FDA informed healthcare professionals of reports of suicidal thoughts and aggressive and erratic behavior in patient who have taken Chantix, a smoking cessation product. There are also reports of patients experiencing drowsiness that affected their ability to drive or operate machinery. FDA is currently reviewing these cases, along with other recent reports. A preliminary assessment reveals that many of the cases reflect new-onset of depressed mood, suicidal ideation, and changes in emotion and behavior within days to weeks of initiating Chantix treatment. The role of Chantix in these cases is not clear because smoking cessation, with or without treatment, is associated with nicotine withdrawal symptoms and has also been associated with the exacerbation of underlying psychiatric illness. However, not all patients described in the cases had preexisting psychiatric illness and not all had discontinued smoking.

Healthcare professionals should monitor patients taking Chantix for behavior and mood changes. Patients taking this product should report behavior or mood changes to their doctor and use caution when driving or operating machinery until they know how quitting smoking with Chantix may affect them.

Read the complete 2007 MedWatch safety summary including a link to the FDA Early Communication Sheet about an Ongoing Safety Review regarding this issue at:
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Chantix.

Smoking is responsible for five million deaths worldwide and while most people are aware of the harmful effects of smoking few are aware that smoking is concentrated among people with mental illness, often compounded by substance-abuse disorders such as alcoholism.

Go to most Alcoholics Anonymous meetings, and the room will be so full of smoke that you can cut it with a knife. Ask the members, and they will tell you that it was much easier to stop drinking than to stop smoking. Indeed, nicotine, the addictive component of tobacco smoke, is as habituating as cocaine or heroin, and it has a similar effect on chemical receptors in the brain.

For years, mental health professionals ignored smoking. One reason is well intended but uninformed compassion. After years of tolerating, and even encouraging smoking among people with mental illness, mental health professionals are beginning to recognise the hazards of smoking. Two things have been especially powerful: the spread of facts about the dangers of secondhand smoke and a recent analysis showing that people with chronic mental illness die 25 years earlier than the rest of the population, with many of those lost years attributable to smoking.

So, what can be done to help people with mental illness stop smoking? Although their odds of actually quitting are not as high, about half that of smokers who don't have mental health conditions, there are many success stories.

There is a growing trend in the United States to make mental health hospitals smokefree, both indoors and on their campuses. For the first time ever, more than half of these institutions in the United States are now smokefree, and those numbers are increasing. Predicted complications of increased violence and the need for disciplinary actions in the wake of going smokefree have proved false. In fact, removing smoking as a cause of staff-patient friction has meant fewer violent incidents and more opportunity for staff to interact therapeutically with their patients. Tools to help smokers quit, including counselling and drugs such as nicotine replacement, buproprion and varenicline are available but are still greatly underused.

It will not be easy to reverse the long alliance of smoking and mental illness. But the fact that mental health clinicians and patient and family advocacy groups have recognized the problem and are willing to address it is an essential first step toward wellness

Sources: ASH (www.ash.org.uk)and Washington Post, 18 November 2007
Link: http://tinyurl.com/2j24qg

Victorian health authorities will recycle a confronting anti-smoking campaign, after new research revealed most smokers did not identify lung cancer as a disease they could develop.
Research from the Cancer Council Victoria shows that despite smoking accounting for 80 per cent of all lung cancer cases, six in 10 smokers did not mention it when asked to name diseases caused by smoking.
The five-year survival rate for lung cancer sufferers is just 11 per cent, and 34 Victorians each week die from the disease, according to the Cancer Council.

Sources: www.tobacco.org and AAP (Australian Associated Press) (au)
Date: 2007-11-22
URL: http://www.smh.com.au/news/National/Smokers-get-lung-cancer-reminder/2007/11/22/1195321916903.html

The R.J. Reynolds Tobacco Co, which has been under intense pressure from anti-smoking groups and members of Congress over print adverts for its cigarettes, said it would not advertise its brands in newspapers or consumer magazines next year.

The company had been criticized sharply for both its colourful and feminine Camel No. 9 adverts, which appeared in fashion magazines and were seen as cynically aimed at young women.

R.J. Reynolds spokeswoman Jan Smith said the decision had been made sometime before October and was unrelated to the Rolling Stone controversy.
In a telephone interview, Smith called the move "an effort by the company to enhance and sharpen the effectiveness and efficiency of its marketing programmes and the company had taken into account, the protests over the Camel No. 9 adverts."

