Tobacco.org

• The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences 

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Research shows that two-thirds to three-quarters of ex-smokers stop unaided. In contrast, the increasing medicalisation of smoking cessation implies that cessation need be pharmacologically or professionally mediated.

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Most published papers of smoking cessation interventions are studies or reviews of assisted cessation; very few describe the cessation impact of policies or campaigns in which cessation is not assisted at the individual level.

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Many assisted cessation studies, but few if any unassisted cessation studies, are funded by pharmaceutical companies manufacturing cessation products.

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Health authorities should emphasise the positive message that the most successful method used by most ex-smokers is unassisted cessation.

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• Study: 'Electronic cigarettes' don't deliver  

Electronic cigarettes" that vaporize nicotine juice to inhale instead of smoke from burning tobacco do not deliver as promised, according to research at Virginia Commonwealth University.

"They are as effective at nicotine delivery as puffing on an unlit cigarette," said Dr. Thomas Eissenberg, at the school's Institute for Drug and Alcohol Studies.

His study, funded by the federal National Cancer Institute, is the first by American doctors to check the function of so-called "no-smoke tobacco" devices . . .

The latest clinical evidence suggests users are not getting the addictive substance they get from smoking tobacco. "These e-cigs do not deliver nicotine," Eissenberg said of the findings he expects to publish in an upcoming issue of the British Medical Journal.

This past summer, Eissenberg recruited smokers without prior experience using e-cigarettes to volunteer to use two popular brands of the devices for a set period. The 16 subjects were regularly measured in a clinical setting for the presence of nicotine in their bodies, their reported craving for conventional cigarettes, and certain physiological effects such as a change in heart rate.

"Ten puffs from either of these electronic cigarettes with a 16 mg nicotine cartridge delivered little to no nicotine," the study found.

But the units may deliver hazardous chemicals, according to preliminary checks by federal regulators.

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Smoking may pose 'third-hand' cancer hazard 

Residues of cigarette smoke deposited on indoor surfaces can turn carcinogenic when they react with airborne chemicals. This "third-hand" exposure could in theory cause health problems, particularly in children, says Hugo Destaillats, a specialist in indoor pollution at Lawrence Berkeley National Laboratory in California.

His team found several chemicals on the inside of the cab of a half-pack-a-day smoker's truck, including a carcinogen called a NNK. Destaillats's team reckon that NNK is produced when nicotine from tobacco smoke reacts with nitrous acid in the air.

To test the theory, the team deposited either nicotine or tobacco smoke on sheets of paper, and exposed them to nitrous acid. In both cases this produced the same chemicals found in the smoker's cab.

"Nicotine can persist on indoor surfaces for days, weeks and even months," says Destaillats. Young children who spend a lot of time on the floor could absorb these compounds through their skin, and the researchers argue that this means people should not smoke in homes and cars, and should replace nicotine-laden furniture and carpets.

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Nicotine Tob Res -- Table of Contents (February 2010, 12 [2]) 

• FDA concerned dissolvable tobacco appeals to kids 

The Food and Drug Administration is saying in letters to two tobacco companies that flavored, dissolvable tobacco products - that the agency compares with candy and says contain a lot of nicotine - could be particularly appealing to kids and young adults.

The FDA's Center for Tobacco Products wrote to R.J. Reynolds Tobacco Co., maker of Camel cigarettes, and the smaller Star Scientific Inc. on Monday voicing concern over smokeless products that are consumed like breath mints but made from finely milled tobacco.

"CTP is concerned that children and adolescents may find dissolvable tobacco products particularly appealing, given the brightly colored packaging, candy-like appearance and easily concealable size of many of these products," Dr. Lawrence Deyton, director of the Center for Tobacco Products, told the companies.

Deyton said regulators are worried the products' nicotine content and rapid dissolution could cause nicotine dependence and addiction and be especially dangerous to children and young adults.

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CTP is concerned that children and adolescents may find dissolvable tobacco products particularly appealing, given the brightly colored packaging, candy-like appearance and easily concealable size of many of these products.
Dr. Lawrence Deyton, director of the FDA's Center for Tobacco Products in a letter to RJR and Star about the companies' smokeless products that are consumed like breath mints but made from finely milled tobacco.

