Author Interviews, NEJM / 19.12.2014

natalie_walkerMedicalResearch.com Interview with: Natalie Walker, Ph.D. National Institute for Health Innovation School of Population Health, University of Auckland Auckland, New Zealand Medical Research: What is the background for this study? What are the main findings? Dr. Walker: Cytisine is a plant-based alkaloid and is structurally similar to nicotine.  It is found in various plants from the Legume Family (Fabaceae), the third largest plant family on earth.  Cytisine is currently manufactured by Sopharma Ltd, Bulgaria (Tabex®) and Aflofarm Pharma, Poland (Desmoxan®) as a smoking cessation treatment, with the cytisine used in the tablets taken from a plant called Golden Rain (Laburnum anagyroides).  Cytisine has been available with and without prescription for smoking cessation since the 1960s, largely in Eastern Europe.   Cytisine is not currently registered for use in any Western countries (although regulatory approval is currently been sought for the USA , UK and Japan).             We know from trial evidence that cytisine is better than a placebo for helping people quit smoking.  Cytisine is also one of the most affordable smoking cessation medicines available. It is much cheaper than nicotine patches, gum and/or lozenges and other smoking cessation medicine such as varenicline. This means smokers and governments are more likely to afford cytisine, especially those from low and middle income countries. However, we don’t know if cytisine is as good as nicotine patches and/or gum or lozenges, one of the most commonly used smoking cessation treatments in many western countries. We therefore undertook a pragmatic non-inferiority trial to answer this question, with recruitment of 1310 adult daily smokers who were motivated to quit, undertaken using the New Zealand national Quitline. Smokers were randomised to receive the standard 25 days of cytisine treatment or 8 weeks of nicotine patches and/or gum or lozenges.  Both groups received standard Quitline behavioural support.  Follow-up occurred at one week and one, two, and six months. At all time points, cytisine was found to be better at helping people quit smoking than nicotine patches and/or gum or lozenges.  This finding was consistent irrespective of ethnicity, age, alcohol consumption, degree of cigarette dependence or whether participants smoked factory-made cigarettes or roll-your-owns. For reasons unknown, cytisine helped more women quit smoking than nicotine patches, gum and/or lozenges.  For men the effectiveness of the two products was similar.  Cytisine use made people less likely to relapse back to smoking. Those who did smoke when using cytisine didn’t enjoy smoking as much, and reduced the number of cigarettes they smoked.  Self-reported, non-medically verified adverse events were more common in those that used cytisine. Three out of every 10 people who used cytisine reported an adverse event, compared to 2 out of every 10 that used nicotine patches, gum and/or lozenges.  However the majority of reported side effects were mild and self-limiting. More people in the cytisine group experienced nausea, vomiting and sleep disturbances (e.g. bad dreams). (more…)
Author Interviews, CDC, Cost of Health Care, Smoking / 17.12.2014

MedicalResearch.com Interview with: Xin Xu, Ph.D. Senior Economist Office on Smoking and Health and Darryl Konter Health Communications Specialist McNeal Professional Services Centers for Disease Control and Prevention Office on Smoking and Health Atlanta, GA 30341 Medical Research: What is the background for this study? What are the main findings? Response: Tips From Former Smokers (Tips), the first federally funded national mass media antismoking campaign, launched by the CDC, provides a unique opportunity to assess the cost effectiveness of a nationwide public health intervention that meets the ad exposure recommendation in CDC’s 2014 Best Practices for Comprehensive Tobacco Control Programs.  The 2012 campaign spent $393 per year of life saved—far less than the $50,000 per year of life saved figure used as a common threshold for cost-effectiveness. The campaign  added about 179,000 healthy life years, at $268 per healthy year gained. The campaign spent about $480 per smoker who quit. The campaign averted more than 17,000 premature deaths, at a cost of about $2,200 per premature death averted. (more…)
Author Interviews, Cost of Health Care, Smoking / 14.12.2014

