Fewer Washington adults light up these days.

The adult smoking rate has dropped to 14.8 percent — a new low and the third-lowest smoking rate in the nation, a survey released last week by the state Department of Health shows.

The latest ranking is the best since measurements started in all 50 states in 1995. The rate declined from 15.3 percent in the previous year.

“Our rise to a number three national ranking is good news for the health of people in Washington,” state Secretary of Health Mary Selecky said in a news release.

But the survey showed people from low income and lower educational backgrounds continue to smoke at higher rates. Moreover, smokeless tobacco use — including chew and similar products — is also on the rise among smokers.

Since the state started the Tobacco Prevention and Control Program a decade ago, the smoking rate has declined by about a third.

The smoking rates among people from low income — 29 percent — or lower educational backgrounds — 27 percent — remain higher than the norm.

“I’m pleased with our continued improvement in smoking rates, yet we’ve still got work to do,” Selecky said. “We must be sure everyone in our state — regardless of income and education level — is included in these gains. We must also combat new trends — like the increased use of smokeless tobacco, including dissolvable products that look like candy. Smokeless tobacco is not a safe alternative to cigarettes.”

The state attributed the decline to several factors, including strong smoke-free laws, the third-highest cigarette tax in the country and a comprehensive tobacco prevention and control program.

The department operates Quitline — 800-QUIT-NOW or 877-2NO-FUME — to provide free help to smokers and smokeless tobacco users interested in quitting.

Quit coaches help callers identify triggers for tobacco use, cope with withdrawal symptoms and develop a personal plan to quit. Callers receive a packet of quit materials by mail.

The state health agency tracks adult tobacco use through the Behavioral Risk Factor Surveillance System. The department culled the latest data come from telephone surveys conducted throughout 2009. The survey participants included 20,000 adults from across the state.

Dr. David Gartman (center) and his team operate on their portion of the second patient ever west of the Mississippi to receive a hybrid procedure for atrial fibrillation at Swedish Medical Center. Issaquah resident Steve Beer received the first. Contributed

Steve Beer has always enjoyed living in the Issaquah area for its convenient access to outdoor activities, such as hiking to motorcycle riding.

Then, a few years ago, as he approached his 50s, Beer noticed his energy reserves were sapped more quickly.

“I could work out in the yard for hours and be dead as a doornail afterwards,” he recalled. “I just thought I was getting older, out of shape.”

Then, in 2008, an unrelated sinus surgery had to be postponed due to anomalous electrocardiogram readings that concerned his doctors. Further tests by a cardiologist proved Beer had atrial fibrillation, the most common type of arrhythmia or abnormal electrical activity in the heart.

Beer wasn’t alone in his diagnosis. According to the American Heart Association, about 2.2 million Americans live with AF. It is also the most common “serious” heart rhythm abnormality in people over age 65.

Atrial fibrillation occurs when the heart’s two small upper chambers (the atria) quiver — instead of beating rhythmically and effectively — and won’t fully contract (squeeze blood out of the heart completely). Some electrical signals go to the ventricles, which still pump out blood. But blood isn’t pumped completely out of them, so it may pool and clot. If a piece of a blood clot in the atria leaves the heart and becomes lodged in an artery in the brain, a stroke results.

Thus began a two-year journey to cure Beer of his arrhythmia. But the typical treatments weren’t working. He underwent three cardioversions — a brief procedure where an electrical shock is delivered to the heart to convert an abnormal heart rhythm back to a normal rhythm. He was put on blood thinners. Beer also underwent cardiac ablation surgery, essentially inserting a catheter into the heart and scar tissue is left over short-circuited electrical pathways that were causing the arrhythmia.

Each solution was only temporary, leading Beer’s heart back into arrhythmia.

That’s why, at age 50, he volunteered to be Swedish Medical Center’s first patient west of the Mississippi River to undergo a hybrid procedure for atrial fibrillation.

“Actually, I didn’t learn of the ‘first west of the Mississippi’ part until after the surgery,” Beer said.

