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Somehow, this time - maybe it was the nicotine-replacement patch, maybe the counseling - Collins resisted the call of the cigarette. But there is no denying: The stranglehold nicotine places on smokers can sometimes prove insurmountable.
Ask Jerry Remy, the Red Sox TV analyst who acknowledged last month that, despite enduring lung cancer, he still falls prey to the occasional impulse to smoke.
Ask Barack Obama . . .
The failure to quit, research has shown, has nothing to do with weakness of will. Nicotine, the primary addictive agent in tobacco, steals into the brain, setting on fire circuitry that regulates our sense of pleasure. At the same time, cigarettes acquire a sort of social permanence in smokers' lives - a way to start the day, to end a meal, to celebrate good times, to muddle through bad times.
So specialists who treat smokers now emphasize a double-barreled approach that combines counseling and medication, including patches, gum, and other nicotine substitutes along with drugs designed to thwart nicotine's addictive effects. There's even a nicotine vaccine being tested that would prevent the substance from reaching the brain.
Still, it's estimated that while roughly 70 percent of smokers want to quit, fewer than 10 percent succeed each year. . . .
Her first major attempt to quit was in 2000, when she went to group counseling at Mass. General. "I'd go there and I'd talk. And I'd leave immediately and have a cigarette.'' She tried again and again to stop smoking for good. Finally, last year, she decided, "This is ridiculous.'' She again sought counseling and wore the most potent nicotine patch available.
Her last drag on a cigarette, she said, was last October.
"No one can tell you to quit smoking. No one can make you feel like a social miscreant to make you quit smoking,'' said Collins, who lives in Belmont. "You have to summon it up from inside. You really, really do.''
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This is an Olympic year, and athletes the world over are gearing up for the Beijing games in August. There they will face afternoon temperatures that average 30 °C and can hit 42 °C, along with high humidity that will make cooling down harder. In such conditions athletes in endurance sports reach exhaustion long before their muscles would normally tire, as their brains tell them to ease up before they reach brain-damaging temperatures over 40 °C.
Romain Meeusen of the Free University of Brussels (VUB) in Belgium discovered in 2005 that the drug bupropion can cheat this switch.
But. There was a "but". A week after my "quit date", I was at home, watching a film with a friend. As the credits rolled, a frantic, nameless dread washed over me. Within minutes, I was a quivering wreck. My mind was drifting away from reality, tethered only by a narrow thread that might snap at any moment. Heart pounding, palms sweating. I clutched my head, blinking, hyperventilating, nerves jangling at 9,000 rpm.
It was a major panic attack, which eventually lasted over four hours, deep into the night. I've never known such terror. I became obsessed with the notion that I might snap at any moment; attack my friend, leap from a window, gouge my own eyes out with my thumbs, screaming, shrieking; a banshee. I've had better evenings in.
The next day I decided I'd had enough of that for one lifetime. I threw the pills away. Thing is, it takes days to clear your system. For a week, I walked around like a de-tuned radio, continually anxious, fighting insane paranoid notions; a horrified alien visitor on a tour of my own life. I was terrified it was permanent; slowly, normality returned.
Weeks later, I still can't believe I was legally prescribed something that could bend my brain over its knee with such demented zeal - although it's worth pointing out I have no evidence that what happened to me had anything to do with Zyban. All I know is it happened while I was taking the drug, and stopped several days after I binned the pills. Maybe it was a coincidence. Maybe I'm just crazy. I don't know. I do know, however, that pharmaceutical companies have ominous legal departments orbiting the planet in almighty Death Stars, and that a lawyer twice as powerful as God is doubtless reading this right now.
Anyway. Smoking kills, and I'm glad I've stopped. Quitting's worth it. Just don't choose a cure worse than death.
A BATTLE to sell the nicotine patches Nicorettes has broken out between Queensland-based NightOwl Convenience Stores and pharmaceutical giant Pfizer, which wants to restrict the sale of its patches to pharmacies.
NightOwl has lodged a formal complaint with the Australian Competition and Consumer Commission claiming Pfizer is inappropriately applying pressure on distributors of its products to restrict its availability outside of pharmacies.
Denying the company was engaging in anti-competitive behaviour, a spokesman for Pfizer yesterday confirmed it had made a conscious decision to retail its Nicorette products only through pharmacies.
"All research shows nicotine replacement therapy only works when it is issued in conjunction with counselling," the spokesman said.
"You're not going to get that through a convenience store.
Conclusion: We conclude that 1 week of tobacco abstinence is associated with slowed motor speed but is not associated with detectable worsening in performance on a range of neuropsychological tests or clinical symptoms in the subset of patients who were able to quit smoking. We also conclude that bupropion treatment may be associated with improvement in variability of attention.
Researchers at UCLA's David Geffen School of Medicine have used positron emission tomography (PET) to reveal the mechanism through which bupropion, a smoking cessation drug, works in the brain to reduce cigarette cravings.
The scientists used PET imaging to examine brain activity in bupropion-medicated and unmedicated smokers who were exposed to smoking cues, such as the sight and feel of a cigarette. They were able to show that in the presence of bupropion, brain cells in the anterior cingulate cortexa region known to be involved in drug cravingdo not activate in response to cigarette-related cues. Until now, scientists and clinicians knew the drug reduced the urge to smoke, but the central nervous system process by which it did so was unknown.
Constipation is a significant withdrawal symptom experienced by 1 in 6 people who quit smoking, according to a large British study on abstaining smokers.
Anecdotal evidence has suggested that constipation is associated with tobacco withdrawal; however, it is not included in the DSM-IV tobacco withdrawal symptoms due to lack of systematic data.