MedicalResearch.com Interview with: Darryl Konter Health Communications Specialist McNeal Professional Services Centers for Disease Control and Prevention Office on Smoking and Health Atlanta, GA 30341 Medical Research: What is the background for this study? What are the main findings? Darryl Konter:         Fifty years after the first Surgeon General’s report, tobacco use remains the nation’s leading preventable cause of death and disease, despite declines in adult cigarette smoking prevalence. Smoking-attributable healthcare spending is an important part of overall smoking attributable costs in the U.S.         Data came from the 2006–2010 Medical Expenditure Panel Survey (MEPS) linked to the 2004–2009 National Health Interview Survey (NHIS). The MEPS is a nationally representative survey of civilian non-institutionalized families and individuals, their medical providers, and employers that collects information on individual healthcare utilization and medical expenditures.         By 2010, 8.7% of annual healthcare spending in the U.S. could be attributed to cigarette smoking, amounting to as much as $170 billion per year.  More than 60% of the attributable spending was paid by public programs, including Medicare, other federally-sponsored programs, or Medicaid. (more…)
Author Interviews, CDC, Smoking / 30.11.2014

MedicalResearch.com Interview with: Darryl Konter Health Communications Specialist, Office on Smoking and Health at Centers for Disease Control and Prevention Medical Research: What is the background for this study? What are the main findings? Response: Tobacco use is the leading cause of preventable disease and death in the United States, resulting in more than 480,000 premature deaths and $289 billion in direct health care expenditures and productivity losses each year. Despite progress over the past several decades, millions of adults still smoke cigarettes, the most commonly used tobacco product in the United States. Cigarette smoking among U.S. adults declined from 20.9% in 2005 to 17.8% in 2013. Among cigarette smokers who smoke daily, the average number of cigarettes smoked per day declined from 16.7 in 2005 to 14.2 in 2013, and the proportions of daily smokers who smoked 20–29 or ≥30 cigarettes per day also declined. However, an estimated 42.1 million adults still smoked cigarettes in 2013. Moreover, cigarette smoking remains particularly high among certain groups, including adults who are male, younger, multiracial or American Indian/Alaska Native, have less education, live below the federal poverty level, live in the South or Midwest, have a disability/limitation, or who are lesbian, gay, or bisexual. (more…)
Author Interviews, CDC, JAMA, Tobacco / 15.10.2014

Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, MarylandMedicalResearch.com Interview with: Dr. Brian Rostron PhD, MPH Center for Tobacco Products US Food and Drug Administration Silver Spring, Maryland Medical Research: What are the main findings of the study? Dr. Rostron: We estimated that Americans in 2009 had had 14 million major medical conditions such as heart attack, stroke, lung cancer, and COPD that were attributable to smoking.  COPD was the leading cause of smoking-attributable morbidity, with over 7.5 million cases of COPD attributable to smoking. (more…)
Author Interviews, Occupational Health, Smoking / 22.09.2014

MedicalResearch.com: Interview with: Girija Syamlal MBBS, MPH , Epidemiologist Division of Respiratory Disease Studies National Institute for Occupational Safety and Health CDC, Morgantown, West Virginia CDC/NIOSH/DRDS Morgantown,WV 26505 Medical Research: What are the main findings of the study? Dr. Syamlal: During 2004–2011, of the 141 million U.S. adults, 20.7% were current cigarette smokers. Smoking prevalences were higher among men (22.8%) than women (18.3%). In both men and women, cigarette smoking prevalence varied widely by occupational group. In certain occupations, the prevalence of smoking was three times greater than the Healthy People 2020 goal that aims to reduce cigarette smoking prevalence to 12%. (more…)
Author Interviews, Rheumatology, Tobacco Research / 10.08.2014

Dr. Bente Glintborg: Copenhagen Centre for Arthritis Research Centre for Rheumatology and Spine Diseases Copenhagen University Hospital Glostrup Copenhagen, DenmarkMedicalResearch.com: Interview Invitation Dr. Bente Glintborg: Copenhagen Centre for Arthritis Research Centre for Rheumatology and Spine Diseases Copenhagen University Hospital Glostrup Copenhagen, Denmark Medical Research: What are the main findings of the study? Dr. Glintborg: Current smoking had a negative impact among patients with psoriatic arthritis treated with TNFi. This was especially observed among male patients and among patients treated with infliximab and etanercept. Current smokers had a shorter treatment duration (=poorer treatment adherence rate) compared to non-smokers. And current smokers had poorer treatment response (measured as ACR20, ACR50 and ACR70 responses and EULAR good response) compared to non smokers. Especially among male smokers the EULAR good response and ACR20 response rates were nearly half of the rates among male non-smokers. The response rates among women did not seem to be affcted by smoking status. Current smokers had poorer self reported outcome measures (HAQ and VAS global and VAS fatigue) when they started treatment with TNFi. (more…)
Author Interviews, BMJ, Cost of Health Care, General Medicine, Tobacco / 10.07.2014

