Tag Archives: Tobacco

Straight, No Chaser: Hookahs and Health

Respiratory/Lungs, Toxicology/Drugs, , , , , , , , , , , ,

I love the responses I get from you. Even the spam is entertaining. Most recently, when I posted this, the most common response was some variation of this theme: “What’s a hookah? Is it slang for what I think it is, and how would you smoke it?”

jabba-hut-hookah-shisha

Actually, your demonstration that you aren’t familiar with hookahs is reflective of the ever-present gaps parents have regarding what their teens are doing. Hookahs (aka hubble-bubble, narghile, shisha and goza) are water pipes that are used to smoke flavored tobacco. It’s a long-standing phenomena, going back centuries in India and ancient Persia. I bet you didn’t know that’s what Jabba the Hut was doing in the original Star Wars!
It’s popularity is increasing among teens and young adults all around the world. In the US alone, 17% of boys and 15% of girls state they have used a hookah in the past year, according to surveys reviewed by the Centers for Disease Control and Prevention (CDC). Studies of college students show past-year usage ranging from 22% to 40%.
Let’s answer some common questions about hookahs.

HOOKAH_2_FT1-620x415

Why is this necessary? Why would anyone do this?
There are many reasons for this, including the peer bonding and socialization aspects. This is facilitated by group sharing of the hookah, which is typically passed from person to person. Hookah tobacco comes in many different flavors, such as apple, cappuccino, cherry, chocolate, coconut, licorice, mint and watermelon. Once the decision has been made to participate in the activity, it really isn’t that hard to find a flavor to your liking.

hookah chemical levels

Is hookah use safer than cigarette smoking?
No. Hookah smoking is not a safe alternative to cigarettes. It has several of the same health risks as cigarette smoking.
What are the adverse health effects from hookah smoking?

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals and cancer-causing chemicals.
  • Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder and oral cancers.
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

Are there other concerns about using hookahs?

  • Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.
  • Infections may be passed to other smokers by sharing a hookah.
  • Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to nonsmokers.
  • Babies born to hookah smokers are also at increased risk for respiratory diseases.

Here’s your bottom line. If you’re involved in hookah smoking, you’re smoking, and should consider yourself to have a similar risk profile as a cigarette or cigar smoker.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPres

Cigar Smoking: Facts and Fiction

General Health and Wellness, , , , , , , , , , , ,

Fidel-Castro-smoking-ciga-001 mouth_cancer_cr

It’s the latest, greatest, coolest past-time.  Endorsed and practiced by celebrities the world over, cigar smoking has clearly and successfully marketed itself as a convenience of the successful.  Even the notion that the ‘best’ cigars are forbidden fruit (i.e. come from Cuba) adds to the allure if and when you’re able to wrap your lips around one.  I wasn’t surprised, but it’s worth noting that beyond the success stories received from those of you who have successfully stopped cigarette smoking, the next set of questions involved whether cigar smoking is a safe alternative.
Since you have little old me taking on an $8 billion a year industry and the wrath of the very passionate, I have no recourse but to arm myself with some data – cold, hard facts.

  • 49% of all cigars sold are large cigars.  A single large cigar contains as much tobacco as an entire pack of cigarettes.
  • Cigar use is on the rise, with over 13 million people identifying as current users.
  • 15% of male students in grades 9-12 are current users.
  • African-Americans have the highest rate of cigar smoking (among ethnicities/races), with a 7.7% user rate.

You want to know the effects of cigar smoking?  Let’s cut to the chase.
Here are the five “SURGEON GENERAL WARNING” text-only labels, one of which must be displayed on all cigar packaging and advertisements.  This is done on a rotating basis.

  1. Cigar Smoking Can Cause Cancers Of The Mouth and Throat, Even if You Do Not Inhale.
  2. Cigar Smoking Can Cause Lung Cancer and Heart Disease.
  3. Tobacco Use Increases the Risk of Infertility, Stillbirth and Low Birth Weight.
  4. Cigars Are Not A Safe Alternative To Cigarettes.
  5. Tobacco Smoke Increases The Risk of Lung Cancer And Heart Disease, Even In Nonsmokers. 

