Early Intervention Shows Promise in Treating Schizophrenia

WEDNESDAY, July 8, 2015 (HealthDay News) — Interventions that include resiliency training, education and job support may boost the mental health of patients in the early stages of schizophrenia, new research reveals.

The finding, reported in the July issue of Psychiatric Services, followed an assessment of several specialty care programs, including some funded through a U.S. National Institute of Mental Health (NIMH) initiative known as RAISE (Recovery After an Initial Schizophrenia Episode). The comprehensive treatment programs also include family education and goal-setting.

Investigators found that patients who completed RAISE fared better both socially and on the job. They also showed fewer symptoms and were less likely to relapse.

Clinicians credit the program’s emphasis on shared decision-making as key to its success, along with a respectful, flexible and warm attitude toward patients by the RAISE staff.

“Now that we know which programs are most effective, we can begin to offer these services across the United States,” study author Amy Goldstein, associate director for prevention at NIMH, said in an institute news release. “This research will help us give hope and support to people with schizophrenia and their families.”

About 1 percent of Americans suffer from the severe brain disorder during their lives, according to NIMH. People with schizophrenia may hear voices, or fear other people are controlling their thoughts or plotting to harm them.

More information

The U.S. National Institute of Mental Health has more information
about schizophrenia.

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Painkiller Overdoses Often Involve ‘Pharmacy Shopping’

WEDNESDAY, July 8, 2015 (HealthDay News) — Nearly half of all deaths resulting from an overdose of narcotic painkillers involved Medicaid recipients who used multiple pharmacies to fill their prescriptions, a new study finds.

“Pharmacy shopping,” or the use of multiple pharmacies at the same time, is a way some patients obtain more medication than they need. Medicaid programs in many states track the number of pharmacies patients visit to prevent such abuse of painkillers, the study authors said.

It’s unclear, however, how many pharmacies must be visited or how much time should lapse between prescriptions to identify patients engaging in pharmacy shopping with the intent to misuse their medication. Some patients, the study authors pointed out, may legitimately use more than one pharmacy if they move, travel or make a change in their insurance coverage.

To investigate this issue, researchers examined the records of more than 90,000 Medicaid recipients aged 18 to 64, who were long-term users of narcotic painkillers, such as Oxycontin (oxycodone) or Vicodin (hydrocodone). These patients had used three or more narcotic prescriptions for 90 days from 2008 to 2010.

Patients using overlapping painkiller prescriptions had a higher rate of overdoses, the study published recently in The Journal of Pain revealed. Patients who used four pharmacies within 90 days, which the study said could be considered an indication of pharmacy shopping, had the highest odds of overdosing.

Study author Zhuo Yang, of the U.S. Centers for Disease Control and Prevention, and colleagues concluded that the use of overlapping prescriptions and multiple pharmacies isn’t medically reasonable or necessary. Programs to restrict reimbursement for controlled prescriptions, such as narcotic painkillers, could designate one pharmacy and one doctor for patients on these medications, they suggested.

More information

The U.S. National Institute on Drug Abuse has more about opioids.

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Exotic Squirrels Transmit Deadly Virus to Breeders in Germany, Study Finds

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 8, 2015 (HealthDay News) — After the mysterious deaths of three German variegated squirrel breeders, researchers have identified a deadly new virus that can be transmitted from variegated squirrels to humans.

But you don’t need to be concerned about the squirrels scurrying across your path every day. Variegated squirrels are an exotic breed native to southern Mexico and Central America.

“A new bornavirus that can be transmitted to humans and cause severe disease has been detected in variegated squirrels. The study shows that exotic animal species can have the risk of transmitting novel zoonotic viruses to humans from close contact,” said the study’s senior author, Dr. Martin Beer, head of virus diagnostics at the Friedrich-Loeffler Institute in Insel Riems, Germany.

Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, said that based on these few cases, the general public should not be concerned about this new virus.

