New experimental nicotine vaccine seems to work better than previous versions.

If only you could just get a single shot and you’d be cured of your nicotine addiction forever…

Nicotine vaccines aren’t exactly new, but previous versions haven’t worked all that well and when they did work their effects wore off rather quickly.

But now things are moving in the right direction.

Scientists at Weill Cornell Medical College in New York say they’ve developed a novel nicotine vaccine that seems to work very well (it blocks more than 80% of nicotine from reaching the brain) and importantly, it seems to last for a lifetime (at least in mice.)

What’s Different with This Version?

Using a harmless virus as a delivery mechanism the researchers injected the vaccine into the liver. The vaccine carried coded genetic messaging into the cells of the liver, causing the liver cells to start producing nicotine antibodies.

Previous vaccines versions have introduced antibodies directly into the bloodstream and these types of vaccines have demonstrated very short lived efficacy (days or weeks only.)

Since this vaccine causes the body to start producing its own antibodies there is no need for frequent boosters – in theory (and this is supported by animal testing) the vaccine should last for a lifetime.

How Well Did It Work?

• The researchers say that mice given the nicotine vaccine showed no behavioral response after an administration of nicotine – as if the nicotine was not reaching the brain.
  
• Mice not given the vaccine, however, responded to nicotine administration with lowered activity levels and a reduction in heart rate and blood pressure.
  
• Antibody levels among mice given the vaccine remained high over the course of 18 weeks of experimental testing.

Commentary

Although a nicotine vaccine won’t eliminate a person’s cravings over the short term, it will make it impossible to satisfy a nicotine craving and so there would be very little motivation to continue with smoking.

The results are promising but  although a lot of work still needs doing before human testing could begin in a few years, lead study author Dr. Ronald G. Crystal said that the results of this study show the promise of vaccines, and that, “as far as we can see, the best way to treat chronic nicotine addiction from smoking is to have these Pacman-like antibodies on patrol, clearing the blood as needed before nicotine can have any biological effect."

The full study results are published in Science Translational Medicine.

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Researchers say, no matter how old you are, your risk of early death falls dramatically after you quit smoking.

It doesn’t matter how old you are, whether you’re in your 60’s 70’s or even in your 80’s – quitting smoking now still greatly decreases your risk of early death; even if you’ve smoked for decades.

That’s the story coming from a group of researchers at the German Cancer Research Center in Heidelberg Germany who performed a meta-analysis of 17 clinical studies performed on smoking cessation.

Their Findings

They found that:

• Current smokers show the highest death rates in any age cohort
• The longer you quit for, the greater your benefits
• Quitting smoking in your 60’s is associated with a 21% reduction in risk of early death
• Quitting smoking in your 70’s is associated with a 28% reduction in risk of early death
• Quitting smoking in your 80’s is associated with 24% reduction in risk of early death

Commenting on the significance of the findings that quitting smoking at any age results in a substantial decrease in risk of early death, lead researcher Hermann Brenner, MD, noted, “This fact calls for effective smoking cessation programs that are likely to have major preventive effects even for smokers aged 60 years and older. Even older people who smoked for a lifetime without negative health consequences should be encouraged and supported to quit smoking.”

The full research results can be read in Archives of Internal Medicine.

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Quit now to reduce your odds of dementia later in life. People who quit for at least 10 years prior to late middle age experience no increased risk for tobacco related dementia.

Need some inspiration and motivation for your battle against tobacco? Well you surely know that smoking damages your heart and lungs, but did you know that it also damages your long term cognitive abilities…that is unless you quit in time.

English researchers say that elderly male smokers experience greater cognitive decline than their non smoking peers.

The Study

Researchers at University College London, England examined smoking data and tested cognitive function on over 7000 older members of the British Civil Service.

• Each subject received a cognitive abilities assessment. Subjects were an average of 56 years old at the time of this assessment.
• Over the decade following this first assessment, each subject received two further cognitive assessments
• Each subject provided information on smoking habits over the previous 25 years.

The Results

• Male smokers experienced quicker cognitive decline than male non smokers
• Male smokers who continued to smoke during the decade after the first cognitive assessment experienced the quickest rates of decline
• Men who had quit smoking more than 10 years prior to the first assessment showed no accelerated cognitive decline.
• Female smokers did not experience a comparable accelerated rate of decline.

