Today marks the American Cancer Society's Great American Smokeout, an effort meant to encourage those who smoke or vape to quit, especially younger people who are at great risk of developing a lifelong deadly habit.

The majority of adult tobacco users say they picked up the habit as a kid, but increasingly cigarettes are being replaced with e-cigarettes or vapes. The most recent National Youth Tobacco Survey showed vaping is by far the most popular option for school-age children.

Kim Coronis, policy and program manager for Breathe New Hampshire, said while the numbers of kids vaping may in fact be declining, those who do vape are doing it more often.

"So the nicotine addiction is setting in sooner and is hitting them more dramatically," Coronis observed. "And unfortunately more impactfully, because the nicotine levels in these products have gone up over time."

More than 14% of high school students and 3% of middle-school students report they have vaped at least once over the past 30 days, but most youths who responded to the national survey reported they would like to quit.

For teens who may have picked up the vaping habit to cope with depression or anxiety, quitting is made even more difficult by the way nicotine impacts the developing teenage brain. Coronis pointed out nicotine withdrawal can exacerbate the anxiety which may have led teens to start vaping in the first place.

"The kids are getting into a vicious cycle," Coronis noted. "Or people of any age, because you have that temporary chemical feeling that your brain releases the adrenaline and the dopamine, and you feel good, but then it wears off."

Coronis added teens are open to talking about the risks of vaping to their health without the use of scare tactics.

She stressed many are surprised such dangerous products are marketed to them in the first place, but it may be changing. E-cigarette maker Juul Labs recently agreed to pay nearly $440 million to settle an investigation by 33 states into the marketing of its high-nicotine products.

Health-care professionals say low pay and a worker shortage have led a dramatic number of nursing homes in rural Iowa to close their doors. They hope increased government funding and more focus on rural health care this year will help.

Looking at a graph that shows the number of nursing-home employees between January 2019 and January 2020, the bright red line goes almost straight down. The pandemic was a big reason for that, but Iowa Health Care Association President and CEO Brent Willet said there are other economic factors at work, and the staffing shortages have already resulted in double-digit closures.

"It is alarming," he said. "The latest figures are, we've had 17 nursing homes in Iowa close in the last 12 months. Fifteen of those 17 have been in rural parts of the state."

Willet said nursing homes can't offer competitive wages to people who are willing to take these demanding jobs, especially in rural areas where the population is declining. He said he remains optimistic, though, adding that the Iowa Legislature will reconsider those wages this year, since more than half of nursing-home funding comes from state and federal governments.

Willet said it's also becoming harder for people in rural nursing homes to get the support they need from other medical-service providers in town. He said this adds to the problems already caused by staffing shortages, simply because those services dwindle along with the population.

"Like dialysis, like their primary-care doctor," he said. "As those services become harder and harder to come by, it creates additional challenges pertaining to costs and logistics to care for people in their home community."

The national long-term care facility numbers are also alarming. The Centers for Medicare and Medicaid Services reported recently that 129 nursing homes closed in 2022 - although this year, the numbers are starting to improve.

Health-care professionals and advocates in Connecticut have said it will take sweeping reforms to bolster the state's flailing public health system.

At the labor union 1199 SEIU's Health-Care Policy Symposium, experts spoke of the system's long-time underfunding and staffing shortages. A union-related group, called Expand Services to Save Lives, wants to see part of the state's multi-billion-dollar surplus used to address the issues - including $30 million to recruit and retain public-health workers.

Rebecca Simonsen, vice president and director of the public division at 1199 SEIU, said the state needs to revitalize this system of critical services.

"State health-care services generally serve the most at-risk, highest need, complex residents," she said. "Often folks without insurance, often folks that have been turned away from the private sector. And we created these services because, as a state, we believe that every resident's life should be valued."

In 2022, the state received a $32 million grant from the Centers for Disease Control and Prevention for public-health workforce development. She added that even if the group gets everything it's seeking from this legislative agenda, it wouldn't be the entire solution.

One area of the staffing crisis to be addressed is retention of nurses, more of whom are leaving the field due to burnout and higher patient limits. The union wants to see a pipeline created for nursing students to prepare them for public-sector jobs.

Brian Williams, an organizer for 1199 SEIU and a certified addiction counselor with the Connecticut Department of Mental Health and Addiction Services, said it's time to commit to action instead of acknowledging the problem.

"We cannot continue to say, 'Hey, you know, we have a nursing crisis, we have a nursing crisis.' We have to create incentives to actually expand the pool of nurses," he said. "And this is one of the proposals that we have that we believe will have an impact."

The group also proposed a $12 million investment to add workers to the department to address what was described at the conference as an ongoing mental-health crisis.


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Iowa lawmakers are considering a bill which would dramatically reduce the use of cellphones in vehicles.

Right now, it is illegal in Iowa to send or read text messages while driving, but drivers can use a cellphone for navigation, which often takes more attention than texting. Senate Bill 60 would tighten the rules further, prohibiting drivers from operating a phone if it takes more than a single touch to activate or deactivate it.

Sen. Claire Celsi, D-West Des Moines, said she is personally motivated by the measure after attending the wake of a constituent's 12-year-old child who was killed by a distracted driver.

"It really affected me," Celsi recounted. "The dad just said, 'Please, please, please make this illegal. Please help people like us never to have to go through a loss like this.' So, that's what really spurred me to join onto the bill this year. It's a Republican bill, but I completely support it."

The Iowa Department of Public Safety said drivers who use handheld devices are four times more likely to be in a collision causing injuries than those who are not using their phones. The bill is headed to a Senate committee.

Celsi acknowledged she used to oppose hands-free cell phone measures, because she felt the costs were prohibitive, but she said technology has caught up, and prices have come down.

"You can buy something at Walmart for $20 that can help you go hands free in your car," Celsi pointed out. "I think it really demands now that we reexamine the issue and do something about distracted driving in our state."

The Insurance Institute for Highway Safety said about half of states prohibit the handheld use of cellphones when driving, and all but Montana prohibit text-messaging while driving.