“It’s likely that bornavirus, commonly found in horses and sheep and capable of causing neurological symptoms, was present in the squirrels that scratched these men, causing the neurological and behavioral symptoms,” he said.

“It is possible that this virus could spread to squirrels here in the U.S. and occasionally to humans, but we wouldn’t see sustained spread, as there is no evidence of spread from human to human,” Siegel said.

Details of the findings were published in the July 9 issue of the New England Journal of Medicine.

The three squirrel breeders were diagnosed with encephalitis — inflammation of the brain — and died within two to four months of developing symptoms, the study reported.

The three deaths occurred between 2011 and 2013. Analysis of the squirrels and the victims’ brains found that this previously undetected virus was present in both the animals and the humans.

Beer said that the three men were in their 60s or older and had other medical conditions that possibly could have contributed to their reaction to the virus.

The three men were friends, and all were members of the same squirrel-breeding association, the researchers said. And, at least two of them were known to have been scratched by their squirrels, and one had been bitten, according to the study.

Symptoms of the virus can include fever, shivers, and low energy, according to the study. Symptoms of encephalitis include clumsiness, an unsteady walk, confusion, disorientation, drowsiness, irritability, sensitivity to light, stiff neck and vomiting, according to the U.S. National Institute of Neurological Disorders and Stroke.

“These findings indicated that the virus most likely caused the lethal human infections and should be considered as a novel zoonotic virus that was transmitted from infected squirrels,” Beer said. “Zoonoses are infectious diseases that can be transmitted between animals and humans,” he said.

The infected squirrels showed no signs of the infection and the cause of infection is still unknown, he said. Whether the animals contracted the virus in the breeding facility or brought it with them from Latin America isn’t known. “Bites or scratches are a likely route of transmission,” Beer said.

Analyses showed that this virus, named variegated squirrel 1 bornavirus (VSBV-1), is separate from the other known bornavirus species, he said.

“However, there is, up to now, no indication that other squirrel species can also be infected, and there are no further human cases reported,” Beer said.

More information

For more on encephalitis, visit the U.S. National Institute of Neurological Disorders and Stroke.

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Type 2 Diabetes May Damage Thinking Skills: Study

By Kathleen Doheny
HealthDay Reporter

WEDNESDAY, July 8, 2015 (HealthDay News) — In as little as two years, people with type 2 diabetes may develop problems with blood flow in the brain, which could lower their thinking and memory skills, a small study suggests.

“Our major finding is we have linked the acceleration of the cognitive decline to impaired blood flow regulation in the brain,” said senior study author Dr. Vera Novak, an associate professor of neurology at Harvard Medical School in Boston.

The problem the researchers found was with dilation of the blood vessels, which allows more blood to flow through the brain. Adequate amounts of blood are crucial for thinking skills and other activities.

The researchers found that the higher someone’s average blood sugar levels were over the previous several months (a measure called A1C), the worse the problem with blood vessel dilation was, Novak said.

The study was published online July 8 in the journal Neurology. It was funded by the U.S. National Institute on Aging, the American Diabetes Association, the Harvard Clinical and Translational Science Center and the U.S. National Center for Research Resources.

In the study, the researchers evaluated 40 people. Their average age was 66. Nineteen of the study volunteers had type 2 diabetes, and 21 didn’t have the blood sugar disease.

In type 2 diabetes, the body doesn’t use insulin efficiently and eventually can’t make enough insulin to control blood sugar levels, according to the American Diabetes Association (ADA). Insulin is a hormone that’s crucial for metabolizing carbohydrates in foods. More than 29 million people in the United States have diabetes, and most of them have type 2 diabetes, the ADA said.

The researchers tested everyone at the start of the study, and again two years later. The volunteers completed thinking and memory tests. They were also given MRI scans to look at blood flow in their brains, and they had blood tests to measure their average blood sugar levels and inflammation.

At the two-year mark, those with type 2 diabetes had less ability to regulate blood flow to the brain when needed and scored lower on the thinking and memory tests.