Dr. David Gartman, Beer’s cardiothoracic surgeon, said the procedure is so new that only a few people east of the Mississippi had undergone it.

The hybrid procedure combines the benefits of surgical and catheter-based ablation to treat patients with persistent and long-standing forms of AF. During back-to-back procedures done in the same operating room, the physicians used minimally invasive surgical ablation products (on the outside of the heart, or epicardial) in conjunction with a catheter ablation platform (on the inside of the heart, or endocardial) to return the patient’s heart to a normal or “sinus” rhythm.

Electrophysiologist Darryl Wells said the breakthrough was realizing there was no reason both specialists could do their procedure while the patient was under just the one time.

“This is really powerful stuff,” he said.

Gartman added that a patient used to have to be opened up like regular heart surgery, cracking the chest cavity.

“Now, we make three, noninvasive holes on the side of the chest a half-inch in length — one for the TV and the other two to operate through,” Gartman said.

He said the benefits to the patient include combining the procedures into one trip to the operating room for quicker treatment, a shorter two- to three-day hospital stay and an expedited return to normal activities.

“And from a physician’s perspective,” Gartman added, “there are numerous benefits to the approach, including the direct visualization afforded a surgeon with the sophisticated mapping and electrical signal technology within the realm of a cardiac electrophysiologist.”

Beer went in for the combined procedure June 9, spending six hours in the operating room. He was given three and a half days of recovery time.

“It was way easier than I expected,” Beer said.

He was walking his neighborhood hills the next day. He was taken off the blood thinning drugs and his heart remains in rhythm to this day.

Now, he’s up to walking four to five miles a day, rebuilding his stamina, getting reacquainted with the area.

“My wife and I like hiking,” he said. “Thanks to the procedure, I can love living in this area with its access to the outdoors again.”

What to know

The symptoms of atrial fibrillation include:

• irregular heart pounding
• shortness of breath
• dizziness
• exercise intolerance
• fatigue

David Hayes: dhayes@isspress.com, 392-6434, ext. 237. Comment at www.issaquahpress.com.

Overlake Hospital Medical Center offers the following classes at its Issaquah clinic, 5708 E. Lake Sammamish Parkway S.E., Suite 103. Register at www.overlakehospital.org/class1.aspx. Call 688-5259 for class information.

Weight Loss Surgery Seminar” — 6-7:30 p.m. Aug. 24, free

-“You and Your Baby: 5 Class Series” — 11 a.m. – 1 p.m. Sept. 2-30 and 10 a.m. – noon Sept. 15 – Oct. 13, $55

-“Condensed Series: Preparation for Childbirth & Newborn Care” — 9:30 a.m. – 3 p.m. Sept. 10 & 17, $95 per couple

-“Comprehensive Preparation for Childbirth and Newborn Care 7-week series” — 7-9 p.m. Mondays Sept. 13 – Oct. 25, $105 per couple

Swedish offers class in Issaquah

“Joint Replacement: The Right Choice for You?” is at 6 p.m. Aug. 26 at Swedish Medical Center’s Issaquah clinic, 2005 N.W. Sammamish Road. Register at https://www2.eventsvc.com/ swedishhealth.

Any Length: 8 a.m. Sundays, Issaquah Valley Senior Center, 75 N.E. Creek Way

Issaquah Smoke Free: 8:30 a.m. Sundays, Issaquah Community Hall, 180 E. Sunset Way

One Step At a Time: 10 a.m. Sundays and 7 p.m. Thursdays, 206-686-2927

Core Relations (men only): 6 p.m. Sundays, Issaquah Community Hall, 180 E. Sunset Way

Sobriety Life Line: 7:30 p.m. Sundays, Issaquah Valley Senior Center, 75 N.E. Creek Way

