President-elect Barack Obama is a remarkably disciplined man. So it is a testimony to the enormously addictive habit of smoking that during a recent interview on Meet the Press, he confessed to Tom Brokaw that his earlier claim to Ellen DeGeneres to have given up smoking wasn’t quite true:
MR. BROKAW: Finally, Mr. President-elect, the White House is a no-smoking zone, and when you were asked about this recently by Barbara Walters, I read it very carefully, you ducked.
Have you stopped smoking?
PRES.-ELECT OBAMA: You know, I have, but what I said was that, you know, there are times where I’ve fallen off the wagon. Well…
MR. BROKAW: Well, wait a minute.
PRES.-ELECT OBAMA: …what can I tell…
MR. BROKAW: Then that means you haven’t stopped.
PRES.-ELECT OBAMA: Well, the… fair enough. What I would say is… is that I have done a terrific job under the circumstances of making myself much healthier, and I think that you will not see any violations of these rules in the White House.
Of course, the anti-smoking groups have now spoken out and so the papers are filled with headlines that read like this one: Anti-tobacco Groups Hope Obama Will Be Role Model, Quit Smoking.
We never smoked and, in fact, as a boy, the Pundit reacted to anti-smoking lessons in school and anti-smoking TV ads motivated by the Surgeon General’s 1964 Report on Smoking and Health by working tirelessly to make Momma Pundit’s life miserable (hiding her cigarettes, leaving her pamphlets, etc.) until she quit.
Still, although not being a smoker, we have always been of two minds regarding the public policy emphasis on reducing cigarette smoking. Although the public health benefits are now well established, it always struck us that the harm was mostly a private matter, whereas consumption of alcohol, with its spin-off into drunk-driving and reckless behavior, etc., seemed much more a proper subject of public concern.
We also have noted that a very high percentage of those who quit smoking seem to gain weight, perhaps substituting one oral pleasure — eating — for another — smoking. With all the public concern over obesity, we wonder how the cost/benefit of replacing one indulgence with another actually has worked out.
In any case, whether a President Obama continues smoking or quits, there is some new evidence that he could do himself a favor by eating broccoli and other cruciferous vegetables:
Broccoli May Lower Lung Cancer Risk in Smokers
The cancer preventive properties of broccoli and other cruciferous vegetables appear to work specifically in smokers, according to data presented at the American Association for Cancer Research’s Seventh Annual International Conference on Frontiers in Cancer Prevention Research.
Cruciferous vegetables have been shown to be protective in numerous studies, but this is the first comprehensive study that showed a protective benefit in smokers, specifically in former smokers, according to lead author Li Tang, Ph.D., a post-doctoral fellow at Roswell Park Cancer Institute.
“Broccoli is not a therapeutic drug, but for smokers who believe they cannot quit nor do anything about their risk, this is something positive,” Tang said. “People who quit smoking will definitely benefit more from intake of cruciferous vegetables.”
Li and colleagues conducted a hospital-based, case-controlled study with lung cancer cases and controls matched on smoking status. The study included all commonly consumed cruciferous vegetables, and also considered raw versus cooked form. Researchers performed statistical calculations to take into account smoking status, duration and intensity.
Among smokers, the protective effect of cruciferous vegetable intake ranged from a 20 percent reduction in risk to a 55 percent reduction in risk depending on the type of vegetable consumed and the duration and intensity of smoking.
For example, among current smokers, only the consumption of raw cruciferous vegetables was associated with risk reduction of lung cancer. No significant results were found for consumption of vegetables in general and fruits.
Researchers further divided their findings by four subtypes of lung cancer and found the strongest risk reduction among patients with squamous or small-cell carcinoma. These two subtypes are more strongly associated with heavy smoking.
“These findings are not strong enough to make a public health recommendation yet,” said Li. “However, strong biological evidence supports this observation. These findings, along with others, indicate cruciferous vegetables may play a more important role in cancer prevention among people exposed to cigarette-smoking. “
Public health recommendations depend on more than one study, and so it will be a while under the best of circumstances before confirmatory work is done and such a recommendation could be issued. Still, the report is very big news. Although a general urging to good health — as with the Fruits & Veggies More Matters campaign — can have influence, a specific health recommendation for specific people, such as, “People who quit smoking will reduce their risk of cancer by 20 to 55% by eating at least weekly servings of broccoli or other cruciferous vegetables,” is a much more specific and thus more powerful motivator.
