Arthritis is Australia’s major cause of pain and disability. Nearly four million people are affected and it costs our economy almost $24 billion each year.

Arthritis is often thought of as a single disease, but it’s really an umbrella term used to describe more than 100 medical conditions that involve our bones and muscles and particularly the joints where two or more bones meet. After osteoarthritis (OA), rheumatoid arthritis (RA) is the next most common form (OA, RA and gout together account for more than 95% of arthritis cases in Australia).

While OA affects mainly the weight-bearing joints – the legs, the shoulders, the knees and the lower spine – RA symptoms are much more widespread and potentially disabling.

Joint pain, stiffness and tenderness are common to both major forms of arthritis, but with RA significant inflammation and swelling of the joints is likely; small (usually painless) lumps or nodules occur beneath the skin and there is general muscle weakness and fatigue.

RA is not just a function of getting old; it’s not a wear-and-tear disease as OA is sometimes described. RA is an autoimmune disease; that is our immune system starts to attack our own healthy tissues. In military terms, it’s the body coming under “friendly fire” – the good guys attacking the good guys.

In RA, the immune system targets the lining of the joints (the synovial membrane). The joints most likely to be affected first are the joints in the hands and feet – the row of knuckles closest to the wrist, the middle joints on the fingers, the wrist itself and the row of joints at the base of the toes. However, larger joints such as the hips or the knees can also be affected.

As well, parts of the body other than the joints can be affected – diverse areas of the body like the tear glands, salivary glands, blood vessels and heart and lung tissue.

In fact, RA which is not effectively treated can result in shortened life expectancy with increased deaths due to heart and blood vessel disease, infection and cancer.

Clearly, early diagnosis is essential so that appropriate treatment to prevent disease progression and serious joint damage can be initiated. Symptoms suggestive of RA should be assessed as soon as possible.

The cause of RA is not known. However, there appears to be a genetic pre-disposition to the condition; more women are affected than men; and possible trigger factors include pregnancy, infection and especially smoking. Some studies have shown smokers are six times more likely to develop RA.

Not surprisingly, being overweight or obese can put more strain on already damaged joints; so lifestyle factors are important in both prevention and management.

Effective management usually involves the use of potent medicines; some with potentially serious side effects. It is important, therefore, to check with your doctor and pharmacist as to what to expect from your treatment.

Generally complementary therapies have not proven to be effective. Fish oil has the best credentials; but adequate doses taken regularly, often for many months will usually be required for any benefit.

The “Rheumatoid Arthritis” fact card, which is available from pharmacies distributing the Pharmaceutical Society’s Self Care health information, provides helpful advice on the identification and management of RA. For the nearest location of a “Self Care” pharmacy check out the Pharmaceutical Society website at www.psa.org.au or phone 1300 369 772. The “Women’s Insights” book can be downloaded from the Arthritis Australia website: www.arthritisaustralia.com.au.

©2010 Pharmaceutical Society of Australia

More recently, these same rats – or at least members of their family – are being trained by APOPO for use in neighbouring Tanzania to more easily and more quickly detect one of the world’s most deadly infectious diseases – tuberculosis (TB).

The organism which causes TB is carried by two billion people – almost a third of the world’s population – and there are an estimated two million deaths every year. The World Health organization (WHO) has declared TB to be a global health emergency and designated 24 March each year as World TB Day.

TB is a contagious disease which spreads through the air. When infectious people cough, sneeze, talk or spit they propel the TB organisms into the air. Only a small number of these organisms (called bacilli) need to be inhaled for people to become infected. In poorly ventilated and enclosed environments bacilli can remain airborne for hours.

Of course TB is not new. Genetic evidence gathered from archaeological excavations in the eastern Mediterranean has indicated strains of TB existed 9000 years ago; and fragments of spinal column from Egyptian mummies from 2,400 BCE show definite signs of TB.

In the early eighteenth century it was suggested that TB could be caused by “wonderfully minute living creatures” and 150 years later the actual organism (mycobacterium tuberculosis) was identified by Robert Koch.