Morning Buzz: 6:30 am. weekdays, Lakeside Milam, 98 N.E. Gilman Blvd. Suite 200

Issaquah Breakfast: 7 a.m. weekdays, Issaquah Community Hall, 180 E. Sunset Way

Issaquah Breakfast (step study): 7 a.m. Saturdays, Issaquah Community Hall, 180 E. Sunset Way

Joy of Living: noon Mondays, Tuesdays, Wednesdays and Fridays, and 4 p.m. Thursdays, IHOP Restaurant, 1433 N.W. Sammamish Road

It’s In the Book (men only): 7 p.m. Mondays, 14919 Issaquah-Hobart Road

59 Minutes at Pine Lake: 8 p.m. Mondays, Pine Lake Community Club, 21333 S.E. 20th St.

A Resentment and a Coffee Pot: 7 p.m. Tuesdays, Preston Fire Hall, 8641 Preston-Fall City Road S.E.

Book Bag Stag (men only): 7 p.m. Tuesdays, Issaquah Community Hall, 180 E. Sunset Way

Issaquah Tuesday Night: 8 p.m. Tuesdays, Our Savior Lutheran Church, 745 Front St. S.

Young Drunks (young people): 8 p.m. Tuesdays, Our Savior Lutheran Church, 745 Front St.

Sammamish by the Book: 7:30 p.m. Wednesdays, Mary, Queen of Peace Catholic Church, 1121 228th Ave. S.E.

Issaquah New Start: 5:30 p.m. Thursdays, Community Baptist Church, 205 Mountain Park Blvd. S.W.

Sammamish Big Book Study (children): 6 p.m. Thursdays, Pine Lake Covenant Church, 1715 228th Ave. S.E., Room 104

Raging on the River: 7 p.m. Thursdays, Preston Baptist Church, 31104 S.E. Eighth St.

Issaquah Women (women only): 7:30 p.m. Thursdays, Issaquah Valley Senior Center, 75 N.E. Creek Way

Pine Lake Stag (men only): 8 p.m. Thursdays, Pine Lake Community Club, 21333 S.E. 20th St.

Tiger Mountain Stag (men only): 8 p.m. Thursdays, Issaquah Community Hall, 180 E. Sunset Way

Friday Night Firehouse Meeting: Issaquah Highlands Fire Station, 1289 N.E. Park Drive

Search for Serenity (big book study): 8 p.m. Saturdays, Issaquah Senior Center, 75 N.E. Creek Way

Alzheimer’s Disease and Dementia Support Group: 6-7:30 p.m. second Thursday, Aegis of Issaquah, 780 N.W. Juniper St., 313-7364

Alzheimer’s and Caregiver Family Support Group: 6-7:30 p.m. second Thursday, Faith United Methodist Church, 3924 Issaquah-Pine Lake Road S.E., 313-7364.

Angel Care-Breast Cancer Foundation: free emotional support to the newly diagnosed, enhancing emotional recovery while going through treatments, www.angelcarefoundation.org

Bereavement Support Group: 7-8:30 p.m. second and fourth Mondays, Overlake Hospital, 688-5906

Family Caregivers Support Group: 3-4:30 p.m. second and fourth Thursdays, Overlake Senior Health Center, 1750 112th Ave. N.E., Suite A-101, Bellevue, 688-5807

Issaquah Parkinson’s Support Group: 1:30-3 p.m., second Monday, Our Savior Lutheran Church, 745 Front St. S., 206-230-0166 or 392-4169

Overeaters Anonymous: 10:30 a.m. Mondays, Our Savior Lutheran Church, 745 Front St. S. Call 392-2488 or 761-2555. Childcare available upon request.

Prostate Cancer Support Group: 7 p.m. third Tuesday, Lincoln Center, 555 116th Ave. N.E., Suite 125, Bellevue, 369-2552

TOPS (Take Off Pounds Sensibly): 9:30 a.m. Thursdays, Our Savior Lutheran Church, 745 Front St. S., 746-4195 or 391-1889

Summer means barbecues, outdoor activities — and more encounters with biting and stinging bugs.