We wanted to know more about this research and asked Pundit Investigator and Special Projects Editor Mira Slott to see if she could find out more:
Dr. Li Tang
Department of Cancer Prevention and Control
Roswell Park Cancer Institute
Buffalo, New York
A: We’re submitting the study for publication. I am not sure when the paper will be published. Although we will submit soon, the journal may take a long time to review it. We have strong biological evidence, but these findings are not strong enough to make a public health recommendation yet.
Q: What could a health recommendation be based on?
A: Smoking intensity and duration were co-founding factors in the results. Our study looked at cruciferous vegetables including broccoli, cauliflower, cabbage, brussels sprouts, turnip greens, collard greens and mustard greens. We also took into account raw and cooked intake.
Q: Did the results vary depending on whether the vegetables were eaten raw or cooked?
A: We know the phytochemicals in cruciferous vegetables combat against smoking carcinogens. The impact can be substantially reduced by the cooking element. This is why it was very important to separate out raw from cooked. Isothiocyanates, a group of phytochemicals uniquely present in cruciferous vegetables, can inhibit lung cancer growth in smokers and appear to be very preventative in long-term cancer risk. This agent is a rich source of phytochemicals shown to modulate smoking carcinogens in both animal and human studies. Cooked cruciferous vegetables also have a factor but a decreased amount. Raw ones are more potent.
Q: Have you examined the impact of cruciferous vegetables in reducing the risk of other cancers or diseases?
A: At this moment we are pursuing other studies related to bladder cancer research presented last year, where we also found cancer risk reduction with cruciferous vegetables.
Q: Is the bladder study linked to smokers as well?
A: That’s why we are looking at this. Smoking is related to both bladder and lung cancer. Smoking is a big risk with these two cancers. What’s most striking is that the phytochemicals in cruciferous vegetables make a difference in reducing bladder cancer risk in former smokers, people who never smoked and with heavy smokers. But for lung cancer you only see the factor with smokers.
Q: Why is that?
A: Because of the exposure amount and metabolism. The bladder is the most exposed organ in the human body, so you expect more effect with isothiocyanates in the bladder. With lungs, smoking carcinogens are a key factor. We’re still doing studies in this area.
Obviously there is much more work to be done, this study has to be peer reviewed and published, other researchers have to confirm the results, questions raised will prompt still further studies, but we see in this research some very interesting implications for the Produce for Better Health Foundation and the Fruits & Veggies More Matters campaign.
First, we recall that the old 5-a-Day program was initially launched with the National Cancer Institute as the lead agency; it was eventually transitioned over to the Centers for Disease Control and Prevention in no small part because the connection between produce consumption and reduced incidence of cancer was seen as less persuasive than other health benefits of consuming fresh produce.
This kind of specific tie-in between produce and cancer may help reinvigorate the tie-in between the National Cancer Institute and what is now the Fruits & Veggies More Matters campaign.
The second thing we find very interesting about this research is that it finds this effect to be much more powerful when the vegetables are consumed raw. We’ve written several pieces on the challenge to fresh produce being posed by the fact that the Fruits & Veggies More Matters Campaign includes fresh, frozen, canned and juices in its purview. You can read some of our pieces on this subject below:
Now this inclusion of canned and frozen is a matter of scientific integrity. The body of science upon which the program is based does not provide convincing evidence that consuming fresh provides any special health benefit over canned or frozen.
Virtually all canned or frozen produce is at very least blanched. Beyond that, the defrosting process typically makes the product adequate for cooking but not eating raw. If these studies are confirmed and if further research shows that the positive effects of raw produce consumption are found to be meaningful compared to the state of commercial frozen and canned product, it would provide a scientific justification, perhaps a scientific requirement, for Fruits & Veggies More Matters to abandon the inclusion of frozen and canned produce in its promotional effort.
In other words, if confirmed, this type of research would lead to a transformation in the relationship between fresh produce and public health. Instead of a general endorsement for healthy eating, including increased produce consumption that is tied to general benefit such as reduced obesity, we would enter an age in which fresh produce items are explicitly endorsed for specific people and specific purposes. That would be a nutritional, public health and produce industry revolution.
Perhaps our new President will have a personal interest in seeing money made available to fund the needed research in this area.