Ms Qi Wu: Mental Health and Addiction Research Group, Department of Health Sciences University of York, Heslington York UKMedicalResearch.com Interview with: Ms Qi Wu: Mental Health and Addiction Research Group, Department of Health Sciences University of York, Heslington York  UK Medical Research: What are the main findings of the study? Ms Qi Wu: At any time in the UK about one in six adults has a mental health problem, the prevalence of smoking in this group is over 33%, which is around 50% higher than in the general population. It is estimated that 3 million adults with mental disorders were smokers in 2009-10. Meanwhile, people with mental health disorders are also more likely to smoke heavily, this group accounts for as much as 42% of the total national tobacco consumption.  In this study, we calculated the avoidable economic burden of smoking in people with mental disorders. The main finding was that people with mental disorders who smoke cost the UK economy £2.34 billion a year. The total costs are more or less equally divided among losses sustained from premature death, lost productivity, and healthcare costs to treat smoking related diseases such as lung cancer, cardiovascular disease and chronic obstructive pulmonary disease (COPD) in this group.  An estimated £719 million (31% of the total cost) was spent on treating diseases caused by smoking. Productivity losses due to smoking-related diseases were about £823 million (35%) for work- related absenteeism and £797 million (34%) was associated with premature mortality. (more…)
Author Interviews, JAMA, Smoking / 09.07.2014

MedicalResearch.com Interview with: Coenie Koegelenberg, MBChB, MMed (Int), FCP (SA), MRCP (UK), Cert Pulm (SA), PhD Associate Professor: Pulmonology Stellenbosch University & Tygerberg Academic Hospital MedicalResearch.com Interview with: Coenie Koegelenberg, MBChB, MMed (Int), FCP (SA), MRCP (UK), Cert Pulm (SA), PhD Associate Professor: Pulmonology Stellenbosch University & Tygerberg Academic Hospital Medical Research: What are the main findings of the study? Dr. Koegelenberg: The aim of this study was to evaluate the efficacy of combining varenicline and a nicotine patch versus varenicline alone as an aid to smoking cessation in a double-blind study design in a larger group and with a longer assessment period than has been studied to date. It was found that the combination treatment was associated with a statistically significant and clinically important higher continuous abstinence rate at 12 weeks (55.4% vs. 40.9%; P=.007) and 24 weeks (49.0% vs. 32.6%; P=.004), and point prevalence abstinence rate at 6 months (65.1% vs. 46.7%; P=.002). The present study was not adequately powered to fully assess safety and tolerability endpoints, but the results suggest that adverse events were balanced across treatment arms, except for mild skin reactions that were more frequently observed in the nicotine patch group (14.4% vs. 7.8%, P=.03). (more…)
Allergies, Author Interviews, BMJ, Smoking / 29.06.2014

Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, PolandMedicalResearch.com Interview with Dr. Wojciech Feleszko Department of Pediatric Respiratory Diseases and Allergy The Medical University of Warsaw Działdowska Warsaw, Poland MedicalResearch: What are the main findings of the study? Dr. Feleszko: We combined data from nineteen population-based cohort studies of 24 000 children and we found that household exposure to tobacco smoke after birth has immunomodulating effects.  We demonstrated an increased sensitivity to allergens, measured by serum IgE and skin testing which may contribute to the increased development of allergy in children exposed postnatally to household tobacco smoke. (more…)
Author Interviews, JAMA, Smoking / 24.03.2014

Pamela Ling, MD MPH Associate Professor, Department of Medicine Director, Tobacco Control Policy Fellowship Center for Tobacco Research and Education University of California San Francisco San Francisco, CA 94143-1390MedicalResearch.com Interview with: Pamela Ling, MD MPH Associate Professor, Department of Medicine Director, Tobacco Control Policy Fellowship Center for Tobacco Research and Education University of California San Francisco San Francisco, CA 94143-1390 MedicalResearch.com: What are the main findings of the study? Dr. Ling:  We followed a sample of smokers from a nationally representative panel for one year.  We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not. Put another way, smokers who had used e-cigarettes at the beginning of the study were equally likely to have quit smoking one year later as those who did not use e-cigarettes. There was no relationship between e-cigarette use and quitting even after taking into account measures of tobacco dependence (number of cigarettes smoked per day, how early in the day a smoker has his first cigarette) and intention to quit smoking. (more…)
Author Interviews, JAMA, Pediatrics, Tobacco, UCSF / 12.03.2014

Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143MedicalResearch.com Interview with: Lauren Dutra, ScD Postdoctoral Scholar, UCSF School of Medicine Cardiovascular Research Institute San Francisco, CA 94143 MedicalResearch.com: What are the main findings of the study? Answer: Middle and high school students who used e-cigarettes were more likely to smoke tobacco cigarettes. They were also more likely to progress from experimenting with tobacco cigarettes to becoming regular smokers. Teen smokers who used e-cigarettes were more likely to be planning to quit in the next year and less likely to have abstained from smoking recently, compared to smokers who had never used e-cigarettes. They were also more likely to be heavier smokers (smoke more cigarettes per day) than those who had never tried e-cigarettes, that being said there are eliquids available that have no nicotine content whatsoever and these are therefore a much healthier option, you can see a wide variety of these at Gourmet E-Liquid. (more…)
Author Interviews, CHEST, Pulmonary Disease, Smoking / 23.02.2014

Chunxue Bai, MD & PhD Director, Shanghai Respiratory Research Institute Professor of Medicine, Chairman, Shanghai Leading academic discipline Chair, Chinese Alliance against Lung Cancer Vice President of Respiratory Society, Chinese Medical Association Editor-in-Chief, Translational Respiratory Medicine (Springer) Editor-in-Chief, International journal of Respiration (China) Editor-in-Chief, Perspectives of Respiratory Medicine (China)MedicalResearch.com Interview with: Chunxue Bai, MD & PhD Director, Shanghai Respiratory Research Institute Professor of Medicine, Chairman, Shanghai Leading academic discipline Chair, Chinese Alliance against Lung Cancer MedicalResearch.com: What are the main findings of the study? Dr. Bai: Recently, we found a dilemma phenomenon that the incidence of chronic obstructive pulmonary disease (COPD) and lung cancer has remained high in southwest China despite the 1976 National Stove Improvement Program for indoor air quality. However, little information is known to the public about a regional endemic related to Chinese waterpipe smoking, which is different from the Arabic waterpipe. The Chinese waterpipe has been traditionally misconceived as less harmful for three reasons:
  • (1) no charcoal was used in contrast to the Arabic waterpipe,
  • (2) tobacco smoke passed through the water as opposed to cigarette smoking and
  • (3) smoking through a large volume waterpipe could “improve lung function.”
In our study, we provide robust results that the large volume Chinese waterpipe use and exposure are associated with the elevated prevalence of COPD, which have been identified by epidemiologic, physiologic, radiology, and toxicologic findings for the first time. (more…)
Author Interviews, BMJ, Mental Health Research, Smoking / 14.02.2014

MedicalResearch.com Interview with: Gemma Taylor MSc MBPsS Doctoral ResearcherGemma Taylor MSc MBPsS Doctoral Researcher and Paul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral MedicinePaul Aveyard and PhD MRCP MRCGP FFPG Professor of Behavioral Medicine Fellow of Wolson College Primary Care Clinical Sciences The University of Birmingham Birmingham United Kingdom MedicalResearch.com: What are the main findings of the study? Answer: Smoking cessation is associated with improvements in mental health compared with continuing to smoke. The effect sizes seem as large for those with psychiatric disorders as those without and are equal or larger to effect estimates of antidepressant treatment for mood and anxiety disorders. (more…)
Author Interviews, Breast Cancer, Cancer, Smoking / 12.02.2014

MedicalResearch.com Interview with: Masaaki Kawai MD, PhD Division of Public Health Sciences, Fred Hutchinson Cancer Research Center Seattle, Washington MedicalResearch.com:  What are the main findings of the study? Answer:  Ever-smokers had a 1.3-fold increased risk of breast cancer. They also had a 1.4-fold increased risk of ER-positive breast cancer. Current/recent smokers with a 10 pack-year history of smoking had a 1.6-fold increased risk of ER-positive breast cancer. (more…)
Author Interviews, JAMA, Ophthalmology, Smoking / 14.01.2014

