Monmouth County's Ask The Doctor Early Spring 2021

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Ask The Doctor is CNJ’s only magazine that only contains editorial regarding health and wellness.

Monmouth County’s Ask The DOCTOR THE HEALTH &WELLNESS MAGAZINE F R YOU ANDYOUR FAMILY EARLY SPRING 2021

Local Physicians Answer Your Health Questions

NEWS YOU CAN USE:

• Kids’ Health • Beauty • Eating Well • Fitness • Aging • ...and more

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THE FIRST STEP TOWARD A NEW TOMORROW STARTS HERE. Newsweek has ranked Blake Recovery Center as the #1 addiction treatment center in New Jersey. Addressing substance abuse is never easy, especially during stressful times. But be assured that changing your life for the better can begin today in a supportive and safe environment, providing inpatient and intensive outpatient services. We treat every form of addiction, right here in New Jersey. You deserve this and your loved ones deserve to have you back in their lives. Visit CarrierClinic.org/BRC or call 800-933-3579.

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OUR DEPARTMENTS As We Age...........................................11 Articles and physician information just for seniors Kids’ Health & Camp......................... 17 Information, news and expert advice to raising healthy children from pregnancy to 18 Family Matters ................................. 21 Information, resources and news related to the health and well-being of your families future Healthy Home................................... 26 Here you will find expert tips to make your home healthier, safe and fabulous The Healthy Palate........................... 30 Recipes to enjoy and local dining options for eating out

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Beware Of Covid-19 Vaccine Scams

As the COVID-19 vaccine roll-out continues, it’s important to be on the lookout for scams. The Financial Crimes Enforcement Network (FINCEN) recently issued a new warning about vaccine scams: • Beware of scams offering early access to vaccines for a fee. • Keep an eye out for phishing scams where scammers email or text you with phony vaccine information. • Steer clear of scammers trying to sell fake versions of vac- cines. Here are the facts: • You can't pay to get early access to the vaccine. • Medicare covers the cost of the COVID-19 vaccine. COVID-19 vaccines are also free to others throughout the country, although providers may charge an administration fee. • Don't share your personal or financial information if someone calls, texts, or emails you promising to get you the vaccine for a fee. For the latest vaccine updates, check with the (CDC) Center for Disease Control & Prevention’s website.

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Are You a Target for Health Fraudsters? People spend billions of dollars a year on health-related products and treatments that not only are unproven and often useless, but also sometimes are dangerous. The products promise quick cures and easy solutions for a variety of problems, from obesity and ar- thritis to cancer and AIDS. But the "cures" don't deliver, and peo- ple who buy them are cheated out of their money, their time, and even their health. That's why it's important to learn how to evaluate claims for products related to your health.

Health fraud trades on false hope. It promises quick cures and easy solutions for a variety of problems, from obesity and arthri- tis to cancer and AIDS. Fraudulently marketed health products can have dangerous interactions with medicines people are already tak- ing and can keep them from getting a proper diagnosis and treat- ment from their own health care professional. Many unapproved treatments are expensive, too, and rarely covered by health insur- ance.

Health fraudsters often target people who are overweight, have serious conditions like cancer, or conditions without a cure, like: • Multiple Sclerosis • Diabetes • Alzheimer's disease • HIV/AIDS • Arthritis The Federal Trade Commission (FTC), the nation’s consumer protection agency, and the Food and Drug Administration (FDA) say it's important to learn how to evaluate health claims, especially if you have a serious condition. Cancer If you or someone you love has cancer, you may be curious about supposed “miracle” cancer-fighting products — like pills, powders, and herbs — that you’ve seen advertised or heard about from family and friends. Scammers take advantage of the feelings that can accompany a diagnosis of cancer. They promote unproven — and potentially dangerous — substances like black salve, essiac tea, or laetrile with claims that the products are both “natural” and effective. But “natural” doesn’t mean ei- ther safe or effective, especially when it comes to using these products for cancer. In fact, a product that is labeled “natural” can be more than ineffective: it can be downright harmful. What’s more, stopping or delaying proven treatment can have serious consequences. The truth is that no single device, remedy, or treatment can treat all types of cancer. All cancers are different, and no one treatment works for every cancer or everybody. Even two people with the same diagnosis may need different treatments. That’s one more reason to be skeptical of websites, magazines, and brochures with ads for products that claim to treat cancer, and to decide on treatments with your health professional. People with cancer who want to try an experimental treatment should enroll in a legitimate clinical study. The FDA reviews clinical study designs to help ensure that patients are not subjected to unreasonable risks. For information about cancer treatments, contact the American Cancer Society. You can find your local chapter at www. cancer.org.For free publications on cancer research and treatment, or to learn about clinical trials, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). HIV and AIDS Although proven treatments can extend and improve the quality of life for people with AIDS, so far there is no cure for the disease. If you’ve been diagnosed with HIV, the virus that causes AIDS, you may be tempted to try untested drugs or treat- ments. But trying unproven products or treatments — like electrical and magnetic devices and so-called herbal cures — can be dangerous, especially if it means a delay in seeking medical care. For example, the herb St. John's Wort has been promoted as a safe treatment for HIV. But there’s no evidence that it is effec- tive in treating HIV; in fact, studies have shown that it interferes with medicines prescribed for HIV. ...continued on page 32

