PHYSICALLY ACTIVE SMOKERS MORE LIKELY TO KICK THE HABIT

Physically active smokers might have greater success quitting smoking than those who are more sedentary, according to a new study from the University of Toronto in Canada.

The study, which appears in the May issue of American Journal of Public Health, looked at the demographics of nearly 23,000 Canadian smokers. Physically active men were 36 percent more likely to have tried to quit smoking within the past year and women were 37 percent more likely to do so than their less-active peers were.

Previous studies have suggested that participating in one healthy behavior, such as physical activity, may lead to the adoption or maintenance of another positive behavior, such as smoking cessation, said lead author Wayne deRuiter.

Sources: www.tobacco.org and Health Behavior News Service
Date: 2008-04-01
Author: Marijke Vroomen-Durning
URL: http://www.hbns.org/getDocument.cfm?documentID=1682

FDA Warns of Adverse Events Linked to Smoking Cessation Drug and Antiepileptics

Patients taking the smoking cessation drug varenicline or antiepileptic drugs may be at risk of developing severe neuropsychiatric symptoms, according to recent alerts from the US Food and Drug Administration (FDA).
JAMA. 2008;299(10):1121-1122.
http://jama.ama-assn.org/cgi/content/full/299/10/1121

Preliminary evidence for gender-specific effects of topiramate as a potential aid to smoking cessation

Abstract: Aims
 
Study aims were threefold: (i) to determine the feasibility, potential efficacy and safety of topiramate as an aid to smoking cessation; (ii) to examine potential predictors of abstinence including gender; and (iii) to explore topiramate's effects on tobacco withdrawal and post-cessation weight gain. Design 
Randomized, double-blind, placebo-controlled, 11-week clinical trial with a 6-week dosage titration period and 5 weeks of maintenance treatment.
Setting 
Single-site, out-patient, randomized clinical trial.
Participants 
Thirty-eight adult male and 49 female chronic smokers who smoked an average of > 10 cigarettes per day and who were motivated to try to quit smoking.
Intervention 
Random assignment to receive either topiramate (n = 43) up to 200 mg daily in divided doses or placebo (n = 44) orally combined with brief counseling over an 11-week period.
Measurements 
Carbon monoxide (CO)-confirmed 4-week prolonged abstinence rate during weeks 8-11. Changes in tobacco withdrawal, body weight and safety parameters were also assessed.
Findings 
Overall, no significant increase in the prolonged abstinence rate was detected, but logistic regression analysis indicated significant gender-specific differences. Men treated with topiramate were nearly 16 times more likely to quit smoking than women on topiramate [37.5% versus 3.7%; odds ratio (OR) = 15.6; P = 0.016] and were roughly four times more likely to quit smoking than placebo-treated men (37.5% versus 13.6%; OR = 3.8; P = 0.098). Topiramate-treated men reported significantly lower tobacco withdrawal scores than both women taking topiramate and men on placebo. On average, male cessators on placebo gained 3.30 kg, whereas topiramate led to a 0.72 kg weight loss (P = 0.03). Study discontinuation rates due to adverse events (AEs) were significantly higher in the topiramate group (topiramate 23% versus placebo 2%). The most commonly reported AEs in the topiramate arm were paraesthesia, fatigue, difficulty with concentration/attention and nervousness.
Conclusions 
Topiramate produced gender-specific effects on smoking cessation. Male smokers had markedly greater quit rates than female smokers and men were roughly four times more likely to quit smoking when treated with topiramate as compared to placebo. Topiramate was fairly well tolerated, although higher discontinuation rates were seen. Topiramate's triple effects aiding smoking abstinence, attenuating nicotine withdrawal and preventing post-cessation weight gain might make it a promising agent for treating tobacco addiction, at least in men.

Authors: Anthenelli, Robert M.; Blom, Thomas J.1; McElroy, Susan L.2; Keck, Paul E.
Source: Addiction, Volume 103, Number 4, April 2008 , pp. 687-694(8)

China: Beijing to ban smoking ahead of Olympics

Smoking in most public places from May 1 will be banned as part of Beijing's efforts to improve the city ahead of the Olympics, state media reported on Monday.

Lighting up in the Chinese capital will be prohibited in all restaurants, offices and schools, becoming the first city in China to have such a comprehensive ban, the China Daily reported.

Hotels must also have rooms for non-smokers, but the proportion is still being discussed, a tobacco control expert involved in drafting the new rule told the paper.

Bars, meanwhile, will be required to clearly separate smoking from non-smoking areas, according to the newspaper.

Institutions that fail to comply face fines of up to 5,000 yuan (USD 700), and there are proposals to fine individuals up to 200 yuan although this has not been decided yet, the China Daily said.

Beijing authorities had announced in January that there would be a ban, but Monday's report was the first time a start date had been announced.

The city already has some restrictions on smoking in place, such as bans in cinemas, sports arenas and other large public venues, but they have had little success.

Beijing taxi drivers have also, in theory, been banned since last year from smoking in their vehicles.

The approach of the August Games has provided the impetus for the new ban, with Beijing pledging a smoke-free Olympics.

The places that will accommodate athletes and officials during the Games will all be non-smoking.

China has about 350 million smokers, or about a quarter of its population, and accounts for a third of the world's smokers, according to official statistics. About a million people die of smoking-related diseases each year in China.

Sources: ASH and Channel News Asia, 31st March 2008
Link: http://tinyurl.com/34plbv

Egypt: Water pipe smoking causes significant TB risk

The smoking of the traditional `shisha' water pipe is increasingly emerging as a significant health risk in Egypt, due to air-borne tuberculosis (TB) transmission from pipe sharing and uncontrolled, manual preparation of the pipe.

Rania Siam, professor of microbiology at the American University in Cairo (AUC), said the most important risk factor for TB infection was close household contact with a TB case, but she said water pipe smoking (WPS) and the sharing of the pipe with someone with pulmonary TB led to a great risk of TB transmission, especially among young adolescents.

"`Shisha' [smoking] is Egyptian culture, where people smoke tobacco and inhale directly from this device. If I smoke `shisha', some bacteria may reside in it. When you go to a fancy bar, they do change the mouthpiece, but what about the tube of the pipe? And the water? You still have water in the container where the bacteria resides," she said.

The World Health Organization (WHO) regional office in Cairo estimates that 17 percent of TB cases in the eastern Mediterranean are attributable to the smoking of water pipes.

According to the latest WHO statistics for Egypt, 31.6 in every 100,000 people had TB in 2005, and the rate of new TB cases that year was estimated at 25 per 100,000 people.

The WHO regional office said lack of TB control initiatives led to inadequate health care behaviour, affecting patients' diagnoses and treatment, and it therefore called for new public health care strategies.

Sources: ASH and Middle East Online, 29th March 2008
Link: http://tinyurl.com/34889v