On one test that looked at learning and memory, the scores of those with diabetes dipped an average of 12 percent, from 46 points to 41. Those without type 2 diabetes stayed at an average of 55 points over the two years.

A decline from 46 to 41 would translate roughly to remembering 10 words on a memory test the first time, and then remembering only 8 or 9 two years later, said Novak. “It’s only [in] two years, that’s what is concerning.”

The higher the inflammation levels, the worse the blood flow regulation, the research team found. That was true even for people who had good control of their diabetes.

Blood flow regulation decreased 65 percent in the people with type 2 diabetes, the researchers found.

Dr. Marc Gordon, chief of neurology at Zucker Hillside Hospital, North Shore Long Island Jewish Health System, Manhasset, said it’s not new to suggest type 2 diabetes is linked with inflammation and stress to the cells that can lead to problems in the blood vessels.

“What’s new here is they are documenting that the changes in the blood vessel in response to circumstances is what seems to be predicting a decline in cognition,” said Gordon, who is also professor of neurology and psychiatry at Hofstra North Shore Long Island Jewish School of Medicine.

In other words, he said, it appears the inability of the blood vessels to respond to various demands is what leads to the thinking problem, although inflammation also plays a role in damaging the blood vessels.

In previous research, Novak found that the brain of a person with diabetes is about five years older, on average, than the brain of someone without the condition. “So essentially, the diabetic brain ages faster,” she said.

The researchers added that a study with a larger group of people and done for a longer time is needed to better understand how type 2 diabetes may affect blood flow to the brain.

More information

To learn more about type 2 diabetes, visit the American Diabetes Association.

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Experimental Psoriasis Drug Shows Promise

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, July 8, 2015 (HealthDay News) — Preliminary trial results suggest that an experimental psoriasis drug may control the chronic skin disease better than the current standard treatment.

The drug, guselkumab, was compared to the commonly used medication adalimumab (Humira, Enbrel) in a study involving nearly 300 patients with plaque psoriasis.

Up to 86 percent of patients who received guselkumab cleared their psoriasis or had minimal psoriasis after 16 weeks of treatment, compared to 58 percent of patients taking adalimumab, the researchers reported.

However, patients getting guselkumab were somewhat more prone to infections, the researchers said.

“As a dermatologist, I am particularly excited about the potential of guselkumab and what this investigational therapy may mean for patients and the treatment of moderate to severe plaque psoriasis in the future,” said lead researcher Dr. Kristian Reich, a partner at Dermatologikum in Hamburg, Germany.

The drug works by blocking the protein interleukin-23 (IL23), which plays a role in the immune system and autoimmune diseases such as psoriasis.

The study — the second of three phases of trials needed for drug approval in the United States — shows that blocking IL-23 resulted in significant skin clearance, Reich said.

“These findings provide important insights into the role of IL-23 in psoriasis and the potential therapeutic benefit of guselkumab. My patients specifically like the long injection intervals,” Reich said.

After an initial injection, another one is given at four weeks and again every eight weeks or 12 weeks, he said.

Psoriasis causes itchy, dry and red skin. It also increases a patient’s risk for depression, heart disease and diabetes, among other conditions, the researchers said in background notes with the study. Plaque psoriasis is the most common form of the disease.

Reich said the drug is now being tested in more patients in a phase 3 trial.

“Findings from the ongoing phase 3 trial studies will provide even greater insights into the efficacy [effectiveness] and safety profile of this novel drug,” Reich said.

The trial was funded by the drug’s maker, Janssen Biotech Inc., a subsidiary of Johnson & Johnson. The results were published July 9 in the New England Journal of Medicine.

Dr. Mark Lebwohl, chairman of dermatology at the Icahn School of Medicine at Mount Sinai in New York City, welcomed the trial results. “We have clearly found the critical pathway in the immune system that is responsible for psoriasis,” he said.

