Cigarettes -- Quitting Tool or Trap for Fools?
By: Daniel DeNoon -
Dacember. 15, 2003
-- Coming soon to a store near you: nicotine-free cigarettes. Smoking them is supposed to
help you quit smoking.
This isn't the first time that the tobacco
industry has come up with this idea. The soon-to-be-renamed Philip Morris Co. Inc.
couldn't sell cigarettes made from tobacco treated to remove nicotine. Vector Tobacco Inc.
recently began selling the "reduced carcinogen" Omni cigarettes. Now Vector has
a new almost-no-nicotine product made from genetically engineered tobacco plants. It's
slated for release some time this year.
Why would anybody smoke this high-tar,
no-nicotine product -- even if, as advertised, they taste like full-nicotine cigarettes?
The idea is that these "no-nics" might satisfy the urge to smoke while at the
same time weaning a person from nicotine. Can it work?
That depends on whom you ask. So far, the only
researcher to look at how the new tobacco product might help people quit smoking is Jed E.
Rose, PhD, a neuroscientist at Duke University in Durham, N.C. Rose has some pretty good
credentials -- he's the inventor of the nicotine patch.
"I think it is a very seriously promising
approach that needs to be explored," Rose tells WebMD. "A lot of people jump to
conclusions based on the presumed motives of the tobacco companies. Whether it works is a
scientific issue, not a political one. There is widespread acceptance of the theory that
people smoke because they are dependent on nicotine. So if you remove nicotine, it might
possibly be a step toward quitting. It needs to be tested and it may or may not
Other observers are far less impressed with
the idea. One of them is Jeff Wigand, PhD, the former cigarette company executive who
revealed what tobacco companies knew about the risks of smoking.
"The way to help smokers to quit is to
help them get over their nicotine addiction -- and this is best done with help from people
who have the person's heath as their first interest, not a tobacco company," Wigand
tells WebMD. "When has a single tobacco company got into the smoking-cessation
business? Now we are going to give out cigarettes as a quitting strategy? If smokers need
something to hold in their hands, give them a pencil."
Randolph D. Smoak Jr., MD, immediate past
president of the American Medical Association, says nicotine-free and reduced-carcinogen
cigarettes are just marketing gimmicks.
"A cigarette is nothing but a delivery
device for premature death," Smoak says. "No matter how you dress it up or dress
it down, it is the same product. If you take away the nicotine, then people are not going
to smoke it, because they do not get the nicotine kick. If people are still smoking
cigarettes without nicotine -- if they will -- they still are exposed to the carcinogens.
To say we will take away the addictive portion is no salvation. To diminish the nicotine
is just a false sense of security and hope for people who are addicted and are exposed to
In a study being presented to the Feb. 20-23,
2002, annual meeting of the Society for Research on Nicotine in Tobacco, Rose looked at
what happens when smokers use no-nic cigarettes.
Smokers who use low-tar, low-nicotine
cigarettes puff harder to get a satisfactory smoke. But Rose found that these same smokers
take normal puffs of high-tar, no-nicotine cigarettes. And the no-nics satisfied smokers'
craving for cigarettes -- although it didn't keep them from getting the bad mood that's
part of nicotine withdrawal.
Rose says that cigarettes give a smoker a
quick nicotine "spike." This acts as a reward and makes a smoker want another
cigarette. Rose says that no-nic cigarettes don't have that reward -- so smoking them
might eventually break the vicious smoking-reward circle.
"Whether those internal cues to keep
smoking extinguish over time, that is the big unknown," Rose says. "If it turns
out to be a period of weeks, that would be great. If it took years [of smoking no-nic
cigarettes], it would not be so great. We just don't know the answer to that question
Rose's study was partially funded by an
unrestricted gift to Duke University by Vector. Rose says he's free to use the funds any
way he likes, has no limits on what he's able to say about the work, and has no financial
interest in Vector.
© 200 WebMD Inc. All rights reserved.
Trying to Quit
by Jennifer Warner - WebMD Medical News
Cessation Attempts Rise Since Introduction of Nicotine
Feb. 26, 2002 -- If you make it easier to get
over nicotine, more smokers will at least try to quit. That's the message of new research
that shows the number of smokers attempting to break the habit has grown to nearly 40%
since over-the-counter nicotine replacement therapies were introduced in 1996. And more
help may soon be on the way in the form of anti-inflammatory drugs to ease nicotine
withdrawal symptoms such as depression and fatigue.
"In the same period that nicotine
replacement therapies, such as the nicotine patch or nicotine gum, became available, we
see more Americans trying to quit smoking," said study author Saul Shiffman, PhD,
professor of psychology at the University of Pittsburgh, in a news release.
Of the 48 million American adults who smoke,
about 70% say they would like to quit, but only about 1.2 million do so successfully. The
FDA approved the first nicotine replacement in the form of a chewing gum, Nicorette, in
1984. The transdermal (skin) patch, NicoDerm, came in 1991. Both were available only by
prescription until 1996, when they were reclassified as over-the-counter products.
The study authors say that reclassification
and easier access to nicotine replacement may have prompted a spike in the number of
smokers who tried to quit. According to data collected by the U.S. Census bureau from 1992
to 1999, the researchers found the number of adult smokers who reported attempts to quit
smoking in the past year rose from 38% in 1993 and 36% in 1996 to 40% in 1999.
GlaxoSmithKline Consumer Healthcare, the
marketers of Nicorette and NicoDerm, sponsored the Census analysis.
Another study presented at the same conference
suggests anti-inflammatory drugs may be the next wave in treatments to help smokers stick
with their decision to quit. For the first time, researchers have shown that smokers who
stop smoking cigarettes have symptoms similar to people having an inflammatory response or
stimulation of the immune system.
"Our research shows that nicotine
withdrawal is a significant physical as well as psychological stressor that impacts
multiple systems of the body, including the immune system," said study author
Elizabeth Corwin, PhD, assistant professor in the school of nursing at Pennsylvania State
University, in a news release.
"If we can relieve some negative symptoms
-- including depression -- by reducing the inflammatory response, we may be able to
increase the likelihood that heavy or moderate smokers can successfully quit."
Corwin and researchers studied 20 moderate to
heavy smokers while they were smoking regularly and 24 hours after they stopped. Analysis
of blood samples taken from the smokers after they quit showed that elevated levels of
cytokines (substances produced by white blood cells in response to inflammation) along
with fatigue predicted which smokers suffered from depression during nicotine withdrawal.
Changes in the production of cytokines were also associated with muscle aches and
increased appetite after quitting.
"The results support the hypothesis that
smokers who stop smoking may experience depression, fatigue, muscle aches and appetite
changes for similar biochemical reasons that individuals who have acute or chronic disease
do. The same therapies -- anti-inflammatory medications -- may therefore help alleviate
these symptoms," said Corwin.
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Coming Soon: New
Ways to Kick the Smoking Habit
Experts Say Lozenges to
Laughing Gas May Soon Arrive, but Proven Methods Are Already Here
Jan. 23, 2002 -- If you
want to kick the habit, whether it's cigarettes, cigars, or chewing tobacco, you don't
have to go it alone. The tried-and-true quit-smoking methods -- the patch, nasal spray,
gum, and inhaler -- can help get you on the straight-and-narrow. But they're not the only
options. Check out these alternatives that are in the pipeline.