Beyond what the Surgeon General requires, here are some additional facts:

  • All tobacco smoke contains more than 60 chemicals that can cause cancer, and cigar smoke is no exception.
  • Regular cigar smoking increases your risk for the following cancers: lung, esophagus, larynx (your voice box), and oral cavity (lips, tongue, mouth and throat).
  • Cigar smoking is linked to gum disease and tooth decay and loss.
  • In addition to lung cancer, heavy cigar smoking increases the risk for emphysema and chronic bronchitis.

The bottom line?

Cigar smoking is not a safe alternative to cigarette smoking.

There is no level of cigar smoking that does not pose health risks.

As always, it’s not my chore to convince you to do or not to do; freedom of choice is a beautiful thing.  That said, be advised that if you read this blog, you will be an informed consumer.  I welcome your comments or questions.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Hookahs and Health

Respiratory/Lungs, Toxicology/Drugs, , , , , , , , , , , ,

I love the responses I get from you. Even the spam is entertaining. Most recently, when I posted this, the most common response was some variation of this theme: “What’s a hookah? Is it slang for what I think it is, and how would you smoke it?”

jabba-hut-hookah-shisha

Actually, your demonstration that you aren’t familiar with hookahs is reflective of the ever-present gaps parents have regarding what their teens are doing. Hookahs (aka hubble-bubble, narghile, shisha and goza) are water pipes that are used to smoke flavored tobacco. It’s a long-standing phenomena, going back centuries in India and ancient Persia. I bet you didn’t know that’s what Jabba the Hut was doing in the original Star Wars!
It’s popularity is increasing among teens and young adults all around the world. In the US alone, 17% of boys and 15% of girls state they have used a hookah in the past year, according to surveys reviewed by the Centers for Disease Control and Prevention (CDC). Studies of college students show past-year usage ranging from 22% to 40%.
Let’s answer some common questions about hookahs.

HOOKAH_2_FT1-620x415

Why is this necessary? Why would anyone do this?
There are many reasons for this, including the peer bonding and socialization aspects. This is facilitated by group sharing of the hookah, which is typically passed from person to person. Hookah tobacco comes in many different flavors, such as apple, cappuccino, cherry, chocolate, coconut, licorice, mint and watermelon. Once the decision has been made to participate in the activity, it really isn’t that hard to find a flavor to your liking.

hookah chemical levels

Is hookah use safer than cigarette smoking?
No. Hookah smoking is not a safe alternative to cigarettes. It has several of the same health risks as cigarette smoking.
What are the adverse health effects from hookah smoking?

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals and cancer-causing chemicals.
  • Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder and oral cancers.
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

Are there other concerns about using hookahs?

  • Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.
  • Infections may be passed to other smokers by sharing a hookah.
  • Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to nonsmokers.
  • Babies born to hookah smokers are also at increased risk for respiratory diseases.

Here’s your bottom line. If you’re involved in hookah smoking, you’re smoking, and should consider yourself to have a similar risk profile as a cigarette or cigar smoker.
 
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Hookahs and Health

Respiratory/Lungs, Toxicology/Drugs, , , , , , , , , , ,

I love the responses I get from you. Even the spam is entertaining. Most recently, when I posted this, the most common response was some variation of this theme: “What’s a hookah? Is it slang for what I think it is, and how would you smoke it?”

jabba-hut-hookah-shisha

Actually, your demonstration that you aren’t familiar with hookahs is reflective of the ever-present gaps parents have regarding what their teens are doing. Hookahs (aka hubble-bubble, narghile, shisha and goza) are water pipes that are used to smoke flavored tobacco. It’s a long-standing phenomena, going back centuries in India and ancient Persia. I bet you didn’t know that’s what Jabba the Hut was doing in the original Star Wars!
It’s popularity is increasing among teens and young adults all around the world. In the US alone, 17% of boys and 15% of girls state they have used a hookah in the past year, according to surveys reviewed by the Centers for Disease Control and Prevention (CDC). Studies of college students show past-year usage ranging from 22% to 40%.
Let’s answer some common questions about hookahs.

