Reduction In Nicotine Craving Predicts Ability To Quit Smoking

From Science Daily

The stronger the reduction in nicotine craving after smoking the first cigarette in the morning, the more difficult it will be to quit smoking, according to a Yale School of Medicine study in Drug and Alcohol Dependence.

In a study of 207 smokers, the researchers found significant reductions in craving, withdrawal and mood after smoking the first cigarette of the day. The greater the craving reduction, the more likely the smoker would relapse, said Benjamin Toll, assistant professor in the Department of Psychiatry and lead author of the study.

“This preliminary study provides evidence that there are significant changes in craving, withdrawal, and affect related to smoking the first cigarette of the day, with the largest of these changes observed for craving,” Toll said. “Moreover, changes in tobacco craving in response to the first cigarette of the day may be a novel predictor of smoking relapse that should be tested in future studies.”

Toll said it is known that smokers who light up immediately after waking are more dependent on nicotine and may have more trouble quitting smoking than those who do not. Existing evidence also suggests that individuals who experience less light-headedness in response to the initial cigarette of the morning are generally heavier smokers with a longer smoking history.

What has not been studied extensively, he said, and what was examined in this study are changes in craving and mood in response to the first cigarette of the day and examining the relationship of these changes to treatment outcome.

The standard measures of dependence include the Fagerström Test for Nicotine Dependence, which asks smokers how soon after they wake up do they smoke; do they find it difficult to refrain from smoking in places where it is forbidden; which cigarette do they most hate to give up; how many cigarettes do they smoke daily; is smoking more frequent earlier in the day after waking; and do they smoke when bedridden with an illness. Other measures include time to first cigarette, carbon monoxide in exhaled air, level of cotinine, a byproduct of nicotine, in the blood, daily cigarette consumption, and number of years smoking.

Co-authors include Ty Schepis, Stephanie O’Malley, Sherry McKee, and Suchitra Krishnan-Sarin of Yale. Published in Drug and Alcohol Dependence: (May 2007). The research was supported by the National Institutes of Health.

Note: This story has been adapted from a news release issued by Yale University.

Help And Resources For Arizona Smokers Looking To Quit As Smoking Ban Takes Effect

From www.medicalnewstoday.com

There are close to one million adult smokers in the state of Arizona. On May 1st, they will have an added incentive to quit as Arizona implements a statewide smoking ban that prohibits indoor smoking in public places and will require a 20-foot smoke free zone around entrances to businesses. Policy changes like the new smoking ban, and the recent 80-cent tax increase, will encourage many to initiate a quit attempt. Many smokers can use these changes to their environment as the motivation they need to try to quit. To give them a better chance of succeeding than going "cold turkey," GlaxoSmithKline (GSK) Consumer Healthcare recommends that they have access to counseling, behavioral support programs, and FDA-approved safe and effective stop-smoking products.

Nearly 70 percent of smokers nationwide want to quit; however, many people wrongly believe they can simply put down their cigarettes and walk away forever. But while "cold turkey" is the most common method people try, it is also the least successful. In fact, 97 percent of all cold turkey quit attempts fail.

"Quitting smoking can be one of the most difficult and most important steps a smoker can take to improve his or her overall health," said Dr. Keith Kaback, Chairman of the Board of the Tucson region American Lung Association, emergency physician at Tucson Medical Center and GSK Consumer Healthcare spokesperson. "With tobacco use being the leading preventable cause of death in the U.S., it's important to provide smokers who are interested in quitting with tools and resources to help them quit for good."

Quitters can double their chances of success by using therapeutic nicotine products to help reduce craving and nicotine withdrawal symptoms. GSK Consumer Healthcare's therapeutic nicotine products, Nicorette(R) gum, NicoDerm(R) CQ(R) patch, and Commit(R) lozenge are designed to provide a temporary alternative source of nicotine, without exposing the quitter to the more than 4,000 chemicals and at least 69 known or suspected carcinogens in tobacco smoke. People interested in quitting smoking are encouraged to visit http://www.Way2Quit.com to create a customized smoking cessation plan based upon their habits, behaviors, and motivations for smoking and quitting.