Keeping calm around buzzing bugs can help reduce the risk of winding up on the business-end of a bloodthirsty mosquito or irritated wasp.

The state Department of Health has a handy list detailing biting and stinging bugs found in the Evergreen State.

Bees play a crucial role in pollinating flowering plants, including many foods. Honeybees and bumblebees seldom sting as they leave the hive or nest to look for nectar or pollen — unless they get stepped on or deliberately provoked.

Wasps and yellow jackets — more easily provoked than bees — hunt for food and build nests during summer.

To keep from being stung by a bee or wasp, do not disturb the hive or nest. Do not swat at bees or wasps — the action agitates them and makes them more likely to sting.

Avoid brightly colored clothes, open-toed shoes, and perfumes or scented lotions when outside. Keep food covered or behind screens when eating outdoors. Dispose of food properly, including decaying fruit in late summer.

People allergic to wasp and bee stings should carry identification with the allergy information, plus any medicine they are taking. Severe reactions can affect the entire body and can occur very quickly — often within minutes — and may be fatal if left untreated.

Call 911 if someone stung by a bee or wasp experiences chest pain, face or mouth swelling; or has trouble swallowing or breathing; or goes into shock.

Summertime nuisances, like horse- and deerflies, can also deliver a painful, itchy bite. But scratching the bite might lead to infection.

Beware of horse- and deerflies near ponds, streams and marshes. The insects can transmit tularemia, a bacterial disease. Remember to cover exposed skin and use a repellent to keep the flies from biting.

The ticks found in Washington — hard and soft ticks — usually feed on animals, but feed on people sometimes, too.

Though Lyme disease and Rocky Mountain spotted fever remain rare in Washington, hard ticks carry the diseases. The ticks live in wooded, brushy and grassy areas. Campers, hikers and other outdoors-folk should check themselves for ticks often.

Meanwhile, soft ticks transmit tick-borne relapsing fever — the most common tick-borne disease in the state. Houses and cabins infested with rodents may also be home to soft ticks. If a tick bite results in a fever, rash, pain or swelling, call a health care provider.

The state Department of Health offers useful tick-removal tips.

The mosquito season means increased concerns about West Nile virus.

In King County, a surveillance program tracks dead birds to monitor for the disease, because certain species of birds tend to get sick and die from West Nile quickly.

Report dead birds to Public Health – Seattle & King County online or call 206-205-4394.

The public health agency tracks information about dead birds, because increased numbers of dead birds in a particular area can be a West Nile warning sign. Some of the reported dead birds will be tested for the virus.

Throughout Washington, the mosquito-borne virus infected more people and caused the deaths of more horses in 2009 than in previous years. The numbers mean West Nile might be a continual presence in the state, and possibly King County.

Residents should take steps to lessen the chances of mosquitoes breeding on their property, by eliminating standing water. Residents should also take steps to prevent mosquito bites by wearing a mosquito repellent, plus long-sleeved shirts and long pants when mosquitoes are biting.

More than 55 million American men face the risk of prostate cancer, and early detection is important.

Virginia Mason, in partnership with ZERO: The Project to End Prostate Cancer, will host the event from 9 a.m. – 5 p.m. at its Issaquah campus, 100 N.E. Gilman Blvd.

The screening is free, confidential and does not require an appointment or health insurance.

Virginia Mason providers will staff the screening and volunteers will be on hand to explain the process and answer any patient questions.

The screening consists of a simple blood test known as a prostate-specific antigen, or PSA, blood test and an optional physical exam. Patients will be seen on a first-come, first-served basis, a Virginia Mason news release said.

Results are confidential and will be sent to patients in three to four weeks by ZERO. Patients with high PSA scores should follow up with their healthcare providers.

Additional health information for men and women will be available at the event.

Virginia Mason Medical Center is hosting a free prostate screening in Issaquah on Friday.

More than 55 million American men face the risk of prostate cancer, and early detection is the key.