Commentary

The authors say their study adds further evidence to the hypothesis that smoking is linked to dementia in the elderly.

The full research results can be found in Archives of General Psychiatry

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Canadian scientists say that very heavy smokers who quit smoking can experience a spike in an enzyme called MAO-A. MAO-A metabolizes serotonin and so too much MAO-A can result in too little serotonin and feelings of sadness and depression.

Heavy smokers who quit their habit sometimes experience feelings of sadness that closely mimic the feelings of clinical depression. This can make maintaining abstinence from cigarettes much harder than it would otherwise be and may in part explain why about 50% of people who quit smoking relapse back to tobacco within three days of stopping use.

Researchers at Canada’s Centre for Addiction and Mental Health (CAMH) say they think they’ve figured out why quitting smoking can make some people feel so sad.

Dopamine is the body’s major feel-good neurotransmitter, and most studies which have examined tobacco’s effects on mood and pleasure have centered around this chemical. Researchers at CAMH, however, examined the effects of tobacco use cessation on an enzyme in the brain called MAO-A, which is an enzyme that metabolizes (removes) excesses of another feel-good chemical, serotonin, from the brain.

The researchers found that very heavy smokers who quit smoking developed an acute spike in MAO-A levels in the brain which caused a corresponding dip in serotonin levels and thus, feelings of depression.

Why Does This Happen?

The scientists believe that decreased levels of a chemical called harman in the body result in the MAO-A spike. Harman is a chemical that is formed and consumed when tryptophan in cigarettes is burned and then inhaled. When people stop smoking, harman levels in the body fall and this seems to lead to a spike in MAO-A levels.

Only Very Heavy Smokers Are Affected

• In clinical tests, people who smoked more than 25 cigarettes per day saw MAO-A levels rise by 25% upon quitting.
• People who smoked between 14 and 25 cigarettes per day saw no appreciable rise in MAO-A levels.

Why Is This Significant?

The researchers say that understanding how and why quitting smoking leads to feelings of depressions may lead to interventions that would make giving up the habit a little bit easier.

Suggested interventions include giving recently quit smokers an anti depressant called Moclobemide or improving cigarette filters so they do a better job of removing harman from cigarette smoke that is inhaled into the body.

The full study results can be examined in the August edition of Archives of General Psychiatry.

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Although we all know that smoking while pregnant isn’t healthy for mom or unborn child, a surprising number of pregnant women still choose to light up. New research out of University College in London shows that these moms are putting their children at greatly increased risk for birth defects ranging from clubfoot to missing limbs to gastrointestinal problems.

After combing through data on 174 000 cases of birth malformations and data on 11.7 million control subjects (normal births) over the past 50 years, researchers at University College in London have finally completed the first ever major study on the specific birth defects associated with smoking during pregnancy.

According to the scientists, women who light up during pregnancy increase the risks for:

• Skull defects by 33%
• Children born missing one or more limbs by 26%
• Eye defects by 25%
• Cleft lip palate by 28%
• Gastrointestinal problems by 26%
• Clubfoot by 28%
• Gastroschisis by 50% (gastroschisis is a condition where parts of the stomach or intestines push through to the exterior of the skin)

And though smoking while pregnant is widely known to be harmful,  a surprising number of women continue to smoke through their pregnancy.

• In the UK, 17% of women smoke during pregnancy. Among mothers under 20 years of age, that percentage climbs to 45%
• In the US, 20% of women under the age of 25 smoke during pregnancy

Lead study author Professor Allan Hackshaw said that while literature on the harms of smoking during pregnancy have long focused on risks such as low birth weight or miscarriage, information on increased risks for  birth defects has been lacking - because no one really knew which birth defects were associated specifically with smoking.

With the publication of this study, he argues, "Now we have this evidence, advice should be more explicit about the kinds of serious defects such as deformed limbs, and facial and gastrointestinal malformations that babies of mothers who smoke during pregnancy could suffer from…There's still this idea among some women that if you smoke the baby will be small and that will make it easier when it comes to the delivery. But what is not appreciated is that smoking during pregnancy increases the risk of defects in the child that are life-long."

The full study results can be read in the today’s edition of the journal Human Reproduction Update.

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Politicians in Iceland are set to debate a law that would make cigarettes available only with a doctor’s prescription.

