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

Smokers Sleep Less Soundly

Smokers are four times more likely to feel tired when they wake up and they spend less time in deep sleep than nonsmokers do, a new study finds.

This may be because smokers experience nicotine withdrawal each night, which may contribute to sleep disturbances, suggest the study authors, whose report appears in the February issue ofChest.

"It is possible that smoking has time-dependent effects across the sleep period. Smokers commonly experience difficulty falling asleep due to the stimulating effects of nicotine. As night evolves, withdrawal from nicotine may further contribute to sleep disturbance," study author Dr. Naresh M. Punjabi, of Johns Hopkins University School of Medicine in Baltimore, said in a prepared statement.

Punjabi and colleagues studied the sleep patterns of 40 smokers and 40 nonsmokers. They found that 22.5 percent of smokers reported a lack of restful sleep, compared with only 5 percent of nonsmokers. Smokers also experienced a lower percentage of deep sleep and a higher percentage of light sleep.

The largest differences in sleep between the two groups occurred at the onset of sleep, which suggests the effects of nicotine are strongest in the early stages of sleep and decrease as the sleep cycle progresses, the researchers said.

These findings may help develop more effective ways to help people stop smoking.

"Many smokers have difficulty with smoking cessation partly because of the sleep disturbances as a result of nicotine withdrawal," Punjabi said. "By understanding the temporal effects of nicotine on sleep, we may be able to better tailor nicotine replacement to minimize the withdrawal effects that smokers experience, particularly during sleep."

Source: www.washingtonpost.com

Anti-Smoking Injection Shows Promise

A vaccine designed to keep nicotine from reaching the brain may help people quit smoking.

The Associated Press reports that a preliminary study of 301 longtime smokers found that recipients of Nabi Pharmaceutical's NicVAX were more than twice as likely to quit smoking as people who got a placebo.

However, "twice as likely" is a loaded number: 15 percent compared to 6 percent. That's good, but not great -- and nearly a third of trial participants dropped out. On the other hand, the production of anti-nicotine antibodies correlated with reduced cigarette use, and even people who didn't quit still smoked less.

The WiSci verdict: promising, but there's a long way to go.

America Aims Having Smoke-free Workers to Save Medical Bills

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Several business houses in America are conducting help-programmes to encourage their workers to stop smoking in order to reduce their medical bills.

A recent survey indicated that one-third of companies with at least 200 workers offered smoking cessation as part of their employee benefits package.

The companies have to spend as much as 900 dollars to give a participant free nicotine patches and drugs to ease withdrawal.

Phone sessions with smoking addiction counselors can cost more than the estimated 16,000 dollars including the additional lifetime medical bills that a typical smoker generates, according to federal health data.

That federal figure does not count the costs of absenteeism or the drain on productivity when smokers periodically duck outside for a cigarette, New York Times newspaper reported.

With business employers accounting for about 650 billion dollars of the nation's 2 trillion dollar annual medical bill, companies have monetary incentive to get workers leave smoking.

United Parcel Service began offering a smoking cessation program in February to the estimated 13 percent of its employees who use tobacco.

''We decided this was the time to do this,'' said UPS health and productivity manager Judy Pirnie Smith.

The Union Pacific railroad adopted the program two years ago that helped cut the smoking rate to about 17 per cent of its work force.

''Tobacco cessation has been the hot topic for the last year,'' National Business Group on Health president Helen Darling said.

The programmes are another example, along with various other corporate wellness efforts like weight management and diabetes control, of how private employers are taking health care reform into their own hands.

There are more than 44 million smokers in the United States.

The habit is blamed for 435,000 premature deaths annually, and adds more than 75 billion dollars to annual spending on health care, according to the federal Centers for Disease Control and Prevention.

''The number of people who enroll in the programs and then slip back into smoking in the first three months is high,'' said Watson Wyatt Worldwide benefits consulting firm executive Bruce C Kelley, adding that, ''people who quit for 12 months the recidivism rate is very low.''

