to 10 minutes, researchers said. But one-third of the hospitals took between 10 and 15 minutes, while the rest took even longer.

While none of the independent imaging centers took longer than 10 minutes to provide radiology cost information (and calls were never transferred), nearly 10 percent of the hospitals ignored two patient inquiries made over the course of three days, the findings showed.

"The lack of price transparency is certainly not isolated to the field of radiology alone," said study co-author Dr. Mindy Licurse, a diagnostic radiology resident with the University of Pennsylvania Health System. For example, a 2014 analysis by the Health Care Incentives Improvement Institute in Connecticut and Catalyst for Payment Reform in California revealed that most states lack laws making health cost information available to consumers.

"Our study certainly contributes to the underlying hypothesis that pricing information within health care, specifically imaging in this case, may be difficult to obtain depending on the setting, and therefore comparison-shopping by patients is limited," she added.

Licurse and study co-author Dr. William Boonn were scheduled to present their findings Sunday in Washington, D.C., at a meeting of the American College of Radiology (ACR). Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

The researchers focused on three commonly ordered exams: so-called two-view chest X-rays; CT scans of the abdomen/pelvis with contrast; and pelvic ultrasounds.

Across hospitals and imaging centers in three states, X-ray costs varied from a low of $41 to a high of $285. CT scan costs ranged from $437 to $2,239, while ultrasounds went from $150 to $592, the study revealed.

Hospital pricing, when provided, was consistently higher for all procedures, the study found. For example, the average hospital price for an X-ray was $140, compared with $76 at an imaging center. Similarly, average CT scan and ultrasound prices were $1,146 and $442, respectively, at hospitals, compared with $586 and $263, respectively, at independent facilities.

Licurse said the solution to the pricing transparency problem "is unlikely [to be] straightforward."

"Combating health care costs has, of course, been a growing focus amongst policymakers as well as consumers," she said. But, "price transparency is most likely only a small piece of the solution, of which the impact is debatable."

Still, Licurse said, price transparency could contribute to containment of health costs "by improving cost awareness among both physicians as well as patient consumers, possibly leading to lowering of prices for the sake of remaining competitive."

Other schools of thought have warned that consumer-shopping may, however, lead to decreased quality of exams to account for lower pricing, she added. The trick is finding "the appropriate balance," Licurse suggested.

That concern was seconded by Dr. Geraldine McGinty, a radiologist with Weill Cornell Imaging at New York-Presbyterian in New York City. She is also chair of the American College of Radiology's economics commission.

"Price transparency is a laudable goal," she said. "But, it's important that our patients have tools to help them understand potential differences in quality."

McGinty suggested that the ACR's own accreditation programs are one good resource for radiology pricing and quality information.

"We should, however, not make our patients jump through hoops and have to make multiple calls to get an answer," she added. "Patient-centered care should involve prompt responses to questions, not just about billing.

"Part of making our patients feel secure about the care they will receive from us includes being able to answer questions about billing in an efficient and open way," she said.

More information

There's more on health care costs and transparency at Fair Health.

Lithium Beats Newer Meds for Bipolar Disorder, Study Finds

By Dennis Thompson
HealthDay Reporter

THURSDAY, May 12, 2016 (HealthDay News) -- Lithium outperforms newer mood stabilizers in the treatment of bipolar disorder, a new study has found.

Patients taking lithium had lower rates of self-harm and unintentional injury compared to those taking other bipolar drugs, such as valproate (Depacon, Depakote), olanzapine (Zyprexa) or quetiapine (Seroquel), said lead researcher Joseph Hayes. He is a fellow of psychiatry at University College London.

"This is important because people with bipolar disorder are 15 times more likely to die by suicide and six times more likely to die by accidental injury than the general population," Hayes explained.

People taking one of the alternative mood stabilizers were 40 percent more likely to harm themselves compared to patients on lithium, Hayes and his colleagues found.

And people on valproate or quetiapine were 32 percent to 34 percent more likely to fall victim to unintentional injury, most likely while experiencing a manic episode, the researchers said.

"Lithium still is the gold standard for the treatment of bipolar. We really haven't had a medication that surpasses lithium, as far as we know," said Dr. Raphael Braga. He is physician-in-charge of the Center for Treatment and Research of Bipolar Disorder at Zucker Hillside Hospital in Glen Oaks, N.Y., and was not involved with the study.

