New Ways to Kick the Smoking Habit
January 9th, 2009 | by admin |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 weeks.
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 New York.
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 free.
“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 work.”
“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 not.”
Tried-and-True Treatments
“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.
By Jeanie Davis WebMD Medical News
