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Health Highlights: Dec. 31, 2008  

Firm Says FDA OKs Its Generic Version of Nicotine Gum

Watson Pharmaceuticals Inc. said Wednesday that the U.S. Food and Drug Administration had approved its generic version of the nicotine gum Nicorette, and it will begin selling the mint-flavored gum in early January.

The FDA approved the firm's over-the-counter nicotine polacrilex gum in 2 milligram and 4 milligram strengths. Nicorette, made by British drug maker GlaxoSmithKline PLC, is sold by Johnson & Johnson Healthcare. The agency approved Nicorette gum, available in six flavors, in February 1996, the Associated Press reported.

Watson said the market for over-the-counter nicotine gum was more than $300 million in the year ended September 2008. Perrigo Co. also makes a generic version of fruit-flavored Nicorette, AP said.

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Victoria bans battery powered cigarettes 

Battery powered cigarettes that give pseudo smokers a hit of nicotine vapour have been banned in Victoria.

The devices resemble a traditional cigarette and contain nicotine cartridges that create puffs of vapour through an atomiser, like smoke.

From Thursday, the sale and use of nicotine cartridges will be illegal in Victoria and the advertising of battery powered cigarettes banned.

Health Minister Daniel Andrews said nicotine was highly addictive and toxic and was rapidly absorbed through the skin, inhalation and ingestion.

He said users of battery powered cigarettes were in danger of nicotine poisoning, with acute exposure causing possible damage to the mouth, eyes and nervous, digestive and musculoskeletal systems.

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• Ban on battery-powered smokes 

A battery-powered device touted as the "healthy alternative to smoking" has been banned by the State Government.

Health Minister Daniel Andrews today said it would be illegal to sell the nicotine cartridges necessary to use the device.

The device, which resembles a traditional cigarette, does not contain tobacco but delivers nicotine through an atomiser that creates puffs of vapour similar to cigarette smoke.

Health organisations were outraged earlier this year when the cigarettes were promoted as a way to beat smoking bans in pubs, offices and on public transport.

Mr Andrews said the pharmacology of nicotine had been well studied.

"It is addictive and produces a characteristic abstinence withdrawal syndrome," he said in a statement. . . .

The new regulation, which comes into effect tomorrow, outlaws the manufacture, sale, supply, purchase, possession or use of unregulated nicotine delivery systems.

The decision will have no effect on the sale of nicotine replacement therapies, which are used to assist people stop smoking.

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Ban on battery-powered cigarettes  

BATTERY-powered cigarettes, sold as a "healthier alternative" and a way to beat smoking bans, will be outlawed in Victoria from Friday.

Distributors say electronic cigarettes have been used by up to 10,000 Victorians since they hit the market a year ago.

The Egar device works by heating up a small cartridge of liquid nicotine, releasing puffs of vapour resembling smoke that are inhaled by smokers.

But because the lookalike product is not lit, it can be used in "no smoking" areas.

It contains no tobacco, but Health Minister Daniel Andrews says its nicotine is no less toxic and addictive.

From tomorrow, it will be illegal to sell the nicotine cartridges used in the device in Victoria.

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• Lessons for Other Smokers in Obama’s Efforts to Quit  

His pattern matches that of millions of other people who have resolved but stumbled in their efforts to give up cigarettes. Today, 21 percent of Americans smoke, down from 28 percent in 1988. Off-again-on-again smoking and serial quitting are common, as is the long-term use of nicotine gum and patches.

"It takes the average smoker 8 to 10 times before he is able to quit successfully," said Dr. Steven A. Schroeder, director of the Smoking Cessation Leadership Center at the University of California, San Francisco.

Dr. Schroeder said that counseling was helpful, and that if Mr. Obama were his patient, he would urge him to try it, even if only by telephone, toll free at 1-800-QUITNOW (1-800-784-8669). With nicotine replacements and counseling, quit rates at one year are 15 percent to 30 percent, Dr. Schroeder said, about twice that of those who try without help.

But Mr. Obama has apparently been chewing nicotine gum for quite a while. Is it safe? Dr. Neal L. Benowitz, another expert on nicotine addiction from the University of California, San Francisco, said that long-term use of the gum or patches, "if it keeps you off cigarettes, is O.K."

He said people had the best chances of quitting if they used more than one type of nicotine replacement at the same time -- like wearing a patch every day, but also using the gum when cravings took hold.

Studies have found that 5 percent to 10 percent of people who try nicotine replacements were still using them a year later, and nicotine itself appears not to be harmful, except possibly during pregnancy and for people at risk for diabetes, Dr. Benowitz said. The risks of cancer, other lung disease and heart problems come from other chemicals in tobacco smoke. . . .

"Then there is something called hedonic dysregulation," Dr. Benowitz said. "It involves pleasure. Nicotine involves dopamine release, which is key in signaling pleasure. When people quit smoking, they don't experience things they used to like as pleasure. Things are not as much fun as they used to be. It's something you get over in time."

People become hooked on nicotine in part because, like alcohol and other addicting drugs, it alters the brain. Some of the changes are long-lasting, and the younger people are when they take up smoking, the stronger their addiction.