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Lemon balm is a perennial herb from the mint family. The leaves, which have a mild lemon aroma, are used to make medicine. Lemon balm is used alone or as part of various multi-herb combination products. Lemon balm contains chemicals that seem to have a sedative, calming effect. It might also reduce the growth of some viruses. Lemon balm is used for and has shown help for anxiety, stress, Alzheimers Disease, Dementia, Insomnia and Indigestion. Researchers concluded that certain doses and delivery of lemon balm could reduce stress and negative moods or anxiety. Another recent study indicated that lemon balm may help with indigestion. The study looked at 30 people with function- al dyspepsia, a condition that can cause an upset stomach. Researchers gave participants a dessert similar to a sorbet with or without lemon balm that they had also combined with another herb (artichoke, or Cynara scolymus). Participants who ate the dessert with the herbs experienced less stomach upset than those who did not. Other researchers indicated that lemon balmmight help with conditions related to stress, such as: diabetes and chronic disor- ders like Alzheimer’s, Parkinson’s and Cardiovascular diseases. However, the review indicates that factors, including how people manufacture it and dosage, directly impact lemon balm’s effectiveness. Lemon balm contains chemicals that seem to have a sedative, calming effect. It might also reduce the growth of some viruses. Don't use lemon balm if you have Thyroid disease or thyroid issues. There is a concern that lemon balm may change thy- roid function, reduce thyroid hormone levels, and interfere with thyroid hormone-replacement therapy. Talk to your trusted Physician about Lemon Balm and do your research. There is still limited research that proves the effec- tiveness of lemon balm across larger populations. A: q: What Can Lemon Balm Be Used For?

By Surabhi Ashok

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What is a bunion? A bunion is a bump on the first metatarsophalangeal joint (MTPJ), the joint where your big toe and foot connect. When bone alignment problems in your foot force your big toe to tilt toward the other toes instead of pointing up, it pushes the MTPJ outward and causes the bump. Bunions usually appear on the big toe, but can also appear on the little toe. These little toe bunions are called tailor’s bunions or bunionettes. They’re caused by bone misalignment, just as big bunions are. What are the signs of a bunion? The bony bump is the tell-tale sign, but you can also expect other symptoms, including soreness, pain, and red skin around the bump. Many bunion sufferers also have restricted movement in their big toe. How do I treat a bunion? At A Step Up Podiatry, LLC, bunion treatment usu- ally starts with a clinical examination and Xrays to determine its severity. Some treatment options include:

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Relax in a spa like environment. Dr. Richard Allen, DC strives to deliver quality wellness and pain management care using Chiropractic, Active and Passive Therapies, Flexibility Work, In-Office Rehabilitation Services & Home Care Recommendations. Michelle Gursky Allen, MS,RD,CDN provides nutrition counseling for people with eating disorders, weight management issues and medical nutrition therapy, using a nonjudgmental and collaborative approach. Dr. Herng Wu, Lic. Ac., Dipl. O.M., Ph.D. Acupuncture services can help a number of issues such as chronic pain, hypertension, weight, sleep, anxiety, fertility and menopausal changes. Dr. Margo Hurewitz, PsyD licensed psychologist who specializes in treating children, adolescents and adults who are struggling with binge eating, anorexia, and bulimia as well as other psychiatric conditions such as depression and anxiety.