Employers Help Employees Get Ready for Smoking Ban

From Wane.com

Fort Wayne has toughest smoking ordinance in the state that bans smoking in every public place. With two and half months to go before the ban takes effect, employers are helping employees kick the habit.

In Fort Wayne places to light up will soon be few and far between. Dick Conklin of Tobacco Free Allen County said cities with smoking bans do have fewer smokers. "We know from research most smokers want to quit smoking and this forces them to do it," he said.

Only about a 1/3 of smokers will take those classes and it takes a lot more then a seminar to stop the addiction. "Success rate is 25 percent with the class only. Add a nicotine replacement therapy and it doubles. A new class of drugs, Chantix, is amazing. 90 percent of the people are successful," said Conklin.

The new drug is available by prescription only, and some businesses are offering it to employees for free. According one Fort Wayne code enforcement officer, other companies are trying to accommodate their smokers by adding outdoor decks that are the required 20 feet from their building, but that could be more complicated then it sounds. "We refer them to the building department because those are things you need to get permits for," said Fire Marshal James Murua.

While many places and people are being proactive to comply with the ban, some will be scrambling come June first to meet the law's requirements.

"Many people take the attitude I want to see it before I believe it. Procrastination, it's human nature," said Conklin. There will be several smoking cessation classes open to the public if your employer doesn't offer one. A schedule is currently being decided on. The price is 15 dollars a person.

Nicotine’s role in quitting smoking – why it is so hard to quit.

One the reasons many people struggle when quitting smoking is that cigarettes contain nicotine. Nicotine is a stimulant drug which can also be found in tomatoes, potatoes and eggplant but obviously in much smaller quantities. Nicotine is distributed in the body by the bloodstream. The amount of nicotine that actually enters the user’s bloodstream depends on a number of factors. Chewing tobacco tends to be worse than smoking it and even when smoking tobacco, factors such as the amount the user inhales, the type of tobacco and whether the cigarette had a filter also plays a part.

Nicotine is a very addictive drug. The addictive qualities of nicotine can perhaps be best demonstrated by the numbers of people who go back to smoking following surgery as a result of developing a smoking related disease. In fact, the Royal College of Physician published a report in February 2000, Nicotine Addiction in Britain, stating “Cigarettes are highly efficient nicotine delivery devices and are as addictive as drugs such as heroin or cocaine”.

If nicotine is so addictive why do smokers start smoking? Users will often tell you nicotine does have some desirable effects. As the drug is a stimulant, it can make the user feel more alert and improve concentration and memory. Other users get the feeling of calm and relaxation, these desirable feelings produces a great deal of pleasure. Due to the nature of nicotine, it can increase the user’s metabolic rate which in turns suppresses their appetite and may result in weight loss. The effects of nicotine vary from 5 minutes to 2 hours but as the user builds a tolerance to the drug, the effects of nicotine do not last as long as they do initially.

As with any drug, users suffer with withdrawal symptoms when they cease consuming it. Common symptoms include:

• irritability
• anxiety
• restlessness
• difficulties in maintaining concentration
• sleeping pattern disturbances
• increased appetite (due to slowing of metabolic rate)
• weight gain

The reputation of the withdrawal symptoms is often enough to stop many people from even trying to quit smoking. Although it sounds tough, there are techniques and systems which can make it easier for people who desire to quit, but people must desire it!

More colleges adopt smoking bans for dorms

News from pennlive.com

Snuffing smoking is becoming a college trend.

Eight Pennsylvania colleges, including Franklin & Marshall College, the University of Pennsylvania and Indiana University of Pennsylvania, have banned smoking in residential housing, according to the American Nonsmokers' Rights Foundation. More than 40 colleges nationally have banned smoking on their campuses.

Mary Dubroff, a spokeswoman at F&M, said that the campus discourages smoking and teaches wellness. Tall, black cigarette receptacles sit near many campus buildings to capture the smoke, rather than letting it disperse, Dubroff said.

But some students, such as F&M sophomore Shabab Manzoor, are against the ban.

"The policy is really frigid," Manzoor said. "At the end of the day, it's my choice to smoke or not."

