Wayne State University launched its new Office of Women’s Health, a comprehensive approach to improve the health of women overall, through a deep dive into medical research affecting more than half the population of Michigan and the nation, a segment often unintentionally overlooked in research. The Office of Women’s Health marked its official debut with an inaugural symposium Dec. 3 at the university’s McGregor Conference Center that brought together more than 130 researchers from across the university, community and grassroots partnering organizations, and a keynote address from Janine Clayton, M.D. Clayton, the National Institutes of Health’s associate director for Research on Women’s Health and director of the NIH Office of Research on Women’s Health, delivered the address, “Putting Women at Center Stage in Biomedical Research,” the very purpose of the new WSU office. “We have the resources and a wonderful research culture at the university,” WSU President M. Roy Wilson told the attendees. “That, coupled with our concentration on health equity, means we can come together with a focused effort on women’s health.

Efforts to reduce choking deaths among young children seem to have paid off: A new report finds the number of kids dying from choking on household objects has plummeted 75 percent since 1968. Regulations, more education about choking hazards and guidelines from organizations such as the American Academy of Pediatrics have likely all played a role in the downward trend, said study author Dr. John Cramer. Cramer said that regulations may have played the most significant role in reducing child deaths from choking on small objects. "Some of the regulations from the last 50 years have forced people to do the right thing. When you buy toys or cribs now, products are designed so that they can't be choked on. If you're a parent and you go buy a crib, you don't have to think about buying a crib with small parts; it's already regulated," Cramer said. He's an assistant professor of otolaryngology -- head and neck surgery at Wayne State University. One example cited by the study authors is a 1979 law regarding products designed for young children. Products made for young children can no longer contain parts small enough to fit into a test cylinder that is approximately the size of the airway of a child younger than 3. Children under 3 are most at risk from choking, and they've also had the most significant drops in choking death rates over time, the study authors noted. "Choking hazard warnings for toys used in children under age 3 have probably had the biggest benefit over time. This is a developmental stage where kids are oral and exploratory, often putting things in their mouths," Cramer said.

Andrea Schroeder's voice wavers ever so slightly. Somehow, she remains calm, considering the news she'd just gotten. The mother of three was in the midst of an aggressive political campaign for a hotly contested seat for state representative in the 43rd District, an area of Oakland County that includes her hometown of Independence Township. As she drove home from her hairdresser's in Birmingham on the afternoon of Aug. 16, 2018, she got dreadful news. "I have cancer," she said in a voice recording, almost like an audio diary, made just 20 minutes after her doctor called to tell her the results of a test done earlier that week. "I have a very rare form of stomach cancer, and it's gonna kill me." Since symptoms of stomach cancer often do not appear until the disease is advanced, only about 1 in 5 stomach cancers in the United States is found at an early stage, before it has spread to other areas of the body, according to the American Cancer Society. Her prospects were grim. Few people survive stomach cancer because it's rarely caught before it's in its most advanced, and less-treatable stages. The five-year survival rate is 31%, according to the American Cancer Society. "In the United States, there isn't a general screening protocol for it," said Dr. Philip A. Philip, who leads gastrointestinal and neuroendocrine oncology at the Barbara Ann Karmanos Cancer Institute. "The majority of the patients we diagnose in this country really do not fulfill the criteria for being very early. And for that reason, the outcome of the disease, is, in general less than what we see, for example, in a country that has screening and early diagnosis." Dr. Steve Kim, chief of surgical oncology at Karmanos and associate professor of the Wayne State University School of Medicine, performed successful surgery on Schroeder removing her entire stomach and attaching her esophagus directly to her small intestine. "The long and the short of it is, it works just like normal," Schroeder said. "I can eat anything, drink whatever I want. I try to be careful about sugars. Really high sugar-content things are hard to digest.

The theory of chronic cerebrospinal venous insufficiency, or CCSVI, was developed by Italian vascular surgeon Paolo Zamboni, who suggested that MS patients have abnormal veins that fail to properly drain blood from the brain and spinal cord. Opening those vessels, he reasoned, could restore blood flow and relieve symptoms -- a procedure widely known as "liberation therapy." The theory became one of the most bitterly contested in recent medical history, embraced by desperate patients and scorned by doctors. Yet every year on the anniversary of the program, MS patients write emails to say the experimental therapy changed their lives for the better. Mark Haacke, a scientist from Wayne State University who studies better ways to see inside the brain, helped found the Institute for Neurovascular Diseases (ISNVD) the year after Zamboni’s work first went public. Haacke, too remains undeterred by the firestorm over the theory. As imperfect as it may have been initially, he says, it opened the door to expanding the learning and understanding of the brain’s venous system. "The more data I see here ... the more I know he's right. There is some form of chronic hypertension (linked to certain brain diseases) ... but we don't know where it comes from," said Haacke. The physicist and his team have developed some increasingly detailed and striking images showing blood flow in and blood flow out and hopes to use the new way of visualizing blood flow to learn more about what’s going on upstream in the brain. The question really is "if there are flow obstructions, where are they taking place?"