"There is increasing evidence that you lay down new neural circuits related to smoking, sort of memory tracks," Dr. Benowitz said. "Nicotine does it, and other aspects of smoke do, too. Your brain is forever changed."

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Health Tip: Using a Nicotine Patch To help kick the smoking habit  

If you've opted for a nicotine patch to help you quit smoking, it's important to know how to use it correctly.

The American Academy of Family Physicians offers these suggestions on how to use the patch:

* Leave the package closed until you are ready to use the product. When ready, open the package, peel off the patch's backing, and don't touch the sticky side of the patch.

* Clean and dry an area of skin on your upper body on which to apply the patch. Don't put it on an area that is hairy, burned, sore or has a cut.

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New Crown7 Device Allows Smokers to Puff Without Smoke 

Crown7.com, the global leader in electronic cigarettes, announced today its launch of the HYDRO product line representing the most advanced e-cigarette on the market. The HYDRO is sleek and sexy and the same size as a traditional 100 length cigarette; however it is smokeless and does not contain any tar or carcinogens.

In response to global smoking bans, the Crown7 product allows bars, restaurants, casinos and other businesses where smoking is now banned, to retain loyal customers they would otherwise lose.

The Crown7 HYDRO looks and acts like a cigarette without the harmful side effects of traditional cigarettes. The HYDRO replicates the act of smoking using a nicotine cartridge, a microchip and a water vapor mist. When the user inhales through the tip, the battery-powered microchip activates an atomizer which provides small amounts of nicotine with each inhalation, and instead of unhealthy smoke a harmless water vapor mist is dispersed.

"If it (Crown7 HYDRO) doesn't contain any tobacco, it would not be prohibited since the law is designed to protect workers and others from the harmful effects of secondhand tobacco smoke," said Celina De Leon at New York City Department of Health & Mental Hygiene.

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New Research May Encourage Smokers to Jump-Start Their New Year's Resolution to Quit Smoking 

While New Year's is the most popular time to try quitting smoking, research shows the majority of smokers who try to quit at that time resume smoking in less than one week.(1) By starting a quit attempt early, smokers can avoid the pressures of a New Year's resolution and may be well on their way toward being smoke-free by January 1st. New research shows that smokers who use the 21 mg NicoDerm(R) CQ(R) nicotine patch every day for the first three weeks of a 10-week treatment significantly improve their chances of success.(2)

The study, published in the November issue of Clinical Therapeutics: The International Peer-Reviewed Journal of Drug Therapy, shows that people who use the 21 mg NicoDerm CQ nicotine patch every day for the first 21 days of quitting were three-times as likely of being smoke-free at the six week point in the course of treatment compared to those who do not wear their patch every day.(2) Further, when used as directed, the NicoDerm CQ patch can significantly increase a smoker's chance of quitting (versus placebo) and remaining smoke-free long-term (6 months or longer).(3)

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• Stop Smoking: Secrets of Successful Quitters  

At any age, quitting can avert or blunt myriad health hazards and might avoid heartache for would-be parents—smoking can hamper conception in women and reduce sperm count in men. The earlier a smoker grinds out that last cigarette, the greater the gain. Male doctors who ditched the habit before age 35 had nearly the same life expectancy as did a matched group of physicians who never picked it up, according to a 2004 study in the British Medical Journal.

But most smokers know perfectly well they should quit, and 7 out of 10 say they want to. The challenge is how to break free of nicotine's suffocating grip for good. Just 2 to 4 percent of those who try are smoke free—with no slip-ups—a year later.

Pure willpower is the usual strategy, says Douglas Jorenby, director of clinical services at the University of Wisconsin's Center for Tobacco Research and Intervention, and it rarely works. "Tobacco dependence is a chronic disease," he says, so over the long term, "the odds are very great that you'll relapse."

Addictive potential. Most experts agree that smoking is a drug habit with a tenacious clutch. . . .

Even a faceless online peer network can be effective. Logging onto the American Lung Association's Freedom From Smoking message board is what finally worked for Heidi Norie, a 46-year-old mother of three from Vista, Calif. Having smoked for 30 years—at times more than two packs a day—she has been an ex-smoker since March of 2008.

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Health Tip: Using a Nicotine Patch To help kick the smoking habit  

If you've opted for a nicotine patch to help you quit smoking, it's important to know how to use it correctly.

The American Academy of Family Physicians offers these suggestions on how to use the patch:

* Leave the package closed until you are ready to use the product. When ready, open the package, peel off the patch's backing, and don't touch the sticky side of the patch.

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Right help key to quit success for women smokers  

Female smokers who want to kick the habit face different challenges than men, but with the right help they can be just as successful, according to experts from the Mayo Clinic in Rochester, Minnesota.

"The problem is that there are specialists or interventionists who deal with everyone in the same manner," Dr. Ivana T. Croghan, research program coordinator at the clinic's Nicotine Dependence Center, told Reuters Health.

While research suggests women may be more likely than men to relapse after quitting, Croghan added, her own analysis of 3,000 people treated at the Mayo Clinic center found no difference between men and women in the ability to stay smoke free six months later.

