Audiences 'at risk' from on-stage smoking

Audiences 'should not be exposed to smoke' from actors, says Prof Sargent Should actors be allowed to smoke on stage during a play if it's what the director and the play demand? Or would banning them be 'political correctness gone mad'?

The question arises because one of the world's top experts on diseases connected to smoking has complained to the National Theatre in London that he was shocked to witness members of the cast smoking in character during a production which was set in a red-light district.

Prof James D Sargent of the Dartmouth Medical School in the US has just published a big study of the effects of the ban on smoking in public places in Germany in the journal Clinical Research in Cardiology.

He and his colleagues found that heart attacks fell there by 8% after the ban came into place.

Prof Sargent has also studied Britain, and on his last visit went to a production of Shakespeare's Comedy of Errors at what is arguably Britain's premier theatre.

During the interval, some actors remain on stage as the set is changed and smoke as part of their performance as low-life characters lounging outside sex-shops and bars as the production demands.

But Prof Sargent does not accept that it was necessary for the drama: "It puts the audience at risk", he told the BBC.

"At the end of the interval, you could see the smoke in the air and clearly smell it."

He is adamant that this is dangerous.

There is no scientific evidence, he said, that the air has to be thick with smoke for it to be harmful, adding that there is an increased risk, he said, with relatively small amounts.

'Pot and soap'

The National Theatre said the actors smoked tobacco on stage because of the dramatic needs of the production.

But she would not comment on whether there was a health risk to the audience or to the cast, or whether the risk had been assessed.

Britain has a tough ban on smoking in public places, but she said theatres were exempt if there was "artistic licence".

She said the actors were only smoking for around five minutes, though she accepted that there "was a problem at one performance" where it went on for longer.

In films, actors are nowadays often asked to smoke non-nicotine cigarettes - in film, what the cigarette smells like doesn't matter because the audience can't smell it.

In the American series "Mad Men", for example, which is set in early 60s New York when offices were smoking zones, the actors often smoked herbal cigarettes.

Matthew Weiner, the creator of the series, was quoted in the New York Times as saying: "You don't want actors smoking real cigarettes. They get agitated and nervous. I've been on sets where people throw up, they've smoked so much".

The star of the show, John Hamm, who plays Don Draper, was asked what the herbal cigarettes tasted like. "Terrible", he said. "They taste like a mixture between pot and soap".

Psoriasis 'linked to stroke risk'

Psoriasis linked to stroke and heart problems People with psoriasis have nearly three times the normal risk of stroke and abnormal heart rhythm, according to scientists in Denmark.

A study of 4.5 million people, published in the European Heart Journal, showed the highest risk was in young patients with severe psoriasis.

Researchers believe this may be because the skin and blood vessels may share similar sources of inflammation.

The Stroke Association said this should not be an immediate cause for concern.

Super fast

Skin cells are normally replaced every three to four weeks but, in patients with psoriasis, that process can be greatly speeded up.

It can take between just two and six days, resulting in red, flaky, crusty patches on the skin.

The condition affects 2% of people in the UK and the cause is unknown.

Researchers analysed data from everyone in Denmark between 1997 and 2006 - 36,765 had mild psoriasis and 2,793 had the severe form of the condition.

In patients under 50 with mild psoriasis, the risk of abnormal heart rhythm - atrial fibrillation - increased by 50%. The risk of ischaemic stroke increased by 97%.

In those with severe psoriases, the risks increased by 198% and 180% respectively.

The increased risks for patients over the age of 50 were much smaller.

Inflammation

The researchers said: "The relative risks of atrial fibrillation and ischaemic stroke were highest in young patients with severe psoriasis.

"The results add to accumulating evidence that patients with psoriasis are at increased cardiovascular risk."

The study can say only that there is a link between psoriasis and increased risk, not that one causes the other.

Psoriasis in an inflammatory disorder caused when the immune system attacks healthy skin cells, which stimulates the production of new skin.

Researchers believe the inflammation may play a role in stroke and heart problems.

Dr Sharlin Ahmed, research liaison officer at The Stroke Association said: "Previous research has shown that psoriasis could increase a person's risk of heart disease and this research seems to suggest that it could also increase a person's risk of atrial fibrillation and stroke.

"However, the reasons for this are not known. Psoriasis is a very common condition and the results of this research should not be an immediate cause for concern.

"Anyone concerned about their stroke risk should speak to their GP."

TV couch potatoes 'diabetes risk'

Telly time may distract from more 'healthy' activities, say the researchers Child TV hours obesity risk linkTV daily limit call 'unrealistic' Couch potatoes beware, say researchers who link prolonged TV watching with an increased risk of diabetes and heart disease.