Chiming in will be two nicotine-addiction
experts: Tom Glynn, PhD, director of cancer science and trends at the American Cancer
Society, and Richard Olmstead, PhD, assistant research psychologist at UCLA.
A new nicotine lozenge triples a
smoker's quitting efforts and is more effective than other forms of nicotine-replacement
therapy, according to researcher Chris Steele, MD, who directs one of Europe's largest
quit-smoking clinics in Manchester, England. His most recent study of the nicotine lozenge
included more than 1,800 smokers in England and the U.S.
The lozenges are available in Great Britain in
2 mg and 4 mg doses, about the same nicotine dosages as in the gum. They are designed to
reduce cravings and withdrawal symptoms and were taken in gradually reduced amounts for 12
According to the trial results, which will be
published later this year in the Archives of Internal Medicine, cigarette cravings
were reduced by 23% in the first week. Steele said the lozenge is more effective than the
gum because it releases about 25% more nicotine from each dose.
"The early results look positive,"
Glynn tells WebMD. "It's a form of nicotine medication that people are used to
taking. It's similar to nicotine gum, where you can get a fairly quick uptake of nicotine.
And it can be delivered on as-needed basis, whereas the patch, while it is very
successful, is delivered slowly over a long period of time. Most nicotine-replacement
products are similar in that they about double the quit rate."
While Olmstead says the lozenge looks good, he
also notes he is skeptical that it will be any better than other nicotine-replacement
therapies. "A lot of these things look better coming out of the gate than they are in
practice." He's a big fan of the nasal spray and inhaler, which are just as effective
but haven't been marketed well, he says. "In fact, the nasal spray looks like it's
the most effective, but people sometimes don't like to use it because it causes burning in
the nose and watery eyes."
A new seizure drug known as Topamax --
already used to treat epilepsy -- blocks some nicotine-triggered changes in brain
chemistry and may be useful for treating nicotine addiction, says lead author Wynne
Schiffer, researcher at the U.S. Department of Energy's Brookhaven National Laboratory in
Brookhaven scientists have been studying the
chemistry of drug addiction for nearly two decades. Nicotine addiction research has
focused on several brain chemical messengers that are felt to play a role in the pleasure
and reward derived from smoking.
Schiffer and colleagues have found that
Topamax changes chemicals in the brain that drive the urge to smoke.
"In principal, it has
possibilities," says Glynn. While the studies are too preliminary at this point to
make recommendations, he says, you have to applaud the development of any new methods to
help people stop smoking -- drug treatments or otherwise."
"There may be something to it,"
Olmstead tells WebMD. "In our lab, we're looking at combining a lot of different
drugs, because any one is insufficient to address all the withdrawal-related symptoms
people have. We'll probably see in six months to a year whether it works in humans in
affecting smoking behavior."
A dose of laughing gas on the day they
decide to quit may help smokers successfully kick the habit, according to Jesse H. Haven,
MD, at the Anchor Health Center in Naples, Fla. He reported his findings at the 2001
meeting of the American Academy of Family Physicians held in Atlanta. Laughing gas, or
nitrous oxide, is the gas used to anesthetize patients undergoing dental work.
Haven's theory: nitrous oxide may help smokers
quit by replenishing stores of the brain chemical dopamine, which becomes depleted during
drug and alcohol withdrawal.
In a study involving 25 smokers, half were
given nitrous oxide and half were given oxygen on the day they planned to quit. None of
the smokers took any other kind of smoking cessation treatment. Three days later, those
who took nitrous oxide had an 85% overall reduction in number of cigarettes smoked per
day. Forty percent of patients were able to completely stop smoking during the three-day
period, and 92% said their craving for tobacco had "noticeably decreased." Six
months later, "many" of the people who quit completely had remained cigarette
"People have tried laughing gas on and
off, and to date, there are no good data to suggest it works," Glynn tells WebMD.
"That's not to say it doesn't work; we just don't know yet. It's certainly not
anything we would encourage people to do, given that there are treatments we know
"It's certainly the weakest of the
three," says Olmstead. "Besides, such studies have strong potential for placebo
effect. People are going to know whether they're feeling the effects of nitrous oxide or
"If you're really trying to quit smoking,
the most helpful are nicotine replacement products -- gum, patch, inhaler, nasal spray --
plus the anti-depressant Zyban," Glynn says. "Zyban is the only medication
recommended by the U.S. Public Health Service. It's also the only one where there are good
long-term clinical trial data. There are two other antidepressants that are possible, but
there just aren't sufficient data."
Treatment should also include counseling with
a health professional, Glynn tells WebMD. "That kind of support helps a lot
particularly in terms of avoiding relapse, which we run into regularly with tobacco
cessation. Some people try to quit three or four times before they're successful."
Research shows that get good counseling along with the drug treatments helps reduce the
number of relapses.
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FDA urged to regulate 'reduced risk' cigarettes
- 12/18/2001 Health groups filed petitions with the Food and Drug Administration
Tuesday urging the agency to regulate tobacco products the activists say are marketed as
safer alternatives to regular cigarettes.
The Supreme Court ruled
last year the FDA did not have the authority to regulate tobacco products, but the health
groups argue the agency can require tobacco companies that make health claims to provide
If they cannot back up
their claims, the FDA could order the companies to pull their ads, the petitioners say.
"Our purpose in
filing these petitions is that a number of tobacco companies have tried to take advantage
of the Supreme Court decision to make unproven health claims about their products based on
the premise FDA wouldn't act," said Matthew Myers, president of the Campaign for
The group filed
petitions against Vector Tobacco Ltd. and Brown & Williamson for marketing new brands
as reduced risk products. The ads say the cigarettes have less carcinogens than older
"The reality is
they have no evidence," Myers said.
Brown & Williamson
Spokesman Mark Smith said his company, based in Louisville, does not make health claims
about its new Advance Lights cigarette.
"We go out of the
way to say there's not enough medical information to know if Advance, with less toxins,
will lower health risks," Smith said.
But, by stating that
the cigarettes have less toxins, the companies are "definitely appealing to concerns
about people's health," said Edward L. Sweda, senior attorney at the Tobacco Control
Resource Center at Northeastern University in Boston. "Certainly a very strong case
can be made that they are making health claims."
advocates also argue the Supreme Court decision did not prohibit the FDA from regulating
nontraditional products containing nicotine or tobacco.
They filed a petition
against R.J. Reynolds Tobacco Holdings Inc. calling for regulation of its Eclipse
cigarette. The groups argue Eclipse is not a true cigarette, because it heats tobacco
rather than burning it. Therefore, it is a "nicotine-delivery system" that can
be regulated as a medical device, the groups argue.
Petitions also were
filed against the companies Star Scientific and S.F. Garret for making mint-flavored
tobacco lozenges and nicotine water. Both are marketed as products smokers can use in
places where cigarettes are banned.
Myers says the gum and
water should be regulated as a drug or food. He says the agency's authority to regulate
these products is no different from the FDA's ability to regulate smoking cessation
products such as nicotine gum.