Study: Hypnosis Works to Treat Hospitalized Smokers

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Patients who are hospitalized may be more likely to quit smoking with the help of hypnotherapy, according to researchers.

A study, conducted by the North Shore Medical Center and Massachusetts General Hospital in Salem, Mass., found that more patients were likely to quit smoking after six months, compared to patients who used nicotine replacement therapy (NRT) or those who wanted to quit on their own, which is known as going "cold turkey." Researhers also found that patients who were admitted to the hospital with cardiac disease were three times more likely to quit smoking than those with pulmonary (lung) problems.

Researchers studied 67 patients with cardio and pulmonary diseases who wanted to quit smoking. The patients were divided into four groups, based on their preferred method of treatment, including: 14 using hypnotherapy; 19 using an NRT; 18 using an NRT and hypnotherapy; and 16 who wanted to quit "cold turkey".

The control group received brief counseling while other groups received intensive counseling, which included a free supply of NRT and/or a free hypnotherapy session within seven days of discharge. Follow-up telephone calls at 1, 2, 4, 8, 12, and 26 weeks after discharge were also made.

Those patients who received hypnotherapy were also taught to do self-hypnosis and were given special hypnosis tapes to play at the end of the session.

At the end of the 26 weeks, following discharge, 50 percent of the patients who were treated with hypnotherapy were nonsmokers, compared with 50 percent of nonsmokers in the NRT/hypnotherapy group, 25 percent in the control group, and 15.78 percent in the NRT group.

“Our results showed that hypnotherapy resulted in higher quit rates compared with NRT alone,” Faysal Hasan, MD, North Shore Medical Center said. “Hypnotherapy appears to be quite effective and a good modality to incorporate into a smoking cessation program after hospital discharge.”

Patient data, based on cardio or pulmonary diagnosis, showed that patients admitted with cardiac problems were more likely to quit smoking at 26 weeks (45.5 percent) than patients who were admitted with a pulmonary problem (15.63 percent).

“Patients admitted with coronary symptoms may have experienced ‘fear and doom’ and decided to alter a major health risk to their disease when approached about smoking cessation,” Dr. Hasan said. “In contrast, pulmonary patients admitted for another exacerbation may not have felt the same threat. They likely felt they can live for another day and continue the smoking habit.”

New Blood Test Can Detect Cigarette Smokers Who Lie About Thier Habbit

www.allheadlinenews.com

Nidhi Sharma

People who hide a cigarette habit can easily be caught now. Researchers have found a new blood test that identifies levels of carbon monoxide in a person to determine whether someone is a smoker or not.

The device, pulse cooximeters detects levels of carbon monoxide in patients and firefighters, a U.S. study found. It can also be used to detect carbon monoxide levels in people who smoke, thus educating patients about the effects of smoking.

Study author Dr. Sridhar P. Reddy of St. Clair Pulmonary and Critical Care, St. Clair, Mich., said, "It starts a conversation to make people more and more aware of what smoking can do to them and to give them more information about why they should quit, instead of a boring sermon every time."

If smokers knew their blood carbon monoxide levels, they might be more motivated to quit smoking or never start in the first place. Reddy said.

Pulse oximeter is a device that's placed over the fingertip and measures oxygen levels in the blood by passing light waves into the skin. The device costs $4,000-$5,000 and measures the level of carbon monoxide in hemoglobin.

It accurately spotted up 95 percent of all smokers when Reddy looked only at those who had a 6 percent or higher level of carbon monoxide.

Though the device doesn't detect every smoker but Reddy said it can be used to detect light or heavy smokers.

The findings were presented at Chest 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians in Chicago.

Smokers 'need more help to quit'

news.bbc.co.uk

Nicotine should be freely available in products which do not carry cigarettes' health risks, to help smokers who find it impossible to quit, say doctors.

Nicotine should be freely available in products which do not carry cigarettes' health risks, to help smokers who find it impossible to quit, say doctors.