Up until then and indeed really until the middle of the last century, so-called sanatorium care – rest, fresh air and good nutrition – provided the only even mildly effective treatment. Real success came in the 1940’s with the development of the antibiotic streptomycin. Though streptomycin has potentially side effects; and monotherapy (treatment with one drug) quickly results in resistant strains of the bacteria.

However, with proper treatment almost all cases of TB are curable. Generally a TB patient must take four different antibiotics for at least two months then two antibiotics for four more months. But because the medicines often cause unpleasant side effects and patients start feeling better a month or so, not everyone completes the full course. As well, in many less developed countries where TB is most common, drug supplies may be inadequate.

According to the Global Tuberculosis Institute at the New Jersey Medical School in the US, while wealthy industrialised countries with good public health systems can be expected to keep TB under control, in much of the developing world a catastrophe awaits.

Hopes that TB might be eradicated by 2025 have all but evaporated as a variety of medical and social factors resulting in the emergence of multi-drug resistant strains present a new challenge in the battle against TB.

In contrast to most of the rest of the world, Australia is fortunate in having a relatively low but nevertheless constant pattern of TB. There is an average of around 1,000 cases a year. This is primarily due to re-activation of a dormant infection in people who were first infected in another country before emigrating to Australia; or who may have been originally infected during their childhood in Australia when the TB rates among the general community were much higher.

But wherever TB exists, successful treatment will depend on early and accurate diagnosis, correct selection of medication and patient adherence – that is taking the right dose for the appropriate length of time.

Naturally these principles apply to the treatment of all medical conditions, especially infectious diseases.

For more advice about the use of antibiotics, ask for a fact card at one of the two thousand pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. For the nearest location, log on to www.psa.org.au and click on Self Care Pharmacy Finder. And if you want more information about World TB Day, go to the WHO website www.stoptb.org

©2010 Pharmaceutical Society of Australia

If the lungs are our air-conditioning unit, then the kidneys are our body’s washing machine and waste disposal system. They’re also a superbly effective filter system with about 200 litres of blood passing through 2 million tiny filters every day; resulting in the removal of about 2 litres of waste products and unneeded water.

As well as enabling us to excrete certain unwanted and toxic substances, the kidneys produce hormones and regulate water levels and blood pressure.

Of course, properly regulated blood pressure is critical for good health. While there are no firm and fast rules about what constitutes a normal blood pressure reading – blood pressure varies from person to person and with individuals from time to time – a confirmed reading of greater than 140/90 is considered sufficiently high to require treatment.

There is a close relationship between high blood pressure and kidney disease: high blood pressure can cause kidney damage and kidney damage can cause high blood pressure.

The kidneys produce a hormone called renin which helps control blood pressure. When the kidneys are not functioning effectively, there is often an increase in the release of renin and a subsequent rise in blood pressure. Likewise, if high blood pressure is left unchecked, it can cause the walls of blood vessels in the kidneys to become, thickened. The blood vessels therefore become narrow causing reduced kidney function and ultimately kidney failure.

Uncontrolled blood glucose levels (diabetes) is another major risk factor for long-term or so-called chronic kidney disease (CKD). About half of all people with diabetes develop kidney damage; so it’s important for people with diabetes to have regular kidney function tests.

With diabetes, all the small blood vessels in the body are damaged; and those in the kidneys are especially vulnerable. The blood cleaning activity of the kidneys does not operate effectively; the body retains more salt and eater than it should, leading to swelling of the ankles and weight gain.

Diabetes may also cause damage to the nerves in the body. This can cause difficulty in emptying the bladder and further injury to the kidneys. Kidney failure is one of the most serious complications of diabetes; and kidney failure cause or contributes to about 10% of all deaths in Australia.

Being overweight or obese are in themselves risk factors for kidney disease. As well as increasing the likelihood of both blood pressure and diabetes (and therefore increasing the risk of CKD), as we get bigger and more overweight, the kidneys have to cope with a greater workload.

Being overweight is a very visible characteristic, but having high blood pressure and diabetes can often go unnoticed until the CKD is well established and difficult to treat. So a regular visit to the doctor is essential. The kidney health check involves a blood pressure test, a urine test for protein and blood test for a substance called creatinine.