Penn State York senior George Kapterian, a nonsmoker, said he's for the smoking ban at colleges because "it's better for everyone." But he said that he can see both sides of the issue.

"I don't believe students should suffer because of the smokers. But it's not fair to tell smokers what to do and what not to do, either," he said.

Penn State York has designated smoking areas near a few buildings, but there is no smoking in front of any of the building entrances, said Bill Vangreen, director of safety and security. Vangreen said he supports smoking bans to help decrease secondhand smoke.

Kutztown University spokesman Philip Breeze said that a ban would "avoid having one person's habit affect someone else's health." Smoking is prohibited in Kutztown's buildings, but students are allowed to smoke around campus.

Dinesh Asnani, a Penn State Harrisburg senior and nonsmoker, said it's a good idea to have designated smoking areas on campus because that can force smokers to try to quit.

"Smoking is an expensive and unhealthy habit," he said. "If we make it an inconvenience for them, maybe they'll think more about where and when to smoke so they can realize that it's not a good habit."

Penn State Harrisburg prohibits smoking in its buildings, at building entrances and in university vehicles, but designated smoking areas are being considered, said Donald Holtzman, senior director of student life and enrollment services.

"Counseling services for students or faculty who want to quit the habit are also offered," Hevner said. "We all know the dangers of smoking, so limiting it is a good idea."

At Lebanon Valley College, smokers have to be at least 20 feet from campus buildings to puff away, spokeswoman Lauren Cusick said.

"Not smoking tends to make everyone a little healthier and happier," said Elwood Brandt, an LVC resident assistant and junior. A ban "motivates smokers to quit, and I wouldn't mind if it happened here, too," he said.

Marin Bendoritis, a Penn State Harrisburg freshman in the public policy program, believes that a smoking ban on campus would be unfair but supports the idea of designated smoking areas. She considers herself to be a social smoker.

"I would definitely disobey a complete smoking ban policy and try to fight it because then we have nowhere to go for a few quick puffs between classes," she said.

Like Bendoritis, freshman Joseph McAndrew, studying advertising and public relations at Penn State Harrisburg, said he wouldn't obey a smoking ban because it violates his freedom of choice.

At Elizabethtown College, there are no designated smoking areas or restrictions to smoking outdoors, spokeswoman Mary Dolheimer said. But "smokers usually are courteous enough to nonsmokers" when they smoke, she said.

Not many students complain openly about smokers, college officials said.

"Students only complain when smokers stand right in front of building entrances, but even then they are considerate enough to move out of the way," said Roger Serr, acting vice president for student affairs at Shippensburg University.

Harrisburg Area Community College's building and grounds committee is considering the issue of smoking on campus, said Patrick Early, executive director of public relations.

"Many times, students don't put out their cigarettes, and the materials stay on the ground for a very long time, so it becomes a littering issue," Early said.

Quit-Smoking Diet - more vegetables, less meat

Article from www.onhealth.com

Some Foods Make Cigarettes Taste Terrible; Others Boost Tobacco Taste

Getting ready to quit smoking? Try eating more vegetables and less meat -- and swap that coffee for a glass of milk.

A Duke University study shows that fruits, vegetables, and dairy foods make cigarettes taste terrible. But meat, coffee, and alcoholic beverages make smoking much tastier, find Duke University psychologist F. Joseph McClernon, PhD, and colleagues.

"The conventional wisdom is that cigarette addiction is all about the nicotine," McClernon tells WebMD. "But we are learning more and more it is also about sensory effects like the taste and the smell and the visual experience and the habitual routines of smoking. The taste effects are important."

McClernon, a researcher at the Duke center for nicotine and smoking research, kept hearing smokers say that certain foods and beverages made their cigarettes taste much better. He began to wonder exactly which foods these were -- and whether any foods made smoking a worse experience.

To study the issue, he asked 209 smokers to list foods that worsened or enhanced the smoking experience. The smokers averaged a little better than a pack of cigarettes a day for an average 21 years. About half were women, a fourth were black, two-thirds were white, and nearly all of them were high-school or college graduates.

Nearly 70% of the smokers said some foods made their cigarettes taste better. These foods tended to be caffeinated beverages, alcoholic beverages, and meat.