Millions continue to smoke because they are addicted to nicotine, but it is the toxins in cigarette smoke that kill, said the Royal College of Physicians.

It called for the regulation of new cigarette substitute products to give the "nicotine hit" that smokers crave.

The Department of Health said it would consider the RCP report.

The RCP said its proposals could help to prevent millions of deaths and would particularly help the worst off, who tend to smoke more heavily and find it harder to stop.

'Safe sources'

Professor John Britton, report author and chairman of the RCP tobacco advisory group, said: "Smokers smoke because they are addicted to nicotine, but it isn't nicotine in cigarette smoke that kills - it's the hundreds of other toxic chemicals that come with it.

"The best thing that a smoker can do for his or her health is to quit all smoking and nicotine use completely.

"However, there are millions of smokers who can't quit, or else who are unlikely to quit, and those people need nicotine products that can satisfy their addiction without killing them."

Almost a quarter of adults in the UK currently smoke and fewer than 5% of smokers manage to quit every year, despite most saying they would like to.

Manufacturers should be encouraged to develop safe nicotine sources, which might be as addictive as cigarettes, for smokers, the RCP report concluded.

But current medicines regulation in the UK actively discourages the development, marketing and promotion of cigarette substitutes containing nicotine because it is addictive.

Current nicotine replacement therapy, such as chewing gum, delivers the drug at a much lower dose than in cigarettes to help wean people off their craving.

Controversy

More research should be done on the effectiveness and safety of other forms of tobacco as alternatives to smoking, the RCP also said.

Smokeless products such as snus, which is widely available in Sweden but banned in the EU, may be safer than smoking and be an acceptable alternative for smokers, although not without health risks, the RCP said.

Professor Britton, who is also an expert in epidemiology at the University of Nottingham, said the concept was controversial as some saw it as "encouraging addiction".

"If lots of people stop smoking but switch to medicinal nicotine products, it would be no more harmful than the existing use of caffeine," he said.

Action on Smoking and Health and Cancer Research UK backed the report's recommendations.

Jean King, Cancer Research UK's director of tobacco control, said: "If nicotine can be provided in a form and at a price that offers a far more attractive and accessible alternative to smoking than at present, many lives could be saved."

But Professor Martin McKee, an expert in European public health at the London School of Hygiene and Tropical Medicine, said there should be a clear distinction between nicotine replacement therapy, which had been proven to be safe, and types of smokeless tobacco such as snus.

"What we're very concerned about is that tobacco companies have been pushing for legalisation of snus, which would undermine the impact of the smoking ban because it would keep people addicted rather than encourage them to quit."

The Department of Health said reducing rates of smoking remained a priority and with the support of the NHS, smokers greatly increased their chances of stopping smoking for good.

Tobacco Age Of Sale Rises To 18 On Monday, UK

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Photo by http://www.stanfordreview.org/

From Monday 1st October the tobacco age of sale will increase from 16 to 18 in the latest government step to cut smoking rates in the UK, and prevent young people buying tobacco.

This major step follows on from public places going smokefree in July and the recent announcement by the Secretary of State that cigarette packets will carry picture health warnings from next year.

An outdoor advertising campaign to explain the the change in the law was launched on Monday 24th September as part of an awareness campaign over the past four months to ensure that both retailers and teenagers are fully aware.

Public Health Minister Dawn Primarolo said:

"We are determined to reduce the number of young people who smoke. Raising the legal age of sale to 18 will make it easier for retailers to spot under-age smokers and lead to less young people becoming addicted to nicotine and continuing to smoke into adulthood.

"Research shows that the younger people start the more likely they are to become life-long smokers and die early. This change in law highlights our commitment to protect our children and will potentially save thousands of lives and others will be spared the misery of watching family and friends die prematurely from smoke related illnesses."