For the year-long trial, researchers randomly assigned 293 adults with moderate to severe psoriasis — meaning at least 10 percent of their body was affected — to different doses of guselkumab, adalimumab or a placebo.

They found that after 16 weeks of treatment, patients on guselkumab showed significantly more improvement than those on adalimumab or a placebo.

The improvement in psoriasis among those getting 100 milligrams of guselkumab remained more significant at 40 weeks (77 percent versus 49 percent with adalimumab), the researchers found.

However, over 16 weeks, infections — including appendicitis and lung problems such as pneumonia — were seen in 20 percent of patients taking guselkumab, compared with 12 percent of those taking adalimumab and 14 percent of those taking the placebo, they added.

“Adalimumab is an excellent drug, so it’s particularly promising that the higher doses of guselkumab were even more effective than adalimumab,” Lebwohl said.

This study is important as it highlights the variety of options available for the treatment of psoriasis, said Dr. Katy Burris, a dermatologist at North Shore-LIJ Health System in Manhasset, N.Y.

“It should be kept in mind, though, that this is an early study with somewhat preliminary results, and more work needs to be done before one can fully assess the drug’s safety and efficacy,” she said.

More information

For more on plaque psoriasis, visit the U.S. National Psoriasis Foundation.

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Another Study Shows Link Between Antidepressants and Birth Defects

By Randy Dotinga
HealthDay Reporter

WEDNESDAY, July 8, 2015 (HealthDay News) — New research provides more evidence of a possible link between antidepressant use early in pregnancy and a small increased risk of birth defects.

But the study didn’t prove that the medications cause birth defects, and experts aren’t advising women to stop taking the drugs entirely.

“Depression can be very serious, and women should not suddenly stop taking their medications. Women should talk to their health care providers about available options, ideally before planning a pregnancy,” said study author Jennita Reefhuis. She is an epidemiologist with the U.S. National Center on Birth Defects and Developmental Disabilities at the U.S. Centers for Disease Control and Prevention.

Still,Reefhuis said, the study found that “some birth defects occur two to three times more frequently among babies born to mothers who took paroxetine [Paxil] and fluoxetine [Prozac] in early pregnancy.”

The findings also suggest that one antidepressant, Zoloft, may be safer than others. But experts said that could also be a statistical fluke.

Studies in recent years have differed about the risk, if any, to babies born to women who take antidepressants during pregnancy. The new research examined statistics from almost 18,000 mothers of infants with birth defects and close to 10,000 other mothers. The children were born between 1997 and 2009.

The researchers focused on antidepressant use in the first three months of pregnancy, when the drugs are thought to have the most potent effect on the unborn child.

They found no connection between sertraline (Zoloft), the most commonly used antidepressant in the study, and five birth defects to which it has been previously linked. The study authors said this was reassuring, as roughly 40 percent of women who reported taking an antidepressant in early pregnancy used Zoloft.

However, Dr. Adam Urato, a maternal-fetal medicine specialist at Tufts Medical Center in Boston, said statistical error could explain the lack of a Zoloft link.

The researchers found no connection between the antidepressants and nine birth defects that previously had been linked to them.

However, they did link a higher risk of five birth defects to Paxil and two birth defects to Prozac. The defects include problems with the heart, brain, skull and abdominal wall. But the added risk was small, the researchers said.

“A woman’s chance of having a child with the heart defect we described is about 10 per 10,000. Our results suggest that if she took paroxetine [Paxil], that risk could increase to 24 per 10,000,” said Reefhuis.

She pointed out that birth defects are common no matter what mothers do: One baby in 33 is born with one.

Reefhuis also cautioned that it’s not certain that antidepressants directly boost the risk of birth defects. Depression itself could affect the risk “or other factors that we either did not know about or did not measure well in our study, or simply, chance,” she said.

Urato believes antidepressants do affect the unborn child. “Chemicals have consequences, and chemicals going into a developing embryo and fetus are going to have consequences,” he said.