Prevention strategies (and often initial treatment as well) involves dietary and lifestyle changes – losing weighty, cutting down on alcohol intake, exercising regularly, consuming less salt and stopping smoking. If medication is necessary it may involve life-long treatment.

This year the theme for World Kidney Day is ”Protect your kidneys – control diabetes”. You can get more information about diabetes and high blood pressure and their relationship to kidney disease from pharmacies throughout Australia providing Self Care health information. For the nearest location phone the Pharmaceutical Society on 1300 369 722 or check the website www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia

However, coeliac (pronounced see-lee-ac) disease, which affects about one in every 100 Australians, is more than just a trivial and occasional adverse reaction to something we have eaten. The disease is triggered by the ingestion of gluten – usually in people who are genetically predisposed; that is, they have an inherited tendency to get the disease.

Gluten is the name given to the protein component of wheat and other grains – rye, oats and barley. So gluten is present in cereals but also often in bread, cakes, biscuits, pasta, pizzas and many processed foods – meats, soups, sauces and so on.

The symptoms of coeliac disease vary enormously. It is probably the main reason that it seems so difficult to diagnose; with evidence suggesting only one person in five has had the condition properly identified. In infants and very young children, common symptoms are vomiting, diarrhoea and abdominal bloating and failure to thrive, but these symptoms commonly occur in children anyway. These symptoms can also occur in adults; and as well they are more susceptible to mouth ulcers, osteoporosis, unexplained weight loss, hair loss, skin problems and chronic fatigue.

In the UK children with peanut allergy will soon be undergoing experimental desensitising therapy with peanut flour to build up immunity to the potentially deadly peanut allergen. While no such studies are underway with gluten, Professor Peter Green from Columbia University in New York in a talk to Coeliac Society members in Sydney last year, said that when gluten is feed to infants for the first time prior to four months of age or after seven months of age, there is an increased risk of the development of coeliac disease. He said there is also a protective effect with breastfeeding. So the advice to mothers is to breast feed for at least the first six months and give small amounts of gluten between four and six months.

Each year, National Coeliac Awareness Week (13-20 March) highlights the need for us to consider coeliac disease when stomach problems persist. Despite the markedly varying symptoms and sometimes their extreme severity, treatment is usually simple and effective.

Early diagnosis of coeliac disease is important. However, the good news is that once diagnosed, the treatment for coeliac disease is very successful. It simply involves strict adherence to a gluten free diet.

This might sound difficult but it’s well worth the challenge of finding gluten-free foods on the supermarket shelves. Once started on a gluten-free diet coeliac disease suffers will pick-up and regain their energy and good health. Be aware, that a gluten-free diet is not a fad diet; and a gluten-free diet should not be started before the appropriate blood screening and other tests your doctor can order. Otherwise diagnosis may prove difficult or inconclusive.

Your local Coeliac Society (www.coeliac.org.au) can provide more information. They have dietary advice, recipes, information on where to buy gluten-free food, and above all the support needed to achieve effective control over the condition.

You can also get advice about intestinal and bowel problems from pharmacies providing the Pharmaceutical Society’s Self Care health information. Phone 1 300 369 772, or check out the Pharmaceutical Society website at www.psa.org.au and click on Self Care pharmacy finder for the nearest location. There are fact cards on heart burn and indigestion, vomiting and diarrhoea, constipation and irritable bowel syndrome.

©2010 Pharmaceutical Society of Australia

Most Australians would probably ask: what is there to be aware of? We’re all aware of salt. But maybe we’re not all aware of just how much more salt we consume than is good for our health.

The ideal intake of salt is 1-2 grams per day, but many Australians consumer five or ten times that amount.

Salt is a leading cause of high blood pressure; and high blood pressure is a major risk factor for heart attack and stroke.

The Australian Division of World Action on Salt and Health (AWASH) has developed some simple ways we can pinch salt from our diet: we should limit takeaways and fast foods, avoid salty snacks or limit them to occasional treats, look for low fat or no fat options when shopping, use lemon juice, garlic, vinegar or herbs and spices when cooking (we should also avoid rock salt and sea salt). The AWASH website: www.awash.org.au provides other good suggestions on how we can “drop the salt”.