Virginia Mason, in partnership with ZERO: The Project to End Prostate Cancer, will host the event from 9 a.m. – 5 p.m. at its Issaquah campus, 100 N.E. Gilman Blvd.

The screening is free, confidential and does not require an appointment or health insurance.

Virginia Mason providers will staff the screening and volunteers will be on hand to explain the process and answer any patient questions.

The screening consists of a simple blood test known as a prostate-specific antigen, or PSA, blood test and an optional physical exam. Patients will be seen on a first-come, first-served basis, a Virginia Mason news release said.

Results are confidential and will be sent to patients in three to four weeks by ZERO. Patients with high PSA scores should follow up with their healthcare providers.

Additional health information for men and women alike will be available at the event.

Listen to Issaquah yoga instructor Anita Boser as she offers tips to prevent muscle injuries and recover from past strain Friday.

Boser, proprietor of Vital Self in downtown Issaquah, will be interviewed on the Living Yoga Radio Show at 1 p.m. Tune in to 1150 AM or 98.9 FM to listen to Boser. Or listen live online.

Host Robin Rothenberg, author of the “Essential Low Back Program,” and Boser will discuss how aches, pains and repetitive strains can get locked into connective tissue.

Boser will also offer tips to unwinding the tension patterns for more ease.

Swedish Medical Center sleep experts want you to spend the night.

Sleep Medicine Associates, a Swedish affiliate, plans the first all-night “sleep up” Thursday — a live, online stream documenting a patient’s overnight sleep-disorder testing. During the event, sleep doctors and technicians will answer viewers’ questions via Twitter and in video interviews.

The team hopes to raise awareness about sleep disorders and treatments through the social media experiment.

The sleep up runs from 8 p.m. Thursday to 8 a.m. Friday. Sleepless in Seattle types can follow along here.

The sleep experts will monitor a consenting patient for sleep patterns, disorders and dream cycles as high-def cameras capture commentary from sleep specialists. Infrared cameras will watch over the patient’s sleep patterns and movements.

Doctors will also monitor and discuss the patient’s brain activity. Expect charts, graphs and other visuals in the live stream.

The sleep up starts at 8 p.m. with a live webcast with the patient, a sleep doctor and the patient’s wife.

Then the patient will bed down at Swedish’s Cherry Hill campus. Sleep Medicine Associates operates a clinic in Issaquah. Swedish has a standalone ER here. The hospital’s Issaquah Highlands campus is under construction and slated for a 2011 opening.

Turn to Twitter for more information during the sleep up.

Feeds will be posted by the hospital (@Swedish), the sleep clinic (@gosleepseattle), Swedish spokesman Ed Boyle (@edboyle), and social media gurus Aaron Blank and Drew Symonds (@SeattleBlank and @drewsymonds).

Use the hashtag #sleepup to chat with the team. Tweeting should start at about 7:30 p.m. Thursday.

Experts estimate more than 50 million adults in the United States suffer from a chronic sleep disorder. The often-curable disorders tend to cause daytime drowsiness, fatigue and distress.

Michelle Johnson, Jackie Potter and Hayley Magee (from left), on summer vacation from classes at Skyline High School, share sunscreen sprays and lotions of SPF 15, 30 and 50, before sunbathing July 14 on the dock at Pine Lake Park. By Greg Farrar

Go into any drugstore and you’re bound to run into a plethora of sunscreen options this summer. But do you really know what to look for?

Many people don’t, so you’re not alone.

“There are a lot of sunscreens out there,” Amy Cheng, a dermatologist with Virginia Mason Medical Center, said.

Even the federal Food and Drug Administration doesn’t have a consumer-friendly system of standards regulating the claims of companies who make sunscreen, despite the Sunburn Protection Factor label.

Since 2007, officials with the FDA have posted consumer updates on its website saying it’s in process of developing a set of standards, but those have yet to come to fruition.

With more than 3.5 million cases of skin cancer reported annually in the U.S., according to the nonprofit Skin Cancer Foundation’s website, a system can’t come fast enough. Especially since many sunscreens only provide protection against ultraviolet B rays, but not against equally harmful ultraviolet A rays.