In the big picture, he said, “we should be very concerned about the widespread use of these medications in pregnant women like we’re seeing.” He added, however, that pregnant women who are depressed need appropriate care.

“The key here is not to tell pregnant women what to do. Instead, it’s crucial to make full information available to them,” Urato said. “Counsel them about drug exposures in pregnancy, and allow them to make the best choice for themselves.”

The study appears in the July 8 issue of the journal The BMJ.

More information

For more about birth defects, visit the March of Dimes.

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Breast-Feeding Tied to Healthier Arteries in Middle Age

By Amy Norton
HealthDay Reporter

WEDNESDAY, July 8, 2015 (HealthDay News) — Young women who breast-feed may have healthier-looking arteries years later, compared with those who bottle-feed their babies, a new study finds.

It has long been reported that breast-feeding is the healthiest option for babies. The study, published in the August issue of Obstetrics & Gynecology, hints at another potential health benefit from breast-feeding. But researchers also stressed that the findings do not prove cause-and-effect.

What the study did show: Of over 800 U.S. women who gave birth at least once, those who breast-fed for a longer period of time had less thickening in the carotid artery wall once they’d reached middle age.

The carotid arteries supply blood to the brain, and thickening in the artery wall is considered an early sign of atherosclerosis — the buildup of artery-clogging “plaques” that can lead to heart attack or stroke.

Thickening in the artery walls can be viewed as “vascular aging,” explained lead researcher Erica Gunderson, of Kaiser Permanente Northern California’s division of research in Oakland, Calif.

In this study, she said, women with the greatest carotid artery thickening were essentially three to five years older — in terms of blood vessel health.

But the question remains: Is the difference because of breast-feeding?

Dr. Suzanne Steinbaum, a preventive cardiologist who was not involved in the study, was not convinced.

“This is an interesting study,” said Steinbaum, director of the Women’s Heart Health program at Lenox Hill Hospital in New York City. “There’s clearly a correlation between breast-feeding and [artery-wall thickening], but we can’t be sure what it means.”

She pointed out that women who breast-fed, particularly for a longer time, were generally thinner, better-educated and more physically active — both in young adulthood and 20 years later.

Gunderson’s team did account for those factors, and still found a statistical connection between breast-feeding and artery-wall thickness. But it’s difficult to zero in on breast-feeding as the direct cause, Steinbaum said.

The findings are based on 846 U.S. women who, in the 1980s, enrolled in a long-term study of cardiovascular health. They were between the ages of 18 and 30 at the time.

All of the women underwent ultrasound scans of the carotid artery 20 years after entering the study.

On average, Gunderson’s team found, women who had breast-fed their babies for one month, or not at all, had more thickening in the carotid artery wall. Those who had breast-fed for 10 months or longer had the clearest arteries.

Gunderson agreed that the findings show only a correlation, rather than a definite case of cause-and-effect.

She suspects, however, that breast-feeding might be beneficial through effects on body weight and, even more so, on blood pressure: When her team accounted for the study participants’ weights and blood pressures in middle-age, that seemed to explain much of the connection between breast-feeding and artery health.

“That’s consistent with what we’d expect,” Gunderson said. When a woman breast-feeds, the body releases the hormone oxytocin, which other research has linked to lower blood pressure.

“Pregnancy is an incredibly stressful physiologic process,” Gunderson said. “It puts greater demands on the cardiovascular and metabolic systems.”

Breast-feeding, she said, may help “reset” those systems after pregnancy.

A big question, though, is whether breast-feeding moms actually have lower rates of heart attack and other cardiovascular problems down the road. Gunderson said her team wants to continue to follow this study group to find out.

In the meantime, since breast milk is considered the best nutrition for babies, moms already have reason to do it, Gunderson said. The potential long-term heart benefits might just offer “more motivation,” she added.

At the same time, both she and Steinbaum stressed that women shouldn’t feel guilty if they do not breast-feed.