HOOKAH_2_FT1-620x415

Why is this necessary? Why would anyone do this?
There are many reasons for this, including the peer bonding and socialization aspects. This is facilitated by group sharing of the hookah, which is typically passed from person to person. Hookah tobacco comes in many different flavors, such as apple, cappuccino, cherry, chocolate, coconut, licorice, mint and watermelon. Once the decision has been made to participate in the activity, it really isn’t that hard to find a flavor to your liking.

hookah chemical levels

Is hookah use safer than cigarette smoking?
No. Hookah smoking is not a safe alternative to cigarettes. It has several of the same health risks as cigarette smoking.
What are the adverse health effects from hookah smoking?

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals and cancer-causing chemicals.
  • Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder and oral cancers.
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

Are there other concerns about using hookahs?

  • Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.
  • Infections may be passed to other smokers by sharing a hookah.
  • Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to nonsmokers.
  • Babies born to hookah smokers are also at increased risk for respiratory diseases.

Here’s your bottom line. If you’re involved in hookah smoking, you’re smoking, and should consider yourself to have a similar risk profile as a cigarette or cigar smoker.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Learn About Hookahs – Your Teens Have!

Respiratory/Lungs, Toxicology/Drugs, , , , , , , , , ,

I love the responses I get from you. Even the spam is entertaining. Most recently, when I posted this, the most common response was some variation of this theme: “What’s a hookah? Is it slang for what I think it is, and how would you smoke it?”

jabba-hut-hookah-shisha

Actually, your demonstration that you aren’t familiar with hookahs is reflective of the ever-present gaps parents have regarding what their teens are doing. Hookahs (aka hubble-bubble, narghile, shisha and goza) are water pipes that are used to smoke flavored tobacco. It’s a long-standing phenomena, going back centuries in India and ancient Persia. I bet you didn’t know that’s what Jabba the Hut was doing in the original Star Wars!
It’s popularity is increasing among teens and young adults all around the world. In the US alone, 17% of boys and 15% of girls state they have used a hookah in the past year, according to surveys reviewed by the Centers for Disease Control and Prevention (CDC). Studies of college students show past-year usage ranging from 22% to 40%.
Let’s answer some common questions about hookahs.

HOOKAH_2_FT1-620x415

Why is this necessary? Why would anyone do this?
There are many reasons for this, including the peer bonding and socialization aspects. This is facilitated by group sharing of the hookah, which is typically passed from person to person. Hookah tobacco comes in many different flavors, such as apple, cappuccino, cherry, chocolate, coconut, licorice, mint and watermelon. Once the decision has been made to participate in the activity, it really isn’t that hard to find a flavor to your liking.

hookah chemical levels

Is hookah use safer than cigarette smoking?
No. Hookah smoking is not a safe alternative to cigarettes. It has several of the same health risks as cigarette smoking.
What are the adverse health effects from hookah smoking?

  • The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon monoxide, metals and cancer-causing chemicals.
  • Even after it has passed through water, the smoke from a hookah has high levels of these toxic agents.
  • Hookah tobacco and smoke contain several toxic agents known to cause lung, bladder and oral cancers.
  • Tobacco juices from hookahs irritate the mouth and increase the risk of developing oral cancers.

Are there other concerns about using hookahs?

  • Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart disease.
  • Infections may be passed to other smokers by sharing a hookah.
  • Babies born to women who smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies born to nonsmokers.
  • Babies born to hookah smokers are also at increased risk for respiratory diseases.