"Obviously tobacco industry issues are in mind with every decision we make," Smith said. "A result of this is there should be less controversy over cigarette advertising in magazines and newspapers, because we won't be doing it."
The Washington based Campaign for Tobacco-Free Kids, which has long protested the Camel adverts, called the company's decision "more a strategy to deflect criticism than a real change in marketing."

Matthew Myers, president of the group, said it was unfortunate that R.

J. Reynolds had not committed to permanently stop print advertising. Smith said the company, based in Winston-Salem, N.C., would make decisions about future years at a later time.

Myers also said the company has far to go to curtail egregious marketing practices, which include promotions at bars and nightclubs.
He added,"What they've done is just to limit the adverts that have prompted the fiercest criticism, because they are the most visible. The company is still engaging in direct mail advertising, heavy promotion at retail outlets, and price promotion "for the brands kids like most."
The print adverts account for only a tiny portion of what the tobacco industry spends on marketing. But they've been notable because they often appear in magazines side by side with articles promoting women's health.
Print adverts for tobacco are banned in a number of countries, including throughout Europe, but legal in the United States. Tobacco advertising was banned from radio and TV a long time ago and more recently from billboards.
A number of magazines refuse to accept tobacco adverts. A few are Self, Men's Health and Money, according to the Tobacco-Free Periodicals Project.
Source: www.tobacco.org and Associated Press, 28 November 2007
Link: http://tinyurl.com/24bdkj

Rates of tobacco use among individuals diagnosed with schizophrenia have been estimated as high as 80%. A variety of hypotheses have been proposed to explain the high rate of tobacco use among this vulnerable group. This study examined the tobacco industry's efforts to establish and promulgate beliefs about schizophrenic individuals' need to smoke and the hazards of quitting.
The current study analyzed previously secret tobacco industry documents. The initial search was conducted during January-July 2005 in the Legacy Tobacco Documents Library. The search yielded 280 records dating from 1955 to 2004.
Documents indicate the tobacco industry monitored or directly funded research supporting the idea that individuals with schizophrenia were less susceptible to the harms of tobacco and that they needed tobacco as self-medication. The tobacco industry promoted smoking in psychiatric settings by providing cigarettes and supporting efforts to block hospital smoking bans. The tobacco industry engaged in a variety of direct and indirect efforts that likely contributed to the slowed decline in smoking prevalence in schizophrenia via slowing nicotine dependence treatment development for this population and slowing the rate of policy implementation vis-à-vis smoking bans on psychiatric units.

Schizophr Bull. 2007 Nov 5; [Epub ahead of print]
http://schizophreniabulletin.oxfordjournals.org/cgi/content/abstract/sbm117v1

According to researchers involved in a study on international tobacco control policies, graphic warning labels on cigarette packages, tobacco advertising bans, increased cigarette taxation and smoking bans are among the most effective ways to discourage smoking.

According to researchers who have been investigating progress on controlling tobacco use under the Framework Convention on Tobacco Control (FCTC), regulating tar and nicotine levels in cigarettes hasn't been as effective as other approaches.

Michael Cummings, chair of the department of health behaviour at Roswell Park Cancer Institute in New York said, "For the first time ever, we are beginning to scientifically assess which governmental tobacco control policies are working and which ones are not."

He added, "In the same way that evidence based medicine has been built from rigorous evaluation of treatment options, our goal is to contribute to the development of a sound science base for tobacco control policies."

He launched the study in four countries in 2002 and has expanded into 15 countries with the help of 60 investigators from 17 research institutes.

The International Tobacco Control Policy Evaluation study compares the behaviour of tobacco use in nations that have implemented FCTC policies with countries such as the United States that have not implemented such measures. There are between 1,000 to 2,000 participants in each country included in the study.

A number of policies are effective, including graphic warning labels on cigarette packages.

"Our research on package warnings has revealed that these warnings, especially if they are large and graphic, are more effective than anyone realised, especially in poorer countries that can't afford expensive counter marketing campaigns," Cummings said.