The first week in February was also designated National Naturopathy Awareness Week; and while so-called natural medicines have appeal (it is estimated more than 50% of Australians regularly use some form of complementary or alternative medicines) much of the advice offered by natural medicine practitioners really does need to be taken with a grain of salt.

One form of alternative “medicine”, namely homeopathy, is not really medicine at all. Homeopathic products contain no active ingredients. There is no evidence of benefit except for a placebo effect.

There can be a distinction between complementary and alternative treatments, where the former are used together with the “conventional” therapy and the latter instead of. In either case, with complementary and alternative medicines (CAMs), there is the potential for problems to occur.

Clearly, natural is not always necessarily safe. But if CAMS are your cup of herbal tea, then there are ways of managing the risk.

The Pharmaceutical Society of Australia has produced a fact card titled Complementary Medicines. The card – which is available from all pharmacies across Australia providing the Self Care health information – identifies the problems and pitfall of CAMs, and also indicates which of the claims made for various CAMs can be supported by evidence.

Recent studies have shown the herb saw palmetto, previously thought to be effective in treating non-cancerous prostate enlargement, may not be any better than placebo; while echinacea may not be of any benefit in preventing or treating colds.

Of even greater concern is the fact that some commonly used CAMs can cause serious side effects. Following a safety review, the Therapeutic Goods Administration (TGA) in Australia has concluded that medicines containing black cohosh should include the warning statement that, “Black cohosh may harm the liver in some individuals”.

St John’s wort – considered useful to treat mild depression – can interact with a number of prescription products causing toxicity or a reduction in effectiveness.

On the positive side, many people have gained some pain relief from osteoarthritis symptoms with glucosamine; and long-term use of cranberry juice or extract helps prevent the occurrence of urinary tract infection.

The undeniable fact is that complementary and alternative medicines are made up of chemicals, just like any medicine. If they are taken in a dose sufficient to have some benefit, they can also do harm.

Before self selecting any CAM, especially if you are taking a prescription medicine, check first with your pharmacist. And ask for the Complementary Medicines fact card at one of the Self Care pharmacies – call 1 300 369 772 or check out the Pharmaceutical Society’s website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia

Interestingly, it’s not only the colour of our hair and our eyes that is established before we’re born; children have a genetic predisposition to prefer certain tastes (the fact that some children prefer meat pie and sauce to seafood risotto might, therefore, be blamed on what took the fancy of their grandparents!) Nevertheless, the main influence on a young child’s eating behaviours and food choices are their parents and care-givers. We adults must set the example. We can help children to establish healthy eating habits that are carried into adulthood.

However, older children and adolescents are also subject to many other influences on their eating habits. These include peer pressure and, not surprisingly, television. Several studies have shown rates of overweight and obesity in children related to hours of TV viewing (a recent study has also shown increased death rates from all causes in adults watching more than four hours of TV daily – these deaths being apparently linked to lack of mobility). Obese children have a significantly higher risk of becoming obese adults with all the associated health risks.

Soft drinks, vitamin drinks and energy drinks have all become fashionable. Consumption of such drinks is a fashion that should not be allowed to extend to children.

Up to the age of 12 months, breast milk, infant formulas and water are the only fluids recommended. From 12 months onwards, cows’ milk is an important source of calcium, protein and some B group vitamins for children and adolescents; and the trend toward the greater consumption of soft drinks, instead of milk, is fraught with danger. Cola drinks seem to present particular problems.

In the United States, the consumption of cola beverages has been associated with bone fractures in physically active high school girls, possibly due to the high phosphoric acid content in cola drinks. In addition, caffeine increases the rate of elimination of calcium from the body. Similarly, energy drinks are considered unsuitable for children, mainly because of their caffeine content.

As with drinks, so with food; fashion and fad diets might be commonplace with adults, but have no place with young children. A child on a vegetarian diet is at risk of a number of nutrient deficiencies. So, such a diet for a child must be carefully planned; while a strict vegan diet is not recommended at all.

As well, there are a number of specific foods which are considered unsuitable for children under the age of five – foods such as nuts, lollies, popcorn and pieces of raw vegetables and raw apple.