Under the terms of a proposed new law introduced by the former minister of health, Siv Fridleifsdottir:

• Only smokers aged 20 and older would be allowed to buy cigarettes
• Cigarettes would be sold only in pharmacies. Eventually, only smokers with a doctor’s certificate would be able to buy cigarettes
• Doctors would work with smokers to help them break free from their habit. Those that cannot or will not stop, would be granted a medical license to purchase nicotine.
• Cigarette costs would increase by 10% initially (which according to the WHO, should lead to a 4% to 8% decline in smoking rates) but eventually, once cigarettes were available by prescription only, prices would drop down below current prices.

President of the Icelandic Society of Cardiology, Thorarinn Gudnason, helped draft the proposed law. Commenting on the plan to eventually reduce the price of cigarettes, he explained, “Under our plan, smokers who are given prescriptions will be diagnosed as addicts, and we don't think the government should tax addicts."

Price increases and reduced disposable income after the nation’s economic crash are credited with cutting smoking rates from 30% in 1991 to 15% today – which is one of the lowest smoking rates in Europe. Other measures already in place to further reduce smoking rates over the next 10 years include a coming ban on smoking in all public places and in cars carrying children.

The proposed law is backed by the Icelandic Medical Association and various anti-tobacco groups. At present, 20% of deaths in Iceland are attributable to smoking, a figure that health experts think they can reduce by two thirds with tough anti smoking measures.

In other international anti-tobacco efforts:

• Surgeons in Sweden already refuse to perform operations on smokers who will not quit, citing smoking’s detrimental effect on the recovery process.
• Bhutan has completely banned smoking
  
• Costa Ricans can be arrested for smoking in their own homes, should the second hand smoke bother family members

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Children and tweens exposed to secondhand smoke absorb more nicotine out of that smoke than adults do – so much, in fact, that researchers out of Montreal Canada say that some children living with smokers, who had never before smoked cigarettes, were showing signs of nicotine addiction.

Researchers at Concordia University and the University of Montreal studied 327 6th and 7th grade students enrolled at public schools within the province of Quebec.

These students were asked about their exposure to second hand smoke and asked about their beliefs and perceptions about smoking in general. Additionally, saliva samples were taken to measure byproducts of nicotine in the systems of these children who had never before smoked cigarettes.

Findings

• Children who were more exposed to more smokers were more likely to hold positive views about the benefits of smoking
• Some of the tweens (who had never smoked) who had been exposed to regular secondhand smoke, described experiencing symptoms of nicotine dependence, such as craving cigarettes and finding it tough to go for long periods without exposure to smoke

Lead study author, Simon Racicot, of the Concordia University Department of Psychology explained the significance of the study findings, stating, “To our knowledge, this is one of first studies to show how increased exposure to second-hand smoke leads to youth who’ve never smoked to report having symptoms of nicotine dependence,” and that “Preteens who were surrounded by more smokers believed that there are greater advantages to smoking. Therefore, smoking by parents, siblings, and friends increases risk factors for later smoking.”

The full study results can be read in the journal, Nicotine and Tobacco Research

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The billionaires Bill Gates and NYC Mayor Michael Bloomberg have combined $500 million to help governments around the world to curb tobacco addiction. The task at hand couldn't be on a grander scale. If nothing is done against global tobacco use, by the end of the century, 1 billion people will have died of their addiction, Bloomberg says.

The Microsoft founder Bill Gates, who is also backing scientific research to cure the world's worst diseases such as AIDS and malaria, is now investing to battle the smoking epidemic that kills even more people, especially in developing countries like China, South-East Asia and Africa.

The joining of forces with Bloomberg is Gates first full-time event as philanthropist, since his departure from Microsoft, last month.

Rather than fighting the tobacco companies directly or waiting for a scientific breakthrough, "the challenge here is really more about policy and getting society energized," Gates said.

Using proven strategies, large-scale tobacco addiction is entirely preventable.

The two billionaires first discussed a joint anti-smoking program during a dinner at Gates' Medina mansion, last year.

Follow this initiative on Bill & Melinda Gates Foundation website.

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Researchers at Brigham Young University say that while cutting back on smoking helps a bit, that smoking even an occasional cigarette each day still does considerable harm.