More information about this possible side effect is necessary in order for clinicians to provide appropriate counselling to people wishing to quit smoking.
Peter Hajek, MA, PhD, and colleagues at the University of London, United Kingdom, evaluated whether constipation is a potential tobacco withdrawal symptom.
Two drugmakers on Thursday moved closer to marketing their generic versions of profitable GlaxoSmithKline Plc (GSK.L) (NYSE:GSK) drugs, dealing blows that sent shares of the world's second-largest drugmaker lower. . . .
And Impax Laboratories Inc. (Nasdaq:IPXL) signed a deal with Andrx Corp. (Nasdaq:ADRX) that would allow Impax to market its generic versions of antidepressant Wellbutrin SR and smoking cessation drug Zyban even if Andrx got approval for its copycats before Impax did.
A multi-billion dollar drug company is fighting the Federal Government in court over measures that reduce subsidies for its anti-smoking pill.
The Government is trying to cut the cost to the taxpayer of the anti-smoking drug, Zyban, produced by the multinational GlaxoSmithKline, which in 2002 had global sales of more than $50 billion.
Late last year, in response to concerns about the cost effectiveness of the current prescribing regime, the Pharmaceutical Benefits Advisory Committee reduced the number of tablets available under the Pharmaceutical Benefits Scheme. . .
The Government proposes allowing patients who keep taking the drug after a fortnight to return to their doctor for a prescription to cover the rest of the nine-week period.
In the Federal Court hearing on March 31 and April 1, counsel for the Government said the two-week prescription would provide the opportunity for patients to get extra support from their doctor, reduce wastage and improve cost effectiveness.
But counsel for GlaxoSmithKline labelled the committee's decision on Zyban as "prejudicial", and said increasing access to counselling for people taking the drug would be a more effective way to deal with non-completion of a full course. . .
Simon Chapman, a professor of public health at Sydney University and an anti-tobacco campaigner, along with three other physicians, resigned from Glaxo's smoking-cessation consortium on Wednesday in protest over the court action.
He believes the court action was "almost certainly" motivated by the company's desire to access the maximum Pharmaceutical Benefits Scheme funding for the drug.
Faster than an injection, more reinforcing than crack cocaine: Smoking a cigarette speeds nicotine to the brain faster than any other delivery method . .
Researchers are using knowledge about the biology of addiction to study specific genes that might predispose or protect people from getting hooked, with the hope of keeping future generations from inhaling. . .
Two companies, Xenova Group and Nabi Biopharmaceuticals, are taking a vaccine approach to block nicotine's action on the brain. . .
Vocci says he's studying other drugs such as small-molecule D1 dopamine receptor agonists and drugs that affect the glutamate system to block an effect called priming, whereby researchers reexpose previously addicted animals to a drug, inducing a reinstatement response. Both Dalack and Lerman think future studies--such as comparing schizophrenic patients who smoke with those who do not, or stratifying smokers according to their biological response to nicotine on brain scans or blood tests--will provide finer resolution of the smoking phenotype.
The use of the antidepressant, sustained release (SR) bupropion, triples quit rates among women and smokers with a history of depression as compared to placebo, according to a new study just published in Nicotine and Tobacco Research by researchers at the Center for Tobacco Research and Intervention. Historically, women and formerly depressed smokers are at particularly high risk of relapse.
The European Medicines Evaluation Agency said on Thursday GlaxoSmithKline's anti-smoking drug Zyban had cleared a safety review.
The agency was asked by Germany to review the drug after reports that a number of people using it to quit smoking had died.
But in a statement today the EMEA said it scientific committee had concluded that the "balance of risk and benefits (of Zyban) remains favourable."
It said however that the drug should be used in accordance with smoking cessation guidelines and would be kept under review by regulatory agencies across Europe. . .
Britain's Medicines Control Agency said in January it had received 6, 975 reports of suspected adverse drug reactions, including 57 deaths.
However, British drug regulators have stressed that the drug's contribution to the deaths is "unproven" and that in most cases the individual's underlying condition might have been responsible.
Women are more likely to give up cigarettes if they take smoking cessation drugs rather than depend on nicotine replacement therapy, research suggests.
A study by doctors at Oregon Health and Science University in the US found women who took the anti-smoking drug bupropion were more successful in kicking the habit.
Bupropion is marketed as the anti-smoking drug Zyban. However, it is also prescribed as an anti-depressant under the name Wellbutrin.
The authors believe the anti-depressant features of the drug may particularly benefit women who are more likely to start smoking again than men.
They suggest the drug helps to relieve depression, irritability and other negative feelings which many women say leads them to take up the habit once more.
Dr David Gonzales followed 784 members of a smoking cessation study at five centres in the US.
The Government's medicine watchdog has ruled that an expensive anti-smoking treatment should be available on the NHS.
The National Institute for Clinical Excellence recommended the use of Zyban and other nicotine replacement therapy (NRT) such as patches, inhalers and gums for smokers who wish to quit.
The decision means every health authority in England and Wales is now obliged to make money available for the treatment.
GlaxoSmithKline said on Friday it would appeal a U.S. court decision to reject a lawsuit alleging that rival Andrx Corp's generic versions of Wellbutrin and Zyban infringed Glaxo's patents on the drugs.
``GSK is actively reviewing the judge's ruling and intends to appeal immediately,'' the company said in a statement.
Fort Lauderdale, Florida-based Andrx earlier said it expected the U.S. Food and Drug Administration to approve the generic versions by mid-year.
It said U.S. District Judge Wilkie Ferguson Jr. of the U.S. District Court for the Southern District of Florida granted Andrx's motion for summary judgment in the Glaxo lawsuit.