Wearing Patch 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 one in seven, 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, 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."

The patch reduces cravings and withdrawal symptoms by releasing a slow and steady dose of nicotine through the skin. The latest guidelines from the U.S. Public Health Service recommend that smokers who are trying to quit use the patch for eight weeks or less, although some brands of patches are designed to be used for up to 10 weeks.

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. At that point, half of the smokers continued to wear the nicotine patch for an additional 16 weeks, while the others wore an identical placebo patch for the same amount of time.

After 24 weeks, 32 percent of the participants who received the nicotine patch for the duration hadn't smoked in the previous week, compared to just 20 percent of those who received the placebo patch. (Whether the participants had smoked that week was verified by checking a breath sample for carbon monoxide.)

The longer nicotine treatment also proved more effective when a stricter measure of quitting was used. At the 24-week mark, 19 percent of the people who wore the patch throughout hadn't smoked even one cigarette since quitting, compared with 13 percent in the placebo group.

People who wore the patch for a full 24 weeks were also more inclined to try to quit again if they temporarily fell off the wagon, the researchers found. "If somebody has a slip and smokes a few puffs or even has a whole cigarette, they'll be more likely to return to abstinence if they're on the nicotine patch," Lerman says.

After one year, however, there was no significant difference between the two groups in the percentage of study participants who remained smoke free. Just 14 percent of the people in either group hadn't smoked a cigarette in the previous week - underscoring just how hard it is to kick the nicotine habit.

Many smoking-cessation experts have come to believe that wearing the patch for eight to 10 weeks is insufficient for most smokers. In its 2008 guidelines, the U.S. Public Health Service called for more research into the effectiveness of longer-term nicotine replacement therapy. Lerman and her colleagues are now conducting another study in which quitting smokers will wear the patch for an entire year.

There's no evidence that wearing the patch for an extended period is unsafe, says Robert A. Schnoll, the lead author of the current study. The two groups of participants in the study showed no significant differences in side effects, he points out. And, Schnoll says, "Everyone would agree that it's safer than smoking."

Nicotine patches deliver a relatively pure dose of the drug, while cigarettes contain chemical additives that have been shown to cause cancer.

Jonathan Foulds, the director of the Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey, in New Brunswick, says the study's findings should prompt experts to reconsider how they help people quit smoking.

"We should tailor the duration of pharmaceutical treatment for smoking cessation to the client's needs, rather than what the box says," says Foulds, who wasn't involved in the study. "It's clear that what the box says may not be long enough for some patients."

Foulds has his patients stay on the patch until they go a full two weeks without any cigarette cravings or withdrawal symptoms. At that point, he weans them off the patch by using progressively smaller sizes.

"There's nothing magical about 24 weeks," he says. "The point is that staying on [nicotine replacement therapy] helps you stay off cigarettes - and, it seems, the longer the better."

Every smoker is different, according to Lerman. Some can quit with brief treatment, she says, but others will need to stick with nicotine replacement therapy for a longer time. People who experience very severe withdrawal symptoms, for example, are likely to be better off with longer-term use, she says.

Source: www.cnn.com


Mixing herbal remedies and heart drugs is dangerous

People who take herbal remedies while using heart drugs may face higher risk of cardiac problems, a medical report warns.

Some herbal medications affect the activity of prescription drugs for heart troubles, dampening or enhancing their effects, says report author Dr. Arshad Jahangir, a consultant cardiologist at the Mayo Clinic in Arizona.

Herbs, if mixed with drugs, could make blood pressure medications and rhythm-controlling medications less effective and might cause serious heart rhythm problems and bleeding, according to the report published in the February issue of the Journal of the American College of Cardiology.

Even grapefruit juice, recommended as an aid in weight-loss programs, is problematic in interfering with enzymes that break down drugs in the digestive system, including the statins used to lower cholesterol levels and amiodarone used to treat and prevent abnormal heart rhythms, Jahangir says.

Using herbal remedies among the elders is specially problematic because they
typically have more than one disease and take multiple medications.

While up-to-date statistics are not available, it appears that more than 15
million Americans are using herbal remedies and the number is growing, according to Jahangir.

However, many patients have not realized the danger and fail to inform doctors of their use of herbal remedies.

Douglas Mackay, vice president of the Council for Responsible Nutrition, an
industry association, encourages patients to inform their doctors of their herbal remedies.

"Many herbal supplements offer healthful benefits and fiber, garlic, and hawthorne provide heart health benefits, and the potential risk for a drug interaction can be eliminated by speaking openly with your doctor," he says.

Source: News.Xinhuanet.com


Five-day Limit for Post-sex Pill

A recently licensed type of emergency contraception may offer women protection from pregnancy even when taken five days after sex.

Scottish researchers found that ulipristel acetate worked well after the three-day limit of the most commonly used drug, levonorgestrel.

At present ulipristel - unlike levonorgestrel - is only available with a prescription.

The British Pregnancy Advisory Service welcomed the study.

Emergency contraception uses hormones to either prevent the release of an egg by the ovary in the hours after sex, or stop it implanting into the the womb.

Levonorgestrel is available from pharmacies, either with a prescription, or sold directly to over-16s.

A study by specialists working for NHS Lothian tested the effectiveness of levonorgestrel and ulipristel (which was licensed for use last year) using a sample of more than 1,600 women from the UK, Ireland and the USA.

A total of 2.6% of the levonorgestrel group became pregnant despite taking the drug, compared with 1.8% in the ulipristel group.

In a much smaller group of women who received emergency contraception more than three days after sex, there were no pregnancies among women who had taken lipristel compared with three pregnancies among those taking levonorgestrel.

The levels of side effects were roughly the same in both two drugs.

'Time window'

However, researchers said that the newer drug cannot be sold 'over-the-counter' at pharmacies because it did not yet have the established safety record of levonorgestrel.

Ann Furedi, chief executive of the British Pregnancy Advisory Service described the new type of drug as "exciting news".

She said: "It offers a longer time window for use than the traditional, emergency contraception pill.

"Different hormones are involved to the ones traditionally used in contraception, so it may be that these will prove to have other contraceptive uses in future.

"However, accessibly is key to the uptake of any time-sensitive medication and since this pill is not currently available over-the-counter and is significantly more expensive to buy than the traditional 'morning after pill', it may be that many women who could benefit from it are not able to access it."

Source: news.bbc.co.uk


Low-Carb Diet Effective in Lowering Blood Pressure

A new study initiated by researchers at Veterans Affairs Medical Centre and Duke University Medical Centre, reveals that a low-carbohydrate diet is equally effective for weight loss as the weight loss drug orlistat, but in a surprising twist, a low-carbohydrate diet proved more advantageous in lowering blood pressure, as well than the weight-loss medicine.

Researcher William S. Yancy, Jr., MD, an associate professor of medicine at Duke University Medical Centre, says, “If people have high blood pressure and a weight problem, a low-carbohydrate diet might be a better option than a weight loss medication”.

The study, published in the Archives of Internal Medicine, involved 146 obese or overweight adults who were randomly segregated into two groups. Among them many were suffering from high blood pressure or diabetes.

A low-carbohydrate was imposed on the first group while the second group received the weight loss drug orlistat thrice a day.

The results revealed weight loss was similar in the two groups. The low-carb diet group lost an average of 9.5% of their body weight and the orlistat group lost an average of 8.5%. However, those in low-carbohydrate group witnessed a fall in their blood pressure, compared to only 21% of those in the orlistat group.

Researchers say weight loss itself typically produces a healthy reduction in blood pressure, but it appears that a low-carbohydrate diet has an additional blood pressure-lowering effect that merits further study.

Source: topnews.us