Think that you’re doing your heart health a favor by only sneaking the occasional cigarette each day? Well, smoking a couple of cigarettes a day might not raise your risk of early death as steeply as a heavy habit will, but researchers at the American Heart Association and Brigham Young University say that smoking just 3 cigarettes per day raises your risk of death from cardiovascular disease by 65%.

Brigham Young University researchers stumbled on the concern inducing statistic after extracting data from the massive American Cancer Society Prevention Study and combining this data with other resource studies on second had smoke exposure and fine particulate air pollution exposure.

Other findings from the data analysis include:

• Smoking half a pack daily increases your risk of death from cardiovascular disease by 79% and a pack a day habit increase the risks by 100%
• People exposed to second hand smoke who live in areas of high air pollution have a 20-30% higher risk of death from cardiovascular disease

The researchers say that while reducing the amount you smoke has some health benefits, the benefits of reducing intake do not come close to matching the decrease in disease risk associated with quitting entirely.  Lead Researcher C. Arden Pope Ph.D.  of Brigham Young University commented, saying, “A critical finding of our study is that smoking is unhealthy even at small amounts. Reducing the amount one smokes does some good, but the biggest benefits come from stopping completely.”

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Cigarettes that were once marketed as ‘light’ are in fact no safer than any other – which is why most Western nations now outlaw the use of the terms light or mild on packaging. Nevertheless, about 1 in 5 smokers still believe that cigarettes sold in light colored packages are less harmful.

All types of cigarettes cause very similar health damage and addiction, and because of this, cigarette makers in most Western nations can no longer use the terms ‘light’ or ‘mild’ in branding or packaging. Yet despite this prohibition, researchers out of International Tobacco Control  found that about 1 in 5 smokers is still misled into believing that some types of cigarettes - those sold in white, silver or gold packaging - are healthier than others.

In many countries, brands that used to be called light or mild used white, gold or silver coloration on packaging. Although these brands have now dropped terms such as light (for example, Marlboro Light has become Marlboro Gold) many smokers still equate these colored brands as light and less harmful cigarettes.

The study, which is published in the journal Addiction, presents research collected by survey of more than 8000 past and present smokers from the US, Canada, Australia and the UK. 

Key findings include:

• One fifth of smokers wrongly believe that some types of cigarettes are less harmful than others
  
• Slim cigarettes are wrongly perceived as less harmful
  
• Nicotine causes most tobacco related cancers (this is false)
  
• Filters reduce health risks (this is false)
  
• American smokers are most likely to falsely believe that different types of cigarettes present different levels of health risk
  

Lead researcher, Dr. David Hammond, commented on the significance of the study results, saying,  "The findings highlight the deceptive potential of 'slim' cigarette brands targeted primarily at young women. The findings also support the potential benefits of plain packaging regulations that will soon take effect in Australia, under which all cigarettes will be sold in packages with the same plain colour, without graphics or logos.

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About a third of us have a genetic malfunction which disables our ability to regulate nicotine consumption. Those of us with this particular genetic abnormality are at a greatly increased risk of nicotine addiction.

Scientists working at the Scripps Research Institute in Florida are studying a pathway to brain cell receptors that regulates nicotine consumption. They say that between 30 and 35% of people have a malfunction within a gene called CHRNA5 and that medications targeting the activity of this gene might work well to help people stop smoking.

Animal model studies show that CHRNA5 regulates the operation of receptors in the brain which are activated by nicotine neurotransmitters. When CHRNA5 is working to control nicotine intake properly, consuming more than a very small amount of nicotine produces aversive feelings – feelings of disgust at the thought of further nicotine intake; and this disgust helps to limit how much a person consumes and thereby the likelihood a person would become addicted to nicotine deliver systems, like cigarettes.

When CHRNA5 doesn’t work as it’s supposed to (as in between 30% and 35% of all people) consuming nicotine results in little aversive stimuli – only in positive sensations. People with defective CHRNA5 genes get all of the good feelings from nicotine intake, and little of the bad, and because of this - these people are at far greater risk to develop nicotine addictions.

In the study:

• Rats with functioning CHRNA5 receptors consumed small quantities of nicotine, experienced aversion and limited their intake.
• Rats with genetically altered CHRNA5 receptors felt no aversion and consumed large quantities of nicotine.