Of course poor food choices can occur as we get older as well. It would seem most unlikely that anyone in Australia could be malnourished; and yet malnutrition among older people is quite common; and it’s a condition that often goes unnoticed.

Elderly men seem to be more at risk than elderly women (men living alone are less likely to eat regular well-balanced meals), but some risk factors affect both men and women. Gastro-intestinal symptoms such as heartburn, indigestion, constipation, vomiting and diarrhoea might be obvious. Perhaps less obvious are conditions such as arthritis, difficulty in swallowing, poor fitting dentures, dry mouth, oral infections and medication side effects.

If you are caring for a child or may be an older person, and you’d like some nutrition advice, call into one of the 2000 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information – they have a series of fact cards on nutrition. For the nearest location, go to the Pharmaceutical Society website at www.psa.org.au and click on “Self Care Pharmacy Finder” or phone 1300 369 772.

©2010 Pharmaceutical Society of Australia

There are claims that the first association between Valentine’s Day and romance was referenced by Chaucer writing in the 14th century. In any event, there was a certain element of romance by the time Shakespeare wrote Hamlet in 1600.

Paper Valentines, the beginnings of the Valentine Day cards, became popular in the early 1800s; so popular it was written that “St Valentine’s Day” had virtually become a “national holy day” in the USA.

Whilst around the time of Valentine’s Day 2010 our thoughts may still turn to romance, those romantic thoughts may not be so likely if you’re afflicted with an annoying cold sore.

Your friends and family probably won’t find cold sores all that appealing either; a fact confirmed by a survey conducted a few years ago by one of the pharmaceutical companies involved with the marketing of a cold sore relief cream. Cold sores were shown to be more off-putting than tinea, dandruff or even bad breath!

In this warm summer weather, cold sores will be more common. Dry, burnt lips present the ideal conditions for a cold sore to break out.

Nevertheless, there are effective products to treat cold sores and some excellent information from your local pharmacy on how to prevent them from occurring.

Pharmacies which provide the Pharmaceutical Society’s Self Care health information have a recently updated “fact card” on cold sores. It tells you all you need to know, and more, about these annoying little skin infections – what cold sores are, how they occur, what medicines help and how best to use them.

Cold sores are caused by one of the viruses from the herpes family, known as herpes simplex (HSV). There are two types of HSV infections. HSV-1 usually causes infections on the face, such as cold sores around the lips and nose, whereas HSV-2 usually causes genital herpes.

Unfortunately, cold sores come back time after time because, as with all the herpes infections, the virus “hides” in the nerve cells in the skin at or near the original site. A range of triggers can then reactivate the virus to cause another cold sore – as well as sunburn, other triggers can include cold weather, fever, illness, and fatigue; in fact just about anything that puts our immune system under some stress.

There are formulations containing so-called immune system boosters: ascorbic acid, zinc and the amino acid lysine; but there is little evidence to support the use of other herbal or vitamin products in the prevention and treatment of cold sores.

Mild and occasional cases of cold sores can be treated with anaesthetic and analgesic ointments, creams and lotions. Topical antiviral preparations containing acyclovir or penciclovir will help if applied frequently and from the first sign of the lesion – that is when the itch or tingle is first noticed. Severe or recurrent cold sores respond well to oral antiviral medications which are currently available as prescription products.

Cold sores are easily transferred from person to person, and they can be particularly dangerous if caught by babies or people taking medicine that affects their immune system. Cold sores are not the kind of condition that you can kiss better – kissing’s a sure fire way of spreading them around. In fact kissing’s probably very much off the agenda anyway. With cold sores you’re almost certain to get the cold shoulder as well.

There may be no permanent cure for cold sores, at least not yet (not even St Valentine has the answer); but you need to know how best to prevent them and how best to treat them when they do occur – so your social life won’t become “no social life at all”. Phone the Pharmaceutical Society (PSA) on 1300 369 772 or visit the website www.psa.org.au to find the nearest pharmacy providing the Cold Sore fact card and have a talk with your pharmacist.

©2010 Pharmaceutical Society of Australia

Children will be meeting old friends and making some new friends too. Probably “sleep-overs” will again become part of the school-year landscape. But beware, you could be entertaining some uninvited guests as well.

