Better Use of Nicotine Replacement Therapies Can Help Smokers Quit

MedicalResearch.com Interview with:

Dr Nicola Lindson PhD CPsycholCochrane Tobacco Addiction Group (TAG) Managing Editor & Senior Researcher Nuffield Department of Primary Care Health Sciences,University of Oxford 

Dr. Lindson

Dr Nicola Lindson PhD CPsychol
Cochrane Tobacco Addiction Group (TAG) Managing Editor & Senior Researcher
Nuffield Department of Primary Care Health Sciences,
University of Oxford
 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: People have been using nicotine replacement therapy, otherwise known as NRT, to quit smoking for more than 20 years. NRT is available in a range of forms: skin patches, chewing gum, nasal and oral sprays, inhalators, and lozenges. We have good evidence that it is safe and that it helps more people to quit than trying to stop smoking using no medication.

We carried out a systematic review to try and find out what the best ways are to use NRT to maximise a person’s chances of quitting successfully. We did this by looking at studies that compared at least two different types of NRT use, such as higher versus lower doses, or longer versus shorter use.

The takeaway message from the review is that using more nicotine (in the form of nicotine replacement therapy, ) to aid quitting can help more people to stop smoking in the long-term. There is high quality evidence that using two forms of nicotine replacement at the same time – a patch as well as a faster-acting form such as gum – increases chances of quitting, and evidence also suggests that starting to use nicotine replacement before the day you give up cigarettes can help more people quit than beginning use on the day you stop.

There is no evidence that using more nicotine replacement is harmful when used as directed. Continue reading

Parents: Vaping is Drawing Adolescents into Nicotine Use

MedicalResearch.com Interview with:

Richard Miech Ph.D Professor Principal Investigator, Monitoring the Future Institute for Social Research University of Michigan

Dr. Miech

Richard Miech Ph.D
Professor
Principal Investigator, Monitoring the Future
Institute for Social Research
University of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: Every year Monitoring the Future conducts a survey to examine trends in adolescent substance use.  We draw a random sample of schools from a list of all schools in the United States and conduct our survey in ~400 schools.  Our survey is representative of U.S. 8th, 10th, and 12th grade students.  In other words, our results are what you would find if you surveyed every single 8th, 10th, and 12th graders in the United States, within the bounds of a small sampling error of a few percentage points.

An increase in vaping is the big news for 2018.  In 10th and 12th grade the increase in nicotine vaping was the largest we’ve ever seen for any substance in the past 43 years.  As a result of this increase in nicotine vaping, overall use of nicotine increased as well, which suggests that vaping is drawing youth into nicotine use.  We also saw a significant increase in marijuana vaping. Continue reading

Should Nicotine Content of Cigarettes Be Reduced Gradually or Suddenly?

MedicalResearch.com Interview with:

Dorothy K. Hatsukami, Ph.D. Forster Family Professor in Cancer Prevention Professor of Psychiatry Associate, Director Masonic Cancer Center University of Minnesota

Dr. Hatsukami

Dorothy K. Hatsukami, Ph.D.
Forster Family Professor in Cancer Prevention
Professor of Psychiatry
Associate, Director Masonic Cancer Center
University of Minnesota 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The U.S. Food and Drug Administration is considering a rule that would reduce nicotine in all cigarettes and possibly other burned tobacco products sold in the U.S. to minimally addictive levels.   Reducing nicotine in cigarettes does not make the cigarette safer, but because nicotine is the addictive chemical in tobacco, nicotine reduction would reduce the progression towards tobacco dependence and make it easier for smokers to quit smoking.  We recently published a study in JAMA that adds to the accumulating evidence to support reducing nicotine in cigarettes and addresses if a gradual reduction or a targeted immediate reduction in nicotine in cigarettes is the best approach.

In a large clinical trial involving 1,250 smokers across 10 academic institutions, immediate reduction of nicotine was compared to a gradual nicotine reduction approach. These two groups were also compared to smokers who continued to smoke usual nicotine content cigarettes.

Key findings showed that immediate nicotine reduction is likely to result in more rapid positive public health effects.  That is, smokers in the immediate reduction group experienced significantly less exposure to toxic cigarette smoke chemicals and reported smoking fewer cigarettes per day, less dependence on cigarettes and greater number of days that they were smoke-free compared to the other two groups. On the other hand, smokers in the immediate nicotine reduction group experienced more severe but transient withdrawal symptoms and greater drop-outs.  Continue reading

Can Propranolol Reduce Nicotine Cravings?

MedicalResearch.com Interview with:

Lin Lu, M.D. Ph.D. Director/Professor, Institute of Mental Health and Peking University Sixth Hospital Director/Professor, National Institute on Drug Dependence, Peking University Beijing China

Dr. Lin Lu

Lin Lu, M.D. Ph.D.
Director/Professor, Institute of Mental Health and Peking University Sixth Hospital
Director/Professor, National Institute on Drug Dependence, Peking University
Beijing China

MedicalResearch.com: What is the background for this study?

Response: Nicotine addiction is the leading preventable cause of mortality, and causes over 6 million deaths each year. One fundamental mechanism that maintain smoking relapse in smokers is the persistence of memories of both nicotine reward and nicotine-associated conditioned stimulus (CS, e.g. ashtray,cigarette lighters, etc.).Preclinical studies suggest that the drug reward memories can be reactivated by nicotine-associated CS undergo an unstable stage, named memory reconsolidation, and that pharmacological or behavioral manipulations that interfere with reconsolidation inhibit subsequent drug relapse.

However, most of the translational studies targeting reconsolidation stages of the drug reward memory have not been successful.One important reason is that when participants were exposed to nicotine-associated CS to induce memory reconsolidation, the pharmacological or behavioral manipulations only interfere with the reconsolidation of memories selectively associated with the reactivated CS, without affecting other CSs.

However, in real life, smoking is associated with multiple CSs that vary across individuals. Thus, a key question is how to interfere with reconsolidation of multiple nicotine-associated memories . In the present study, we introduce a novel memory reconsolidation interference procedure in which we reactivated multiple nicotine reward memories in rats and human smokers by acute exposure to nicotine (the UCS) and then interfered with memory reconsolidation using the noradrenergic blocker propranolol, an FDA-approved drug.

Continue reading