Surprisingly, just under half of the smokers -- 45% -- said some foods made their cigarettes taste worse. These foods tended to be fruits and vegetables, noncaffeinated beverages such as water and juice, dairy beverages, and dairy foods.

"We were surprised that smokers would say anything would make their cigarettes taste worse," McClernon says.
Black Smokers at Greater Risk

Another surprise: Menthol-cigarette smokers were very likely to say that their cigarettes tasted the same no matter what kind of foods and beverages they consumed. Nearly 90% of the black study participants smoked menthol cigarettes.

This means that black smokers may have a particularly hard time quitting cigarettes, suggests Scott McIntosh, PhD, associate professor of medicine at the University of Rochester in New York and director of the greater Rochester area tobacco cessation center.

McIntosh says most experts think the reason why black Americans are more likely to smoke menthol cigarettes is because they were targeted to do so by tobacco-company ads, McIntosh tells WebMD. "But this study suggests that menthol lessens the effect of taste deadening or enhancing. And you are more likely to be addicted if you are not affected by variations in taste and pleasure."

McClernon and McIntosh note that counselors tell people who quit smoking to drink lots of water and to eat carrots and celery sticks.

"The idea is to get the smoker to do something with the hands and mouth that is not smoking -- but it might actually be good to engage in some of these behaviors before quitting, to alter the taste," McClernon says. "We might ask clinicians to ask patients getting ready to quit to start consuming healthy dairy products also to see if they can alter their smoking behavior that way."

McIntosh says this is an exciting idea that will add to the repertoire of quit-smoking counselors. He looks forward to suggesting the technique to the counselors he trains.

"And this emboldens me for a strategy we use called habit breaking," he says. "The idea is to switch to a different brand of cigarettes -- and smokers say brand has a dramatic effect on taste. So if taste is such a predictor of enjoyment, this is a good reason to tell people to switch brands as a quitting strategy. It might be even more powerful than we are thinking."

McClernon says he doesn't know why some foods make cigarettes taste worse but he plans to find out.

"We are going to do research to try to understand why drinking water and eating fruits and vegetables worsens the taste of cigarettes," he says. "We don't have a lot of super good ideas about that right now. But if we understood the mechanisms, we could maybe use them to develop new treatments."

Smokers, particularly teen smokers, tend to have a poorer diet than nonsmokers do. So while quitting smoking may be the best thing you can do for your health, it isn't the only thing, suggests Avery M. Lutz, a Duke research technician who worked on the McClernon study.

"It can't hurt to eat more fruits and vegetables even before people quit smoking. It will help them have a healthier life," she tells WebMD.

The McClernon study appears in the April issue of the journal Nicotine & Tobacco Research.

Genes may help some quit smoking

Posted by the Asbury Park Press on 04/6/07

HEALTHDAY

Smokers without certain DNA may face an even tougher battle kicking the habit, new research shows.

A U.S. study finds that people who were able to quit smoking had variants in 221 genes that weren't found in smokers who weren't able to kick the habit. The researchers analyzed 520,000 genes taken from blood samples.

"The long-term hope is that identifying these genetic variables in smokers will help us determine which type of treatment would be most effective," Jed Rose, director of Duke University's Center for Nicotine and Smoking Cessation Research, in Durham, N.C., said in a prepared statement.

His team published the study online Monday in the journal BMC Genetics.

The findings suggest that doctors may be able to tailor smoking cessation programs to a person's individual genetic makeup, the researchers said.

"Knowing a smoker's genetic makeup could indicate how intensely they need to be treated. People who are having trouble quitting because of their genes might need more treatment to overcome their addiction," Rose said.

The scientists said they understood the function of 187 of the 221 gene variants that were present only in smokers who had been able to quit. The functions of the remaining gene variants still need to be determined.

"We also found that at least 30 of the genes that we had previously identified as playing roles in dependence to other drugs also contribute to nicotine dependence. These findings lend further support to the idea that nicotine dependence shares some common genetic vulnerabilities with addictions to other legal and illegal substances," George Uhl, a neurologist and neuroscientist in the molecular neurobiology branch of the National Institute on Drug Abuse, said in a prepared statement.