Getting a head start on Pfizer’s anti-smoking drug Chantix may help smokers kick the habit, according to a preliminary study funded by the company. More than a third of smokers who started on the drug a month before quitting were still completely smoke-free 3 months later. That compared to about one in seven of those who only started Chantix the recommended one week before they quit.

Although researchers warn the study was short and needs to be confirmed, they say it hints that decreasing smoking pleasure — one of Chantix’s effects — early on might help smokers stay off cigarettes over the long haul.

Writing in the Archives of Internal Medicine, Peter Hajek of the UK Center for Tobacco Control Studies and colleagues compare the effect to making food look unappealing.

“The level of hunger pangs may be the same, but it is easier to resist a food that has become less tempting,” they note.

Chantix has been approved in the U.S. since 2006, but reports of suicidal thoughts and other mental health problems in users led health officials to order a “black box” warning on the drug in 2009.

Medical alternatives to Chantix – which costs a few hundred dollars per month — include nicotine patches and GlaxoSmithKline’s Zyban, which also carries a black box warning.

The researchers tested 101 middle-aged smokers from a stop-smoking clinic in London. They randomly assigned half of them to start Chantix 4 weeks before quitting, while the rest got a sugar pill for the first 3 weeks and then switched to Chantix as well.

After the first 3 weeks, the participants on Chantix smoked less and said they didn’t enjoy it as much as before. More than one in three of them had cut the number of cigarettes they smoked by half, compared to only one in ten of the people who started out on sugar pills.

Both groups had a lot of nausea, with nearly six in 10 of the early-starters reporting at least one episode over the study.

In an editorial in the journal, Dr. Joel A. Simon of the San Francisco VA Medical Center calls the new findings “exciting,” but says longer studies are needed.

One in five Americans smokes, he notes, and only between 4 and 7 percent of those who try to stop succeed. Researchers estimate that half of all smokers die prematurely of a smoking-related illness.

“There already exists a sufficient evidence base for counseling and drug interventions that if broadly, wholeheartedly, and effectively implemented would likely result in decreased tobacco-related misery,” he added.

Recent studies have shown that those who smoke menthol cigarettes may have a harder time kicking the smoking habit. Racial or ethnic minority smokers who choose to smoke menthol cigarettes have a lower quit rate than those of the same bracket who smoke regular cigarettes. The distinction is greater among smokers who are younger.

Menthol cigarettes have been shown to contain higher levels of carbon monoxide, cotinine and nicotine in each cigarette, as compared to regular cigarettes. Menthol cigarettes use the menthol compound produced from mint oils to create a cooling sensation in the mouth. The result, according to Jonathan Foulds, Ph.D., professor of Public Health Sciences at Penn State College of Medicine, could be that smokers inhale more nicotine per cigarette and so become more addicted. Thus, economic pressures may mean that people smoke menthols in order to get the most nicotine from fewer cigarettes.
The results of the study were published in the journal Nicotine and Tobacco Research. The research compiled data from ten published studies on patterns of menthol smokers versus regular smokers. Not all studies found a relation between menthol and quitting, but the effects of menthol on quitting were more greatly pronounced in younger smokers, and especially African-American and Latino smokers.

The December issue of CEBP, a journal of the American Association for Cancer Research, is designed to provide researchers with the critical tools to conduct research directed to assisting decision-makers, such as those at the U.S. Food and Drug Administration (FDA), with a comprehensive review of the most up-to-date research on tobacco use. The journal includes nine review articles by leading experts in the field and covers topics from clinical trail design to how to best assess toxicity levels in new tobacco products. Shields is lead investigator for a series of papers in the issue.

“The FDA will soon grapple with very challenging issues,” Shields says. “It cannot ban tobacco entirely, and its policy makers will need to address a unique paradigm — how to regulate and balance health risks with continued protection of an industry whose products harm and kill people when used as intended.”

Shields says the special issue of CEBP will provide the FDA and those who serve on the FDA’s tobacco advisory panel with a strong scientific context to move tobacco regulation forward.

“Still, it is evident that not much scientific data are available to support the type of tobacco regulation that we would like to have today which could lead to a substantial drop in the tobacco-related diseases and deaths,” Shields explains. “Perhaps this lack of data will help drive more funding for this under-researched area. These papers identify the strengths, limitations and research gaps for a wide spectrum of tobacco research methods.”

The reviews in CEBP will also help inform future research by describing some of the strategies that might be applied when assessing differences in product risk and harms. Additionally, the issue features several studies on lung cancer in minorities, risk for experimentation, the impact of popular culture and the effect of alternative products like herbal cigarettes.

Shields he has served as an expert witness on behalf of plaintiffs in tobacco-related litigation.
ScienceDaily, Dec. 3, 2009

The tobacco industry has side stepped laws banning advertising and promotion by skilfully marketing cigarettes to reel in smokers according to a new Cancer Research UK study* yesterday (Monday).

Between 2003 and 2005 the Tobacco Advertising and Promotions Act (TAPA) outlawed all tobacco advertising. Since then the tobacco industry has invested heavily in their packaging, with cleverly marketed new brand names, colours, sizes, shapes and materials to attract new smokers and help keep existing smokers from switching brands.

The researchers monitored retail, marketing and tobacco industry magazines to identify new packaging. Then they tracked three different categories of packaging.

1) Value based packaging is used to communicate value for money so offers larger or smaller packs at cheaper prices.

2) Image based packaging uses new pictures, colours and designs that appeals to target groups. Floral patterns, images such as racing cars, holograms, silver and gold colours have all been introduced to packs since the ban.

3) Innovation based packaging involves the pack itself being changed, with new packs switching from cardboard to metal, having side openings, or being hexagonal shaped.

The researchers cite the introduction of picture warnings on packs as an example of where they believe pack design has been altered to undermine the anti tobacco images.

In the four months after the graphic pictures were added the tobacco industry went into overdrive adding more new distracting images to packs during that period than for the previous four years.

These measures are all designed to make tobacco appear glamorous and desirable despite more than 114,000 people in the UK dying each year from smoking-related diseases including cancers.

Professor Gerard Hastings , lead researcher based at the Institute for Social Marketing at the University of Stirling, said: “Tobacco packaging is no longer the ‘silent salesman’ it once was, now it shouts loudly. These screams for attention are used to defy advertising bans and drown out health warnings. The industry will fight tenaciously but the only consistent and effective policy response is generic packaging.

“Contrary to the public pronouncements of the tobacco industry, the pack is an important promotional tool that is being used more aggressively and effectively as other channels are removed and health warnings are strengthened.”

Jean King, Cancer Research UK’s director of tobacco control, said: “Marketing tobacco hasn’t stopped simply because we don’t see cigarettes advertised in our magazines and on billboards or TV. The tobacco industry has simply adapted its marketing skills to attract customers with packaging.

“The advertising ban was bought in to protect children from tobacco promotion. The slick designs and attractive branding used to promote tobacco should no longer be allowed in the UK. The harsh reality is that half of all long term smokers will die from this deadly addiction. We urge the government to close the loophole and enforce plain packaging for all tobacco products.”

Notes

* Making the pack the hero, tobacco industry response to marketing restrictions in the UK: Findings from a long-term audit. Crawford Moodie, PhD; Gerard B Hastings, PhD International Journal of Mental Health & Addiction

Source
Cancer Research UK