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Coronavirus Vaccines and People with Cancer:

A Q&A with Dr. Steven Pergam Many people being treated for cancer are asking whether they should get one of the COVID-19 vaccines. Steven Per- gam, M.D., of the Vaccine and Infectious Disease Division at the Fred Hutchinson Cancer Research Center in Seattle, was a co-leader of a committee formed by the National Compre- hensive Cancer Network (NCCN) that recently released rec- ommendations on COVID-19 vaccination in cancer patients. In this Q&A, Dr. Pergam discusses some of the questions people with cancer and cancer survivors have about these vaccines.

CDC, the NCCN recommendations, and other can- cer-related organizations say that cancer patients are a high priority group for vaccination. Why? We all want to get the vaccines to the people who are at most risk for severe COVID-19 complications, and the data show that cancer patients are high risk. Making highly effi- cacious vaccines available to those populations is going to be important to saving lives. Are there any patients undergoing active cancer treatment who should not get vaccinated? For patients who have just had a stem cell transplant or received CAR T-cell therapy, who are typically receiving im- munosuppressive therapy, we recommend that they delay COVID-19 vaccination until at least 3 months after they’ve completed treatment. That’s based on data that [other] vac- cines have had limited efficacy during periods when these pa- tients are their most immunosuppressed.

Dr. Steven Pergam of the Fred Hutchinson Cancer Research Center receiving his first dose of a COVID-19 vaccine on December 29, 2020. Credit: Image courtesy of Dr. Steven Pergam

The data are a little less clear for patients who are getting ag- gressive chemotherapy, but for those who are receiving more intensive treatment regimens—for example, those starting initial therapy for leukemia—we recommend that they delay vacci- nation until their cell counts recover. Those are the two main groups where I think there is agreement that they should delay COVID-19 vaccination, at least ini- tially. And survivors, those not undergoing active cancer treatment. Are there any reasons they shouldn’t get vaccinated? I think that depends on when you ask the question. How much vaccine do you have [available]? If you have unlimited amounts, then everybody should get vaccinated. But when you get into vaccine allocation issues, that’s when it gets challenging. But there’s no question that many cancer survivors have immunologic deficiencies, so I see many of them as being at high risk. Cancer survivors are also people who tend to be older and have other comorbidities—heart disease, kidney or lung dys- function—so they’re going to have other reasons that will put them at risk for developing severe COVID-19, and those are all reasons for them to get vaccinated. And what about those who may be undergoing treatment soon, such as somebody just diagnosed with cancer or whose treatment has been delayed by the pandemic? The approach we discussed in the NCCN committee is that we really don’t want to create guidance that will prevent cancer patients from getting vaccinated. If you start trying to nuance it for the “right time,” it may mean that many patients won’t get the vaccine. So, the best approach is to get the vaccine when you can. Still, there are some caveats. We do recommend delays for patients undergoing stem cell transplant and those getting induc- tion therapy for leukemia. In addition, cancer patients who are about to undergo surgery should probably wait for a week until after surgery to get vaccinated. Because we don’t want any potential side effects from the vaccine—for example, a fever—to potentially delay their surgery. So, there are some specific callouts, but we tried to limit restrictions. Are researchers collecting data on how effective the vaccines are in people with cancer? There are a number of research groups interested in vaccine efficacy in patients who have had bone marrow transplants, and there are groups looking at people who have blood cancers, like CLL or CML, because they are more likely to have immuno- deficiency over a long period of time.

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Everyone wants to know the answer to the question: How do they respond to these vaccines? There will be lots of analyses that will need to be done. I want to see studies of how well the vaccines work in people with specific cancers, as well as in those who receive specific chemotherapies or treatment regimens. Is there any indication that current patients or survivors will have less protection from a COVID-19 vac- cine? Based on the data from other vaccines, I think it’s highly likely that it’s not going to be the 95% protection we’re seeing against symptomatic COVID-19 [from the Pfizer and Moderna vaccines] in the general public. I think it will be less than that. But even if it’s 50%, it’s still going to be a major benefit. And similar to the flu vaccine, preventing infection is not the only aim, it’s also preventing the complications of infection. These COVID-19 vaccines may not prevent the primary infection, but we hope that they can prevent cancer patients from developing COVID-19 symptoms or being hospitalized, as has been seen in the phase 3 trials among the general public. There could be other downstream benefits that could be very helpful. What about caregivers of those with cancer? Should they be a priority group for vaccination? This is an underappreciated question. There’s no doubt that if you think about a vaccine strategy, if we assume that people with cancer aren’t going to respond as well to the COVID-19 vaccine, one of the best ways to protect them is to give the vaccine to people who will respond well. And that means anybody who they spend time with. So, anybody who is a caregiver, a loved one, or is in close contact with somebody with cancer, it’s important for them to get vaccinated. Because the thought is that, first, it will decrease the caregiver’s risk of developing symptomatic infections and data suggest that symptomatic people are more likely to transmit the virus to people around them. And, two, we hope that available vaccines may prevent transmission—although available studies evaluating this question are ongoing. If that’s true, then caregivers and loved ones getting vaccinated will really help. Because that cocooning effect, vacci- nating the close contacts around people with cancer, can provide extra protection. Is there any indication that people with cancer/cancer survivors are choosing not to get vaccinated? That’s hard to know right now. Cancer patients are just starting to get these vaccines, due to challenges in the supply chain. I think some cancer patients will be hesitant, but not necessarily more so than the general population. We hope that they are more accepting of vaccines because they know they’re at risk [of severe COVID].