November is Pancreatic Cancer Awareness Month, and Thursday, Nov. 21, is World Pancreatic Cancer Awareness Day. This disease is the third leading cause of cancer-related death in America – more than breast cancer. Dr. Asfar Azmi, assistant professor of oncology at Wayne State University School of Medicine, has been working on the front lines of finding new treatments. “We have a drug that can lock the good proteins at the right place. And when we see that locking, these are tumor suppressors. They can prevent a tumor from growing, and we see the pancreatic cancer cells die,” said Azmi. They are also researching how to catch pancreatic cancer sooner. “If we are able to bring a new biomarker – what we call – which can detect this disease early, that would change the game,” Azmi explained. The work is encouraging, but Dr. Philip Philip -- a gastrointestinal oncologist at Karmanos and professor of hematology-oncology at Wayne State University, says the research is lagging behind that being done into other major cancers. “[Pancreatic cancer] is difficult to fight for a number of reasons. One of them is because we often get the patients diagnosed at a late stage in their disease -- late as in it’s gone beyond the pancreas and spread to other parts of the body,” explained Philip. He says you need to know the signs and symptoms. “Patients often times ignore these symptoms thinking that it could be for ‘something I ate’ or ‘something I’m doing’… and they ignore those symptoms for a long time,” Philip explained.  “The key message here is that if you have symptoms that are persistent for a few days/weeks, you have to see your doctor,” said Philip.

Roughly 10 percent of children worldwide — an estimated 15 million babies — are born prematurely, or before 37 weeks gestation, each year. In developed countries, surviving an early birth has become more likely, thanks to the availability of intensive medical care. More than 98 percent of U.S. preemies survive infancy, according to a study published in the American Journal of Obstetrics and Gynecology in 2016, though as many as 44 percent of the youngest preemies don’t make it. Survival is least likely in nations with the fewest resources. Worldwide, complications associated with preterm birth are the leading cause of death in children younger than 5 years old. Some of the signs of inflammation linked to preterm birth differ from those found during full-term birth, says Nardhy Gomez-Lopez, a reproductive immunologist at Wayne State University. For example, in 2017, she and colleagues reported in the American Journal of Reproductive Immunology that some proteins involved in inflammation, called cytokines, were present at higher than normal levels in amniotic fluid from a subset of women who delivered preterm. The earlier the women delivered their babies, the higher the cytokine levels. Infections, which are present in at least a quarter of preterm births, could be the cause, but inflammation and cytokine levels were also elevated when no infection was found. Part of the problem with developing a predictive test is that preterm labor isn’t just one condition. Thirty years ago, preterm labor was viewed simply as regular labor that happened early, says perinatologist Roberto Romero at Wayne State, who directs the perinatology research branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Although scientists now recognize that the biology of preterm labor is distinct, they still have to grapple with the reality that it varies depending on the underlying cause. Wayne State and NICHD recently released gene activity data from the whole blood of 150 Detroit women, 71 of whom delivered preterm, and encouraged researchers to use the data to find predictors of preterm labor, as part of a crowdsourcing collaboration called the DREAM challenge. The challenge is expected to be completed in January 2020. “We are at the beginning of an exciting period,” says Romero at Wayne State. The field is now equipped to start studying preterm birth as a collection of several different syndromes and seek out treatments to address each one, he says.