Other groups that joined the petition effort
included the American Cancer Society, American Heart Association, American Legacy
Foundation, American Lung Association and American Medical Association.
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smoke may do damage in 30 minutes
CHICAGO (AP) - 8/13/2001
Just half an hour of secondhand smoke can impair normal blood flow to the heart, a
Japanese study suggests.
The study examined the effects of spending 30 minutes in a hospital's smoking room on 15
nonsmoking men and 15 smokers. The smokers, whose heart arteries already showed damage,
were not affected. But in nonsmokers, the result was a reduced ability of heart arteries
to dilate, which previous research has suggested may be a precursor to hardening of the
"This change may be one reason why
passive smoking is a risk factor for cardiac disease" and related deaths in
nonsmokers, the researchers said in Wednesday's Journal of the American Medical
The study did not examine whether the changes from the one-time exposure to smoke were
permanent. Previous research in smokers has found similar changes that may be reversible
if smokers quit, said Dr. David Faxon, president of the American Heart Association.
If exposure continues, "gradually, as
hardening of the arteries sets in, it's irreversible, " he said. The study
"really sort of confirms prior information that we've had about the adverse effects
of secondhand smoke," Faxon said.
In the study, Dr. Ryo Otsuka of Osaka City University Medical School and colleagues used
blood pressure tests and an imaging technique called echocardiography to examine the
effect on heart arteries' ability to dilate. Measurements were taken before and after
exposure to secondhand smoke.
The smoke appeared to impair the
functioning of the endothelium, a lining of cells in the arteries that helps regulate
dilation. Scientists believe coronary artery disease may begin when the endothelium
becomes damaged, leaving the arteries prone to blockages or narrowing. Stanton Glantz, a
University of California at San Francisco professor of medicine, said the findings add
fuel to the debate over secondhand smoke.
"People walking into a smoky restaurant, do they want to be clobbering the ability of
the arteries in the heart to get blood to the heart, even if it's just for a little
while?" he said.
Seth Moskowitz, spokesman for R.J. Reynolds
Tobacco Co., said the study does not change the company's belief that there is no
scientific evidence establishing that secondhand smoke is a risk factor for lung cancer,
heart disease or any other disease in adult nonsmokers.
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May Help Smokers Quit
NEW YORK - Researchers are developing what they hope will be an entirely new way for
cigarette smokers to kick their tobacco habit -- an oral nicotine solution that can be
consumed with a wide range of popular beverages.
"The nicotine is metabolized fairly rapidly, providing a quicker
nicotine boost than is provided by a nicotine patch," said Dr. Eric C. Westman of
Duke University Medical Center in Durham, North Carolina. "And unlike nicotine gum,
which comes in regular, mint and orange flavors, the oral solution can be flavored in
almost any way the smoker chooses to flavor it."
Cigarette smoking is the leading preventable cause of death in the US --
directly linked to 435,000 deaths each year.
A preliminary 3-month study conducted by Westman and his colleagues tested
the ability of the oral solution to help 25 smokers abstain from smoking. After deciding
upon a personal quitting date, the participants were given vials of the solution to
self-administer throughout the day -- whenever they felt the urge to smoke.
To each drink consumed the quitters added between 2.5 and 10 milligrams
(mg) of the solution. The researchers pointed out that 3 mg of the nicotine solution was
equivalent to the amount of nicotine typically inhaled from a single cigarette.
Westman's team noted that, in addition to plain water, the oral solution
can be added to both alcoholic and non-alcoholic drinks, including coffee, tea, soda, beer
The investigators found that with minimal behavioral counseling and few
side effects, the participants were able to abstain from smoking at the same levels
typically achieved by smokers who use currently available cessation tools such as nicotine
patches, nicotine gums, lozenges, and nicotine nasal sprays. Only one study participant
dropped out of the study.
"The breakthrough is we have found a way to develop the oral nicotine
so that it is tasteless, and can be used to relieve craving," Westman told Reuters
Health. "The prevailing wisdom was that this couldn't be done -- that the nicotine
would be too intolerable and would taste bad and you couldn't get sufficient levels to
curb craving. But with this solution, a smoker can control the taste of the nicotine
delivery system -- and that is not possible with any other nicotine therapy that we have
Westman suggested that the oral solution also appears to be more
convenient to use, working more quickly and with less irritation to the nose and throat
than alternative cessation methods. He cautioned, however, that the oral nicotine solution
has not yet received Food and Drug Administration approval -- a process taking at least 3
to 5 years -- and is not yet ready for consumer use.
"We have far too few options for the treatment of
nicotine dependence," Dr. Scott Leischow, chief of the tobacco control research
branch of the National Cancer Institute in Washington, DC, told Reuters Health. "So
we definitely support the need for new medications. But this requires a full review, so we
can be sure the new medication works and can be safe."
Reuters Health Information
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Can Make It Tougher to Stop Smoking
By Mark Moran, MPH - WebMD
June 20, 2001 -- Smokers
with a history of depression may have an especially difficult time kicking the tobacco
habit, according to a study in the June 16 issue of Lancet. The findings confirm a
long-held and distressing suspicion -- that reaching for a cigarette may be an especially
toxic way that some depressed individuals self-medicate their symptoms.
"It's self-medication with terrible
consequences," says psychiatrist Alexander Glassman, MD, chief of clinical
psychopharmacology at New York State Psychiatric Institute and professor of psychiatry at
Columbia University College of Physicians and Surgeons, in New York.
But the flip side of the story is more
encouraging. Glassman says the sites in the brain where nicotine may be acting to dampen
the effects of depression could be targets for new drugs designed to have a similar action
-- without the harmful effects of smoking.
"It will result in a new class of
antidepressant drugs," he predicts.
In the study, 100 smokers with a history of
major depression were enrolled in a two-month smoking-cessation trial. Of those, 76 were
followed for six months after completion of the program to see if they had another
occurrence of depression. Of 42 people who successfully quit smoking, 13 had an episode of
major depression, while only two of the 34 people who continued smoking became depressed.
"The people who continued to smoke got
depressed 5% of the time, but the people who stopped smoking got depressed over 30% of the
time," Glassman says. "It's a really big difference."
The study grew out of the widely observed
phenomena that people with a history of depression are much more likely to smoke than
nondepressed people, Glassman says. It was this observation that contributed to the
approval of the antidepressant Wellbutrin for use as a smoking-cessation agent, under the
new name Zyban.
Now, Glassman says, new studies will be
undertaken to determine whether continued use of Zyban will prevent the recurrence of
depression in people with a previous history of the illness. Those studies will be funded
by the National Institute on Drug Abuse, he says.
Raymond Niaura, MD, who co-wrote an
accompanying editorial to the study, calls the findings "striking," and says
they are the strongest confirmation yet of what professionals working in smoking-cessation
programs have long suspected.
"There are probably even more people at
risk of becoming depressed when they try to quit smoking than we had previously
thought," says Niaura, professor of psychiatry at Brown University Medical School, in
Providence, R.I. "If people with a history of depression try to quit, they are going
to have a harder time. They are in a tough place -- they are quitting smoking to improve
their health, but at greater risk for depression."