Heritability

Having a malfunctioning CHRNA5 seems to greatly increase your chances of becoming a nicotine addict, and if either or both of your parents smoke, you may well have inherited that genetic liability yourself!

Smoking Cessation Medications

Although nicotine replacement systems, like the nicotine patch, can help a person overcome a cigarette addiction, the nicotine in the patches is itself addictive, and some people can become dependent on the medication used to treat the addiction! Scripps researchers wonder if medications which targeted this genetic pathway to cell receptor activation might work better to help people overcome their nicotine dependencies; the idea being:

1. You take the medication, a medication which enables your CHRNA5 gene to work properly
2. You use nicotine
3. You experience revulsion
4. You use less or no nicotine!

The National Institute of Health will provide $8.2 million dollars to the Scripps researchers over the next 5 years to aid in the research and the work towards an effective medication for an addiction that kills 5 million Americans per year.

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A new law enacted on Monday in Honduras bans smoking in most enclosed public and private spaces – and if people smoke in the home near family members, they might get arrested.

According to the provisions of the new law:

• Smoking is banned in most public and private enclosed places, such as in bars and restaurants, on public transport, in stadiums or shopping areas, etc.
  
• Smokers can still light up outside, provided they stay at least 1.8 meters away from any other person.
  
• Smokers whose second hand smoke bothers family members within the home can be arrested. Family members can call the police to report second hand smoke within the home and offenders would be liable to pay a $311 fine – which is as much as the average Honduran makes in a month.
  

About 30% of Hondurans are currently smokers.

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An Israeli researcher says that on average, young male smokers tend to have lower IQs than young male non smokers.

Prof. Mark Weiser of Tel Aviv University's ran a study on more than 20 000 army recruits in Israel. Military service is compulsory in Israel, and so the subjects were from diverse backgrounds and socio-economic situations. All subjects were in good health, as required for entrance into the army and between 18 and 21 years of age.

Professor Weiser looked at intelligence as measured by IQ testing and compared that to smoking status, and for smokers, by the number of cigarettes smoked per day. He found that:

• The average IQ of non smokers tested was 101
• The average IQ for smokers was 94
• The average IQ for men who smoked a pack a day or more was 90

An IQ score of 100 is considered average and an IQ score of between 84 and 116 is considered a normal range score.

Weiser commented on the study, saying, "People on the lower end of the average IQ tend to display poorer overall decision-making skills when it comes to their health.” He says that knowing that lower IQ children are at increased risk to smoke cigarettes could lead to special health interventions for this at risk population.

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Smoking bans work to save lives and improve health, say researchers in New Zealand who followed heart attack incidences in years following the implementation of a major public smoking ban.

Researchers in New Zealand examined the rate of hospital admissions for heart attacks following the implementation of a smoking ban in many public spaces, including all workplaces, bars and restaurants.

In the three years following the passing of this legislation:

• Heart attacks dropped by 13% amongst 55 to 74 year old men and women who had never smoked and 9% across all 55 to 74 year olds

• Heart attacks amongst those over the age of 30 declined by 5%

• Men benefited more from the smoking ban than women (men had a greater decline in hospital admissions)

• People from wealthier neighborhoods experienced a greater decline in heart attacks than people from poorer neighborhoods

The full results of the study can be read in the Australian and New Zealand Journal of Public Health.

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Smokers have twice the likelihood of wound healing complications after surgery, but those who abstain from tobacco for 4 weeks prior to an operation can eliminate this elevated risk.

Researchers at the German Institute for Quality and Efficiency in Health Care (IQWiG) say that quitting smoking before going under the knife greatly reduces the chances of wound healing complications – one of the most common types of post surgical complications.

The researchers analyzed data to compare the surgical outcomes of smokers and ex-smokers. The ex-smokers studied used nicotine replacement delivery systems (nicotine gum or the nicotine patch) for 4 weeks prior to an operation to quit smoking.

They found that those who used nicotine replacement therapy had half the instances of poor wound healing, just 14% occurrence, compared to 28% occurrence amongst the smoking group.

The institute’s director, Professor Peter Sawicki, explained why smokers risk post surgery complications, saying, "Anaesthetics and surgery put a strain on the body's oxygen supply as it is. Smoking reduces the amount of oxygen that is available in the blood even more, making it more difficult for wounds to heal – a process which requires oxygen."

Visit the IQWiG website for more information.

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