According to a December 2018 report from the CDC, the number of new uterine cancer diagnoses increased an average of 0.7 percent per year between 1999 and 2015, resulting in an overall 12 percent rise. Rates of endometrial cancer, specifically, jumped 4.5 percent per year on average. The uterine cancer mortality rate increased 1.1 percent per year on average between 1999 and 2016, amounting to a 21 percent leap overall. What’s more, the burden of uterine cancer is greatest for black women, and the disparity is increasing with time. While that same CDC report found that non-Hispanic white and black women had similar incidences of uterine cancer (about 27 cases out of 100,000 people), black women were more likely to be diagnosed with uterine sarcoma, the most aggressive form of uterine cancer, than women of other races, and also more likely to be diagnosed at a later stage than women of other races. Teasing apart the potential reasons behind this disparity is a complex task. The puzzle pieces start to come together when you look at some of the major risk factors for developing uterine cancer. Let’s start with endometrial cancer risk factors. “We do know that obesity is one risk factor,” Michele L. Cote, Ph.D., a professor of Oncology at Wayne State University and associate center director of Cancer Research Career Enhancement, tells SELF. This is because it’s a health condition that can increase the amount of estrogen in your body. Another endometrial cancer risk factor revolves around children. “The more children you have, the lower your risk,” Cote says. Pregnancy increases your output of progesterone, so you might benefit from its protective effects against this cancer. But people are generally having fewer kids these days, Cote explains, including black women. “Unfortunately, we don’t have a lot of research data yet on why black women are more likely to have a more aggressive form of uterine cancer,” Cote says.

Armed with care packages, clothes and clinical supplies, medical students in Detroit are learning outside the classroom. They are putting their knowledge and boots to the pavement, providing free health care to the city's homeless. Each week, students under the supervision of a registered physician or nurse practitioner get on their bikes and look for those in need. Programs such as Michigan State University's Detroit Street Care, Wayne State University's Street Medicine Detroit and the University of Michigan's Wolverine Street Medicine work together to treat as many of the city's homeless as possible. Jedidiah Bell, a fourth-year med student at Wayne State University and president of Street Medicine Detroit, says seeing issues from lack of health care access in his home country of Zimbabwe made him want to participate. "When I moved to the states for university and medical school, I saw the similar things [lack of access] with the homeless population," said Bell. "When I saw street medicine, I appreciated the model of how can we take medical care to the street and build up trust to bridge the gap between the homeless and the medical world." While the programs provide a vital service to the community, Bell says the real-world experience teaches students things the classroom or clinic can't. "It teaches medical students to hone-in on, not just medical conditions of patients, but to be able to sit down and form relationships and discuss other things that might be contributing to [patients'] health but might not come up during a traditional medical encounter." Bell says there's a widespread belief that the "students take away more from people on the streets than they take away from us." Anneliese Petersen, a second-year medical student at Wayne State University and volunteer with Street Medicine Detroit, says the experience also shows upcoming medical professionals another side of health -- the social determinants. "Things that are not strictly medical-based but have a strong impact on health and well-being. Income, access to health care, access to medication, being able to eat well, sleep well, to be able to relax and not be under chronic stress."

Arash Javanbakht, M.D., director of the Stress, Trauma, and Anxiety Research Clinic (STARC) at Wayne State University, wrote a piece for Psychology Today about the film “Joker.” “I am a psychiatrist expert in trauma in adults and children, and a movie lover. When friends tried to convince me to watch "Joker" with them, I was hesitant. I was not interested in an action movie solely focused on the bad guy, especially given I liked Batman. However, a few minutes into the movie I realized what I had got myself into. "Joker" is not an action movie, it is a sad psychological drama, depicting the suffering of a man who was wronged, and got it wrong.”

Arash Javanbakht, associate professor of psychiatry, wrote a piece about benzodiazepines, a class of anti-anxiety medications that increase the activity of the gamma-aminobutyric acid receptors in the brain. There has been increasing attention into long-term risks of benzodiazepines, including potential for addiction, overdose and cognitive impairment. The overdose death rate among patients receiving both benzodiazepines and opioids is 10 times higher than those only receiving opioids, and benzo misuse is a serious concern. The benzo family includes diazepam, or Valium; clonazepam, or Klonopin; lorazepam, or Ativan; chlordiazepoxide, or Librium; and the one most commonly known to the pop culture, alprazolan, or Xanax, among others. A major risk of long-term use of benzos is addiction. That means you may become dependent on these meds and that you have to keep increasing the dose to get the same effect. Actually benzos, especially Xanax, have street value because of the pleasant feeling they induce. In 2017, there were more than 11,000 deaths involving benzos alone or with other drugs, and in 2015, a fifth of those who died of opioid overdose also had benzos in their blood. There are safer effective treatments for anxiety, but they require patience to work. A first line treatment for anxiety disorders is psychotherapy, mainly cognitive behavioral therapy. During therapy, the person learns more adaptive coping skills, and corrects cognitive distortions to reduce stress.