Hayes noted that lithium has been used for more than half a century to treat bipolar disorder, but it's still not clear how the drug stabilizes a person's mood.

Bipolar disorder, which used to be called manic depression, is characterized by extreme mood swings ranging from emotional highs to depressive lows.

The researchers undertook their study following evidence reviews and studies that suggested lithium might be better than newer medications at preventing suicide and self-harm.

These studies have contended that lithium achieves these results by reducing symptoms such as depression, aggression, risk-taking and impulsive behavior, according to background notes in the study.

Lithium can be hard on the body, the study authors said, increasing a person's risk of kidney and thyroid disease, but even that may have a positive side in bipolar patients. Because patients must be closely monitored for side effects, they are in more frequent contact with doctors who can pick up on emotional problems that lead to suicide, the researchers contend.

To compare lithium against newer medications, Hayes and his colleagues collected medical data on nearly 6,700 people diagnosed as bipolar and prescribed only one of the drugs -- lithium, valproate, olanzapine or quetiapine.

The investigators found that people on lithium were less likely to harm themselves, either intentionally or by accident.

The suicide rate was lower in the lithium group, but too few suicides occurred to allow accurate risk estimates, the study authors said.

The findings were published online May 11 in the journal JAMA Psychiatry.

Lithium can cause kidney disease and hypothyroidism (underactive thyroid gland), Braga and Hayes said.

Doctors need to carefully weigh benefits versus harm when prescribing lithium to people with kidney or thyroid problems, and "if these are severe, it should be avoided," Hayes said. "Lithium [also] needs to be reviewed on an individual patient basis before pregnancy."

Braga said psychiatrists often require patients taking lithium to undergo lab tests every three to six months, to make sure their kidney function hasn't been compromised.

Even with this, lithium is much cheaper than the other medications in the study, Braga said. Hayes noted a 2008 study that found lithium was nearly $500 cheaper per month compared with olanzapine.

"Lithium is a great drug," Braga said. "It's definitely a drug every clinician should think about when prescribing for bipolar disorder."

More information

For more on lithium, visit the National Alliance on Mental Illness.

If 1 in 10 U.S. Smokers Quits, $63 Billion Saved

TUESDAY, May 10, 2016 (HealthDay News) -- Kicking the smoking habit boosts more than just your health -- it also saves money.

That's because health care costs plummet just one year after stopping, new research shows.

A 10 percent decline in smoking would reduce U.S. health care costs by $63 billion the following year, a study from University of California, San Francisco (UCSF) estimated.

"Our study shows that significant changes in health care expenditures begin to appear quickly after changes in smoking behavior," study first author James Lightwood, an associate professor in the UCSF School of Pharmacy, said in a university news release.

The researchers reviewed health care costs linked with smoking in all 50 states and the District of Columbia. They looked at the time period between 1992 and 2009.

In addition to the direct effects that cigarettes have on smokers, the study also included the indirect effects of passive smoking on nonsmokers.

Smoking causes a wide range of serious health issues. These include heart and lung disease, as well as pregnancy complications, the researchers explained.

The researchers found clear evidence that reducing the number of people who smoke, and getting smokers to have fewer cigarettes, was quickly followed by a rapid decline in health care costs.

A major reason is that the risks for smoke-related diseases also change quickly once smokers quit, the study reported. For example, once smokers quit, their risk of heart attack and stroke drop by roughly 50 percent within one year. The risk of having a low birth weight baby virtually disappeared when a pregnant woman stopped smoking during her first trimester, the researchers said.

"These findings show that state and national policies that reduce smoking not only will improve health, but can be a key part of health care cost containment even in the short run," said study co-author, Stanton Glantz, director of the UCSF Center for Tobacco Control Research and Education.

The study authors estimated that California spent $15 billion less on medical costs in 2009 because smoking in that state is well below the national average. On the flip side, Kentucky's higher-than-average smoking rate cost the state nearly $2 billion more in health care expenditures, the study authors said.

"Regions that have implemented public policies to reduce smoking have substantially lower medical costs," the study authors wrote. "Likewise, those that have failed to implement tobacco control policies have higher medical costs."

The study was published May 10 in PLOS Medicine.

More information

The American Cancer Society provides more information on the benefits of quitting smoking.