The research was to be presented at an American Association for Cancer Research meeting in Philadelphia

Source: www.ash.org.uk and Healthfinder, 06 December 2007
Link: http://tinyurl.com/2nr98g

Young adults trying to stop smoking may soon be able to look to their cellphone for support.
Researchers at the University of Auckland are using mobile technology to send video diaries from one quitter to another.
It has been six months since 18-year-old Sarah had a smoke - a habit she picked up, and practised, at school.
"We even had a name for the teachers - Ako - the Maori name - cause they wouldn't understand," says Sarah Leatitagaloa, a former smoker.
But her addiction was not always a joke - while trying to stop, she discovered she was five weeks pregnant.

Sources: www.tobacco.org and nzoom.com (TVNZ)
Date: 2007-11-24
URL: http://tvnz.co.nz/view/page/1318360/1461668

A new study from the Danish Cancer Society charges the tobacco industry with knowingly adding at least 200 different chemicals to its products in order to make it easier for people to smoke.
Some of the chemicals also increase the addictive power of nicotine, according to Per Kim Nielsen of the Cancer Society.
He added that some of the chemicals are directly harmful to the body.

Source: www.tobacco.org and Copenhagen Post (dk)
Date: 2007-11-26, info@cphpost.dk
URL: http://www.cphpost.dk/get/104533.html

Researchers say that simple measures to reduce salt intake, smoking and damage to arteries could save 32 million lives a year by 2015 in those countries most afflicted by chronic disease.

The annual cost of the strategy would be equivalent to just 50p per head in the countries investigated.

Experts conducted a series of studies looking at achievable ways to reduce the chronic disease burden in 23 low to middle-income countries around the world. They included Mexico, Egypt, India, Nigeria, Poland, Thailand and China.

The countries were chosen because between them they account for more than 80% of worldwide deaths due to heart disease, cancer, chronic lung conditions and diabetes.

The measures could be achieved through voluntary reductions in the salt content of processed foods and anti-tobacco measures such as workplace smoking bans, higher tobacco taxes, and health warnings on cigarette packets.

The experts, who reported their findings in a special series of papers to be published in The Lancet medical journal, said the lives could be saved with sufficient commitment.

Professor Robert Beaglehole, from the University of Auckland, New Zealand, a member of the international team, said: "Nothing like this has ever been presented for chronic diseases before.

"We can avert 32 million deaths by 2015, and approximately half of these averted deaths would be among relatively young people under 70 years of age."

Source: www.ash.org.uk and Channel 4 News, 05 December 2007
Link: http://tinyurl.com/3yzsbo

Reducing salt intake and tobacco use in poorer countries can save almost 14 million lives by 2015, public health specialists said.

The annual expense would be as little as 36 cents a person, according to a series of articles in The Lancet. The researchers also said providing aspirin, two blood pressure-lowering medicines and a cholesterol-reduction treatment would save another 18 million lives at a cost of $1.10 a person per year.

The five studies looked at 23 low- and middle-income countries, where more than 60 percent of the deaths from chronic diseases occur. About six in 10 of the 58 million deaths worldwide in 2005 came from illnesses including heart disease, stroke, cancer, diabetes, asthma and smoker's cough, according to the World Health Organization in Geneva.

``The idea in a lot of people's heads is that these are diseases of rich countries,'' said Colin Mathers, a WHO official who co-wrote one of the articles. ``It's not true. Most deaths in the world from heart disease, cancer and so on are in low- and middle-income countries.''

The countries studied included Russia, China, India, South Africa, Brazil, Turkey, Mexico, Pakistan, Poland and Nigeria.

Source: www.tobacco.org and Bloomberg News
Date: 2007-12-05
Author: Andrea Gerlin, agerlin@bloomberg.net
URL: http://www.bloomberg.com/apps/news?pid=20601102&sid=am.rhaz79MKQ&refer=uk ID: 256247

NHS 'stop smoking' clinics have been hailed a success after figures showed particular progress in deprived areas.
The study found 8.8% of smokers in poorer areas had quit at the four-week mark, compared to 7.8% elsewhere.
The comparison is particularly relevant as smoking is a key factor in health inequalities with those from deprived backgrounds more likely to smoke.
The Bath University-led team compiled the data from the 1.5m people using the clinics in England from 2003 to 2006.
Smoking cessation clinics, offering counselling and treatment in the form of nicotine replacement therapy, were set up in 1999.
This study shows that extra NHS cash really has managed to get more people to stop smoking

Source: www.tobacco.org BBC Online Date: 2007-12-05
URL: http://news.bbc.co.uk/1/hi/health/7127193.stm

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