The state Attorney General's Office has found that a nonprofit for a program linked to Mayor Mike Duggan did not compensate staff or contractors to raise money nor did it take in enough funds to require state registration. Attorney General Dana Nessel's Charitable Trust division delved into the fundraising practices of the nonprofit Make Your Date, Inc. The single-page finding issued Tuesday by the Attorney General's Office notes that "it appears this organization does not compensate staff or independent contractors for services related to fundraising." "Additionally, this organization does not solicit or receive contributions in excess of $25,000 in a 12-month period," the letter notes, adding that based on the finding and state laws for charities, registration under the Charitable Organizations and Solicitations Act was not required. Wayne State University noted in a Thursday statement that the attorney general office's analysis included interviews and inspection of documents and "confirmed that its registration exemption status was proper. The attorney general confirmed that the separate nonprofit had not spent or received in excess of $25,000 in a 12-month period," the university's statement reads. "In fact, it spent or received no money." Wayne State on Thursday said that the report reaffirms that the university is the only entity operating the program. "Wayne State is proud of Make Your Date, which a recent study has shown has reduced preterm birth among the program’s clients by up to 37%," the university wrote. "Wayne State University will continue to execute and expand the Make Your Date Program to further reduce preterm birth and improve pregnancy outcomes for women and children in the City of Detroit and beyond."

A Wayne State University pediatrician played a critical role in developing a national policy statement that recognizes for the first time the impact racism has on the health of American children and teens. Lynn Smitherman, M.D., FAAP, assistant professor of WSU Pediatrics, is a member of the American Academy of Pediatrics’ Task Force Addressing Bias and Discrimination. The task force’s work contributed to the policy statement, “The Impact of Racism on Child and Adolescent Health,” issued by the AAP on July 30. The statement is a call for action by the nation’s pediatricians to reduce the impact of racism and improve the health of American children. The AAP believes that racism has a significant impact on children’s health. The academy says that pediatricians must play a part in improving the health condition of children through listening to families, creating “culturally safe medical homes” and by becoming advocates for social justice in their communities. “Eliminating discrimination, racism and bias in the care of our most valuable resource, our children, is a basic tenet to any civil society. Participating in the AAP’s Task Force on Addressing Bias and Discrimination in the care of children was one of the many highlights of my professional career,” said Smitherman, who also chairs the National Medical Association’s Pediatric Section and is the vice chair of Medical Education for the WSU Department of Pediatrics. “Any activity to bring people together and heal the divides of this country are critically important to the well-being and health of the society in general. I was very proud that the AAP took this important position and that I, as a WSU faculty member, was able to contribute.”

The National Institutes of Health launched the “Helping to End Addiction Long-term Initiative” in April 2018 to improve prevention and treatment strategies for opioid misuse and addiction and to enhance pain management. This initiative aims to improve treatments for chronic pain, curb the rates of opioid use disorder and overdose, and achieve long-term recovery from opioid addiction. A team of researchers led by Wayne State University this week received one of 375 grant awards across 41 states made by the National Institutes of Health in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis. This $4 million award, “Dual-orexin antagonism as a mechanism for improving sleep and drug abstinence in opioid use disorder,” will bring together a research team from Wayne State University and Henry Ford Health System to investigate a rigorous treatment method that may offer a new therapeutic approach to reduce opioid addiction relapse. According to Mark Greenwald, Ph.D., principal investigator on Wayne State’s grant and professor and associate chair of research and director of the Substance Abuse Research Division in the Wayne State School of Medicine’s Department of Psychiatry and Behavioral Neurosciences, insomnia is common in opioid addictions and is a major predictor of potential relapse. Current medications to treat insomnia have limited results on relapse and may produce unwanted side effects. “There are FDA-approved medications for treatment of insomnia, but there is an unmet need for alternatives, especially to aid in preventing opioid addiction relapses,” said Greenwald. “The Orexin (OX) system plays a key role in sleep and substance use, and offers promise as a potential alternative to other medications currently used to treat insomnia.