I can say that locally, in [Seattle-area] institutions, cancer patients are clamoring to get the vaccine. Physicians are feel- ing challenged because they’re getting so many calls from their patients to ask when it will be available and when can they get it. The patients know the risk, and they see it as an opportunity to protect themselves. That’s great to see. And I hope it continues. How do you see the approach to vaccination changing over the coming months? One thing for people to be aware of is that the guidance around the COVID-19 vaccines is going to change over time. And that’s for a couple of reasons. One, because more data will become available. Even if they’re small studies, they can be very informative. Two, there are going to be more vaccines, the Johnson & Johnson and AstraZeneca adenovirus vector vaccines may soon be available for the public.... And there are the protein-subunit vaccines, like the one currently in trials from Novavax. We expect that other vaccines will allow more people to get vaccinated. But there may be one or two vaccines that will be better for cancer patients, so we’ll need to see more data. I really want to see NCI and NIH and other funding agen- cies support these types of studies. It is critical to choose the vaccines with the highest efficacy in cancer patients and to help us decide who should be vaccinated and when. We’re just beginning to think about trials that can be pragmatic and use- ful for providers—to best understand how to protect patients. That is going to be very important as we continue to address the pandemic and protect patients against SARS-CoV-2 in the future.

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Dr. Steven Linker, OD

QUESTION: What is Optomap retinal imaging?

ANSWER:

The optomap ultra-widefield retinal image is a unique technology that captures more than 80% of your retina in one panoramic image while traditional imaging methods typically only show 15% of your retina at one time. Your retina (located in the back of your eye) is the only place in the body where blood vessels can be seen directly. This means that in addition to eye conditions, signs of other diseases (for example, stroke, heart disease, hypertension and diabetes) can also be seen in the retina. Early detection of life-threatening diseases like cancer, stroke, and cardiovascular disease. It also facilitates early protection from vision impairment or blindness. Early signs of these conditions can show on your retina long before you notice any changes to your vision or feel pain. While eye exams include a look at the front of the eye to evaluate health and prescription changes, a thorough screening of the

free. It is suitable for every age, even children. The capture takes less than a second. Images are available immediately and you can see your own retina and exactly what your eye care practitioner sees in a 3D animation. Most importantly, early detection means successful treatments can be administered and reduces the risk to your sight and health.

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MONMOUTH CROSSING Assisted Living at Its Best

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Better hearing is an important part of how we communicate and stay connected to the world and the people we love. For many, seeking hearing care is the first step to a happier and healthier future, being able to secure these ser- vices at home is paramount for many of our clients. Whether you want to explore hearing aids, or discuss concerns about your hearing health, Dr. Laura Padham Visiting Audiologist is here to provide you with options.

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A lot has changed. Here’s what hasn’t… Beautiful accommodations. Engaging activities. Around-the-clock support. And a dedicated team that develops strong, lasting bonds with our residents and are committed to enhanced safety protocols. This is assisted living at its best. And we’re not alone in that thinking. Monmouth Crossing has been repeatedly recognized for outstanding quality care by both Holleran, a national leader in senior living research, and the NJ Department of Health and Senior Services by earning Advanced Standing Distinction for 9 consecutive years. Get more information and schedule a live virtual tour: monmouthcrossing.com Debbie Yigit, 732.303.8600