Some women simply can’t, because of the “demands of the workplace,” Gunderson explained. Others find breast-feeding difficult, she added — in which case they can ask their health care provider for help.

Steinbaum made another point: There are plenty of other ways for women of all ages to boost their heart health, such as eating a healthy diet, exercising regularly and not smoking.

“It’s important to be heart-conscious during all parts of your life,” Steinbaum said.

More information

The American Academy of Pediatrics has more on the benefits of breast-feeding.

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Follow Along As One Woman Helps Her Ailing Dog Finish His Bucket List

When many people look to adopt a pet, they gravitate toward the cute and fluffy puppies and kitties they can spend years creating memories with, filling their Instagram and Facebook feeds with adorable pics of a perfect life with a furry friend.

Nicole Elliott of Columbus, Georgia, did just the opposite: She’s giving one lucky shelter dog a second chance at life with his limited remaining days.

RELATED: 10 Rules for Raising a Healthy Dog

In April, Elliott became a foster parent to Chester, an adorably scruffy dog who was rescued from a high-kill shelter by another shelter. You have to see his radical before-and-after photo to believe it:

RELATED: This Man’s Tribute to His Dog Will Make You Want to Hug Your Pets NOW

After removing all the matted hair, the animal shelter that saved him found a large tumor on his side and had it removed, but soon it, and more tumors, returned all over his body. The sweet dog—whom the shelter guesses to be around 13 or 14 years old—has terminal cancer.

“I saw a post about him needing a hospice for his remaining days. I had to consider it for a while and decide if I could handle it,” Elliott wrote in the first post for his Facebook page, Chester’s Final Journey. “I decided it would be an amazing experience to take on. It will be so tough to lose him shortly, so I decided to take the time he has left and make it as happy as I can. Today he has many cancerous lumps all over his body. He is also heart worm positive. He is still so sweet and as perky as he could be. I am wanting to do a sort of bucket list for Sweet Chester and give him an awesome final ride.”

RELATED: 20 Must-Have Gadgets for Exercising With Your Dog

Since then, the 24-year-old mom has made it her mission to help Chester make the most of his remaining time. For their first adventure together, Elliott took him shopping for toys and other doggie delights. Since then, she told local news station WTVM, he’s taken a fun car ride with the windows down, eaten a Nathan’s hot dog and a dog-friendly sundae, relaxed in a special oatmeal milk bath, and enjoyed all the treats and toys a dog could possibly want.

She told WTVM she has other plans for Chester that include “a dinner at a nice restaurant, a day at the beach and a birthday party at the animal rescue with his four-legged friends.” As they go about their bucket list, Elliott will be posting photos of their fun on Instagram and Facebook. We’ll be watching to see what amazing things Chester gets to experience next.

RELATED: My Dog Helped Me Heal

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6 Life Lessons From the Founder of Burt’s Bees

 

You may not know his full name, but you surely know his face: Burt Shavitz, the co-founder of Burt’s Bees, and “The Bee Man,” as he was known, passed away on Sunday at the age of 80. You’ve seen him—his wild beard, white hair, and classic conductor cap—adorn the school bus yellow packaging of some of the brand’s cult favorite products.

A passionate beekeeper, wisecracker, and lover of nature, he was an unlikely face of a cosmetics company. He started by simply doing what he loved—making honey from beehives. Eventually, the leftover beeswax was turned into candles, and later on, lip balm, as Burt’s Bees, the company that’s now synonymous with natural beauty, grew and blossomed.

“Burt never set out to change the world, but he was a pioneer who found himself always on the precipice of progress,” the company said in a statement. He was a “complex man who sought a simple life” and always stayed true to who he was. There is much to be learned from the way Burt lived his life, and his commitment to nature and the environment. Here, six life lessons we can all take away from the kind, passionate, free-spirited man who will live on forever in our hearts—and our Hand Salve.

