Smoking Research: 2016 News Updates
Smoking tobacco is linked to approximately six million deaths per year, according to the World Health Organization. Understandably, every year, more and more people are trying to quit smoking.
To assist in this effort, the American Cancer Society sponsors the Great American Smokeout each November. This year’s Smokeout takes place on Nov. 17, 2016 (the 3rd Thursday of Nov.), so now is a good time to review the research that was reported in 2016 regarding smoking and smoking cessation:
A Link Has Been Found Between Nicotine and Inflammation
Nicotine is a major cause of inflammatory diseases among smokers. It is also implicated in diseases among non-smokers, via passive inhalation, or secondhand smoke. Chronic obstructive pulmonary, or lung, disease (COPD) affects more than 10 percent of the adult population in western countries. Nicotine is believed to be a major underlying factor in many of these cases.
Recently a link was discovered between nicotine and inflammation. Nicotine was found to activate certain white blood cells in an unhealthy way. Neutrophils, the body’s most abundant type of white blood cells, release neutrophil extracellular traps (NETs), to swallow up offending microbes. NETs have been linked to tissue damage in certain inflammatory diseases, including vasculitis (inflamed small blood vessels), arthritis and cancer.
The hope is that this new discovery may lead to anti-inflammatory therapies for tobacco-related diseases.
Depleted Dopamine Chemicals in the Brain Can Return to Normal After Smoking Cessation
Researchers have found that smoking-related deficits in the brain chemical dopamine, which is part of the brain’s reward system, can return to normal after just three months of smoking cessation.
The findings suggest that altered dopamine function among smokers is a consequence of nicotine consumption, rather than the cause. Researchers think that brain circuits involving dopamine may predispose some people to addiction.
After three months of abstinence from smoking and nicotine replacement, initial brain scans revealed a 15-20% reduction in the capacity for dopamine production in smokers compared with nonsmokers.
The return to normal of dopamine levels suggests that treatments could be developed to normalize the dopamine systems of smokers.
Smokers Who Quit Tobacco Also Drink Less Alcohol
If you recently quit smoking, you are also more likely to attempt to cut down on your alcohol consumption.
In an observational study (where participants are observed and certain outcomes measured) it was noted that smokers often chose to restrict their alcohol consumption when they were also attempting to quit smoking. Researchers believe that the participants may have reasoned that by reducing their alcohol use, they’d be less likely to “light up” as well, since both behaviors often go hand-in-hand.
Alternatively, it could also be that people who drink less are more likely to quit smoking. If this is the case, smokers with higher alcohol consumption may need further encouragement to quit smoking.
E-Cigarette Manufacturers Make Unproven Claims About Safety
Sales of e-cigarette products are rising about 25 percent a year. Some people view e-cigarettes as a positive alternative to smoking tobacco. But researchers are skeptical about the ability of e-cigarettes to help smokers quit; and they worry that young people who start out smoking e-cigs may end up smoking tobacco cigarettes.
The law states that companies can no longer claim that their products help a person quit smoking, unless they provide scientific evidence to the FDA backing up the claim. Nor can they make advertising claims that e-cigarettes provide other unproven health benefits – as sleep aids or to boost sex drive.
Going “Cold Turkey” Found to be Best Quitting Strategy
A study of 700 adult smokers seems to indicate that the best way to quit smoking is to go cold turkey.
Study participants were divided into two groups. One had to quit abruptly on a given day, going from about a pack a day to zero. The other group tapered down over the course of two weeks, starting at a half a pack a day, and then going to a quarter of a pack before quitting. All participant used nicotine patches before they quit, plus second form of nicotine replacement, such as gum or nasal spray. They also had talk therapy with a nurse before and after their quit day.
Researchers checked in on participants four weeks after and six months after their quit date to see if they were still smoke-free. The researchers also measured carbon monoxide levels in participants’ lungs to see if they’d been smoking. They found that more people who had quit abruptly were able to stick with it – more than one-fifth of them, compared to about one-seventh in the other group.
Researchers surmised that, instead of giving people practice, the gradual reduction of cigarette consumption likely caused more cravings and withdrawal to be present prior to quit day, making it more difficult for these people to quit than those who had not smoked, leading up to the quit day.
In other studies, participants who do not get behavioral support and nicotine replacement therapy prior to initiating their quit day, had little success in stay remaining smoke-free.
Stop Smoking Aids All About Equally Effective
While some studies show that cessation medications help smokers quit, recent evidence suggests that a more comprehensive approach could be better. The nicotine patch, the drug Chantix, and a combination of the patch and lozenges all appear to work equally well.
Six months after quitting, the quit rate for users of the patch was 23 percent; it was 24 percent for users of Chantix, and 27 percent for those who used a combination of the patch and lozenges. This is significant because many people are wary of taking Chantix because of its side effects.
In the comparison study, people taking Chantix had more frequent side events, including vivid dreams, insomnia, nausea, constipation, sleepiness and indigestion. However, findings from the study may have been skewed because of the particular smoking habits of participants. Most people in the study were light smokers, who typically smoked less than a pack a day. Most had tried to quit before. Their prior experiences with quitting, the fact that they were not heavy smokers, their motivation to quit, and the provision of counseling sessions most likely had an impact on their quit success, regardless of the use of medication, researchers said.
Stop Smoking Resources
Freedom From Smoking Online (American Lung Association) – The Lung Association’s smoking cessation program, now available online for free.
Centers for Disease Control and Prevention webpage – Quitting Fact Sheet; Tips for Quitting; other Resources and Information
Free Live Phone Support:
National Cancer Institute’s Smoking Quitline: 1-877-44U-Quit (877-448-7848) – Proactive phone counseling by trained personnel; English and Spanish: Monday through Friday 8:00 a.m. to 11:00 p.m., Eastern time.
A. Hosseinzadeh, P. R. Thompson, B. H. Segal, C. F. Urban. Nicotine induces neutrophil extracellular traps. Journal of Leukocyte Biology, 2016
Lena Rademacher, Susanne Prinz, Oliver Winz, et al: Effects of Smoking Cessation on Presynaptic Dopamine Function of Addicted Male Smokers. Biological Psychiatry, 2016
Jamie Brown, Robert West, Emma Beard, et al:. Are recent attempts to quit smoking associated with reduced drinking in England? A cross-sectional population survey. BMC Public Health, 2016;
Elizabeth G. Klein, Micah Berman, Natalie Hemmerich, et al: Online E-cigarette Marketing Claims: A Systematic Content and Legal Analysis. Tobacco Regulatory Science, 2016
Nicola Lindson-Hawley, PhD; Miriam Banting, MSc; Robert West, et al; Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Noninferiority Trial; Annals of Interaln Medicine, 2016
Michael Fiore, M.D., M.P.H., professor and director, University of Wisconsin Center for Tobacco Research and Intervention, Madison; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Patricia Folan, D.N.P., director, Center for Tobacco Control, Northwell Health, Great Neck, N.Y.; Jan. 26, 2016, Journal of the American Medical Association
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