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We provide Adult Day Services For Special Needs Adults (21 years old +) Things You Should Know About Qualifi d Medicare If you’re among the 7.5 million people in the Qualified Medicare Beneficiary (QMB) Program , doctors, suppliers, and other providers should not bill you for services and items covered by Medicare, including deductibles, coinsur- ance, and copayments. If a provider asks you to pay, that’s against the law. The Centers for Medicare & Medicaid Services (CMS) has heard from people with Medicare who report being billed for covered services, even though they’re in the QMB pro- gram. Older consumers have also submitted complaints to the CFPB, reporting that debt collectors tried to collect these types of bills, or sent this information to credit report- ing companies. If you’re in the QMB Program and get a bill for charges Medicare covers: 1. Tell your provider or the debt collector that you're in the QMB Program and can’t be charged for Medicare deduct- ibles, coinsurance, and copayments. If you’ve already made payments on a bill for services and items Medicare covers, you have the right to a refund. Tip: To make sure your provider knows you’re in the QMB Program, show both your Medicare and Medicaid or QMB card each time you get care. You can also give your provider a copy of your Medicare Summary Notice (MSN). Your MSN will show you’re in a QMB Program and shouldn’t be billed. Log in to your MyMedicare.gov account at any time to view your MSN or sign up to get your MSN electronically. 2. If the medical provider won’t stop billing you, call Medi- care at 1-800-MEDICARE (1-800-633-4227). TTY users can call (877) 486-2048. Medicare can confirm that you’re in the QMB Program. Medicare can also ask your provider to stop billing you and refund any payments you’ve already made. 3. If you have a problem with a debt collector, you can sub- mit a complaint online or call the CFPB at (855) 411-2372 . TTY/TDD ers can c ll (855) 729-2372. We'll forward your complaint to the debt collection company and work to get you a response from them. You can download a printer-f i ndly version of this infor- mation to share with friends or clients. You can also visit Ask CFPB to learn about your rights when responding to a debt collector and how to dispute an error on your credit report. Stacy Canan is Assistant Director of the CFPB’s Office for Older Americans. To learn more about our work on behalf of older consumers, visit consumerfinance.gov/olderamericans. Tim Engelhardt is Direct r of the Medicare-Medicaid Coor- dination Office at the Centers for Medicare & Medicaid Ser- vices. Call UsToday For ATour or Info! (732) 845-3332 • Free Door-to-DoorTransportation • Health Evaluations • Bi-Lingual staff • Music & PetTherapy • Educational Programs to assist & encourage independance with activities of daily living • Social Activities • Fabulous food and menu options • Recreation, Exercise,Trips to Museums, Stores, Crafts and more... Serving Monmouth, Middlesex & Ocean Residents 20 1-A Jackson Street Freehold, New Jersey We Offer Something Special Nowhere Else Found In CNJ ForYour Loved One! Active Day Adult Services Medicaid/HMO/DDD

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COMPREHENSIVE PERSONAL Care Touch

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DR. KIRAN MEDASANI, MD MEDICAL DIRECTOR

A t King Manor Care and Rehabilitation Center, we are dedicated to providing professional quality health care in a warm environment. Our highly experienced and devoted sta of health care professionals treat each patient with respect, compassion and dignity. Centrally located on the Jersey Shore, King Manor Care and Rehabilitation Center has been servicing the community for over 25 years.

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ASSISTED LIVING IN THE HEART OF MONMOUTH COUNTY

Safe visits in a designated area allow families to visit their loved ones at The Chelsea.

445 Rt. 9 South, Manalapan, NJ 07726 P 732-314-7084 • chelseaseniorliving.com We are keeping our residents engaged and active. Call today 732-314-7084 to arrange a safe visit!

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180 Turning Lives Around, Inc. Helping Survivors of Domestic &Sexual Violence By, Pam Teel