RELATED: 5 Habits to Steal from Powerful People

Remember the simple things can be the most magical

 

Be refreshingly honest

RELATED: A Guide to Natural Beauty Products

 

Live life your way

 

Let nature ground you

 

Follow your own curiosities and passion, and be rewarded

RELATED: 7 Times Celebrities Embraced Their Natural Beauty

Live your life one day at a time

Photos: Getty; Quotes provided by Burt’s Bees

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CVS Health Leaving U.S. Chamber of Commerce Over Smoking Spat

Photo: Getty Images

The pharmacy is quitting the Chamber over the trade group’s efforts to target anti-smoking laws abroad, saying it runs counter to its efforts to promote better health.

CVS Health is quitting the U.S. Chamber of Commerce because of the trade group’s purported efforts to lobby against anti-smoking laws in countries around the globe.

The drugstore and pharmacy benefits manager, which last year stopped selling cigarettes and other tobacco products at its stores in a quest to become more of a healthcare destination, said the chamber’s lobbying efforts were not compatible with CVS’s mission to promote and facilitate better health.

“We were surprised to read recent press reports concerning the U.S. Chamber of Commerce’s position on tobacco products outside the United States,” David Palombi, a senior vice president at CVS, said in a statement on Tuesday to several media outlets. “CVS Health’s purpose is to help people on their path to better health, and we fundamentally believe tobacco use is in direct conflict with this purpose.”

CVS has 7,800 drugstores across the United States, with more retail spots to come shortly when it takes over Target’s pharmacy business. Last year, the company decided to stop selling tobacco products, which generated $2 billion a year in sales and a lot of shopper traffic, betting it could more than make up for the lost business by selling healthier foods, expanding its walk-in clinics business, and winning more pharmacy business. Last month, CVS Health gave Fortune a close-up look at its new post-tobacco retail strategy.

“Given the leadership position we took last year in removing tobacco products from our stores … we have decided to withdraw our membership in the chamber,” Palombi said.

Last week, the New York Times reported that the chamber and its foreign affiliates have been taking aim at restrictions abroad on smoking in public spaces, bans on menthol, advertising restrictions, and graphic warning labels. Cigarette sales have been in free fall in many developed countries, including the United States, for years, but have been strong in many developing countries.

The U.S. Chamber of Commerce responded to the New York Times story by saying it had made it clear to foreign governments that it supported their anti-smoking efforts.

“It’s disappointing that the New York Times gathered a number of letters the Chamber sent to governments around the world for its recent articles but then doesn’t seem to have bothered to read them. Our communications to governments concerning tobacco have explicitly made clear that we support their efforts to address public health concerns,” the Chamber said.

The Chamber on Tuesday said it nonetheless supports “protecting the intellectual property and trademarks of all legal products in all industries and oppose[s] singling out certain industries for discriminatory treatment.”

Its efforts earned it brickbats from the World Health Organization.

“By lobbying against well-established, widely accepted and evidence-based tobacco control public health policies, the U.S. Chamber of Commerce undermines its own credibility on other issues,” Margaret Chan, director general of the WHO, said in a statement on Tuesday to the Times. “So long as tobacco companies continue to be influential members of the chamber, legitimate businesses will be tarred with the same brush.”

The Chamber on Tuesday said it nonetheless supports “protecting the intellectual property and trademarks of all legal products in all industries and oppose[s] singling out certain industries for discriminatory treatment.”

Its efforts earned it brickbats from the World Health Organization.

“By lobbying against well-established, widely accepted and evidence-based tobacco control public health policies, the U.S. Chamber of Commerce undermines its own credibility on other issues,” Margaret Chan, director general of the WHO, said in a statement on Tuesday to the Times. “So long as tobacco companies continue to be influential members of the chamber, legitimate businesses will be tarred with the same brush.”

This article originally appeared on Fortune.com.

More from Fortune:

Target selling its pharmacies to CVS Health for $1.9 billion

Why employers are offering more generous benefit packages

McDonald’s Quarter Pounders are about to get supersized

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