Here’s your bottom line. If you’re involved in hookah smoking, you’re smoking, and should consider yourself to have a similar risk profile as a cigarette or cigar smoker.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com(SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Cigar Smoking: Facts and Fiction

Cardiology/Heart, Hematology & Oncology/Blood Disorders/Cancer, Respiratory/Lungs, Health Prevention, , , , , , ,

Fidel-Castro-smoking-ciga-001 mouth_cancer_cr

It’s the latest, greatest, coolest past-time.  Endorsed and practiced by celebrities the world over, cigar smoking has clearly and successfully marketed itself as a convenience of the successful.  Even the notion that the ‘best’ cigars are forbidden fruit (i.e. come from Cuba) adds to the allure if and when you’re able to wrap your lips around one.  I wasn’t surprised, but it’s worth noting that beyond the success stories received from those of you who have successfully stopped cigarette smoking, the next set of questions involved whether cigar smoking is a safe alternative.
Since you have little old me taking on an $8 billion a year industry and the wrath of the very passionate, I have no recourse but to arm myself with some data – cold, hard facts.

  • 49% of all cigars sold are large cigars.  A single large cigar contains as much tobacco as an entire pack of cigarettes.
  • Cigar use is on the rise, with over 13 million people identifying as current users.
  • 15% of male students in grades 9-12 are current users.
  • African-Americans have the highest rate of cigar smoking (among ethnicities/races), with a 7.7% user rate.

You want to know the effects of cigar smoking?  Let’s cut to the chase.
Here are the five “SURGEON GENERAL WARNING” text-only labels, one of which must be displayed on all cigar packaging and advertisements.  This is done on a rotating basis.

  1. Cigar Smoking Can Cause Cancers Of The Mouth and Throat, Even if You Do Not Inhale.
  2. Cigar Smoking Can Cause Lung Cancer and Heart Disease.
  3. Tobacco Use Increases the Risk of Infertility, Stillbirth and Low Birth Weight.
  4. Cigars Are Not A Safe Alternative To Cigarettes.
  5. Tobacco Smoke Increases The Risk of Lung Cancer And Heart Disease, Even In Nonsmokers. 

Beyond what the Surgeon General requires, here are some additional facts:

  • All tobacco smoke contains more than 60 chemicals that can cause cancer, and cigar smoke is no exception.
  • Regular cigar smoking increases your risk for the following cancers: lung, esophagus, larynx (your voice box), and oral cavity (lips, tongue, mouth and throat).
  • Cigar smoking is linked to gum disease and tooth decay and loss.
  • In addition to lung cancer, heavy cigar smoking increases the risk for emphysema and chronic bronchitis.

The bottom line?

Cigar smoking is not a safe alternative to cigarette smoking.

There is no level of cigar smoking that does not pose health risks.

As always, it’s not my chore to convince you to do or not to do; freedom of choice is a beautiful thing.  That said, be advised that if you read this blog, you will be an informed consumer.  I welcome your comments or questions.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Here's How You Stop Smoking – Quick Tips to START Smoking Cessation

General Health and Wellness, Health Prevention, , , , , , ,

smokingcessation1

  • Don’t pick your birthday or NYE to stop. Do it now. Can’t do it now? Do it Monday. In fact, do it every Monday. It’s a fight. If you fall down, start it back up again. It’s the fight of your life (or should I say for your life?).
  • If you decide to quit after your current (last) pack, throw away one cigarette for every one you smoke.
  • Count (figuratively or literally) all the money you’re saving by not smoking.
  • Throw away (not give away) all cigarettes, cigars, matches, lighters, humidors, cigar cutters and anything else you associate with smoking. You’ll realize how sad it is if and when you find yourself rummaging through the garbage to get a fix.
  • Tell everyone (loudly) that you’ve quit. Empower them to help and hold you accountable. Enlist another smoker friend to go through the journey with you.
  • If you do fall off the wagon, smoke a different cigarette brand. Odds are you won’t like it as much, and that will help combat the natural ease you have with smoking.
  • Contact your physician, and ask for help. Here’s a marvelous best-practices schemata of appropriate interplay between a physician and a patient trying to stop smoking.

smoking cessation As

  • If your physician and you decide to place you on a patch or otherwise medicate you, follow instructions carefully and precisely.
  • Practice deep breathing. Part of the euphoria of smoking is nothing more than the physiologic sensations produced by deep inhalations.
  • Keep other things in your mouth. Mints and chewing gum (low-calorie) are great. Brushing your teeth also serves many purposes. Drinking water when you want to smoke will often remove the urge.
  • Make it past the first day. Then make it past the first week.