MedicalResearch.com Interview with: Birgitta Ejdervik Lindblad, MD PhD Department of Ophthalmology Örebro University Hospital Örebro, Sweden MedicalResearch.com: What are the main findings of the study? Answer: We have investigated the association between smoking cessation and risk of having a cataract extraction among 44 371 Swedish men aged 45-79 years. During 12 years of follow up we identified 5713 incident cases of cataract extraction. Smoking cessation significantly decreased the risk with time. Men who currently smoked more than 15 cigarettes per day had a 42 % increased risk of cataract extraction compared with men who had never smoked. More than 20 years since quitting smoking, men who had smoked more than 15 cigarettes per day had a 21% increased risk of  having a cataract extraction compared with men who had never smoked. The effect of smoking cessation was observed earlier among men who smoked less than 15 cigarettes per day but more than 2 decades since smoking cessation the risk had not decreased to the level of never smokers. (more…)
JAMA, Smoking / 29.10.2013

MediclResearch.com Interview with: John W. Ayers, PhD, MA Graduate School of Public Health San Diego State University, San Diego, California MedicalResearch.com: What are the main findings of the study? Dr. Ayers: Our study, published today in the Journal of the American Medical Association, Internal Medicine was the first to describe daily rhythms in health behaviors. Because trends in quitting contemplations are usually described annually using telephone surveys, we had to use a novel data source that could capture daily patterns. By monitoring aggregate Internet search queries we can see precisely what the population is thinking about by the content of their queries and that the population is engaged in the issue by searching. We therefore analyzed daily search volumes for smoking cessation queries (e.g., "quit smoking") in six languages across the entire globe. We found that people search about quitting smoking more often early in the week, with the highest query volumes on Mondays, using a daily measure representing the proportion of quit smoking searches to all searches. This pattern was consistent across all six languages, suggesting a global predisposition to thinking about quitting smoking early in the week, particularly on Mondays. English searches, for example, showed Monday query volumes were 11 percent greater than on Wednesdays, 67 percent greater than on Fridays, and 145 percent greater than on Saturdays. In total for all six languages, Monday query volumes were 25 percent higher than the combined mean number of searches for Tuesday through Sunday. Practically these findings are very meaningful. For example, in English alone there are about 150,000 more quit smoking queries on Monday than on a typical day; about 8,000,000 over an entire year. (more…)
Asthma, Author Interviews, Genetic Research, Smoking, UCLA / 06.08.2013

MedicalResearch.com Interview with: Virender Rehan, MD Professor of Pediatrics Chief, Division of Neonatology Director, Neonatal Intensive Care Unit Director, Neonatal-Perinatal Fellowship Training Program Co-Director Perinatal Research Center Harbor UCLA Medical Center, David Geffen School of Medicine at UCLA Torrance, CA, 90502 MedicalResearch.com: What are the main findings of the study? Dr. Rehan: The main findings of the study include the likelihood of transmission of asthma to third generation offspring following maternal smoking during pregnancy even when child’s mother didn’t smoke. And these effects seem to be more profound in the upper airways of males compared to that in females. (more…)
Author Interviews, Erasmus, Heart Disease, Tobacco Research / 03.08.2013

MedicalResearch.com Interview with: Dr. R.T. van Domburg Clinical epidemiologist, Associate Professor Erasmus Medical Center Department of Cardiology Ba561 ‘s-Gravendijkwal 230 3015 CE Rotterdam MedicalResearch.com: What are the main findings of your study? Answer: We collected data from the first patients who underwent coronary angioplasty in the early 1980s and followed them for 25 to 30 years. We found that patients who were able to quit smoking in the year following their PCI lived on average more than two years longer than those who continued to smoke. (more…)
Author Interviews, Exercise - Fitness, Heart Disease, JAMA, Smoking, Tobacco Research / 16.04.2013

MedicalResearch.com Author Interview with Dr. Koon Teo, MB, PhD Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada MedicalResearch.com: What are the main findings of the study? Dr. Teo: In this study we examined the prevalence of smoking cessation or avoidance, eating a healthy diet and undertaking regular physical activities in nearly 8000 individuals who had previously experienced a coronary heart disease event or stroke, on average 5 years after their events. The individuals were recruited from over 600 communities in 17 countries with varying incomes and economic development.  We found that although these healthy lifestyle activities could reduce the risk of further heart or stroke events, about one fifth of individuals continued to smoke, only one third undertook regular leisure or work related physical activities and about two fifths ate a healthy diet. (more…)