Campus Chronicle

Issue date: 10/1/07 Section: Pulse

Dr. George

Q. I keep hearing about the dangers of the flu shot, are they true? How effective is the flu shot when there are so many variations in flu strains?

A. To evaluate the "dangers" of which you refer, a thought-provoking exercise is to Google "flu shot danger" and see how it has attracted all the government conspiracy theorists. Check out the www.educate-yourself.org site for a true study in paranoia, or government created mind control schemes, depending on how you see it.

Seriously though, the influenza immunization is extremely safe. At O'Hare Airport, where the University of Illinois and our Emergency Department operate a clinic (near Terminal 2, open 365 days a year, should you ever need us), we immunize thousands of people every year, primarily by injection. Some people report a little arm soreness, fewer report low-grade fever and/or muscle aches. Serious adverse effects would only be expected with severe allergies to the eggs from which the vaccine is made. These serious adverse effects are so rare that I couldn't even find the statistics to quantify them. At the UIC O'Hare Clinic, where we have immunized approximately 5,000 people per year for the last 10 years, we haven't witnessed any serious side effects.

Effectiveness is difficult to assess and still somewhat controversial. There is no question that the vaccine will initiate the formation of suitable antibodies to either ward off or keep a case of the targeted influenza from being very serious. However, since vaccine production takes some nine months, it is necessary to make the determination far in advance as to what strains of influenza are most likely to be present in the US during the next flu season. Last year, the 2006-2007 vaccine was effective for type A New Caledonia, type A Wisconsin and type B Malaysia. If these strains turned out to be the predominant ones present in N. America, then the CDC would get an "A." However, as you correctly suggested, this influenza vaccine has little effect on other distant, unrelated influenza viruses, or other viral illnesses which may also have similar, but often less severe, symptom complexes.

The whole issue is further complicated since students usually live in close proximity to other students, where they would likely have exposure to and expose many others. One infected student could infect many others. The situation is ripe for epidemic spread. But, if most of the population has as least some immunity, the chances of having a severe flu outbreak or "pandemic" is low. Within these limitations, influenza immunization, along with good hygiene, are still the best ways to decrease your chances of being ill this winter. I even got one. And the government didn't send me to sell this to you…. Trust me…. I'm a doctor.

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Dr. Ralph

Q. What is the tobacco equivalent in cigars relative to cigarettes?

A. It is my personal opinion that the contemplative act of smoking a fine cigar is one of life's great pleasures. However, as a physician, I have difficulty reconciling that with the multiple well-documented health hazards of smoking. It should be noted that most of the health risk studies done relating to tobacco use have relied on cigarette smoking because it was more common than cigar smoking. So let's get right into some good rationalizations.

It is very difficult to measure the tobacco equivalent in cigars compared to cigarettes because they are used somewhat differently. Most cigar smokers do not inhale the smoke directly and are essentially only exposed to second hand smoke (as well as direct carcinogen [tobacco] contact with the lips and mucosa). Now I must interject here, if the cigar smoker does inhale the smoke directly from the cigar then they should definitely chose term life insurance over whole life insurance as their beneficiaries would spend less money on the policy before collecting the benefits. It's like putting four unfiltered Pall Malls in your mouth at once and taking a draw.

The weight of one Churchill double corona cigar is more than a pack of cigarettes; so the one hour leisurely smoke of such an excellent cigar with the right friends and properly aged scotch could be thought of as chain smoking a pack of cigarettes in an hour if one didn't inhale the cigarette smoke. Yet there must be some anti-carcinogenic effect from the scotch right? Speaking of not inhaling and cigars, the image of our once great president and his inquiring intern-Monica comes to mind, but perhaps I should leave that for another column.

Another aspect for comparison is that cigars are just tobacco, whereas cigarettes are a manufactured product with additional chemicals added to the tobacco in a secretive formula that makes Marlboro smokers want to put on cowboy boots and start branding steers.

A final difference between cigarettes and cigars involves the fact that cigarette smoke passes through a filter before it is drawn in, but cigars don't have filters. And again rationalizing here, most cigar smokers don't smoke more than two thirds of the cigar with the final one third essentially acting as a filter.

So there you have it: the tobacco equivalent in cigars relative to cigarettes depends on the size of the cigar and the manner in which it is smoked.


Dr. Ralph and Dr. George are Emergency Room physicians with the University of Illinois at Chicago's Medical Center.

As with all medical advice, consult your physician before beginning any regimen or if symptoms persist for more than five days.

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