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What 2012 Has in Store for Star Scientific (CIGX) 

As I discussed last month, Star Scientific put in solid gains in 2011 as the company got out in front of a shift toward cigarette alternatives. But increasingly, tobacco giants Altria (NYSE: MO ) and Reynolds American (NYSE: RAI ) have made pushes into the smokeless tobacco realm, threatening to take away any moat that Star Scientific may have started to build. Can the small company make good on its full potential and bring an even bigger payday for shareholders in 2012? Below, I'll take a closer look at what people expect from Star Scientific and its rivals. . . .

Even with those patents, tobacco will continue to be competitive, and Star Scientific will keep facing potential threats from Reynolds and Altria domestically. As international regulation starts to have a bigger impact on Philip Morris International (NYSE: PM ) and British American Tobacco (AMEX: BTI ) , Star may have new opportunities there as well. But even with some things in its favor, Star will still need to fight hard to keep an edge and repeat 2011's strong stock performance.

If you'd rather just skip the tobacco industry entirely, let us point you to an alternative. In its latest special report, you can learn the name of The Motley Fool's top stock for 2012.

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Addiction to nicotine trumps even lung cancer  

Unfortunately, harm reduction approaches have yet to be widely accepted for those addicted to cigarettes. A new study by the American Cancer Society illustrates the depth of this addiction and the difficulty some smokers face even when a diagnosis of cancer makes it imperative that they quit. One woman, a smoker whose cancerous lung was removed, explained in an MSNBC interview the draw of cigarettes despite the litany of cessation methods she tried. We can't help but think that tobacco harm reduction products could have been a great help to this woman, as well as to many people like her.

The new study, published in the journal Cancer, looked at nearly 2,500 lung cancer patients . . .

"Wouldn't it be nice," ACSH's Dr. Elizabeth Whelan asks, "if these patients had a spectrum of smokeless products, which are both effective and at least 90 percent less harmful than cigarettes, to choose from?" ACSH's Dr. Gilbert Ross agrees. "It's absurd that we're recognizing the benefits of harm reduction for IV drug addicts, but we won't acknowledge how much it would help people who can't quit smoking even after a cancer diagnosis."

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Nicotine & Tobacco Research Advance Access (section view) 

Agreement Between Self-reports and On-Site Inspections of Compliance With a Workplace Smoking Ban

Detecting Graded Exposure Effects: A Report on an East Boston Pregnancy Cohort

Increased Pouch Sizes and Resulting Changes in the Amounts of Nicotine and Tobacco-Specific N-Nitrosamines in Single Pouches of Camel Snus and Marlboro Snus

Evaluation of the Brief Questionnaire of Smoking Urges in Black Light Smokers

Secondhand Smoke Exposure and Hair Nicotine in Children: Age-Dependent Differences

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Nicotine patches get a bad rap  

What about the new report "proving" that nicotine patches (and gums, lozenges) don't work? Baloney. It compared people who quit using nicotine replacements with folks who quit cold turkey. Both groups fell off the non-smoking wagon at about the same rate. That doesn't mean patches don't work.

That logic is as twisted as Snooki's bra strap after a night on the town. They didn't measure quit rates. They measured return-to-smoking rates of quitters. Plus, we know long-term success doesn't happen that often with nicotine replacement alone.

We've helped at least 1,400 people quit. Smoking's a tough enemy, and you need an arsenal to beat it. Nicotine replacement is just one weapon -- only 5 percent to 10 percent of quitters who do just replacement succeed. Thus our combo approach. Nearly 60 percent of people who follow it succeed!

For step-by-steps, go to www.RealAge.com/stop-smoking/. Then go for it.

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• Poorer Folks May Find It Harder to Quit Smoking 

Quitting smoking is much more difficult for poor people than for those who have greater financial and social status, U.S. researchers have found.

For the study, more than 2,700 smokers were given nicotine patches and a type of treatment called cognitive-behavioral therapy, which is based on the idea that people can learn to change their behavior by changing their thinking patterns. The researchers then assessed the participants' progress in quitting smoking three and six months after the treatment period.

The investigators found that, compared to people with the lowest socioeconomic status, those with the highest socioeconomic status were 55 percent more likely to have quit smoking after three months, and 2.5 times more likely after six months. The term socioeconomic status takes into account factors such as income, education, occupation and where a person lives.

In addition, the study authors found that people with a low socioeconomic status received less treatment, and had fewer resources and less support to sustain abstinence from smoking. . . .

The study findings were released online Thursday in advance of publication in the March print issue of the American Journal of Public Health.