180 Turning Lives Around, Inc. offers hope and support and provides sur- vivors of domestic and sexual violence and their families with free and con- fidential programs and resources to process and heal from their experiences. At hand, are caring and experienced counselors who will listen, discuss your options, and provide resources to guide you through. You need to understand that you are not to blame for your experience of abuse and that you and your family deserve to live your life free of fear and full of promise. 180’s mission is to help create a pathway just for you to provide safety, healing, and independence. Domestic violence is a pattern of behaviors used to gain or maintain pow- er and control. However, spotting the signs of an unhealthy relationship can sometimes be difficult to see. Stress and anxiety may be found in any rela- tionship, but unhealthy and abusive relationships are an entirely different dy- namic. 180 counselors can discuss your particular experience and help you determine if you are experiencing domestic violence. Counselors can support you, provide advice, give you access to services, and help you develop a Safety Plan. (If you feel that you are a victim, read more about domestic violence at: https://180 NJ.org. If you are in immediate danger, contact 911). 180’s comprehensive support services are free and confidential, including 24/7 hotlines, counseling, legal advocacy, access to an emergency safe house, and art, play, drama & music therapy are available for children. Timeline of Accomplishments: 2019- Safe House offers pet-friendly housing to survivor families. 2017- Monmouth Family Justice Center (FJC) – 180 creates the county’s newest institution to offer victims of domestic violence and/or sexual assault a one-stop location program to meet all of their immediate needs – reducing their trauma and helping victims and their children expedite the services with other agencies. LGBTQ outreach advocacy – 180 creates a program to provide outreach to the LGBTQ community, which becomes a model for the New Jersey Coalition against Sexual Assault and other state agencies. 2016- Legal Assistance for Victims (LAV) – 180 wins federal funding to support victims of domestic violence/sexual assault who cannot afford legal support on their own. Milestone - serving over 1MILLION victims and their loved ones through its extensive programs and services. Emergency Safe House – 180 opens its doors to the new ADA safe house, one of the largest in the State, which is also the largest homeless facility in the County. The flagship Emergency Shelter is nearly double the capacity of the former shelter and the only emergency shelter in the State able to house adult male victims and their families. 2015- Keeping Families Together (KFT) – a DCF pilot program awarded to 180 and then further extended as a key 180 service to support Monmouth County families. 2010- Domestic Violence Liaison (DVL) – connects the State’s Department of Children and Families with an experienced 180 Domestic Violence support person, closing the loop between the State and 180’s services. 2008- 2ndFLOOR’s Youth Helpline goes Statewide, serving all of New Jer- sey’s youth. 2004- 2ndFLOOR – a youth helpline created as a pilot program to respond to crisis issues for the county’s youth, including support about dating abuse, cyber bullying, sex/sexuality, and mental health issues including suicide. The Women’s Center changes its name to 180 Turning Lives Around to con- vey the comprehensive and integrated programs and services available for families. 1998- Amanda’s Easel (AE) – a trauma-focused arts therapy program for children and their non-offending parents. Domestic Violence Response Teams (DVRT) – 180 trained advocates/coun- selors partner with municipal police to respond to the needs of domestic vio- lence victims where needed, including police stations and hospitals. 1997- Shore Regional Outreach Program (SROP) – 180 extends its reach into minority and immigrant communities providing culturally relevant services to victims of domestic violence and sexual assault.

180 participates in the Sexual Assault Nurse Examiner (SANE) pilot pro- gram. 1996- Families in Transition (FIT) – 180 receives federal funding to provide temporary housing for families. Sexual Assault Response Teams (SART) – trained advocates/counselors re- spond to needs of sexual assault victims and their loved ones throughout the criminal justice system, including medical examinations and police proce- dures. 1989- Emergency Shelter – 180 opens its doors to the county’s first domestic violence emergency shelter to 7 families. 1986- The Family Court Liaison Program is implemented to assist victims in the process of obtaining restraining orders. 446 victims are helped the first year. Emergency Shelter – receiving funding for the first federally-funded battered women’s shelter in US. 1984- The NJ Prevention of Domestic Violence Act is signed into law en- abling victims to obtain restraining orders for police protection. 1976–1977- Advocacy/Counseling/Case management/Community Out- reach & Education – comprehensive services are initiated to address all needs victims and their children face as well as the community. Services include: individual and group counseling; case management support for welfare/food stamps, legal advocacy around divorce and separation issues, advocacy with the criminal justice system around issues like battering and rape, court ac- companiment, and trial preparation for rape victims. Community outreach and education is initiated. 1976- Since its inception in 1976, 180 has provided model programs in the field of rape care and family violence. It serves as the sole provider in Mon- mouth County of a wide range of comprehensive services to individuals and their families that relate to domestic and sexual violence. 180 is the only agen- cy in the County available on a 24-hour, seven days per-week basis. The Agen- cy remains the only Emergency Shelter in the County that offers a protected safe home for battered individuals and their children. 180 offer a wide array of programs concerned with positive approaches to safety and recovery from assault in all situations. The “Founding Mothers” house abused women in their own homes while applying for funding from the federal government to set up a shelter. The Women’s Resource and Survival Center (The Women’s Center) is incorporat- ed. The first Rape Hotline in Monmouth County is established by staff of The Women’s Center. Your support is needed now more than ever. Domestic violence and sexual assault do not just stop because of a crisis like COVID-19. When family stress- ors increase, violence and abuse can quickly escalate. It is in these very trying times that survivors need 180 even more, and they are determined to be there for everyone who needs their services. Hundreds of victims in Monmouth County phoned the hotline during the months of the pandemic. Many victims were left extremely vulnerable while they were quarantined with an abuser where both physical and emotional violence were dominating their lives and threatening the safety and well-being of their children. Donor support has enabled 180 to both remain open throughout this challenging time and adjust all of their services so that survivors can access the support they need. There are many ways you can donate to help these survivors. Please visit their website at: 180nj.org. you can also find them on Facebook. 180 Turning Lives Around, Inc. is a registered 501(c)(3) non-profit organi- zation and receives financial support from individuals, government and civic agencies, faith-based organizations, corporations, and foundations. Gifts to 180 are tax-deductible to the full extent possible under IRS regulations. Contact us today: Domestic Violence: Call (888) 843-9262 | Sexual Violence: Call (888) 264-7273 Deaf & Hard of Hearing: Text (732) 977-2832 | 2NDFLOOR® Youth Helpline: Call or Text (888) 222-2228