Using Nicotine Patch Longer Boosts Efforts to Quit  

Extended use of nicotine patches improves the likelihood that smokers will be able to kick the habit and reduces the risk that they'll start smoking again, a new study has found.

The study included 568 adults who smoked 10 or more cigarettes a day for at least the past year. The smokers who used nicotine patches for the entire 24 weeks of the study (extended therapy) were about twice as likely to quit smoking as those who used nicotine patches for eight weeks and then received placebo patches for the remainder of the study. Standard therapy -- as recommended by manufacturers -- is eight weeks. . . .

In addition, smokers on extended therapy abstained from cigarettes longer and were more likely to stop smoking again if they suffered a relapse, according to the report in the Feb. 2 issue of the Annals of Internal Medicine.

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Wearing patch 6 months may help smokers quit  

STORY HIGHLIGHTS

* Study: Wearing nicotine patch longer than recommended decreases smoking relapse

* Patch reduces cravings and withdrawal symptoms by releasing nicotine through skin

* Smoking experts say wearing the patch for 10 weeks is insufficient for most smokers

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Nicotine patch works better when used longer: study  

Smokers who wore nicotine patches for six months instead of the recommended two were more likely to quit smoking and had an easier time recovering from an occasional slip, U.S. researchers said on Monday.

But the effect appeared to last only as long as the treatment, suggesting that smokers may need longer-term or even chronic treatment to stay smoke-free.

"This suggests that we may need to reconsider our guidelines about the length of treatment and consider, at least for some smokers, longer-term therapy," said Caryn Lerman of the University of Pennsylvania School of Medicine, whose study appears in the Annals of Internal Medicine.

Lerman said the team did the study because of the growing recognition that nicotine dependence is a condition characterized by many relapses.

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• More smokers kick the habit with extended nicotine patch therapy, Penn research shows 

New research from the University of Pennsylvania School of Medicine may help more smokers keep their New Year's resolution by helping them quit smoking. Extended use of a nicotine patch - 24 weeks versus the standard eight weeks recommended by manufacturers - boosts the number of smokers who maintain their cigarette abstinence and helps more of those who backslide into the habit while wearing the patch, according to a study which will be published in the February 2 issue of Annals of Internal Medicine.

"Our data suggest that the many smokers who relapse while trying to quit will be especially helped by extended treatment, which appears to make it easier for smokers to 'get back on the wagon' after a small smoking slip, instead of having it turn into a full-blown relapse," says lead author Robert Schnoll, PhD, an associate professor of Psychiatry at Penn. "We know that tobacco dependence is a chronic, relapsing condition that may require extended treatment, and we hope our research efforts will encourage physicians to recommend to their patients that they use nicotine patches for a longer duration."

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• Wearing Patch for 6 Months May Help Smokers Quit  

If you're trying to quit smoking, wearing a nicotine patch for up to six months—far longer than is generally recommended—may increase your chances of staying smoke-free, a new study has found.

Even with the longer treatment, however, your chances of successfully quitting are only about 1 in 7, according to the study, which was funded by the National Cancer Institute and the National Institute on Drug Abuse.

“There’s an assumption that nicotine dependence is an acute disease that can be treated with short-term therapy,” says Caryn Lerman, PhD, one of the study's authors and the director of the Tobacco Use Research Center at the University of Pennsylvania. “Smokers should talk to their health-care provider about whether it makes sense for them to continue on the nicotine patch for an extended period of time as an alternative to returning to smoking.”

In the new study, published this week in the Annals of Internal Medicine, 568 adult smokers who were otherwise healthy wore a 21-milligram nicotine patch (Nicoderm CQ brand) for eight weeks.

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• Shift in status for anti-smoking aids 

A major shift in the government’s anti-smoking policy has been quietly announced, allowing nicotine products to be sold as a long-term substitute for smoking, not just as an aid to quitting. . . .

The change is quietly noted with no fanfare towards the end of a new anti-smoking strategy published on Monday which aims to halve the proportion of the population who smoke to 10 per cent by 2020.

In what is known as a “harm reduction” approach, the government recognises that “people have different levels of addiction” to cigarettes and so different methods will be used in future “including using nicotine replacement therapy for extended periods of time”.