Until a system is developed, here are some basic things you need to know to protect yourself from the sun.

What is the difference between UVA and UVB rays?

UVB rays are primarily responsible for sunburns, while UVA rays cause tanning, according to the FDA website.

“They’re both present at the same time,” through the sun’s rays, Cheng said. “UVA rays have longer waves and penetrate deeper into the skin. UVB rays are stronger, but penetrate less. They both cause skin cancer and they both age your skin.”

While sunscreen labels are required to carry a SPF value, designed to inform users how well the product protects against UVB light, it doesn’t often inform you whether it protects against UVA light.

“Some studies will say that 98 percent of sunscreens on the market failed protecting consumers, but it depends on what study you look at,” she said. “There are a lot of sunscreens that are broad spectrum and protect against UVA and UVB rays.”

What should you look for?

Nothing beats an umbrella or shade, Cheng said, but when you’re out in the sun, you need to wear sunscreen, no matter who you are.

“Skin is the biggest organ in our body, so it is important to take care of it,” she said. “If you aren’t eating healthfully, you’re tanning, lead a harsh life or smoke, skin is a window to what you’ve been doing. Everything shows up eventually.”

Cheng said she tells patients to look for sunscreens that say they have broad-spectrum protection against UVA and UVB rays. Companies like Aveeno, Neutrogena and Coppertone’s Water BABIES have at least one sunscreen each that meet the requirements, she said.

If you can’t find those, turn to the ingredient list on the back of the bottle, she said. What you are looking for are two things — physical blockers and chemical absorbers.

Physical blockers include titanium dioxide and zinc oxide, which appear white so as to protect your skin like a shield that reflects the rays.

Companies have developed other chemical formulas, too, some with a combination of physical blockers.

Usually, at least three active ingredients are called for to be an effective chemical absorbing sunscreen, according to the Skin Cancer Foundation website. These generally include: PABA derivatives, salicylates, and/or cinnamates (octylmethoxycinnamate and cinoxate) for UVB absorption; benzophenones (such as oxybenzone and sulisobenzone) for shorter-wavelength UVA protection; and avobenzone, ecamsule (Mexoryl) titanium dioxide or zinc oxide for the remaining UVA spectrum.

You can also purchase Ultraviolet Protection Factor clothing at retail stores, like REI, she said. Stores sell a variety of shirts, shorts, hats and even swimwear that protect you from the sun’s rays.

Sans sunscreen? Think again

Diseases most commonly related to prolonged exposure to the sun are skin cancers, Cheng said.

Two types, basal cell and squamous cell carcinomas, affect more than 2.25 million Americans each year, according to the Skin Cancer Foundation website.

Both occur in cells in the upper layer of your skin, your epidermis. They both can occur on all areas of the body, but mostly in sun-exposed areas, like your ears, lips, face, scalp, neck, hands, arms and legs, according to the FDA website.

“I see maybe five cases a day. It is extremely common,” Cheng said. You’ll notice “basal or squamous cells by the red scaly spots that appear on your skin and don’t go away. They look like a red pimple or blemish that doesn’t go away.”

Far more rare, but deadlier, is melanoma.

Depending on what study you refer to, one in every 45 or 75 people diagnosed will die, she said. There are about 68,000 cases of melanoma diagnosed in the U.S. each year, according to the Centers for Disease Control and Prevention.

Melanoma is a malignant tumor that develops in the cells that produce the pigment melanin that colors the skin, according to the Skin Cancer Foundation website. Often, the tumors are a black or brown mole or spot and can be raised, flat or misshapen, Cheng said.

You should see a doctor if you have something on your skin that looks odd, since most skin cancers, diagnosed in early stages, have a high cure rate, she said.

Chantelle Lusebrink: 392-6434, ext. 241, or clusebrink@isspress.com. Comment at www.issaquahpress.com.