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EARLY SPRING 2021

Smoking Initiation Shifting from Teens to Young Adults More young adults than teens are trying smoking for the first time or becoming regular smokers, according to a new study. The past few decades have seen a steep drop in the number of adolescents in the United States who smoke cigarettes. But according to a new study, the average age at which people first try cigarettes or start to smoke regularly has risen. Tobacco control efforts over the last several decades have produced some resounding successes. Overall, less than 14% of adults in the United States currently smoke cigarettes, compared to almost 43% in 1965. And for ad- olescents, the drop has been even more substantial. For example, among U.S. high school seniors, daily cigarette smoking fell from its mid-1990s peak of 33.5% to just 2.4% in 2019. But over the past two decades, the study found, there has been a change in cigarette smoking behavior: the age at which people tend to start smoking has drifted upwards from the mid-teens to the later teens and even into young adulthood. The new results were published October 6 in JAMA Network Open. “For a long time, people have talked about how, if we can just get kids past the age of 18 without smoking cigarettes, they’re home free,” said Jessica Barrington-Trimis, Ph.D., of the University of Southern California, who led the new study. “I think that that’s a flawed way of looking at things today.” Despite the dramatic drop in the number of people smoking cigarettes, smoking remains a leading prevent- able cause of cancer and cancer death in the United States. In addition to raising the risk of lung cancer, it increases the risk of throat, stomach, bladder, and many other can- cer types, as well as heart disease, stroke, and other serious illnesses. ...continued on page 18

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...continued from page 17 But quitting cigarette smoking is hard. Each year, fewer than 10% of smokers who try to quit succeed. So public health experts have focused much of their efforts on ensuring that people never start smoking in the first place. In previous studies, researchers had found that almost 90% of adult dai- ly cigarette smokers first tried smoking before the age of 18. As a result, teenagers have been the primary target for smoking prevention efforts, explained Dr. Barrington-Trimis. “But what we’ve seen with some of our [recent] work in young adults is a substantive amount of cigarette smok- ing initiation” in that age group, she said.