I personally love the START method, which includes several of the above methods. Let me know if it works for any of you.

S: Set a quit date.

T: Tell your friends, family and associates that you’re quitting, and enlist their help.

A: Anticipate and act on the plan you’ve set and challenges you’ll meet.

R: Remove (trash) cigarettes, cigar and other paraphernalia from your environment.

T: Talk with your physician about options and additional support.

For those of you affected (either first or second-hand), this is huge and important. I really wish you all the best. I welcome any comments or questions.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Smoking Cessation

General Health and Wellness, Respiratory/Lungs, Health Prevention, , , , , , , , ,

smoking stop
You’ve all been asked what things you’d take with you on a desert island.  I’ll pose and answer the opposite question, but not on an island but regarding your life.  Getting you to stop smoking is certainly one of the three gifts I’d offer you if it was within my power.  This post won’t be about the dangers of smoking – I’ll continue to hit you over the head with those at every opportunity.  Given that I’m into producing positive outcomes, I’m going to discuss with you effective means of smoking cessation and the benefits of stopping.
The question on your mind is obviously how to stop.  Personally, I’m of the Yoda mindset.  You know, when he was teaching Luke Skywalker, he famously said “Do or Do not. There is no try.”  I can hear you now, “But Doc, I’m addicted…”  Sure you are.  There are many things in medicine about which I’m absolutely sure.  One of these is the most effective way to stop smoking is to quit.  Cold turkey.  The moment you’re motivated.  Not only is this premise supported by the data, which I’ll discuss momentarily, but here’s the benefit of over 20 years in clinical emergency medicine practice and having seen hundreds of people stop, stay stopped, and letting me know months and years later that they stayed stopped.  Despite being addicted, people are amazingly able to quit cold turkey, and they will do it in one of five circumstances.

When they develop the will

After the birth of their first child

After their first heart attack

After their first stroke

When they die

For those of you convinced that you can’t, here’s a fact: today there are more former smokers than current smokers.

I want to point out that I appreciate the difference between cigarette smoking and nicotine dependence.  My particular concern for your health lies in the delivery of smoke (containing over 7000 other toxins, approximately 70 of which can cause various cancers) into the airway system that is supposed to deliver oxygen throughout your body for the maintenance and health of your organ systems.  Still I want you to know I understand and appreciate the difficulty of smoking cessation.

  • Nicotine dependence in the most common chemical dependence in the U.S.
  • Quitting smoking often requires multiple attempts.
  • Nicotine withdrawal produces bothersome symptoms (e.g. irritability, reduced concentration, increased appetite with possible weight gain, and anxiety)

The good news is more than two-thirds of smokers profess a desire to stop smoking, and yearly over half of smokers attempt to stop.  That’s likely a result of knowing that no matter when you stop, you will improve your health outcomes.  Each incremental inhalation of cigarette and cigar smoke produces damage better left unproduced.  Let’s just hope you don’t wait until permanent damage has set in.  Consider a sampling of the following benefits that are sitting there waiting for you.

  • Reduction of the risk for cancers of the lung, esophagus, larynx (voice box), mouth, throat, kidney, bladder, pancreas, stomach and cervix, as well as certain leukemias.
  • Reduction of the risk for heart disease, stroke and peripheral vascular disease.
  • Reduction of the risk for COPD (chronic obstructive pulmonary disease)
  • Reduction of the risk for infertility

In my next post, I’ll review specific methods and tips to help you and/or your loved one stop.  Today’s as good of a day as any.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress