Nicotine patch works better when used longer

Smokers who wore nicotine patches for six months instead of the recommended two were more likely to quit smoking and had an easier time recovering from an occasional slip, U.S. researchers said on Monday.

But the effect appeared to last only as long as the treatment, suggesting that smokers may need longer-term or even chronic treatment to stay smoke-free.

"This suggests that we may need to reconsider our guidelines about the length of treatment and consider, at least for some smokers, longer-term therapy," said Caryn Lerman of the University of Pennsylvania School of Medicine, whose study appears in the Annals of Internal Medicine.

Lerman said the team did the study because of the growing recognition that nicotine dependence is a condition characterized by many relapses.
To test this, she and colleagues set up a clinical trial of 568 people who smoked 10 or more cigarettes per day for at least the past year. About half were given GlaxoSmithKline's Nicoderm CQ patch for eight weeks, followed by a dummy patch. The other half were on the patch for a full six months.

Neither the patients nor the doctors knew who was getting the active patch.

At the end of 24 weeks, smokers who were on extended patch treatment the whole time were twice as likely to have quit smoking as those who got a dummy patch after two months.

"We found that extending the duration of therapy to 24 weeks was significantly more effective in helping smokers quit compared to the standard duration of eight weeks," Lerman said.

However, after a year, there were no differences in the main measures of smoking in the extended patch or conventional patch groups. But the researchers did notice that people who had been on the patch longer were more likely (29.1 percent vs. 21.3 percent) to have reported no periods of smoking lasting more than 7 days in a row -- during the entire year.

The team said the results were comparable to those seen with drugs such as Glaxo's Zyban and Pfizer Inc's Chantix, drugs that have strong safety warnings on their labeling because that can cause depression, hostility and other behavioral changes.

Lerman said the patch, by comparison, is safe and it may be more convenient because it can be purchased over-the-counter without a prescription.

The team is now studying just how long smokers might need to stay on the patch to overcome their smoking dependence, or whether they might fare better taking more than one treatment at a time.

The extended six-month patch therapy in the study cost $2,482, about the same as other drug-related cessation aids, Lerman said.

But just 8.6 percent of health insurance companies fully pay for nicotine patches, and only 33 states pay for Medicaid patients to use the patch. Smoking costs the U.S. economy more than $193 billion each year in health care costs and lost productivity, according to the U.S. Centers for Disease Control and Prevention.

"Whatever healthcare reform that may occur, it will be important for smoking cessation medications be covered, and possibly to be covered for a longer duration than just the acute treatment period," Lerman said.

Cigarette smoking causes lung cancer, heart attacks, strokes, emphysema and other diseases. It is the leading preventable cause of death in the United States, killing an estimated 443,000 people each according to year, according to the CDC.

Source: Thomson Reuters Foundation - 1 February 2010
Link: http://bit.ly/awVp0f

NICE citizens council report on harm reduction In smoking published

The Citizens Council of the National Institute for Health and Clinical Excellence (NICE), which provides public input into the Institute's work, has published a report on its meeting to discuss smoking and harm reduction. The public is now invited to comment on the Council members' views on the theoretical strategy of harm reduction with regard to smoking - an approach not currently used in the UK. This includes the pros and cons of promoting the switch to alternative products such as medicinal nicotine, alongside supporting smokers to quit. NICE has not been asked to produce guidance on harm reduction in smoking. However, should guidance be requested on this topic, the views of the Citizens Council on issues which should be taken into account will be helpful to inform NICE's independent committees. 

Whereas smoking cessation strategies are familiar - helping smokers to quit both smoking and their reliance on nicotine completely - the concept of harm reduction in smoking has a different focus. Instead, it aims to reduce the harm associated with smoking cigarettes for people who cannot quit. This may include replacing cigarettes with a clean form of nicotine, or with cigarettes which intend to deliver lower levels of toxins. In this scenario, nicotine continues to be provided through a less harmful method than by standard smoking.

