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A major new study provides the strongest evidence yet that vaping can help smokers quit cigarettes, with e-cigarettes proving nearly twice as effective as nicotine gums and patches.
The British research, published Wednesday in the New England Journal of Medicine, could influence what doctors tell their patients and shape the debate in the U.S., where the Food and Drug Administration has come under pressure to more tightly regulate the burgeoning industry amid a surge in teenage vaping.
“We know that patients are asking about e-cigarettes and many doctors haven’t been sure what to say,” said Dr. Nancy Rigotti, a tobacco treatment specialist at Harvard Medical School who was not involved in the study. “I think they now have more evidence to endorse e-cigarettes.”
At the same time, Rigotti and other experts cautioned that no vaping products have been approved in the U.S. to help smokers quit.
Top cause of preventable death
Smoking is the No. 1 cause of preventable death worldwide, blamed for nearly 6 million deaths a year. Quitting is notoriously difficult, even with decades-old nicotine aids and newer prescription drugs. More than 55 percent of U.S. smokers try to quit each year, and only about 7 percent succeed, according to government figures.
Electronic cigarettes, which have been available in the U.S. since about 2007 and have grown into a $6.6 billion-a-year industry, are battery-powered devices that typically heat a flavored nicotine solution into an inhalable vapor.
Most experts agree the vapor is less harmful than cigarette smoke since it doesn’t contain most of the cancer-causing byproducts of burning tobacco. But there is virtually no research on the long-term effects of the chemicals in the vapor, some of which are toxic.
At the same time, there have been conflicting studies on whether e-cigarettes actually help smokers kick the habit. Last year, an influential panel of U.S. experts concluded there was only “limited evidence” of their effectiveness.
In the new study, researchers tracked nearly 900 middle-age smokers who were randomly assigned to receive either e-cigarettes or nicotine replacement products, including patches, gums and lozenges. After one year, 18 percent of e-cigarette users were smoke-free, versus 9.9 percent of those using the other products.
“Anything which helps smokers to avoid heart disease and cancer and lung disease is a good thing, and e-cigarettes can do that,” said Peter Hajek, study co-author and an addiction specialist at Queen Mary University of London.
The study was more rigorous than previous ones, which largely surveyed smokers about e-cigarette use. Participants in this experiment underwent chemical breath testing.
Smokers in the e-cigarette group received a $26 starter kit, while those in the nicotine-replacement group received a three-month supply of the product of their choice, costing about $159. Participants were responsible for buying follow-up supplies.
“If you have a method of helping people with smoking cessation that is both more effective and less costly, that should be of great interest to anyone providing health services,” said Kenneth Warner, a retired University of Michigan public health professor who was not involved in the study.
Several factors may have boosted the results: All the participants were recruited from a government smoking-cessation program and were presumably motivated to quit. They also received four weeks of anti-smoking counseling.
The researchers didn’t test e-cigarettes against new drugs such as Pfizer’s Chantix, which has shown higher rates of success than older nicotine-based treatments.
Funding for the study came from the British government, which has embraced e-cigarettes as a potential tool to combat smoking through state-run health services. Some of the authors have been paid consultants to makers of anti-smoking products.
U.S. health authorities have been more reluctant about backing the products, in part because of the long-term effects are unknown.
“We need more studies about their safety profile, and I don’t think anyone should be changing practice based on one study,” said Belinda Borrelli, a psychologist specializing in smoking cessation at Boston University.
The American Heart Association backed e-cigarettes in 2014 as a last resort to help smokers quit after trying counseling and approved products. The American Cancer Society took a similar position last year.
An editorial accompanying the study and co-written by Borrelli recommended e-cigarettes only after smokers have tried and failed to quit with FDA-approved products. Also, doctors should have a clear timeline for stopping e-cigarette use.
Borrelli noted that after one year, 80 percent of the e-cigarette users in the study were still using the devices. Nine percent of the participants in the other group were still using gums and other nicotine-replacement products.
No vaping company has announced plans to seek FDA approval of its products as a quit-smoking aid. Winning such an endorsement would require large studies that can take years and cost millions of dollars.
The FDA has largely taken a hands-off approach toward vaping. It has not scientifically reviewed any of the e-cigarettes on the market and has put off some key regulations until 2022. FDA Commissioner Scott Gottlieb has said he doesn’t want to over-regulate an emerging industry that could provide a safer option for adult smokers.
The delay has come under intense criticism amid an explosion in teenage vaping, driven chiefly by devices like Juul, which resembles a flash drive. Federal law prohibits sales to those under 18, but 1 in 5 high school students reported vaping last year, according to a government survey. It showed teenage use surged 78 percent from 2017 to 2018.
Tank vs. cartridge
Matthew Myers of the Campaign for Tobacco-Free Kids noted that the British study used so-called tank-based e-cigarettes, which allow users to customize their flavors and nicotine levels. Those devices have largely been overtaken in the U.S. by Juul and similar devices that have prefilled nicotine cartridges, or pods. Any benefit of e-cigarettes depends on the individual product and how it is used, he said.