The Chief Medical Officer, Sir Liam Donaldson said:

"I welcome the raising of the legal age for buying tobacco to 18 years. This will result in fewer young people becoming addicted to nicotine, something which ultimately results in early death from cancer and other smoking related illnesses.

"The initiative is another important step in helping to prevent people from taking up smoking in the first place, and in the longer term will help to reduce the burden that smoking causes in our country".

Jean King, Cancer Research UK's director of tobacco control, said:

"We welcome the change in age of sale as a measure to reduce the availability of cigarettes to young people. It sends out a strong message that tobacco products are dangerous but strict enforcement of the law is crucial for it to have the desired effect.

"Smoking is a serious problem among young people - 16 per cent of boys and 24 per cent of girls aged 15 are regular smokers - so youth smoking must remain a Government priority if we are to prevent these teenagers from becoming adult smokers and greatly increasing their risk of developing cancer in later life".

New research conducted by YouGov has revealed that 69% of adults believe it makes sense to raise the minimum age for the sale of tobacco to 18 in line with alcohol.

The latest smokefree compliance statistics show that 97.7% of premises inspected were compliant in terms of no-smoking. This data is consistent with earlier compliance data and indicates there has been a smooth transition to smokefree public places and workplaces in England.

News Analysis: Smoking in Stanford

Forget the smokes

www.edmontonsun.com

Here's another reason to quit smoking - the habit can contribute to dementia or Alzheimer's disease. Smokers are 50% more likely to develop these conditions than former smokers or people who have never smoked, a Dutch researcher has found. Dr. Monique Breteler of Erasmus Medical Centre in Rotterdam studied 7,000 smokers, non-smokers and former smokers over the age of 55 for seven years. Her study, published in the journal Neurology, found that 706 people developed dementia, the majority of them smokers. Smoking increases the risk of diseases of blood vessels in the brain, which is tied to dementia, Breteler said.

Breastfeeding moms should not smoke cigarettes

FoodConsumer.org

By David Liu

Breastfeeding women should not smoke cigarettes as nicotine in the breast milk of lactating mothers can affect their babies' sleep patterns, according to a new study published in the journal Pediatrics.

The study by researchers from the Monell Chemical Sense center found during a 3.5 hours the infants whose mothers smoked prior immediately to breastfeeding slept 53 minutes compared to 84 minutes if their mothers did not smoke.

This means nicotine in breast milk reduces sleep time by 37 percent. The level of reduction depended on the nicotine level in the breast milk.

Disruption of sleep can cause sleep deficiency which can affect a child's intellectual capability. And early exposure to nicotine could also make it easier for the affected child to get addicted to smoking as teenagers.

Smokers have higher risk of dementia

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People who smoke are more likely to develop Alzheimer's disease and other forms of dementia than people who have quit or have never smoked, Dutch researchers reported on Sunday.

Smokers over the age of 55 were 50 percent more likely to develop dementia than similar nonsmokers, Dr. Monique Breteler of Erasmus Medical Center in Rotterdam, Netherlands, and colleagues found.

Writing in the journal Neurology, Breteler and colleagues said they followed nearly 7,000 people age 55 and older for an average of seven years.

Over that time, 706 of the people developed dementia.

There is a well-known gene that raises the risk of dementia called APOE4 or apolipoprotein E4.

Smoking did not affect the Alzheimer's risk for people who had that gene. But people who did not have the gene had a 70 percent higher risk of Alzheimer's if they smoked.

Smoking could cause small strokes, which in turn damage the brain and cause dementia, Breteler said.

"Smoking increases the risk of cerebrovascular disease (stroke), which is also tied to dementia," Breteler said in a statement.

"Another mechanism could be through oxidative stress, which can damage cells in the blood vessels and lead to hardening of the arteries. Smokers experience greater oxidative stress than nonsmokers, and increased oxidative stress is also seen in Alzheimer's disease."

Oxidative stress is a process akin to rusting, in which chemical reactions damage the DNA.