© 2001 WebMD
Corporation. All rights reserved.
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Acknowledge Smoking Dangers
By CATHERINE WILSON, AP Business Writer
MIAMI (AP) - Three of the five cigarette
makers fighting the prospect of a potentially crippling punitive-damage award for smokers
acknowledged to jurors Tuesday that smoking causes disease, exposing a rift within the
Attorneys for Brown & Williamson and
Lorillard promised testimony from their CEOs that would for the first time place their
companies on the same side of the issue as Liggett, which accepted the connection between
smoking and cancer three years ago.
That leaves Philip Morris and R.J. Reynolds on
the other side of an issue that once united a monolithic industry.
The splintered positions were offered in
opening statements by tobacco attorneys trying to avoid a multibillion-dollar punitive
verdict for 300,000 to 500,000 sick Florida smokers.
The jury already has ruled against the
industry twice, saying the companies conspired to produce a deadly product and awarding
$12.7 million in compensatory damages to three smokers with cancer.
The cigarette makers want the jury to award no
punitive damages, arguing that $254 billion from settlements with the states is enough
money to pay for decades of misconduct. The lawsuit seeks $100 billion in damages, but the
smokers' attorney did not specify an amount in his opening statements Monday.
On Tuesday, Lorillard attorney Ken Reilly told
the jury: ``We agree with the public health authorities and the surgeon general that
smoking causes disease. I don't know how more flatly that can be stated.''
Brown & Williamson attorney Gordon Smith
followed by saying CEO Nicholas Brookes ``will tell you it is and has been Brown &
Williamson's position that smoking causes cancer. There is no confusion about that
Such blanket acknowledgments do not amount to
acceptance of blame, however. If tobacco executives concede smoking causes disease, they
generally say it can't be proven in any given smoker because of individual risk factors.
The Reynolds position in the punitive phase
was uncertain. Attorney Jim Johnson focused on company finances and did not address the
issue of smoking and disease in his initial remarks.
In a deposition May 10, Michael Szymanczyk,
CEO of industry-leading Philip Morris, said the company has not adopted the position of
public health officials that smoking causes cancer and is addictive even though it
displays those messages on its Web site.
Liggett owner Bennett LeBow broke ranks in
1997 by saying smoking causes disease and is addictive.
``Liggett's conduct has served as a model for
how a tobacco company should conduct itself in today's world,'' said Liggett attorney
Aaron Marks, predicting the company's cigarette business will die in 20 years.
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Quitting is difficult but beneficial at any age!
Even at 60, giving up smoking almost completely removes the risk of lung
cancer, research has found. People who have not already developed the condition are
unlikely to do so after they quit. Professor Julian Peto, of the Cancer Research
Institute, told a conference in London that the finding indicated a need for new public
health strategies. Currently they focus mainly on dissuading children from starting but
fail to encourage adults to quit, he said.
Public health focus...
The Cancer Research Campaign backed the call to focus efforts on
persuading adults to give up. The government is due to publish a white paper on
public health in the autumn, hich will cover strategies to prevent smoking. Jean
King, head of education for the campaign, said: "We have been pressing the government
to put more on cessation in its white paper." She said: "People should
realise that there are benefits at all ages. "After 10 years the risk of cancer is
significantly reduced, and it only takes one year to cut the risk of heart
disease." She added that although nicotine was extremely addictive and hence
difficult to give up, there were plenty of support bodies to help smokers quit. The
finding came as the result of long-term research projects such as the 40-year British
Doctors Study. They allow doctors to compare the health of 60-year-olds who stopped
smoking at 50 with that of smokers of the same age.
Smoking triggers cancer...
The reason for the advantages of quitting applying at any age could lie in
the sequential way lung cancer develops. Tobacco can trigger changes to cells. A
series of these changes must occur to trigger lung cancer, so if someone gives up smoking
before all of them have taken place, they are unlikely to develop the disease.
Professor Peto said: "It has not been until the last year that we could see the full
horrors of what smoking does." He said that half of all smokers die as a result
of their tobacco use, not a quarter as was previously thought. Other factors that
could cause the cancer were a poor diet lacking in fresh fruit or vegetables and prolonged
exposure to the sun.
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The Only Solution To Smoking Is To Quit
Dec. 22, 2000 (CBS)
It's one of the biggest myths about smoking:
"If I just cut back, my health will improve."
No such luck, says a team of Mayo Clinic
researchers, led by Dr. Richard Hurt.
"There is no safe lowest level of smoking. The best way is not to
smoke at all," Hurt says.
Hurt and his colleagues followed 23 heavy smokers, people like Doug
Coen--who inhaled 2 packs a day--and asked them to cut back to 10 or 15 cigarettes a day
over a two month period. Then they measured specific chemical markers linked to cancer.
One of the markers went down, two stayed the same, and one even went up when smoking was
"Even though there was a 50 percent reduction in the overall smoking
amongst this group, the markers of harm, which are blood tests and urine tests associated
with cancer--did not go down," Hurt says.
It wasn't what Doug Coen was hoping to hear. "I guess, deep inside, I
was probably hoping that yeah, if I could cut down and it was still good for me I could
have the best of both worlds and that, unfortunately, doesn't work out," he says.
Coen had smoked for 30 years and had tried to kick the habit five times.
The new study, he says, has motivated him to quit once and for all.
"I know that having even maybe one, two, up to five cigarettes a day
is just as harmful as relatively smoking a whole pack or a pack and a half," he says.
That's the message scientists are hoping to convey. Perhaps convincing
other heavy smokers to seek the most aggressive treatment to quit.
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Tobacco study: Quitting really does lower lung cancer risk
By Michele Dula Baum
CNN.com Health Writer
ATLANTA, Georgia (CNN) -- Every year, more
Californians are learning that it's a bad idea to smoke. And a new study from the Centers
for Disease Control and Prevention suggests that it's paying off in lower rates of lung
"This is very exciting," said Dr.
David Fleming, deputy director for science and public health at the CDC. "It shows
that when the public pays attention and chooses to invest resources in smoking prevention,
those efforts pay off -- not only in decreased use of tobacco, but in decreased
Studying data from 1988 through 1997, CDC
investigators found that the rate of lung and bronchial cancers fell faster in California
than elsewhere in the country. Compared to an overall drop of 2 percent in five other
states and three metropolitan areas, research showed a 14 percent decrease in lung cancers
"That drop in lung cancer is linked to
the fact that cigarette consumption in California has dropped 50 percent," Fleming
said. "What we're seeing is the first disease reduction resulting from California's
comprehensive tobacco prevention efforts."
In the past 10 years, California has spent
some $634 million -- in part funded by a 25-cent increase in cigarette taxes instituted in
1989 -- on tobacco use-reduction efforts. These efforts include an aggressive campaign of
public education, clean-indoor laws and community-based support for smoking cessation
In 1999, cigarette consumption in California
was measured at about 61 packs per capita. Nationwide, consumption is at nearly 107 packs
a person. More recent statistics from the California Department of Health Services show
the decline in lung cancers continued beyond the CDC's study period.