“It is a fundamental mistake to think that all e-cigarettes are alike,” Myers said. “And in the absence of FDA regulation, a consumer has no way of knowing if the product they are using has the potential to help them or not.”
Myers’ group is one of several anti-smoking organizations suing the FDA to immediately begin reviewing e-cigarettes.
Ian Armitage was skeptical about e-cigarettes as a way to stop smoking, saying he tried vaping several years ago but gave it up after experiencing twitching and shakes from nicotine withdrawal.
`I tried it for a whole month, but it just wasn’t doing it for me,” said Armitage, an audio-visual technician in Washington. “I still wanted a cigarette afterward.”
Armitage, who has smoked for 15 years, said he also tried nicotine patches but found they irritated his skin. (VOA)
Indian Meteorological Department issues a warning of the approaching Cyclone Gulab which will hit Andhra Pradesh and Odisha on 26th September 2021. Heavy rainfall can be expected in northern states till 28th September 2021. It is the third September Cyclone of the century that came knocking on our door unexpectedly. The country has already faced major damage left behind by Cyclone Tauktae and Cyclone Yaas in May. These are the warnings from our environment about the increasing climate change which is becoming more and more severe with days passing by.
The Intergovernmental Panel on Climate Change (IPCC) releases a report on how human-induced climate change is gathering pace and how extreme weather events have reached our doorsteps every seven-year or so. IPCC released a report in August 2021 and issued an environmental warning for India to cut down its carbon emissions to avoid a climate catastrophe. India is the third-largest carbon emitter in the world, the first two being China and the US. In Paris Climate Agreement India pledged to reduce its carbon footprint by 33-35% from 2005 levels by 2030. India aims to produce 40 percent of its power from non-fossil fuel sources by 2030. India's carbon emissions fell 24 percent from 2005 levels by 2016- in 11 years. However, India has not yet set out a target for when it will start reducing total emissions (the so-called peak emission year).
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The Paris Climate Agreement aims to keep global average temperature rise to well below 2 degrees Celsius and strive for 1.5 degrees Celsius to prevent runaway climate change. However, the report shows that this goal is slipping out of reach as several countries are not cutting down their carbon emissions quick enough; and causing global temperature to rising and irreversible climatic changes.
The IPCC report 2021 has something that the second-most populous country in the world, India which was also ranked seventh in a major climate risk index of 2019 cannot ignore. The report says, "The scale of recent changes across the climate system as a whole and the present state of many aspects of the climate system are unprecedented over many centuries to many thousands of years," Climate scientists have claimed such disturbed climate systems of oceans and atmosphere is most likely to result in harsh extreme weather events, that will keep getting worse and so will their impact. The result is right in front of our eyes the third cyclone; Cyclone Gulab from the Bay of Bengal is going to hit the Indian subcontinent merely after 4 months of Cyclone Yaas. The report also warned us about the increasing heavy precipitation from the Himalayan Range shortly which would result in floods in several states.
India will also need to adapt to increased water scarcity, droughts, floods, cyclones, and other natural disasters according to the IPCC report. Gettyimages
According to the 2019 global report by the World Resources Institute India is one of the 17 countries where water stress is extremely high. Even the first-ever climate change report published by the Indian government in 2020 it was discovered that the frequency and intensity of droughts have increased by a large scale as compared to 1952 to 2016. The warning has been issued that the heat waves would intensity by fourfold by the end of the century. India will also need to adapt to increased water scarcity, droughts, floods, cyclones, and other natural disasters according to the IPCC report.
India needs to curb the emissions as soon as possible, embrace sustainable development and natural defenses – and more importantly, the country needs to assess the risk before we do anything with the environment.
Langar means "free food for all". Langar is served by the community kitchens at all gurudwaras regardless of caste, gender, religion, economic status, or ethnicity. The idea behind langar is equality and "the light of God is in all hearts." Langar Sewa was started by the First Guru of Sikhs- Guru Nanak Ji. The meaning behind langar teaches us to come together, sit alongside each and eat as equals, no one has a higher status than another while sitting in the langar. It is a sanctuary of all where all are welcome, treated, and protected equally. The place where the food is cooked in Gurudwaras is referred to as "Communal Kitchen", which is usually managed by the volunteers, who do all the work from cutting vegetables, serving food to washing the dirty dishes. The notable fact about Langar is that all the food that is served is vegetarian, simple, and nutritionally balanced with roti, vegetable dish, lentils, and dessert.
The story behind Langar
The first Guru of Sikhs- Guru Nanak Ji started Langar in the Golden Temple located in Amritsar, Punjab. But what gave him the idea of feeding people all equally? The story goes as when Guru Nanak Ji was a child his father who was a well-known trader in his village gave Guru Nanak 20 rupees and asked him to go to the market and do 'Sacha Sauda' (a good bargain). His father wanted Guru Nanak who was then only a 12-year-old boy about their family business. So, did Guru Nanak went and did some worldly bargain in the market? No, instead he bought food with the money and fed a large group of saints who had been hungry for days and that is what he called was the "true business". The holy book of Sikhism "The Guru Granth Sahib" is kept in all gurudwaras, it contains numerous meaningful teachings of the Guru and is worshiped by the Sikhs. The three main pillars of Sikhism, "Naam Japo" "Kirat Karo" and "Vand chakho" (meditate the Guru's name, lead an honest life and earn an honest and dedicated living by walking on the path that the Gurus have made for us, share what you eat respectively) are the reason why humanity, equality and serving those in need are the primary actions taken by any Gurudrawa.