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LETTER: Nicotine Replacement  

Re "Nicotine Gum and Skin Patch Face New Doubt" (front page, Jan. 10):

The role of nicotine replacement therapy has long been misunderstood. These products are not meant to carry the whole burden of helping smokers quit. Nicotine replacement therapy is intended to jump-start quitting by lessening the physical effects of nicotine withdrawal, and cravings, when they are present. This gives smokers confidence that they can begin living without tobacco.

As the study points out, very few smokers use the therapy correctly. . . .

For many smokers, emotional dependence on smoking is a much higher hurdle to overcome than their chemical dependence. Whether they quit "cold turkey" or with nicotine replacement therapy, smokers need to feel that their lives will be better smoke-free.

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• Quitlines and Nicotine Replacement for Smoking Cessation: Do We Need to Change Policy?  

In the past 20 years, public health initiatives on smoking cessation have increased substantially. Randomized trials indicate that pharmaceutical cessation aids can increase success by 50% among heavier smokers who seek help, and use of these aids has increased markedly. Quitlines provide a portal through which smokers can seek assistance to quit and are promoted by tobacco control programs. Randomized trials have demonstrated that telephone coaching following a quitline call can also increase quitting, and a combination of quitlines, pharmaceutical aids and physician monitoring can help heavier smokers to quit.

While quit attempts have increased, widespread dissemination of these aids has not improved population success rates. Pharmaceutical marketing strategies may have reduced expectations of the difficulty of quitting, reducing success per attempt. Some policies actively discourage unassisted smoking cessation despite the documented high success rates of this approach. There is an urgent need to revisit public policy on smoking cessation.

Expected final online publication date for the Annual Review of Public Health Volume 33 is March 17, 2012.

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Addiction Incorporated: The Other Insider / Opens January 20 at the Shattuck Cinemas. 

In the 1999 movie, The Insider, Russell Crowe starred as Jeff Wigand, a former tobacco industry researcher for Brown & Williams, who dares to reveal the dangers of nicotine to Berkeley-based 60 Minutes producer Lowell Bergman.

This week, Berkeley-grad Charles Evans Jr.,'s Addiction Incorporated hits the Big Screen to tell a parallel story of Philip Morris researcher Victor DeNoble, the whistleblower whose revelations triggered the Congressional hearings and class action lawsuits that forever tarred the reputation of Big Tobacco.

Addiction Incorporated is a prodigious historical documentary bursting with brilliant interviews with key players from every level of the scientific-media-political-corporate playing field.

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UCSD Researchers Reject National Policy on Smoking Cessation  

Researchers at the UCSD's School of Medicine studying smoking cessation found that despite a wide range of pharmaceutical medications and anti-smoking aids, the ratio of successful quitters remains the same. They are asking that the national policy, which recommends that doctors advise smokers to use cessation aids, be changed.

In the 2012 edition of the Annual Review of Public Health, researchers looked at the increased options that smokers have to help them kick the habit. The findings are "troubling" for researchers who study tobacco.

"For the past decade, attempts to quit smoking have increased, but the proportion of people who become successful quitters has gone down,” said Dr. John P. Pierce, UCSD professor and director of Population Sciences at San Diego Moores Cancer Center. “Widespread dissemination of cessation services has not led to an increase in the probability that a quit attempt will be successful."

Researchers blame the lack of results on poor marketing schemes by pharmaceutical companies pushing cessations aids. Often, marketing campaigns underestimate the difficulty in quitting, especially for younger smokers.

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Researchers Call for Review of Smoking Policies 

Smoking is a major public health issue and quitting is the single most important thing smokers can do to improve their health. In the 2012 edition of the prestigious Annual Review of Public Health, researchers at the University of California, San Diego School of Medicine have reviewed the landscape of smoking cessation over the past 20 years. During this time period, there have been improvements in pharmaceutical medications to aid cessation, and free telephone cessation coaching has become available in every state. However, recent trends in smoking cessation are troubling to tobacco control researchers.

“For the past decade, attempts to quit smoking have increased, but the proportion of people who become successful quitters has gone down” said John P. Pierce, PhD, professor of Family and Preventive Medicine and director of Population Sciences at UC San Diego Moores Cancer Center. “Widespread dissemination of cessation services has not led to an increase in the probability that a quit attempt will be successful."