From 1997 to 1998, the rate of lung cancer
decreased from 60.1 cases to 57.6 cases per 100,000 residents.
"There is no mystery as to why California
has witnessed a significant decline in the incidence of lung and bronchus cancers while
other regions nationwide have seen little or no change," department director Diana M.
Bonta said in a statement. "We must continue these programs in full force to
effectively counter the tobacco industry's aggressive marketing of tobacco in California,
and help those who use tobacco products to break the chains of their addiction."
About 90 percent of lung cancers are caused by
tobacco use, said Fleming.
Another interesting CDC finding is that while
lung cancer rates are declining in the nation as a whole, they are increasing among women.
"Lung cancer in women in this country is
really epidemic because women started using tobacco later in the 20th century than men
did. We're still seeing the results," Fleming said. "In California, rates among
women dropped almost 5 percent. But in the rest of the country, they went up 13
In addition to California, other data studied
came from Connecticut, Hawaii, Iowa, New Mexico and Utah, and the cities of Atlanta,
Georgia; Detroit, Michigan; and the Seattle-Puget Sound area of Washington.
"California has been a leader in this
area," said Fleming. "It shows what can happen when you choose to invest
resources in tobacco reduction."
The study "may help other states that
have been ambivalent" about anti-smoking education, he said.
Other studies are ongoing concerning the ways
tobacco-reduction efforts may have impacted other smoking-related illnesses such as heart
disease, Fleming added.
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Quit Smoking With More Kick Per Puff?
Researchers have found a new strategy to wean
smokers from tobacco: extend the nicotine kick that people get from each cigarette in
hopes they'll smoke less.
In a preliminary study, Canadian researchers
focused on an enzyme that metabolizes nicotine. By slowing the enzyme action, more
nicotine remains in the bloodstream and the pleasure that a smoker gets from a cigarette
lasts longer. The result could be that smokers light up less often. Another benefit,
according to scientists at the University of Toronto, is that blocking the enzyme also
reduces activation of carcinogenic substances in tobacco smoke.
"Smoking is a regulated behavior,"
says Dr. Edward M. Sellers, lead investigator of a study presented this week at the annual
meeting of the American Society for Clinical Pharmacology and Therapeutics. "People
will not let their nicotine levels go beyond a certain amount. If they go up momentarily,
smokers will take fewer or smaller puffs. That can be the first step to quitting."
Now, most smoking cessation methods are aimed at reducing withdrawal symptoms.
Sellers used the psoriasis drug
methoxsalen as the enzyme inhibitor in a study with 11 smokers. The drug increased the
blood levels of nicotine while reducing how much carbon monoxide was exhaled. Little of
the drug entered the bloodstream. However, Sellers warns that methoxsalen has not been
approved for use as a smoking cessation aid.
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Massage may help smokers resist cravings!
NEW YORK, April 28, 2001
(Reuters Health) -- Individuals who are trying to give up smoking may find relief in
massage, which has been shown to improve mood and reduce levels of anxiety and stress
According to a study in the journal Preventive
Medicine, about 25% of American adults smoke cigarettes. Smoking has been linked to
increased risks of heart disease, stroke, elevated cholesterol levels, and cancer. While
Gallup polls have found that about 75% of smokers would like to quit, smoking cessation
programs and medical interventions have had little effect. One reason, say researchers, is
the symptoms that accompany withdrawal from nicotine, including anxiety. 'Research
suggests that massage therapy reduces anxiety,' explain Dr. Maria Hernandez-Reif and
colleagues with the Touch Research Institute at Nova Southeastern University in Ft.
Their study included 20 adult smokers between
21 and 45 years old. The ten male and ten female subjects reported smoking an average of
14.5 cigarettes a day, 85% had been smoking for at least five years, and 70% had attempted
to quit smoking at least once.
Researchers randomly assigned participants to
a self-massage treatment group or a control group. The treatment group were taught to
perform a five-minute hand or ear self-massage three times a day during 'cravings' for a
Results, based on self-reports, showed that
the massage group was less anxious, had fewer withdrawal symptoms and smoked fewer
cigarettes than the control group.
'The present findings suggest that
self-massage may be an effective adjunct treatment for adults attempting smoking cessation
to alleviate smoking-related anxiety, reduce cravings and withdrawal symptoms, improve
mood, and reduce the number of cigarettes smoked,' the authors conclude.
The mechanism by which massage works remains
unclear, however. Researchers suggest that self-massage may give smokers something to do
with their hands and may 'thereby assist in achieving smoking reduction and potentially
The authors add that other alternative
therapies, including acupuncture and hypnosis, may help to curb cigarette cravings.
SOURCE: Preventive Medicine
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Smoking Rate Remains Unchanged
November 5, 1999
ATLANTA (AP) Despite years of anti-smoking
campaigns, lawsuits and bans, the smoking rate among American adults has hardly budged
during the 1990s mostly because more and more 18-to-24-year-olds are lighting up.
The Centers for Disease Control and Prevention said
Thursday that 24.7 percent of adults smoked in 1997. As a result, the CDC expects to fall
far short of its goal of reducing smoking to 15 percent of the adult population by 2000.
"During the 1990s we've made virtually no progress
whatsoever," said Michael Eriksen, director of the CDC Office of Smoking and Health.
"The fact that we can't get rates below 25 percent really speaks to the addictive
power of nicotine."
About 48 million adults smoked cigarettes in 1997,
according to a CDC survey that year of more than 35,000 people nationwide. The rate was
the same 24.7 percent in 1995. It was 25.5 percent in 1990.
Among most adult age groups, smoking rates actually
declined from 1990 to 1997, but the percentage of smokers ages 18 to 24 increased during
that period, from 24.5 percent to 28.7 percent.
U.S. smoking rates have dropped drastically since 1965,
when 44 percent of adults were lighting up. Over the following quarter-century, more
health warnings came out, tobacco ads were banned from the airwaves and no-smoking signs
appeared in restaurants, offices and airplanes.
However, smoking rates leveled off during the 1990s rather
than continuing to drop.
At the same time, public awareness campaigns continued to
warn of the dangers of smoking. The patch and nicotine gum went on the market. And states
sued tobacco companies to recoup the cost of treating sick smokers.
"The bottom line on this is it just speaks to how
tough it is to quit and how addictive tobacco is," Eriksen said.
Philip Morris, the nation's largest tobacco company, had no
comment on the CDC report.
Health officials anticipate a drop in smoking rates in 1999
because cigarette makers raised their prices after their $206 billion legal settlement
with 46 states.
And there is another sign that the numbers could begin
falling according to the U.S. Department of Agriculture, per capita cigarette
consumption declined 15 percent between 1990 and 1997.
Shane Toepher, a 23-year-old student at Georgia State
University in Atlanta, said the cost of cigarettes is a major reason he is trying to quit.
"It costs too much money," he said. "Smokers
are aware of what's out there that it's not good for you and it'll kill you. They
just don't care."
Anti-smoking advocates said the popularity of cigarettes
among young adults is troubling, but it is also the group where further reductions are
most likely to occur.