Women report more troublesome symptoms of withdrawal such as depression, irritability, anxiety and lethargy than men do, Patrick Draper, a clinical social worker and tobacco treatment specialist at the clinic, told Reuters Health. Furthermore, smoking can be more of a reaction to negative emotions for women than it is for men, according to Croghan, while women may also have less faith in their ability to quit. . . .

One of the most important keys to quitting smoking is to get professional help, which is often covered by health insurance, Draper and Croghan said.

The fact that nicotine patches and similar smoking cessation aids are now available over the counter may give the impression that people don't need assistance, but these medications were actually designed to be an adjunct to counseling, they pointed out. "Just putting a patch on and going about your life normally usually doesn't work real well," Draper said.

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Secondhand Smoke Boosts Asthmatic Boys' Behavior Woes  

Secondhand smoke in the home increases the risk of behavioral problems in boys with asthma, researchers report.

The study, by a team at Cincinnati Children's Hospital Medical Center, included 220 boys and girls ages 6 to 12, with asthma.

For each doubling of secondhand smoke exposure, boys showed a twofold increase in behavioral problems such as hyperactivity, aggression, and depression.

The researchers found that secondhand smoke had no impact on girls, even though they were on average exposed to higher levels of tobacco smoke than boys. Additional research is needed to explain this gender difference, the researchers said.

The study was published online in the Journal of Developmental & Behavioral Pediatrics.

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Probing Genetic Underpinnings Of Nicotine Addiction 

A new study from the Abramson Cancer Center and Department of Psychiatry in the University of Pennsylvania School of Medicine shows that smokers who carry a particular version of a gene for an enzyme that regulates dopamine in the brain may suffer from concentration problems and other cognitive deficits when abstaining from nicotine - a problem that puts them at risk for relapse during attempts to quit smoking.

The findings, newly published in the journal Molecular Psychiatry, pave the way to identify novel medications to treat nicotine addiction.

"These findings also provide an important step toward personalized therapy for nicotine addiction by clarifying the role of inherited genetic variation in smoking abstinence symptoms that promote relapse," says senior author Caryn Lerman, PhD, the Mary W. Calkins Professor in Penn's Department of Psychiatry and Scientific Director of Penn's Abramson Cancer Center.

"The new data identify a novel brain-behavior mechanism that plays a role in nicotine dependence and relapse during quitting attempts,"

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Paul Arendt: One month of ... Electronic cigarettes 

Somewhere in my geekiest science fiction dreams, there is a future world where the cigarette is a harmless device, designed by sentient supercomputers to deliver vitamins, plump up your eyelashes and fight the seven signs of ageing. So it's not surprising that I reacted to the invention of an "electronic cigarette" with utter glee.

The e-cig gives the smoker a hit of nicotine and the sensation of smoking without the tar and the witch's brew of carcinogens . . .

I get tired of explaining to people that I'm not breaking the law. I feel silly sucking on a metal and plastic tube, like a middle-aged baby. I cadge a real fag from a friend at my weekly poker game, and the slide back to phlegmy normality begins. But something has changed. The cigarette on my lips feels stupid, bizarre. Perhaps that is the e-cig's hidden strength: it makes you realise what a ludicrous business smoking actually is.

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New Crown7 Device Allows Smokers to Puff Without Smoke  

Crown7.com, the global leader in electronic cigarettes, announced today its launch of the HYDRO product line representing the most advanced e-cigarette on the market. The HYDRO is sleek and sexy and the same size as a traditional 100 length cigarette; however it is smokeless and does not contain any tar or carcinogens.

In response to global smoking bans, the Crown7 product allows bars, restaurants, casinos and other businesses where smoking is now banned, to retain loyal customers they would otherwise lose.

The Crown7 HYDRO looks and acts like a cigarette without the harmful side effects of traditional cigarettes. The HYDRO replicates the act of smoking using a nicotine cartridge, a microchip and a water vapor mist. . . .

"If it (Crown7 HYDRO) doesn't contain any tobacco, it would not be prohibited since the law is designed to protect workers and others from the harmful effects of secondhand tobacco smoke," said Celina De Leon at New York City Department of Health & Mental Hygiene.

Crown7 is the first and only manufacturer that offers "Made in the USA" cartridges, the equivalent of 10 cigarettes, available in Regular, Menthol and 10 new flavors such as grape and cherry. . . .

"The best thing about the Crown7 HYDRO is consumers worldwide can now smoke anywhere and anytime they wish, including indoors," said Ron MacDonald, founder and CEO of Crown7. "This product line gives consumers the mental, physical and emotional need they are seeking - plus the nicotine - but what looks like smoke is really water vapor. It is an alternative to smoking regular cigarettes and you don't have to go outside to use it." . . .

"There is no safe cigarette," said Dr. Jonathan Winickoff, assistant professor at Harvard Medical School. "In fact, there's no safe form of tobacco product. Nicotine is not tobacco, so in that sense, the medication component of this product (Crown7 HYDRO) is a thousand times safer than cigarettes."

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