Smokers' Cough Is Not Just a Smokers' Disease, Study Shows

www.bloomberg.com

By Angela Cullen

Chronic obstructive pulmonary disease, a preventable illness mostly caused by cigarettes, is wrongly perceived as a smokers' ailment, masking the public health threat and limiting treatment, scientists said.

The condition known as COPD is killing more and more non-smokers, and its prevalence is higher than previously estimated, according to a study in The Lancet medical journal today. Allergies, tuberculosis and poor ventilation can cause the disease, the fifth-leading cause of death in high-income countries. A shift in the way people view COPD may help save more lives, an accompanying editorial said.

More than 2.5 million people die of COPD every year, as many as die from HIV/AIDS, according to the World Health Organization. Aging populations and the continued use of tobacco may propel it to the third biggest killer by 2020, WHO estimates. Because of its stigma as a self-inflicted disease, COPD is often under-diagnosed and under-treated, scientists including A. Sonia Buist, a medical professor at Oregon Health & Science University in Portland, said.

``If every smoker in the world were to stop smoking today, the rates of COPD would probably continue to increase for the next 20 years,'' Buist and colleague David M. Mannino wrote in the journal.

A study by the scientists of more than 9,000 volunteers, randomly selected, showed that one in 10 adults over the age of 40 suffered from advanced stages of COPD. Prevalence of the disease increased with age, and was similar among people who had never smoked compared with participants who had smoked for a certain period. The results showed a higher prevalence than previous studies of the disease, Buist said.

COPD causes inflammation of the main airways in the lungs and a build-up of mucus, leading to shortness of breath and a persistent cough. More than 15 percent of COPD occurs in people who have never smoked, according to The Lancet editorial.

Although smoking is the most important risk factor in high-income and middle-income countries, low-income nations have more indoor air pollution.

Study says former smokers still at risk of lung cancer

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Bad news this morning for former smokers who think they're out of the woods for lung cancer because they've quit lighting up.

The BC cancer agency says 50-percent of new lung cancer cases are in former smokers as opposed to those who still partake in the habit and they now have a new study, which could explain why.

Researchers have found some former smokers are still susceptible to lung cancer even years after they've quit because of gene damage.

The study finds in former smokers, some genes return to normal levels, while others appear to be permanently damaged - including a number of genes never before associated with tobacco use.

It’s estimated nearly 2300 British Columbians will die of lung cancer this year alone.

Smoking increases risks for head and neck cancers for men and women

http://www.eurekalert.org/

Smoking significantly increases the risk for head and neck cancers for both men and women, regardless of the anatomic site. Published in the October 1, 2007 issue of CANCER, a peer-reviewed journal of the American Cancer Society, a large, prospective study confirmed strong associations between current and past cigarette smoking and malignancies of the head and neck in both genders.

Cancers of the head and neck include cancers of the larynx, nasal passages/nose, oral cavity, and pharynx. Worldwide, more than 500,000 people are diagnosed with these cancers every year. According to the National Cancer Institute (NCI), men are more than three times more likely than women to be diagnosed with head and neck cancer and almost twice as likely to die from their disease. While tobacco use has long been identified as an important risk factor for head and neck cancers, the new study finds that smoking plays a greater role in the development of head and neck cancer in women than men.

Dr. Neal Freedman from the NCI and co-investigators analyzed data from 476,211 men and women prospectively followed from 1995 to 2000 to assess gender differences in risk for cancer in specific head and neck sites. Analysis showed that the risk of smoking leading to any type of head and neck cancer was significantly greater in women than in men. While 45 percent of these cancers could be attributed to smoking in men, 75 percent could be attributed to smoking in women.

“Incidence rates of head and neck cancer were higher in men than in women in all categories examined,” conclude the authors, “but smoking was associated with a larger relative increase in head and neck cancer risk in women than in men.” To reduce the burden of head and neck cancer, public health efforts should continue to aim at eliminating smoking in both women and men.

How to quit smoking in just 30 days o less