"We're all pretty much agreed that the efforts to
prevent youth from smoking, or getting those who have just begun to experiment to put it
away, is where we're going to get success," said Joann Schellenbach, spokeswoman for
the American Cancer Society.
Copyright 1999 The Associated Press. All rights
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C for Smokers - A Long Shot
From the Publishers of the New England Journal of Medicine
A study showing that injecting chronic smokers with vitamin
C helped their arteries widen made headlines when it was published in the July 1
Circulation. But smokers shouldn't think they can pop pills to avoid heart disease.
Cigarette smoke contains chemicals called free radicals,
which initiate a chain of artery- damaging events. They make LDL ("bad"
cholesterol) stickier and more likely to cause atherosclerosis (clogged arteries). Vitamin
C is an antioxidanta substance that mops up free radicals before they wreak havoc.
In this small all-male study, 10 nonsmokers and 10
long-time smokers (a pack a day for more than 20 years) were first given shots of a
chemical that relaxes the lining of the arteries. The result in nonsmokers was wider
arteries, but as expected, the smokers' arteries didn't respond well. Then all the men
were injected with vitamin C. When researchers tried the chemical again, the smokers'
arteries widened much more. But is this a "cure" for smoking-induced
"Not by a long shot," says HealthNews associate
editor Harry Greene, MD. About one gram of vitamin C was injected directly into the men's
arteries; you'd have to swallow a lot of pills to get this amount into your bloodstream,
and daily injections aren't very appealing. Also, the widening effect was probably
temporary, according to the researchers. And the study only looked at the arm arteries;
coronary arteries might react differently.
Increasing your vitamin C intake probably won't help. A
large study published in 1993 by Eric Rimm, an assistant professor of epidemiology at the
Harvard School of Public Health, found no evidence that high intakes of vitamin C, from
pills or food, could reduce smokers' risk of heart disease. His advice: "The best
thing for smokers to do is quit."
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Of Quitting Smoking Apparent Years Later
|September 1, 1999
NEW YORK (Reuters Health) - While quitting smoking remains the
number one means of reducing a smoker's risk for fatal lung cancer, real declines in death
risk only appear between 15-20 years after individuals kick the habit, according to new
"The excess mortality risk associated with smoking can
be avoided by never smoking and can be reduced among smokers only by becoming a long-term
former smoker," write Dr. James Enstrom and Dr. Clark Heath, Jr. of the University of
California, Los Angeles. Their report is published in the September issue of the journal
The study authors studied the impact of quitting smoking on
death rates over the past 40 years in a group of over 118,000 men and women enrolled in
the American Cancer Society's Cancer Prevention Study.
The authors hypothesized that the smoking-related death
rates of former smokers and never smokers would converge -- that is, become the same -- as
a consequence of smoking cessation.
Cigarette smoking rates declined substantially between 1959
and 1994/1999 in the study participants, the report indicates -- from 46% to just 3% for
men and from 32% to 2% for women. Even among men and women who smoked at the beginning of
the study, there has been "almost total cessation," according to the authors.
Only 7% of men and 7% of women who smoked in 1959 still smoked by 1994/1999.
However, quitting did not translate quickly or directly
into reduced death rates, the authors report. Even among former smokers, "the death
rates for those who had quit for less than 1 and (between) 1-4 years were close to the
death rates for current smokers."
In fact, death rates of former smokers only began to match
those of never-smokers "after 15-20 years of (smoking) cessation," according to
Overall, smoking cessation had little real impact on
long-term death rates in the group as a whole. But the researchers point out that most of
the ex-smokers in the study group "were long-term smokers who quit after the age of
55 years." These heavy, long-term smokers tended to have much higher death rates
compared with the smaller number of smokers who quit earlier in life.
"These results explain why there has not yet been a
substantial decline in the lung cancer death rate among older US males as a whole,"
the researchers say, "and why the lung cancer death rate among US females has risen
so much despite a considerable amount of smoking cessation during the past 35 years."
SOURCE: Epidemiology 1999;10:500-512.
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group's butt-out campaign on cigarette packs becomes positive
By Smita Deans
Toronto Star Staff Reporter
An anti-smoking campaign that includes encouraging messages
on cigarette packs was announced yesterday.
The Canadian Council for Non-Smoking said at a news
conference in Toronto the idea behind putting messages on cigarette packs is that
behavioural change is most likely and longer-lasting when based on positive rather than
``According to a survey we conducted among smokers, 70 per
cent said that they found positive cigarette notices more encouraging to make them stop,''
said Frank Dwyer, president and chief executive officer of the council.
``We feel that the current notices are not sufficient.
``The proposed labels include a toll-free number you can
call for help, as 82 per cent of the people we surveyed said that they would call a
toll-free number to get help quitting.''
The proposal for new labels on cigarette packages has been
sent to the federal health department. Dwyer said he is confident that the change will be
accepted and put into force by the end of this year.
More than 40,000 Canadians die every year from
smoking-related diseases, a figure that has not changed despite laws passed to reduce
``I believe that laws do not consider the effect on the
smoker,'' Dwyer said. ``They only serve to alienate a majority of smokers who wish to
change and need help. We are concerned with the part about helping them.''
Also included in the six-point plan are measures to curb
smoking among youth, including an awareness campaign for children aged 8 to 10 that will
deal with the benefits of non-smoking.
The council is hoping to work with school boards and
parents to implement this program. It is scheduled for fall 2000.
``Every day, 637 young people start smoking. Isn't that a
shocking statistic?'' said Maureen Kennedy Baker, the council's executive vice-president.
``That's why we have to take extra measures to ensure that
young people are educated about the dangers of smoking.''
The council also plans to reach out to teens from 13 to 16
through television and radio campaigns.
The council expects the campaign will cost a total of $4
million in its first year and $4 million more in subsequent years. It has approached
various levels of government to fund these programs.
``As there are about 8.5 million smokers in Canada, it
represents about a dollar per smoker,'' Dwyer said.
Other aspects of the plan include day-long seminars for
those who want to stop smoking. As well, passengers on airline flights lasting more than
two hours will be advised to use a nicotine replacement because of a co-relation the
council sees between nicotine withdrawal and air rage.
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Smoker's Face -- An Evident Reason To Quit
by Jane E. Brody Women's Health Digest Vol 2, Number 3 (year?)
Reprinted with permission from the New York Times Company. Copyright 1996.
The doctor could tell the patient had once
been an attractive woman. But now, though only in her 50s, her face was etched with
wrinkles, her features gaunt-looking with prominent underlying bones and her skin
shriveled and gray with purplish blotches. Diagnosis: smoker's face.
Doctor Douglas Model of Eastbourne, England,
added this condition to the medical lexicon in 1985 after surveying 116 patients and
correctly identifying roughly half of current smokers by their facial features alone.
The distinctive characteristics of smoker's
face, which makes people look far older than their years, were present in 46% of the
current smokers, 8% of the former smokers, and none of the nonsmokers, irrespective of
their age, social class, recent weight fluctuations, and exposure to sunlight.
Dr. Jeffrey B. Smith, a senior resident in
dermatology at the University of South Florida in Tampa, recalled this poignant diagnosis
in a review of the effects of smoking - related skin conditions: Smoking damages cells and
tissues in so many ways that it can have myriad effects on the body.
