renvoihypersensitized

Don’t worry. It’s good advice if you can take it. Of course that’s not always easy, especially for health concerns.

The truth is: it’s impossible (and ill-advised) to never worry about your health. But are you worrying about the right things? Let’s compare a sampling of common worries to the most common conditions that actually shorten lives. Then we can think about preventing the biggest health threats.

Dangerous but rare health threats

The comedian John Mulaney says the cartoons he watched as a child gave him the impression that quicksand, anvils falling from the sky, and lit sticks of dynamite represented major health risks. For him (as is true for most of us), none of these turned out to be worth worrying about.

While harm can befall us in many ways, some of our worries are not very likely to occur:

• Harm by lightning: In the US, lightning strikes kill about 25 people each year. Annually, the risk for the average person less than one in a million. There are also several hundred injuries due to nonfatal lightning strikes. Even though lightning strikes the earth millions of times each year, the chances you’ll be struck are quite low.
• Dying in a plane crash: The yearly risk of being killed in a plane crash for the average American is about one in 11 million. Of course, the risk is even lower if you never fly, and higher if you regularly fly on small planes in bad weather with inexperienced pilots. By comparison, the average yearly risk of dying in a car accident is approximately 1 in 5,000.
• Snakebite injuries and deaths: According to the Centers for Disease Control and Prevention, an estimated 7,000 to 8,000 people are bit by poisonous snakes each year in the US. Lasting injuries are uncommon, and deaths are quite rare (about five per year). In parts of the country where no poisonous snakes live, the risk is essentially zero.
• Shark attacks: As long as people aren’t initiating contact with sharks, attacks are fairly uncommon. Worldwide, about 70 unprovoked shark attacks occur in an average year, six of which are fatal. In 2022, 41 attacks occurred in the US, two of which were fatal.
• Public toilet seats: They may appear unclean (or even filthy), but they pose little or no health risk to the average person. While it’s reasonable to clean off the seat and line it with paper before touching down, health fears should not discourage you from using a public toilet.

I’m not suggesting that these pose no danger, especially if you’re in situations of increased risk. If you’re on a beach where sharks have been sighted and seals are nearby, it’s best not to swim there. When in doubt, it’s a good idea to apply common sense and err on the side of safety.

What do Google and TikTok tell us about health concerns?

Analyzing online search topics can tell us a lot about our health worries.

The top Google health searches in 2023 were:

• How long is strep throat contagious?
• How contagious is strep throat?
• How to lower cholesterol?
• What helps with bloating?
• What causes low blood pressure?

Really? Cancer, heart disease and stroke, or COVID didn’t reach the top five? High blood pressure didn’t make the list, but low blood pressure did?

Meanwhile, on TikTok the most common topics searched were exercise, diet, and sexual health, according to one study. Again, no top-of-the-list searches on the most common and deadly diseases.

How do our worries compare with the top causes of death?

In the US, these five conditions took the greatest number of lives in 2022:

• heart disease
• cancer
• unintentional injury (including motor vehicle accidents, drug overdoses, and falls)
• COVID-19
• stroke.

This list varies by age. For example, guns are the leading cause of death among children and teenagers (ages 1 to 19). For older teens (ages 15 to 19), the top three causes of death were accidents, homicide, and suicide.

Perhaps the lack of overlap between leading causes of death and most common online health-related searches isn’t surprising. Younger folks drive more searches and may not have heart disease, cancer, or stroke at top of mind. In addition, online searches might reflect day-to-day concerns (how soon can my child return to school after having strep throat?) rather than long-term conditions, such as heart disease or cancer. And death may not be the most immediate health outcome of interest.

But the disconnect suggests to me that we may be worrying about the wrong things — and focusing too little on the biggest health threats.

Transforming worry into action

Most of us can safely worry less about catching something from a toilet seat or shark attacks. Instead, take steps to reduce the risks you face from our biggest health threats. Chipping away at these five goals could help you live longer and better while easing unnecessary worry:

• Choose a heart-healthy diet.
• Get routinely recommended health care, including blood pressure checks and cancer screens, such as screening for colorectal cancer.
• Drive more safely. Obey the speed limit, drive defensively, always wear a seatbelt, and don’t drive if you’ve been drinking.
• Don’t smoke. If you need to quit, find help.
• Get regular exercise.

The bottom line

Try not to focus too much on health risks that are unlikely to affect you. Instead, think about common causes of poor health. Then take measures to reduce your risk. Moving more and adding healthy foods to your meals is a great start.