Statistics indicate that more than 20% of primary school students are likely to have head lice.

However, the fact is anyone with a head can catch head lice – regardless of age, sex, background or how clean your hair is. Head lice spread anywhere that people work, play and live together. Most often children get them at school – often at the start of school. Indeed, it takes only one infested head to infest a whole classroom full of heads; then our children so unselfishly pass the infestation on to the rest of the family.

The medical term of head lice is pediculus humanus capitis. But whichever way you describe them, these tiny wingless insects are extremely common. Head lice are endemic in Australia. They cannot jump or fly but they certainly get around; and they live their entire life (about a month or so) on the head of their host.

Their favourite hiding places are behind the ears and at the back of the neck. Female lice lay their eggs (known as nits) close to the scalp, where they remain firmly stuck to the base of the hair shaft until they hatch in about a week’s time.

Head lice feed exclusively on human blood; but unlike mosquitoes, another group of little blood suckers, it appears that head lice do not carry disease. They can, however, cause severe itching and this can lead to scratching and skin infections.

Of course an itchy scalp may be due to many other causes – among them dandruff, psoriasis and so-called seborrhoeic dermatitis. So, before you start shampooing with insecticide, it’s best to get an accurate diagnosis. The recently revised Pharmacy Self Care fact card titled Head Lice will help confirm the problem and find the solution as well.

The good news is that if you or your children have head lice, there are simple, safe and effective strategies to send them on their way. Various shampoos, lotions, cream rinses and conditioners are available. Many chemical treatments are based on the chrysanthemum-type pyrethrin insecticides; some contain malathion; and there are several remedies available based on essential oils such as anise, lavender, rosemary and the Australian favourite melaleuca (tea tree) oil. When used as indicated in some studies these natural treatments have been shown to be more effective even than the chemical treatments.

If live lice are found in the combings after treatment, it’s possible that the head lice are resistant to the particular product, and the person should be retreated as soon as possible using a product from a different group. Nevertheless, most treatment failures are due to inadequate time in contact with hair and scalp, inappropriate application methods, or the use of ineffective products. Ask your pharmacist to recommend an evidence-based product – that is: one that is proven to be effective.

Remember whatever head lice treatment you choose, a fine toothcomb is essential to get the nits out and a good hair conditioner will get rid of the knots.

Despite symptoms of tickling, itching and scratching, head lice can sometimes be difficult to find. The answer is to indulge in a little “detection combing”. You apply to dry hair, enough hair conditioner to cover each hair from root to tip. Starting at the scalp and working carefully in sections, you comb the conditioner through the hair with a special lice comb.

Head lice treatments can kill living lice and eggs, but they don’t protect people from getting head lice. Regular inspection, and detection, and persistence and perseverance with an effective product used appropriately are the keys to success. Of course, it helps if you can convince all the parents of your children’s classmates to put in place similar procedures.

For information on where to find a Head Lice fact card, phone the Pharmaceutical society on 1 300 369 772 or go to the Pharmaceutical Society website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia

No doubt also gone is all that cold turkey remaining with some of the other left-overs from Christmas dinner or New Year’s Eve celebrations.

Of course, cold turkey is one of the strategies used to fulfil one of the more common New Year’s resolutions – that is: to quit smoking.

As with all lifestyle and behaviour changes such as exercising more, drinking in moderation and modifying our diet, being able to stop smoking can be really difficult at the best of times. During January when parties or paying bills (or both) make life especially stressful, these kinds of resolutions can be really hard to keep.

Nevertheless, when it comes to smoking, any time is a good time to quit; and it’s never too late. Recent studies have shown that for smokers who quit at age 50 the risk of a tobacco related death is reduced by about two thirds; and for those who stop before middle age the risk is little more than for non-smokers.

Now less than 20% of the Australian adult population smokes; and a significant proportion of this 20% would like to join the other 80% non-smokers. No surprise really that many (maybe most) would quit if they could. We all know the dangers of tobacco smoking.