African Americans have the lowest survival rate of any racial or ethnic group in the United States for most cancers – a problem that is magnified in southeast Michigan. These differences are often due to socioeconomic disparities that result in unequal access to medical care, health insurance, healthy food and more. African Americans who survive cancer also have the shortest survival of any racial/ethnic group in the United States for most cancers, according to the American Cancer Society. A team of researchers from Wayne State University and the Barbara Ann Karmanos Cancer Institute are investigating the combined role that community, interpersonal and individual influences have on the health-related quality of life for African American cancer survivors, and how those influences create racial health disparities between African Americans and white survivors. The team includes Felicity W.K. Harper, Ph.D., associate professor of oncology in the Wayne State School of Medicine and the Karmanos Cancer Institute; Malcolm P. Cutchin, Ph.D., professor in the Institute of Gerontology and the Department of Health Care Sciences in Wayne State’s Eugene Applebaum College of Pharmacy and Health Sciences; and Hayley Thompson, Ph.D., professor of oncology in the School of Medicine and associate center director for community outreach and engagement at Karmanos. The study, “ARISE: African American Resilience in Surviving Cancer,” is a five-year, $3.1 million project funded by the National Cancer Institute of the National Institutes of Health that aims to identify targets of change and inform the development of interventions to address causes of poorer health-related quality of life experienced by African American cancer survivors.

Detroit has one of the worst (highest) preterm birth and infant mortality rates in the country, equal to that of some third world countries. With a preterm birth rate of 14.5 percent, Detroit earned an “F” among major U.S. cities for premature births according to the 2018 Premature Birth Report Card from the March of Dimes, the nation’s leading maternal and infant health nonprofit organization. Research has shown that disparities such as racial inequity, poverty, stress, food insecurity, lack of education, and limited access to transportation or health care can contribute to poor health outcomes for mothers and babies. In efforts to quell this epidemic, the city of Detroit has welcomed several initiatives geared towards reducing the city’s infant mortality rate. One such initiative is the Make Your Date Detroit program. Make Your Date Detroit is a Wayne State University organization that is fighting to turn the tide against premature births in Detroit. “African American infants are at a 50 percent greater risk of preterm birth compared to white infants. As a result, African American infants are now more than twice as likely to die as white infants,” says Marisa Rodriquez, director of strategic operations of the Office of Women’s Health at Wayne State University. “African American women are three to four times more likely to die in pregnancy than white mothers. Hispanic mothers and infants are also at greater risk when compared to white women. There are tests and treatments that exist to reduce preterm birth, but many pregnant women do not have access to them. Our program works to make these lifesaving approaches available. What our program and others provide is important in the fight to reduce the very substantial racial and ethnic health disparities that are seen in pregnancy.” Rodriquez says that the Make Your Date program has already begun saving infant lives in a short period. “Make Your Date has been so successful that participating mothers are 37 percent less likely to deliver at under 32 weeks and 28 percent are less likely to deliver at under 34 weeks,” she said. “In a city with such high rates of preterm birth and infant mortality, these results are remarkable. We are very proud that women are delivering healthy babies as a result of this program.”  

The legalization of recreational marijuana in Michigan has resulted in a spike in kids eating edible pot treats, according to a professor at Wayne State University. According to a news release from the university, more than half of calls made to the Michigan Poison Center at WSU concerning marijuana exposure through edibles like brownies, chocolate bars, candy and gummies involved children as young as six years old. School of Medicine Associate Professor of Emergency Medicine and Toxicology Fellowship Program Director Andy King said the uptick is likely due to the November 2018 legalization of marijuana in Michigan, leading to a higher availability of substance in homes. Since the beginning of the year, 59 pediatric calls to the Michigan Poison Center related to marijuana exposure involved edibles. “Wherever you start seeing legalization, kids are going to have more access to it by sheer numbers and probability to it,” King said. “A lot of the edibles are so desirable to children. This is the age that they really can’t read, and they’re going to (sneak) a cookie or steal a gummy bear.” King recommends all edibles and substances, including prescription drugs, be kept in a locked box to ensure safety. “A typical marijuana cigarette holds about 10 mg of THC," King said. “That’s what you see in a gummy bear. That’s a dose for a novice person to take to get the psychedelic or enjoyable effects of THC. These edibles can go up to 10 times that amount.”