The Citizens Council voted overwhelmingly in favour of the position that harm reduction in smoking is a valid strategy. In particular, using harm reduction as a way to quit smoking and break addiction was supported. However the notion of considering harm reduction as a way to provide a less harmful alternative to smoking - while accepting that nicotine addiction continues - proved relatively unpopular.

Sir Michael Rawlins, Chair of NICE, said: "The Citizens Council makes an important contribution to the work of NICE by enabling it to take the views of the general public into account when undertaking its work. The Citizens Council's comments on harm reduction in smoking - a difficult social values issue that may be seen as contentious in some fields - is therefore particularly helpful.

"The concept of harm reduction conflicts with traditional smoking cessation as it does not necessarily seek to help people stop smoking altogether, nor does it treat nicotine addiction. What would this approach mean for the goal of having a smoke free society? The Citizens Council's view will help guide our independent advisory committees, should they be required in the future to make recommendations about harm reduction in smoking. But first, we are very keen to hear what the general public thinks about the conclusions the Citizen's Council reached, before the report is presented to the NICE Board.

"Importantly, the Citizens Council discussion also revealed that there seems to be general public misunderstanding about nicotine, namely that many people may think that it is the nicotine in a cigarette that kills you. Many members of the public are also unaware of the smoking cessation services already available. The Citizens Council's view was that there was a need for better public information about these services. I'd like, once again, to thank the Council for its consideration of this issue."

The report on the Council's views is available for public comment, at http://www.nice.org.uk. Comments must be sent in by 5pm on Wednesday, 31 March 2010.

Source: Medical News Today - 1 February 2010
Link: http://bit.ly/9C2ox6

Counterfeit tobacco seized in Leeds stop search

Police in Leeds have seized thousands of pounds worth of counterfeit tobacco.

Officers found a "large quantity" of the fake baccy during a check on a van in King Lane, Alwoodley, on Friday, January 29.

A number of pirate DVDs were also discovered in the vehicle.

A 37-year-old woman was arrested and a subsequent search of her home address uncovered more counterfeit tobacco.

Contained in packets of compressed tea imported from China, it had an estimated street value of £12,000.

The woman has since been bailed pending further inquiries.

Friday's vehicle checks were a joint operation between West Yorkshire Police, Customs and Excise and the Environmental Enforcement Agency.

Sergeant Ian Micklethwaite, from the Roundhay, Alwoodley and Moortown neighbourhood policing team, said: "We are committed to working with our partner agencies and we will continue to be robust when tackling crime at all levels.

"We will not tolerate the distribution or importation of counterfeit goods and those that are caught doing so will be prosecuted."

Source: Yorkshire Evening Post - 1 February 2010
Link: http://bit.ly/daFSIr

Roundup of the press coverage of the DH's smoking strategy

The Department of Health released its new smoking strategy, A Smokefree Future, on Monday. Below is a round up of the coverage given to this release by the major news outlets.

Source: The Independent, 01 February 2010
Link: Smokers to face doorway ban in new public health policy

Source: The Guardian, 01 February 2010
Link: Smokers to face doorway ban in new public health policy

Source: The Telegraph, 01 February 2010
Link: Smoking ban could be extended to cover office doorways

Source: The Mirror, 01 February 2010
Link: Drive to halve smoking by 2020

Source: The Independent, 02 February 2010
Link: The Big Question: Can the number of smokers in the UK be reduced to one in 10 by 2020?

Source: BBC News, 1 February 2010
Link: Ministers aim to halve number of people smoking by 2020

Source: BBC News, 1 February 2010
Link: Smoking plan: Your views

Source: Yahoo!/AFP, 1 February 2010
Link: Govt pledges to halve number of smokers by 2020

Source: Reuters Health, 1 February 2010
Link: Britain looks at measures to reduce smokers by half

Source: The Guardian, 1 February 2010
Link: Pledge to halve smoking by 2020

Source: Bloomberg, 1 February 2010
Link: U.K. Plan to Order Plain Cigarette Packs Stirs Anger, WSJ Says

Source: Talking Retail, 1 February 2010
Link: ACS urges ministers to tackle tobacco black market

Staffordshire: Alarm warning to smokers

Firefighters have warned smokers to install smoke alarms following the death of a pensioner.