The problem does not appear to be with the cessation services themselves. “Randomized trials continue to demonstrate that innovations in cessation assistance, such as the new text-to-quit service, increase success rates among smokers motivated to be part of clinical studies,” said Sharon Cummins, PhD, director of Evaluation with the California Smokers Helpline and a co-author on the study. “Indeed, one study showed that heavier smokers are much more likely to quit successfully when a doctor actively monitors the quit attempt, pharmaceutical aids are used, and the smoker receives multiple coaching calls from a quitline service”.

However, recent evidence suggests that part of the problem may lie in how cessation aids are marketed by pharmaceutical companies: many such ads suggest that quitting smoking may be as simple as putting on a patch. . . .

Pierce and colleagues noted that some of the earliest texts in psychology – written more than 100 years ago – include chapters on breaking habits such as smoking. In 1890, William James laid out a series of maxims that were widely recognized then and that still hold true today: smokers need to make a strong resolution to change; they need to act quickly on that resolution; they will be more successful if they make a personal commitment to another to be successful; and finally, it is important to understand the danger of having even a single cigarette during a quit attempt.

The researchers suggest that policy makers join those in academia for a serious review of tobacco cessation policy.

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Potential Role of Natural Alkaloids in Combatting Memory Loss 

Star Scientific, Inc. (NASDAQ: CIGX) - A study released in the January 9th issue of the Journal of Neurology suggests that nicotine patches may help individuals with early memory loss. Dr. Paul Newhouse, a professor of psychiatry at Vanderbilt University Medical Center, led a study which showed that six months of nicotine patch treatment among patients who had mild cognitive impairment - often a precursor to Alzheimer's disease - had a 46% improvement in their long-term memory for their age. The patient group who received a patch without nicotine showed a 26% decline in memory. Both patient groups were treated for six months.

Nicotine is only one of a family of related compounds known as alkaloids. Anatabine, another compound in the same family, has been actively pursued by Star Scientific for a variety of uses, including as a supporter for memory loss. Star Scientific subsidiary Rock Creek Pharmaceuticals also has a number of patents pending that relate to the administration of anatabine for treatment of a variety of neurological conditions, among other things.

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• Linn supervisors consider nicotine regulation 

The Ariva tablet is “the future of tobacco,” according to its maker. A proposal in Linn County to regulate the sale of the dissolvable product may be the future of public-health efforts to restrict access to nicotine.

“These products are popping up more and more,” said Jill Roeder, Linn County Public Health healthy behaviors branch manager. “This is just to set the stage so when they come our kids can’t buy them.”

At least one retailer doesn’t care to be caught up by the new rules.

“I’m just confused on why I need a permit to sell tobacco when I never have and never will sell tobacco,” said Jake Barnes, Marion, owner of the Electracigz kiosk at Lindale Mall. “It just concerns me.”

The agenda for this morning’s county board work session includes the second reading of a proposed ordinance to require a tobacco sales permit for “the sale of nicotine delivery systems and unregulated products containing nicotine.”

Last August, supervisors voted down an outright ban on dissolvable tobacco products. The new measure, which received supervisors’ unanimous support in its first reading last week, would be the county’s first under a 2009 federal law that extended local regulation to new products that contain nicotine but not tobacco.

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LETTER: Study notes how key it is to use nicotine aids correctly  

Before we move to curtail the use of smoking cessation aids because one study suggests that they are not very effective, we should redouble our efforts to educate the public, especially those prescribing such aids and those providing counseling for smoking cessation. Nicotine addiction is serious, and must be approached as such.

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Who receives prescriptions for smoking cessation medications? An association rule mining analysis using a large primary care database  

Aims

To use association rule mining methods to investigate prescribing of smoking cessation medication in the UK primary care and to identify the characteristics of numerically important groups of patients who typically do, or do not, receive cessation therapy. . . .

Results

Of the current smokers, 37 731 (13.4%) were given prescriptions for smoking cessation treatment during 2008. Prescriptions were particularly likely to be given to women, those aged 31–60 years, and people with diagnoses of chronic obstructive pulmonary disease and depression. On the contrary, of patients with dementia, with alcohol intake over recommended levels, atrial fibrillation or chronic kidney disease was extremely unlikely to be prescribed a smoking cessation medication. However, the largest group of patients who did not receive therapy was young and otherwise healthy individuals.

Conclusions

This novel approach identified sizeable and easily definable groups of patients who are systematically failing to receive support for smoking cessation in primary care. Association rule mining can be used to identify key numerically important groups at high or low risk of receiving treatment and hence potentially to improve healthcare delivery.

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VIDEO: Study on Nicotine Replacement Therapy  

A new study doubts the effectiveness of nicotine replacement therapy as an effective tool in helping smokers quit. Russ Sciandra from the American Cancer Society weighs in.

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