However, becoming and staying a non-smoker doesn’t happen by accident. Smokers who plan before they quit are significantly more successful than those who don’t; and planning can be done quickly and easily. The decision to quit must be yours and yours alone, but to help you plan for long term success you should enlist the support of family and friends. Your pharmacist can also offer you valuable support.

Nicotine replacement therapy (NRT) could be an option worth considering. These nicotine substitutes help to treat the withdrawal symptoms and cravings which can make it so difficult to quit.

When you do stop smoking, your body will most likely still have a need for nicotine – the addictive component of cigarettes – and this is what creates the urge to smoke again. By taking nicotine in a “clean form” – that is without the dangerous carbon monoxide and tar ingredients – the physical withdrawal symptoms are reduced, allowing you to focus your energies on breaking the smoking habit.

The effectiveness of NRT in aiding cessation is well established and is supported by the highest level of clinical evidence. Nevertheless, some people have concerns – unfounded concerns – about the continued use of nicotine to help smokers quit.

The reality is using NRT to quit is always safer than smoking.

Four NRT products are currently available in Australia: patches, gum, inhaler and lozenges. All these medications are now available from pharmacies without prescription; and two prescription-only products (bupropion and varenicline) may also be useful for some smokers who want to become committed quitters.

To help you quit for good, your pharmacist can help you choose the most appropriate product.

For more self help strategies have a look at the fact cards titled Smoking and Staying a Non-smoker available at all Self Care pharmacies. Call 1 300 369 772 for the nearest location or visit the Pharmaceutical Society website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia

Sun protection factor (SPF) labelling provides a reasonable indication of the effectiveness of sunscreens. The higher the number, the more time we can spend in the sun before burning – well that’s the theory anyway. The reality is that the protection will depend on a number of factors such as how well the sunscreen is applied and the formulation of the product itself (e.g., degree of water resistance).

Since 1998 the highest SPF label permitted has been 30+ (previously it had been 15+). It is now likely that a new maximum level of 50+ will be approved this year.

It’s a somewhat controversial move, because although it will allow us to more clearly differentiate between different sunscreens, the extra protection provided between 30+ and 50+ is minimal.

Perhaps more important for adequate protection is that sunscreens be applied in sufficient quantity and reapplied every two hours .It’s also important that we choose a sunscreen that has protection from the broad spectrum of ultraviolet (UV) rays. SPF ratings are measured on the burning UVB rays, but other wavelengths of ultraviolet light (e.g., UVA) can be carcinogenic too. Sunscreens are usually made up of a combination of chemical and physical UV filters. The physical filters zinc oxide and titanium dioxide are particularly valuable because of their ability to filter both UVA and UVB light.

When incorporated into sunscreens in their coarse powder form zinc oxide and titanium dioxide give the skin a white colour; so they are now generally used in microfined, so-called nanoparticle form. Despite some concerns expressed about the use of nanoparticles in industry, there is currently no evidence to suggest that use of nanoparticles in sunscreens causes damage to skin cells.

Remember the adverse effects of sunlight on the skin are cumulative. The damage on and beneath the skin is building up, even without burning.

Research undertaken by the Cancer Council and the Australian Department of Health and Aging shows that it’s not just the day, or even several days, at the beach that causes the most sun damage to our skin. The many days spent involved with everyday activities, without adequate protection from the sun, might be even more dangerous. And with most states in Australia now “saving daylight”, there is the possibility we will have more usable leisure time in the sunshine.

If you’re 55 years old or more, you were probably in your 30s when the need for skin protection became well recognised; and most of the damage to your skin had already taken place.

Of course, it’s not too late to look after your skin now; but you also need to check your skin regularly for any new spots or a change in appearance of those existing spots.

If you must have a tan, a fake tan is the best option. There are a number of products your pharmacist can recommend which offer a much safer alternative to the sun-induced variety. But, remember, the colour from a fake tan does not provide protection against UV radiation. And fake tan products that contain a sunscreen only provide protection for a few hours after application – not for the duration of the tan.

You can get more advice and a Sense in the Sun Fact Card on how to stay sun smart this summer, from pharmacies providing the Pharmaceutical Society’s Self Care health information. Phone 1300 360 772 for the location of your nearest Self Care pharmacy or check out the Pharmaceutical Society website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia