HEALTH

JAMA: Director of tobacco research suggests most benefits outweigh risks when considering cessation

BY Michael Johnsen

BOSTON — Smokers who have been unsuccessful to date in trying to kick the nicotine habit may be able to stop smoking by combining two smoking cessation approaches, according to a report published in the Oct. 17 issue of JAMA.  

"Many smokers believe they have tried and failed all treatments because they — and their physicians — have not used existing treatments in the most effective way," noted Nancy Rigotti, director of the Tobacco Research and Treatment Center of the Massachusetts General Hospital Department of Medicine. "Outdated product labeling by the Food and Drug Administration for nicotine replacement therapy contributes to this problem, as does the fear of possible side effects of FDA-approved medications. As a result, some smokers consider using newer, untested and unregulated products like electronic cigarettes."

In her paper, based on a grand rounds presentation at Northwestern University Feinberg School of Medicine, Rigotti presents a hypothetical smoking patient: a 50-year old man who is discouraged because previous quit attempts — one with nicotine replacement, the other with the antidepressant bupropion — did not succeed. He is reluctant to try varenicline, another FDA-approved smoking cessation medication, because of concern about possible serious side effects. Feeling that he has "tried everything," he asks his physician whether he should consider electronic cigarettes.

Rigotti noted that many quit attempts fail because smokers do not use existing treatments or, like the smoker in the example, don’t use them in the most effective way. Only one-third of smokers who try to quit use behavioral support or medication — both of which have been proven to be effective. Even fewer smokers combine both types of assistance, even though this further improves a smoker’s chance of success.

Smokers who do use nicotine replacement therapy may not do so in the most effective way. Though many products are available — including over-the-counter patches, gums and lozenges, and prescription-only inhalers and nasal spray — many smokers only use one product when studies have shown that combining two is safe and more effective, Rigotti wrote. The patch provides steady, prolonged relief of nicotine withdrawal symptoms but cannot help with sudden cravings that may be triggered by environmental cues like watching someone light up. Shorter-acting products like gums or lozenges can help smokers handle those cravings. Despite evidence that combining NRT products is more effective than using single agents and support for combined therapy in the 2008 U.S. Public Health Service Clinical Practice Guideline, the labels currently approved by the FDA caution smokers not to combine different nicotine replacement products.

Some smokers may be discouraged from using two other FDA-approved smoking cessation drugs, bupropion and varenicline, because of reports of behavioral changes in patients taking those drugs, even though they double a smoker’s odds of success when making a quit attempt. Rigotti noted that in any individual it can be difficult to distinguish a side effect from the effects of nicotine withdrawal, which can include nervousness and depression. She stressed that both drugs are among the few effective options for treating tobacco dependence, and noted that physicians and patients need to weigh the potential risk of side effects against the certain risk of continuing to smoke. In most cases, Rigotti concluded, these drugs’ benefits would outweigh their risks, but she cautioned that physicians do need to monitor patients who start on these drugs for behavior changes.

"Tobacco use kills approximately half of regular smokers, and treatment for tobacco use is one of the most cost-effective actions that physicians and healthcare systems can take," Rigotti said. "Those of us who provide health care need to recognize tobacco dependence as the chronic condition that it is and give tobacco treatment as high a priority as we do other chronic diseases like diabetes or high blood pressure."

Rigotti’s work was supported by a grant from the National Heart, Lung and Blood Institute.

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TobyGreenhorn says:
Jun-20-2013 04:57 am

I think whatever the regime is, if you do it religiously and with total commitment and discipline, you will definitely reap success. The same thing goes for smoking. If a smoker stays on a treatment plan and consume/use the medication accordingly, I am sure failure is not a common sight. However, as the article mentions, if a smoker is required to consume/use two medications simultaneously, then go ahead and commit to that before calling the treatment a failure. If all else still fails, green smoke is a good alternative, even though it has not been heavily regulated in many states and countries.

R.MURRAY says:
Oct-25-2012 02:26 pm

The author of this article is most correct. Dbutler also makes and excellent request. As a financial contributor to an e-cig company I can tell you that there have been and continue to be, several studies regarding the safety of the e-cig manufacturing process. Of course some are studies are performed by the individual companies themselves. There are private associations that have also conducted such studies as well. The information is out there, yet like any competitive industry, ie the cigarette companies, they do not wish to look at them. However with Lorrilard and other major cigarette companies now making and/or investigating the e-cig business it will not be long before the good ones prevail and statistical data will become available.

D.BUTLER says:
Oct-22-2012 11:00 am

I'd like DSN to do a report as to the safety of using electronic cigarettes. There doesn't seem to be much in the way of reports or studies on the topic.

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Star Nutrition launches arm, calf sleeves designed to increase circulation

BY Michael Johnsen

CHICO, Calif. — Star Nutrition on Wednesday added the TEC-3 arm and calf sleeves to its Incrediwear line. Engineered from an Italian 3-D weaving machine and utilizing Carbonized Charcoal Anion Technology, the 360-thread count TEC-3 is designed to increase circulation to the arms and calves, while decreasing fatigue, swelling and recovery time.

"The TEC-3 is already loved by many championship athletes around the world," stated Star Nutrition CEO Jackson Corley. "They are using the sleeve because it helps them train harder and longer, as well as recover faster from their workouts," he said. "The TEC-3 is also our thinnest sleeve available so it allows for a premium release of negative ions and maximum benefit to the athlete."

Among the athletes currently using the TEC-3 are Morrocan runner Aissa Dghougi, MMA professional trainer Kevin Kearns, championship snowboarder Terje Haakonsen, professional rock climber Ivan Greene, four-time Olympic Judo competitor and bronze medalist Mike Swain, 2012 U.S. Judo Olympic bronze medalist Marti Malloy and eighth-degree Karate black belt Pat Haley, the company announced.

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SoloHealth to expand health-and-wellness kiosk to 4,000 locations by 2014

BY Michael Johnsen

ATLANTA, Ga. — SoloHealth on Thursday announced it has plans in place to expand its FDA-approved SoloHealth Station health-and-wellness digital kiosks to more than 2,500 store locations by mid-2013, scaling to more than 4,000 by 2014. 

“We are fundamentally changing consumer healthcare access and along with way providing advertisers with a completely unique and effective way to reach consumers in a direct, highly personalized and engaging manner,” stated Bart Foster, SoloHealth CEO. “Our platform allows brands to become solutions for consumers — reaching health-conscious shoppers when they are engaged and interested in products that are aisles away, not miles away.”

The SoloHealth Station provides health screenings for vision, blood pressure, weight and body mass index, a symptom checker as well as an overall health assessment free of charge.  SoloHealth also helps connect consumers to local professionals through their databases, helping people enter the most appropriate and accurate point in the healthcare system.  A cloud-based platform, the SoloHealth Station is backed by technology that allows for flexibility to make changes remotely and quickly so the company can continue to expand the services offered.

The SoloHealth Station also offers highly personalized, targeted and interactive opportunities for consumers, advertisers and retailers by placing kiosks in high-traffic retail locations and offering online advertising — including interactive banners, 15- to 30-second interstitial videos, e-newsletters, email activation and digital signage. Advertisers can engage shoppers through interactive displays, video and custom solutions that can be tailored to specific advertising needs. 

According to data supplied by SoloHealth, consumers are twice as likely to engage in nontargeted media than average online consumers; four times more likely when reached through relevant content; and six times more likely to engage when targeting is based on consumers’ answers to health-related questions.

 

 

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