Wrinkles: "For some patients the
threat of wrinkles may be a more powerful motivator to help them stop smoking than the
more deadly consequences of smoking," Smith wrote. He explained that, as with skin
that is overexposed to sunlight, smoking causes thickening and fragmentation of elastin,
the elastic fibers that are long and smooth in healthy skin. Smoking also depletes the
skin's oxygen supply by reducing circulation. It decreases the formation of collagen, the
skin's main structural component, and may reduce the water content of the skin, all of
which increase wrinkling.
Smoking also interferes with the skin's
ability to protect itself against damage by free radicals, highly reactive substances that
are omnipresent in tobacco smoke. In women, smoking diminishes the level of circulating
estrogen, which in turn fosters dryness and disintegration of skin tissues.
Skin Cancers: Two kinds of skin
cancers, the more curable squamous cell carcinomas and the often lethal melanomas, are
influenced by smoking. Smith said that although smoking did not cause melanoma, smokers
with melanoma were more likely to die of their disease. They are twice as likely to have
advanced disease at the time of diagnosis and are more likely to have their cancers spread
within two years of diagnosis, probably because smoking impairs the immune system.
As for squamous cell carcinoma, even when
exposure to sunlight was taken into account, smokers were found to be at greater risk of
developing this cancer. In a study of more than 107,000 nurses, for example, the risk of
developing squamous cell carcinoma was 50 per cent greater in smokers than in those who
had never smoked. Smokers also tend to get particularly "large, bad" skin
cancers, Smith said.
Other Cancers: Cancers of the lip,
mouth, penis, anus and vulva are also more common in smokers than nonsmokers. For example,
in one study of 903 female cancer patients, 60 percent of those with vulvar and anal
cancers and 42 percent of those with cervical and vaginal cancers were smokers as against
only 27 percent of comparable women without cancer. Smoking more than 10 cigarettes a day
more than doubles a man's risk of developing penile cancer.
Delayed Wound Healing: The problem of
slow or incomplete healing of wounds associated with exposure to cigarette smoke was
clearly demonstrated in laboratory animals in the 1970s. Then surgeons began reporting on
similar problems in patients who smoked: larger scars in women undergoing exploratory
abdominal surgery, more complications and skin sloughing after facelifts and a much higher
failure rate of skin grafts, for example. The more and the longer patients had smoked, the
greater the likelihood of impaired wound healing. Even resuming smoking during an
uneventful recovery could lead to adverse effects. Smith linked the slow healing of wounds
to known effects of cigarette smoking, which constricts surface blood vessels, reduces the
oxygen level in the blood, thickens the blood and impedes the laying down of collagen
needed for healing.
Psoriasis and related disease: Studies
of both men and women with this unsightly and discomforting skin condition have shown that
smokers are about two to three times as likely to develop it as nonsmokers. And the more
cigarettes smoked, the greater the risk. Palmoplantar pustulosis, a difficult-to-treat
skin condition that resembles psoriasis, occurs only on the palms of the hands and soles
of the feet. The skin blisters, then forms a scaly rash. It occurs almost exclusively in
smokers and it does not necessarily go away when the patient quits smoking.
Oral lesions: In addition to smoker's
face, there is also smoker's palate and smoker's tongue. The tars and heat of tobacco
smoke can cause tiny red pimples in the mouth that result from an inflammation of the
openings of salivary glands. Smokers also often develop depressions on the surface of the
tongue. Potentially more serious, however, are lesions called leucoplakia, which are about
six times more common in smokers than in nonsmokers. Although benign, these white patches
in the mouth can become cancerous.
Buerger's disease: This blood vessel
disease results in poor circulation in the lower legs, causing skin problems like burning,
tingling and ulcerations. "It usually occurs in young men who smoke, men in their
30s," Smith said. "But now that women are smoking a lot more, we're seeing it in
Other Skin conditions: Many skin
diseases are associated with diabetes, which impairs circulation to the outer reaches of
the body. A study of more than 112,000 female nurses followed for 12 years showed that
current smokers faced an increased risk of developing noninsulin-dependent diabetes, and
that the risk rose with the number of cigarettes smoked each day. Another study of nearly
43,000 male health professionals showed that smoking 25 or more cigarettes a day doubled a
man's risk of developing diabetes.
People who smoke are much more likely to
develop the bowel disorder Crohn's disease, which can cause "big, ugly-looking
ulcerations, most often on the legs, and painful red nodules, usually on the lower
legs," Smith said. Another condition more common in smokers is systemic lupus
erythematosus, an autoimmune disease that can cause rashes on the face, scalp, hands and
elsewhere, ulcerations in the mouth and hair loss."
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Quit Smoking For Better Lungs and Longer Life
-- Scientists in Finland have conducted a study offering more proof that quitting smoking
is not only good for your lungs but can lead to a longer life.
study, never smokers, past smokers, those who quit smoking permanently or intermittently
lost less of their (lung) function in later adult life than continuous smokers," lead
author Dr. Margit Pelkonen of the University of Kuopio in Finland and colleagues report in
the September issue of the journal Thorax.
And those with the
greatest decline in lung function were most likely to die of any cause, the team found.
"Too much emphasis cannot be given to the importance of smoking cessation," the
followed 1,007 Finnish men for 30 years, beginning in 1959. All underwent medical
examinations six times during the study period. Exams included a test called forced
expiratory volume 0.75 (FEV 0.75), which measures the amount of air a person can expel
from their lungs in 0.75 seconds. The men were also surveyed about their smoking habits.
The researchers evaluated the death certificates of the men who died during the study.
Men who had never
smoked had the smallest decline in lung function, with a FEV 0.75 that declined 46.4
milliliters per year. The men who smoked continuously throughout the study had the largest
decline, with a drop of 66.0 milliliters each year. Past quitters, permanent quitters, and
intermittent quitters had declines in lung function that fell between the two extremes.
experienced the fastest decline in lung function were the most likely to die during the
decline in pulmonary (lung) function can lead to the development of chronic obstructive
pulmonary disease (COPD) and it also seems to be a risk factor for mortality,"
Pelkonen and colleagues write.
condition marked by progressive breathing difficulties--affects at least 16 million people
and is the fourth leading cause of death in the United States. The risk of COPD and the
odds of having an abnormal lung test are much higher in people who smoke cigarettes
compared with people who have never smoked.
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Smokers the Time to Quit
HealthNews from the publishers of the New England Journal of
Even for smokers who want to stop, quitting cold turkey is a daunting task that's
usually unsuccessfulonly about 4 in 100 people who try this method still aren't
smoking a year later. To improve your chances of remaining smoke-free, try establishing a
strict smoking schedule in the weeks before quitting.
A method called scheduled reduction, described in the June Journal of Consulting and
Clinical Psychology, works like this: Divide the minutes you are awake each day by the
number of cigarettes you ordinarily smoke. The result is the time you wait between
cigarettes. The trick is allowing yourself to smoke only on scheduleif you miss your
appointed time by more than five minutes, you wait until your next one. The following
week, make a new schedule using one third fewer cigarettes, which stretches the time
between smokes. Make another one-third reduction during the third week, then quit
completely on the fourth.