They say the vulnerable 79-year-old who died in a fire at her home in Wolstanton last week somehow slipped through the safety net of checks by emergency and social services until it was too late.

The pensioner, who has been identified by neighbours as Beryl Wain, is believed to have been a heavy smoker – but had no smoke alarms in her home on Sparch Avenue.

Fire crews used the annual general meeting of Newcastle's 50-Plus Forum on Saturday to urge other residents to ensure they have the potentially life-saving devices fitted and working.

The pensioner is thought to have died in a blaze fire started by a lit cigarette.

And Newcastle firefighters stressed how smoke alarms can save lives in such situations.

They added that some heavy smokers wrongly believe their cigarette fumes will set off the alarms.

But Firefighter Bob Bennett, pictured below, said: "After 30 years in the fire service I have seen enough death and destruction to know the usefulness of smoke alarms.

"That old lady slipped through the net. She was elderly and she was also a heavy smoker. Some people assume their smoking will set off the alarm but smoke alarms are not sensitive to cigarette smoking unless you are directly underneath them."

Crew manager Steve Snape added: "This fire death was absolutely terrible. The poor woman who died was missed by the fire service and other services. She was a vulnerable person who wasn't referred to us. It appears the fire was all to do with smoking."

The pensioner lived alone and it is understood that experts have found that the fire started after she fell asleep while smoking. No working smoke alarms had been fitted at her home and she had never been referred to Staffordshire Fire and Rescue for a home visit.

But, on the day of the fire, she was visited by a district nurse who recognised she needed help.

That nurse wanted a joint assessment with social services arranged and finally made a referral. But less than an hour later, a community matron arrived to discover the house was on fire.

At Saturday's meeting, firefighters handed out leaflets and free canvas shopping bags advertising the phone number for people to book a home check. Forum secretary Margaret Coley said: "The safety of all people, particularly the elderly, is paramount."

Forum committee member, Peter Cotton,aged 73, of Malham Road, Knutton, added: "I had a home fire safety check about a month ago. The firefighters came and changed the battery in my smoke alarm. It gives you peace of mind and a sense of security."

Source: The Sentinel - 1 February 2010
Link: http://bit.ly/ceo0KE

Drop in foreign travel helps UK tobacco sales

The recession has been a nightmare for many but a surprise boon for tobacco sellers thanks to fewer Brits holidaying abroad and the weakness of the pound against the euro hindering black market traders.

Leading CTN retailer Rippleglen this week reported an increase in tobacco sales. Although Rippleglen's total sales were down 2.9% to £103.5m for the year to 31 July and pre-tax profits also fell 35.5% to £214,000, it said sales in the tobacco category had recovered.

In a note in results published this week at Companies House, the directors attributed the uplift to a reduction in duty-free product and product bearing lower duty rates in other countries being brought back for later consumption.

The note also suggested the fall in the value of the pound during the results period meant that it was becoming uneconomic for black market traders to go abroad and buy lower-cost product. "Their purchasing costs have risen by around 30%," it said. "Some of the biggest tobacco sales increases we have seen have come from outlets near ports, where traditionally this problem was greatest."

The trend was occurring across the country and finally represented some good news for retailers in the fight against smuggling, said Tobacco Retailers Alliance spokeswoman Katherine Graham.

Those involved in the black market were increasingly turning towards counterfeit products and cheap whites, brands made by smaller manufacturers often outside the EU that have no legitimate market in the UK, she explained. These more organised operations were easier for HMRC to target than individuals smuggling cigarettes when returning from holiday, hence the increase in legitimate retail sales.

However, she warned that the trend may only be temporary if the economy and sterling continue to recover. The display ban due to be introduced in 2011 would also drive growth of smuggling, as had been the case in the Republic of Ireland, she added.

Source: The Grocer - 30 January 2010
Link: http://bit.ly/dmhkyq