The volunteers working in the communal kitchen inspire selfless service for everyone outside their community and the outside world.homeneardarbarsahib.com
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Expansion of Langar
The Second Guru – Guru Angad Singh Ji took the initiative of langar i.e. "Satvik Meal" (free vegetarian food) for all and turned it into an all Sikh Gurudwaras' premise by establishing communal kitchens in all the gurudwaras. He set rules and training methods for all the Sevadaars (volunteers) who operate the kitchen. The Third Guru, Guru Amar Das Ji formally established the system as he believed that anyone who wished to have an audience with him first must have their stomach filled hence, must sit with the community and have langar. Even the Mughal King Akbar had to sit with ordinary people and share langar to meet up with the Guru. This depicts how langar is blind to any form of social status, religion, gender, and economic situation.
In today's date, Langar is served in all gurudwaras all over the world. The volunteers working in the communal kitchen inspire selfless service not just for their community but for everyone outside their community and towards the world outside as well. The Golden Temple in Amritsar Punjab is referred to as World Headquarter for Sikhism and has the World's Biggest Communal Kitchen that operates 24×7 and serves about 100,000 people each day.
What is the point of Langar?
The Langar served in gurudwaras not only aims to serve food to all, treat everyone with equality, respect and kindness; it is also about the act of selfless- service after all the people working in the communal kitchen are no one but Sevadaars(volunteers) who not only involve men and boys but also women and children. Women play a major role in the preparation of all the meals for langar, and children serve food to people sitting to be served. Langar is a medium to pass on our culture and tradition to the next generation one after another. The tradition reassures that we remain bonded with our dignified past as we move on to the modernized future.
Prime Minister Narendra Modi addressed the 76th United Nations General Assembly on Saturday held in New York. Prime Minister Modi touched on various issues ranging from making nasal vaccines in India to making an indirect remark on Pakistan for using terrorism as a political tool. PM Modi also highlighted how India is the mother of all democracies and how strategically and effectively India has managed the Covid-19 pandemic. He made comments on the developments in Afghanistan and poverty alleviation.
India: Mother of democracy
In his address at the UNGA session, PM Modi said that for the last one and a half years the world has been facing the biggest global epidemic of the century. He further added that he represents the mother of all democracies, where there are dozens of languages, hundreds of dialects, and different lifestyles and cuisines. India is a shining example of a vibrant democracy and it is recognized for its diversity.
"Yes, democracy can deliver. Yes, democracy has delivered….When India grows, the world grows. When India reforms, the world transforms," Prime Minister Narendra Modi added during his address at the 76th UNGA.
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Manufacture Covid Vaccine India
Prime Minister Narendra Modi in his address made efforts to make India a front-line fighter in the fight against the Covid-19 pandemic. He encouraged worldwide vaccine manufacturers to come to India and make vaccines in India, he said "I, today, invite vaccine manufacture around the world — come, make vaccines in India," He emphasized India's successfully developing the world's first DNA vaccine and added that the vaccine can be administered to anyone above the age of 12. The mRNA vaccine is in its final stage of development. India's scientists are working on developing a nasal vaccine for the coronavirus.
The mRNA vaccine is in its final stage of development. India's scientists are working on developing a nasal vaccine for the coronavirus.PTI
PM Modi put a spotlight on how India managed the "second wave" and emerged as part of the solution for the pandemic. When faced with the second wave India launched a plan "Vaccine Maitri" to reach the capitals with fewer resources at the time when other developed countries obstinately kept their borders closed. This improved India's image worldwide for its goodwill. Highlighting the government's latest decision of resuming the export of vaccines to the under-resourced countries Pm Modi said, "Understanding its responsibility towards humanity, India has once again started giving the vaccine to the needy in the world."
Criticized Pakistan and China
PM Modi referred to the issue regarding the "origin of the Covid virus" aka China and the cancellation of the World Bank's "Ease of Doing Business Index", pointing towards China for lack of transparency in the global institutions. Turning towards Pakistan he argued, "...Countries with regressive thinking that are using terrorism as a political tool needs to understand that terrorism is an equally big threat for them. It has to be ensured that Afghanistan isn't used to spread terrorism or launch terror attacks..."
Protect our oceans
70% of the earth is water, oceans being a massive part of it. PM Modi added on making optimal use of oceans as a life resource. "Our oceans are also the lifeline of international trade. We must protect them from the race for expansion. The international community must speak in one voice to strengthen a rule-based world order," he added in his address at the 76th UNGA session.
Prime Minister Narendra Modi also spoke on the climate crisis, his speech can be seen as an effort based on evidence to transform India's image on an international platform for crisis management.