14th February 2014, Volume 127 Number 1389

Antismoking national media campaign in the United States

The authors of this report state that every year in the USA cigarettes kill more than 440,000 people and cost US$96 billion in direct medical costs and $97 billion in lost productivity.

In 2012, through the ACA, the US Centers for Disease Control and Prevention (CDC) launched the first, federally funded, national, anti-smoking, mass-media education campaign—Tips From Former Smokers (Tips).

This campaign cost US $54 million and this paper reviews its effects. Apparently it reached 80% of US smokers and calls to quit line increased by 132% during the campaign. There was a 12% relative increase in quit attempts among smokers and the prevalence of abstinence at follow-up was 13.4%. Overall it was estimated that more than 100,000 were likely to have been sustained quitters. The conclusion—“expanded implementation of similar campaigns globally could accelerate progress on the WHO Framework Convention on Tobacco Control and reduce smoking prevalence globally.”

Lancet 2013;382:2003–11.

Cancer risk among children born after assisted conception

Since the introduction of in vitro fertilization (IVF) in 1978, the number of children born after assisted conception have increased annually, and currently there are more than 5 million such persons worldwide. There is a documented risk for low birth weight, prematurity and congenital malformation and it has been suggested that such children may have an increased risk of developing cancer.

This report is derived from data from the United Kingdom National Registry of Childhood Tumours to determine the number of children in whom cancer developed before 15 years of age.

The cohort consisted of 106,013 children born after assisted conception in Britain between 1992 and 2008. The average duration of follow-up was 6.6 years. The researchers conclude that there was no increase in the overall risk of cancer in children born after assisted conception.

N Eng J Med 2013;369:1819–27.

Tamsulosin treatment for benign prostatic hyperplasia (BPH) and risk of severe hypotension

BPH is an unwelcome consequence of ageing in men. The unpleasant lower urinary tract symptoms can be alleviated by the use of alpha blockers but their use is limited by associated hypotension. Finasteride, a 5-alpha reductase inhibitor and tamsulosin, an alpha-1A adrenoreceptor blocker are now more commonly prescribed.

Apparently tamsulosin dominates the market globally because of its “lower frequency of associated orthostatic hypotension.” This report concerns a trial comparing the use of tamsulosin and a 5-alpha reductase inhibitor.

Tamsulosin resulted in a roughly doubled risk for hypotension needing hospital admission during the first eight weeks after tamsulosin initiation and first weeks after restarting tamsulosin treatment.

Patients should be warned of this risk.

BMJ 2013;347f6320.