K I D S ’ H E A L T H & C A M P To examine nationwide trends in the age that people begin smoking, Dr. Barrington-Trimis and her colleagues analyzed almost 20 years of data from the National Survey on Drug Use and Health. The yearly sur- vey captures information on tobacco, alcohol, and other drug use from a representative cross-section of the US population aged 12 years or older. The team focused on data collected between 2002 and 2019 from more than 71,000 participants who were aged 22 or 23 in the year when they answered the survey. The proportion of people aged 22 to 23 years who had ever smoked all or part of a cigarette decreased from 75% to 51% over the study period, and the proportion of those who had ever engaged in daily smoking for a period of at least 30 days decreased from 41% to 20%. Also, the age at smoking initiation was moving up over that time period, they found. Specifically, among people who had ever smoked by age 22 or 23, the proportion who reported that they first did so between the ages of 18 and 23 rose, from about 20% in 2002 to more than 42% in 2018. And among respondents who transitioned to daily smoking, the proportion who reported having done so during young adulthood also rose, from about 39% in 2002 to nearly 56% in 2018. The study highlights “an emerging need for tobacco control efforts to further focus on reducing cigarette smoking among young adults,” wrote Ollie Ganz, Dr.P.H., and Cristine Delnevo, Ph.D., from Rutgers University. Nevertheless, they added, “We think it is important to recognize that these findings are the results of a larger public health success of dramatic reductions in youth and young adult smoking.” Given the unquestionable success of tobacco control at reducing youth cigarette smoking, researchers are now asking how to continue making gains, including among young adults. As part of the Master Settlement Agreement (MSA) of 1998, tobacco companies were prohibited from directly or indirectly marketing their products to youths aged 18 and younger. “Tobacco company marketing can be explicitly aimed at the youngest legal target group, which is young adults,” Dr. Kaufman said. “But tobacco products are still marketed in stores and are prominent in other places, including entertainment media, where many youth and young adults can see them.” “Even prior to the MSA… young adults were an important customer base for the tobacco industry; a tobacco company infa- mously referred to young adults as 'replacement smokers' for those who quit smoking or died,” wrote Drs. Ganz and Delnevo. “After the MSA, tobacco industry marketing and promotional efforts targeting young adults only intensified.” The widespread promotion of tobacco products to young adults is coupled with less prevention messaging aimed at those 18 and over, Dr. Barrington-Trimis explained. “Once kids turn 18, they’re a lot more dispersed,” she said. Some go to college, while others join the military or the workforce, she explained. Some stay home, others move in with peers. “Just finding them and doing prevention becomes a lot harder,” she added. Although it can be tougher to reach young adults with anti-tobacco messaging, recent progress has been made in restricting tobacco sales to this age group, Dr. Kaufman explained. For example, at the end of 2019, the Tobacco 21 law went into effect nationwide, making it illegal for retailers to sell any tobacco product—including cigarettes, smokeless tobacco, hookah tobacco, and e-cigarettes—to anyone under 21. Future research will help us understand how these laws influence cigarette smoking among young adults, Dr. Kaufman ex- plained. For now, though, “we need to reinforce our comprehensive tobacco control policies,” she said. That includes federal regulation of tobacco products, substantially increasing the price of tobacco products, smoke-free air laws, expanding efforts to help people quit smoking, and anti-tobacco education campaigns. “These are a part of any effective strategy to keep young adults from starting or becoming regular cigarette smokers,” she said.

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EARLY SPRING 2021

Chris Smith’s Autism CARES Act of 2019 Signed into Law Major autism legislation authored by Rep. Chris Smith (R-NJ) to authorize $1.8 billion over five years to help children and adults with autism by funding research, ear- ly detection and treatment was signed into law by Presi- dent Trump. Smith said the “comprehensive new law,” cosponsored by Rep. Mike Doyle (D-PA) “will fund critical biomedi- cal autism research as well as the develop- ment of best practices to enhance the lives of persons with autism. We need answers now and treatment options and interven- tions that work,” he said. Specifically the Autism CARES Act of 2019: authorizes $1.8 billion—including annual funding for the National Institutes of Health (NIH) at $296 million, the Centers for Disease Control and Pre- vention (CDC) at $23.1 million, and the Health Resources and Services Administration (HRSA) at $50 million. • reauthorizes and expands the Interagency Autism Co- ordinating Committee (IACC) • adds new members of IACC from the Departments of Labor, Justice, Veterans Affairs and Housing and Urban Development • increases from two to three IACC members who are self-advocates, parents or legal guardians and advocacy/ service organizations • empowers the Health and Human Services Secretary to prioritize grants to “rural and underserved areas” and • requires that not later than two years after enactment, a comprehensive report on the demographic factors asso- ciated with the health and well-being of individuals with ASD, recommendations on establishing best practices to ensure interdisciplinary coordination, improvements for health outcomes, community based behavioral support and interventions, nutrition and recreational and social activities, personal safety and more. “Aging out of services is a hurdle every parent or care- taker of a child with autism inevitably faces,” Smith said. “Children grow up and become adults, and then lose their education and support services. But autism is a lifetime neurological disorder, and young adults with autism con- tinue to need their services. The Autism CARES Act rec- ognizes the problem of aging out and ensures that the fed- eral government continues to help hundreds of thousands of young adults with autism and their parents by funding research and support programs.” Smith stepped up his involvement on autism issues in September of 1997, when two constituents, Bobbie and Billy Gallagher of Brick, N.J., parents of two young small autistic children—walked into his Ocean County office looking for help. The Gallagher’s continue to this day to work with Smith on autism advocacy issues, including the aging out problem.

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