And in case you’re curious, the average number of annual deaths due to quicksand is zero in the US. Still a bit worried? Fine, here’s a video that shows you how to save yourself from quicksand even though you’ll almost certainly never need it.

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD

Snuff is a smokeless tobacco similar to chewing tobacco. It rarely makes headlines. But it certainly did when the FDA authorized a brand of snuff to market its products as having a major health advantage over cigarettes. Could this be true? Is it safe to use snuff?

What did the FDA authorize as a health claim?

Here’s the approved language for Copenhagen Classic Snuff:

If you smoke, consider this: switching completely to this product from cigarettes reduces risk of lung cancer.

While the statement is true, this FDA action — and the marketing that’s likely to follow — might suggest snuff is a safe product. It’s not. Let’s talk about the rest of the story.

What is snuff, anyway?

Snuff is a form of tobacco that’s finely ground. There are two types:

• Moist snuff. Users place a pinch or a pouch of tobacco behind their upper or lower lips or between their cheek and gum. They must repeatedly spit out or swallow the tobacco juice that accumulates. After a few minutes, they remove or spit out the tobacco as well. This recent FDA action applies to a brand of moist snuff.
• Dry snuff. This type is snorted (inhaled through the nose) and is less common in the US.

Both types are available in an array of scents and flavors. Users absorb nicotine and other chemicals into the bloodstream through the lining of the mouth. Blood levels of nicotine are similar between smokers and snuff users. But nicotine stays in the blood for a longer time with snuff users.

Why is snuff popular?

According to CDC statistics, 5.7 million adults in the US regularly use smokeless tobacco products — that’s about 2% of the adult population. A similar percentage (1.6%) of high school students use it as well. That’s despite restrictions on youth marketing and sales.

What accounts for its popularity?

• Snuff may be allowed in places that prohibit smoking.
• It tends to cost less than cigarettes: $300 to $1,000 a year versus several thousand dollars a year paid by some smokers.
• It doesn’t require inhaling smoke into the lungs, or exposing others to secondhand smoke.
• Snuff is safer than cigarettes in at least one way — it is less likely to cause lung cancer.
• It may help some cigarette smokers quit.

The serious health risks of snuff

While the risk of lung cancer is lower compared with cigarettes, snuff has plenty of other health risks, including

• higher risk of cancers of the mouth (such as the tongue, gums, and cheek), esophagus, and pancreas
• higher risk of heart disease and stroke
• harm to the developing teenage brain
• dental problems, such as discoloration of teeth, gum disease, tooth damage, bone loss around the teeth, tooth loosening or loss
• higher risk of premature birth and stillbirth among pregnant users.

And because nicotine is addictive, using any tobacco product can quickly become a habit that’s hard to break.

There are also the “ick” factors: bad breath and having to repeatedly spit out tobacco juice.

Could this new marketing message about snuff save lives?

Perhaps, if many smokers switch to snuff and give up smoking. That could reduce the number of people who develop smoking-related lung cancer. It might even reduce harms related to secondhand smoke.

But it’s also possible the new marketing message will attract nonsmokers, including teens, who weren’t previously using snuff. A bigger market for snuff products might boost health risks for many people, rather than lowering them.

The new FDA action is approved for a five-year period, and the company must monitor its impact. Is snuff an effective way to help smokers quit? Is a lower rate of lung cancer canceled out by a rise in other health risks? We don’t know yet. If the new evidence shows more overall health risks than benefits for snuff users compared with smokers, this new marketing authorization may be reversed.

The bottom line

If you smoke, concerns you have about lung cancer or other smoking-related health problems are justified. But snuff should not be the first choice to help break the smoking habit. Commit to quit using safer options that don’t involve tobacco, such as nicotine gum or patches, counseling, and medications.

While the FDA’s decision generated news headlines that framed snuff as safer than smoking, it’s important to note that the FDA did not endorse the use of snuff — or even suggest that snuff is a safe product. Whether smoked or smokeless, tobacco creates enormous health burdens and suffering. Clearly, it’s best not to use any tobacco product.

Until we have a better understanding of its impact, I think any new marketing of this sort should also make clear that using snuff comes with other important health risks — even if lung cancer isn’t the biggest one.

Follow me on Twitter @RobShmerling

About the Author

Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School. … See Full Bio View all posts by Robert H. Shmerling, MD