More children are getting their hands on marijuana edibles in Michigan -- and for toddlers, the effects can be life-threatening. Reports of intoxication in pediatric patients from marijuana edibles to the Michigan Poison Center spiked in 2018, said Dr. Cynthia Aaron, medical director for the center at Wayne State University. That's the year that Michigan saw its first retail sales of medical marijuana products -- and that voters agreed to legalize recreational marijuana. Though commercial sales of adult-use marijuana have yet to launch in Michigan, more and more children are coming into contact with THC-infused products like gummies, cookies and chocolate bars. There were six cases of children who ate a marijuana edible in 2017 -- and 46 cases in 2018, according to data from the Michigan Poison Center. So far this year, 59 children exposed to marijuana edibles have been reported to the center. The reports typically concern two groups: young, toddler-age children and adolescents, Aaron said. The major concern is toddler-age children, Aaron said. "They go unresponsive; many don't breathe," Aaron said. "They're not interacting; they're sleepy… some kids may complain of being dizzy; stumbling around." Though no deaths have been reported from children ingesting marijuana edibles, Aaron said the concerns are serious: some children have spent 24 hours on a breathing machine as a result of exposure. Marijuana edibles are an issue particularly because of the way they are dosed: the package might tell you a dose for an adult is one section of a chocolate bar; or two gummy bears; or half of a cookie. Young children don't see it that way, Aaron said. Aaron said adults should treat marijuana products like any other medication. "This like any other medication in the house -- it really needs to be locked up," Aaron said. "People don't realize how potent they (edibles) are and they don't understand that it's not like smoking or vaping. You don't get your buzz immediately -- it's delayed," Aaron said. "It's a dysphoric trip."

Arash Javanbakht, director of the Stress, Trauma and Anxiety Research Clinic at Wayne State University, wrote a piece about his perspective, as a psychiatrist, on the mental and physical aspects of flying a fighter jet. “The experience was condensed and fast, affecting so many sensory modalities, and its processing took some time: Part of me was in denial for a couple days, and I repeatedly found myself in awe, telling myself excitedly: Dude, I flew a fighter jet! Overall, it took a couple days for my mind and body to come back to normal; it was a once in life experience, and it was amazing,” Javanbakht wrote.

Dr. Daniel Ouellette, a pulmonologist and senior staff physician at Henry Ford Hospital, applauded the e-cigarette ban. "I think that this is a step forward, and I’m really happy to see that my home state is at the forefront of taking this initiative," said Ouellette, who also is an associate professor at Wayne State University's School of Medicine. "For me, as a lung specialist, I think that the only good thing in your lungs is air." Ouellette said the dangers of vaping still aren't fully known. "We know with cigarettes it can take 15- 20 years or more after having started smoking to have an increased risk of cancer," he said. "If we would extrapolate that same kind of data, it’s going to be a couple of decades before we know this for sure about e-cigarettes. "What we do know is that there are some potential carcinogens in the vapor products. We do know that at least potentially there's a risk. Who would want to be 20 years down the road from now and be faced with an epidemic of lung cancer because we didn't act to control and study e-cigarettes?" But he said it's clear that e-cigarettes are highly addictive — and that's especially true for young people whose brains are more susceptible to addiction — and the contents of the e-cigarette cartridges may contain chemicals that are harmful when heated. "One tank or canister of solution for an e-cigarette contains as much nicotine as a pack of cigarettes," Ouellette said. "So people who use these e-cigarettes are going to get addicted to nicotine. That, by itself, is an adverse consequence. Not only will they be addicted to e-cigarettes but also potentially to other tobacco products. "In addition, these e-cigarettes contain propellants, liquids ... in which the nicotine is dissolved. ... There's also the ability to put in other things," such as flavors, cannabinoid (CBD) products and tetrahydrocannabinol (THC), the primary psychoactive component of marijuana. "So there are a great variety of dangers that can be posed by the use of these e-cigarettes," he said. 

Banning flavoring in e-cigarettes and similar devices might move the products further away from Michigan teens, but some worry that an all-out ban also strips cigarette smokers of a powerful tool to help them quit. Smoldering for years now, the health debate ignited Wednesday when, in a surprise move, Gov. Gretchen Whitmer proposed banning flavoring in e-cigarettes and other vaping devices in the state. Still, others worry about adult smokers trying to quit cigarettes by turning to vaping, which early research suggests is not as dangerous as combustible tobacco. At Wayne State University’s School of Medicine, clinicians are helping smokers shake the tobacco habit through the use of incentives — gift cards, for example, sometimes alongside tobacco cessation products, like the nicotine patch. David Ledgerwood, a clinical psychologist and director of Wayne State’s Nicotine and Tobacco Research Division, said vaping products can indeed be used to help smokers cut down or quit cigarettes. But Ledgerwood also noted that adolescents and teens are easily moved by marketing gimmicks and flavored products. “There’s a lot of stuff going on there around the development of the adolescent brain. Their role at that age is to break away from their parents, and that’s why you get this rebellious stage,” Ledgerwood said. “This is where they’re going to try out new things and make decisions about where their lives are going to head, and they can make some really smart decisions and really risky decisions,” he said.