By following this method, twice as many volunteers were still not smoking a year later,
compared to those who quit cold turkey. What's more, they reported far less tension,
fatigue, and nicotine withdrawal.
By having a cigarette only at predetermined times, smokers learn to break their
associations between cigarettes and mood, stress, or habits like having a cup of coffee,
says author Dr. Paul Cinciripini, director of smoking cessation programs at the University
of Texas M.D. Anderson Cancer Center. He believes that gradually increasing the interval
between cigarettes gives smokers time to try out different strategies that help them learn
to cope with their urge to smoke so they aren't overwhelmed when they stop completely.
Since the paper was just published, smokers who want to quit won't be able to find
formal programs that incorporate this method for awhile. "Probably not until I write
my book. If I ever get the time," Cinciripini added.
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|Top Researchers Find Genetic Connection To
Certain Gene Found to Influence Why People Start
Smoking and Why Some Get Addicted and Others Don't
WASHINGTON - Quitting smoking can be difficult for some and almost impossible for
others. The reason -- your genes -- New research has found that a certain gene can make
the difference as to whether or not someone will start smoking and then become addicted to
the nicotine. In two studies featured in this month's American Psychological Association's
journal of Health Psychology, researchers discovered that people carrying a particular
version of the dopamine transporter gene (SLC6A3-9) are less likely to start smoking
before the age of 16 and are more likely to be able to quit smoking if they start.
In their article, "Evidence Suggesting the Role of Specific Genetic Factors in
Cigarette Smoking," psychologist Caryn Lerman, Ph.D., of the Georgetown University
Medical Center and her co-authors demonstrated for the first time that a link exists
between smoking behavior and the dopamine transporter gene (SLC6A3-9). In their study of
289 smokers and 233 nonsmokers, they found that individuals with an SLC6A3-9 genotype were
less likely to be smokers than individuals without that gene. Furthermore, those with that
gene started smoking later and were able to quit for longer periods of time than other
Although many smokers attempt to quit at some point in their lives, only 20 percent
actually succeed in quitting, say researchers. In their article, "A Genetic
Association for Cigarette Smoking Behavior," Dean H. Hamer, Ph.D., of the National
Cancer Institute and colleagues found from examining 1,107 nonsmokers, current smokers and
former smokers that the SLC6A3-9 gene was associated with certain personality
characteristics that influenced a person's susceptibility of being able to start and stop
A person with the SLC6A3-9 genotype was found to have lower novelty seeking traits than
a person without this genotype, according to the study. And because novelty seeking has
been associated with a desire to smoke, said Dr. Hamer, "a low level of novelty
seeking could be a predictor of smoking cessation. Indeed, average novelty seeking scores
were found to be significantly lower in former smokers than in current smokers. Those with
low levels of novelty seeking have an easier time giving up cigarettes than those with
high levels of novelty seeking."
"We found that individuals who have the SLC6A3-9 gene were one and a half times
more likely to have quit smoking than individuals lacking this gene," said Dr. Hamer.
"However," he cautioned that, "the SLC6A3-9 gene is not a strict
determinant of the ability to quit smoking, but rather an influence on an individual's
general need and responsiveness to external stimuli, of which cigarette smoking is but one
example. Hopefully, with more of an understanding of the genetics of cigarette smoking
behavior, we can develop more effective, targeted pharmacological and psychoeducational
cessation strategies that will take these individual differences into account."
### Articles: "Evidence Suggesting the Role of Specific Genetic Factors in
Cigarette Smoking," Caryn Lerman, Ph.D., Janet Audrain, Ph.D., and David Main, M.S.,
Georgetown University Medical Center, Neal R. Boyd, Ph.D., Fox Chase Cancer, Neil E.
Caporaso, M.D., Elise D. Bowman, M.S., Benjamin Lockshin, M.D., Peter G. Shields, M.D.,
National Cancer Institute, Health Psychology, Vol 18, No. 1. "A Genetic Association
for Cigarette Smoking Behavior," Dean H. Hamer, Ph.D., Sue Z. Sabol, Ph.D., Mark L.
Nelson, Ph.D., Craig Fisher, Ph.D., Lorraine Gunzerath, Ph.D., Cindy L. Brody, M.S.,
Stella Hu, M.S., and Leo A. Sirota, Ph.D., National Cancer Institute, Benjamin D.
Greenberg, M.D., Frank R. Lucas IV, B.S., Jonathan Benjamin, M.D., Dennis L. Murphy, M.D.,
National Institute of Mental Health, Stephen E. Marcus, Ph.D., National Institute of
Dental Research, Health Psychology, Vol 18, No.1.
(Full Text available from the APA Public Affairs Office or at http://www.apa.org/journals/hea.html)
The American Psychological Association (APA), in Washington, DC, is the largest
scientific and professional organization representing psychology in the United States and
is the world's largest association of psychologists. APA's membership includes more than
155,000 researchers, educators, clinicians, consultants and students. Through its
divisions in 50 subfields of psychology and affiliations with 58 state, territorial and
Canadian provincial associations, APA works to advance psychology as a science, as a
profession and as a means of promoting human welfare.
Note: This story has been adapted from a news
release issued by American Psychological Association for journalists and other members of
the public. If you wish to quote from any part of this story, please credit American
Psychological Association as the original source. You may also wish to include the
following link in any citation:
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New Link Between Smoking, Cancer Found
By Richard Woodman
04/09/2002 LONDON (Reuters) -
British researchers said on Tuesday they had identified a possible new mechanism that
might explain how smoking can cause breast and bowel cancer as well as lung cancer.
The team, at the Christie Hospital,
Manchester, UK, said they had found that smokers have significantly higher levels of
insulin-like growth factor (IGF) in their blood than non-smokers.
"We are excited about the findings of
this research as they indicate a possible new mechanism to explain the development of some
cancers," said research leader Dr. Andrew Renehan.
"This has potential implications for
cancer risk assessment and cancer prevention strategies in the future," he added in a
The findings were presented at the British
Endocrine Societies' meeting in Harrogate, YorkshireEurope's largest annual meeting
of hormone specialists.
Renehan said that other research had
recently established that IGF is linked to breast and colorectal cancer. This had prompted
his team to examine associations between smoking and IGF.
The team looked at cigarette smoking
histories in over 400 individuals, aged 55 to 65, attending a bowel cancer screening trial
in Manchester. The investigators found that long-term smoking significantly affected
levels of IGF and that this was related to length of use and number of cigarettes smoked.
"The findings were dose-related and
were statistically significant," he added in a telephone interview. "There was a
20% to 25% difference in IGF levels between the heaviest smokers and the
Asked about the likely biological
mechanism, he said it was known that growth factors could encourage cancer cell growth and
protect abnormal cells against natural death caused by apoptosis, the "cell
However, he said that a much larger study
would be needed to prove that smoking, IGF levels and cancer risk are all linked.
Three studies released last year by British
and American researchers suggest that common processes involving insulin signaling control
the ageing process in organisms ranging from yeast to quite possibly humans.
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