The Medicines and Healthcare products Regulatory Agency has already granted a licence for the Nicorette inhalator for longer term use as “a safer alternative to smoking” and is inviting manufacturers of other gums, patches, nasal sprays, inhalators, tablets and pastilles to follow suit. The agency said it is also “encouraging the development and wider availability of safer nicotine delivery medicines”.

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Nicotine Addiction Free With E-Cig 

Nicotine is an addictive drug. It causes alters in the brain that make people want to use it more and more. While Electronic Cigarette123 only contains water to vaporize for the smokers to inhale when they are using it. In addition, according to Electroniccigarette123.com, it is really advisable to stop smoking for the smokers to avoid the nicotine addiction. Some addictive drugs cause unpleasant withdrawal symptoms. The good feelings that consequence when an addictive drug is present -- and the bad feelings when it's absent -- make breaking any addiction very difficult. Nicotine compulsion has historically been one of the hardest addictions to break.

When a person smokes a cigarette, the body responds right away to the chemical nicotine in the smoke. Nicotine causes a short-term enlarges in blood pressure, heart rate and the flow of blood from the heart. It also causes the arteries to narrow. The smoke includes carbon monoxide, which reduces the quantity of oxygen the blood can carry. This, joint with the nicotine effects, creates an imbalance between the demand for oxygen by the cells and the amount of oxygen the blood can supply.

Cigarette smoking may boost the risk of developing hardening of the arteries and heart attacks in several ways. First, carbon monoxide may injure the inner walls of the arteries, encouraging fatty buildups in them. Over time, this causes the vessels to narrow and harden. Nicotine may also contribute to this process. Smoking also causes more than a few changes in the blood that make clots -- and heart attack -- more likely.

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More Than $2 Million In NIH Grants To Barrow Researchers For Nicotine Studies 

Four scientists at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center have been awarded more than $2.2 million from the National Institutes of Health (NIH) to research the effects of nicotine and develop new tobacco-related drug therapies.

The grants will fund three separate research projects at the Phoenix-based institute in the next several years. Ronald J. Lukas, PhD and Vice President of Research at Barrow, is one of the world's leading experts on nicotine and has spent much of his research career studying its impact. Lukas' research lab, shared by Paul Whiteaker, PhD, is the main recipient of the funding. The Barrow laboratories of Jie Wu, MD, PhD, and Yongchang Chang, MD, PhD, also will receive funding from the grants.

Lukas said these Barrow-led projects also will benefit a number of other researchers around the country who will receive collaborative NIH funding of more than $5 million for their participation in the studies. . . .

The newly-funded Barrow studies range from understanding how nicotine may reduce depression, to how it creates addiction, to how nicotine addiction is related to lung cancer.

"These studies have implications for nicotine dependence, tobacco addition, lung cancer and mood disorders,"

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Smoking Cessation Leaders Team Up to Help 'Become an EX' Members Accomplish Their New Year's Resolutions to Quit Smoking 

To better help smokers looking to quit fulfill their New Year's resolutions, Legacy(SM) and GlaxoSmithKline Consumer Healthcare are partnering to offer free Nicorette® starter packs to more than 125,000 members of the EX® program (www.BecomeAnEX.org), where smokers "re-learn life without cigarettes" with a free, comprehensive three-step quit plan and access to a robust online community.

"New Year's is one of the most popular times for a smoker to consider quitting smoking; however, many smokers need support to do so successfully. Smokers who make the important decision to quit should utilize available resources to help them understand what to expect when quitting," said Dr. Cheryl Healton, president and CEO of Legacy. "EX is a program that provides smokers with the tools to help them 're-learn life without cigarettes.' Having access to a cessation medication can also help address cravings and withdrawal symptoms while quitting."

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Nicotine Replacement Therapy Does Not Increase Mortality in Critically Ill Smokers in the ICU 

Nicotine replacement therapy (NRT) is not associated with increased hospital mortality in critically ill active smokers, according to a new observational study from the Mayo Clinic.

Lead author Rodrigo Cartin-Ceba, MD, senior associate consultant and instructor of medicine at the Mayo Clinic in Rochester, Minnesota, reported the results during an oral presentation here at the Society of Critical Care Medicine (SCCM) 39th Critical Care Congress.

He said that NRT is often given to smokers admitted to the intensive care unit (ICU) to prevent their withdrawal. "However, the safety of NRT in the critically ill has not been very well studied, and current data are controversial."

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