Every additional two hours spent in front of the box each day raises the diabetes risk by a fifth and heart disease risk by 15%, a study found.

Switching it off and doing something more strenuous instead could stop two people in every thousand developing these conditions, the authors say.

The work appears in the journal JAMA.

"The message is simple. Cutting back on TV watching can significantly reduce risk of type-2 diabetes, heart disease and premature mortality," said lead researcher Professor Frank Hu, of the Harvard School of Public Health.

The researchers say it is not TV viewing per se that is the problem, but that people who spend hours watching programmes are less likely to lead an active lifestyle as a result and, in turn, are more likely to be overweight or obese.

Continue reading the main story“Start QuoteI'm sure we've all unintentionally lost evenings slumped on the sofa in front of the TV snacking on crisps and biscuits and drinking sugary drinks or alcohol. But it's important that this doesn't become a regular activity”

End QuoteMaureen Talbot of the British Heart FoundationPremature death They say other sedentary activities, like sitting in front of a computer playing games or surfing the internet, might have a similar effect, and this should be studied.

The investigators examined the findings of eight large studies that included over 175,000 people and looked at the health risks associated with TV viewing.

The results showed that more than two hours of TV viewing per day increased risk of type-2 diabetes and cardiovascular disease, and more than three hours of daily viewing increased risk of premature death.

The researchers estimate that for every additional two hours of TV watched a day there is an increased risk of an extra 38 people in every 100,000 in the US dying from heart and circulatory disease and 176 people in every 100,000 developing diabetes.

Dr Iain Frame, of Diabetes UK, said the findings should be a wake-up call about the risk of leading a sedentary lifestyle. He said evidence suggests physical activity can reduce the risk of type-2 diabetes by over 60%.

Maureen Talbot, of the British Heart Foundation, said: "I'm sure we've all unintentionally lost evenings slumped on the sofa in front of the TV snacking on crisps and biscuits and drinking sugary drinks or alcohol. But it's important that this doesn't become a regular activity.

"We should try to be selective in how much time we spend watching the TV, and try to be more physically active instead.

"We need 30 minutes of physical activity at least five days a week to keep our hearts healthy, so why not take a walk after work, join a sports team or even just get out for a bit of gardening in the evenings. It's bound to be a lot more rewarding than staring at the box."

According to the researchers, people in European countries spend around three-to-four hours a day on average watching TV, while people in the US do so for five hours a day.

Bottle-fed toddler 'weight risk'

Babies using a bottle for too long can be consuming too many calories. Babies who are bottle-fed until the age of two are more likely to be obese when they start school, a US study suggests.

Writing in the Journal of Pediatrics, researchers found that children who were still regular bottle users at 24 months were 30% more likely to be obese aged five-and-a-half.

They analysed data from nearly 7,000 children across the United States.

Experts say bottle-feeding can make babies consume too many calories.

The research found 22% of the two-year-olds studied were using a bottle as their main drink container, or were put to bed with a bottle containing a calorie-filled drink.

Nearly a quarter of this group were found to be obese aged five, compared with 16% of children who had not been using a bottle at the age of two.

Too many calories

The study authors, from universities in Ohio and Philadelphia, calculated the odds of obesity for children using a bottle at 24 months as 1.33 times higher than the odds for children not using a bottle.

Continue reading the main story“Start QuoteBabies should be introduced to a cup or beaker from six months and off a bottle completely by one year.”

End QuoteJanet FyleRoyal College of Midwives They suggest that parents should be encouraged to stop using a bottle by the child's first birthday because of the risk of over-feeding.

"Prolonged bottle use may lead to the child consuming excess calories, particularly when parents are using the bottle to comfort the child rather than to address the child's hunger or nutritional needs," the study paper says.

Study co-author Rachel Gooze, from the Centre for Obesity Research and Education at Temple University in Philadelphia, explained: "A 24-month-old girl of average weight and height who is put to bed with an eight-ounce bottle of whole milk would receive approximately 12% of her daily caloric needs from that bottle."

The parents' charity NCT (National Childbirth Trust) advises that babies should stop using a bottle and change to a cup before 12 months.

The Royal College of Midwives agrees. Their professional policy advsior Janet Fyle says that the practices of nutrition in the family determine whether a child is still using a bottle at two years old.

"If the child is continuing to use a bottle then the mother may be tempted to put something else in it like a sugary drink or rusk with milk. Then the child gets used to sweet things in their diet," she said.

"Babies should be introduced to a cup or beaker from six months and off a bottle completely by one year."