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Study finds no increase in cardiovascular events w...

Last year a review of clinical trials of varenicline (Chantix) concluded that this smoking...

Posted by Jonathan Foulds, PhD

Last year a review of clinical trials of varenicline (Chantix) concluded that this smoking cessation medicine may cause an increased risk of serious cardiovascular events among smokers trying to quit and this was widely reported, including on WebMD . However, last week a new study , including all 22 placebo-controlled trials of varenicline published to date, found no significant increase in serious cardiovascular problems associated with use of varenicline. In this study a serious cardiovascular event included any ischaemic or arrhythmic adverse cardiovascular event (myocardial infarction, unstable angina, coronary revascularisation, coronary artery disease, arrhythmias, transient ischaemic attacks, stroke, sudden death or cardiovascular related death, or congestive heart failure).
Overall, the study found that 0.63% (34/5431) of people using varenicline experienced a serious cardiovascular event, as compared with 0.47% (18/3801) of those using placebo pills. This new study possibly came to a different conclusion than the previous review on this topic because it focused on events occurring while people were taking the drug and for 30 days thereafter. The previous study included events occurring throughout the whole duration of follow-up and did not correct for the fact that varenicline treated patients were more likely to participate in the follow-ups (and therefore report events), partly because they were much more likely to quit smoking.
The study authors, Drs Judith Prochaska and Joan Hilton of the University of California, concluded that, "Our meta-analysis of treatment emergent, cardiovascular serious adverse events, ... indicates that the risk of these events associated with varenicline use is small, and statistically and clinically insignificant."
I wonder if WebMD is going to report this new finding?View Thread

Posted by Jonathan Foulds, PhD

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How addicted are you?

One of the most widely used questionnaires designed to measure the strength of addiction to...

Posted by Jonathan Foulds, PhD

One of the most widely used questionnaires designed to measure the strength of addiction to cigarettes is called the "Fagerstrom Test for Nicotine Dependence" or FTND . It is a 6-item questionnaire, yielding a score from 0-10, with a higher score implying stronger addiction. Dr Karl Fagerstrom, the Swedish researcher who originally developed the FTND recently published a study that examined the relationship between baseline (pre quit attempt) FTND score and success in quitting smoking among almost 5000 smokers who participated in placebo-controlled trials of varenicline (marketed as Chantix in the USA). The study confirmed that smokers with lower pre-quit FTND scores had a much better chance of successfully quitting 6 months later. For example, smokers with the lowest scores (0-1) were twice as likely to successfully quit smoking as those with the highest scores (9-10). The study also found that a shorter, two-question version was just about as predictive of success in quitting smoking. The two key questions were:
1. How many cigarettes per day do you smoke?
2. How soon after you wake do you smoke your first cigarette of the day?
Those who smoke more than 30 cigarettes per day or smoke within 5 minutes of waking in the morning have a lower quit rate than those who smoke less than 11 cigarettes per day and typically don't smoke their first of the day until over an hour after waking in the morning. It appears that these two questions on their own can give a reasonable but fairly rough guide to how addicted a smoker is. I say "fairly rough" because even among those scoring a zero on these addiction assessments (i.e. the least addicted), the six month quit rate among those receiving placebo in the clinical trials was only twenty percent. This suggests to me that significant addiction is present among people who smoke less than 11 cigarettes per day. It also suggests that we need some additional questions that can help measure level of addiction at the low levels of daily cigarette consumption (i.e. <11 per day). It is unclear whether an individual actively delaying the first smoke of the day and reducing their daily cigarette consumption over time can make themselves "less addicted". It is possible, if sustained over a reasonably long period (i.e. greater than a month). However, perhaps a more practical use of these types of quick addiction assessments is to guide the smoker about whether they would likely benefit from assistance in quitting (e.g. counseling and/or medication). It seems that people who smoke just a few cigarettes per day and don't smoke within an hour of waking in the morning may have a good chance of success by picking a day and making a serious quit attempt on their own. Heavier smokers may be more likely to benefit from additional assistance. However, in this recent study, even those who had a zero score on the addiction questionnaires were more than twice as likely to successfully quit smoking for 6 months if they received varenicline as compared to those receiving placebo (47% v 20%).View Thread

Posted by Jonathan Foulds, PhD

2 Replies | Reply | Watch This Discussion Report This | Share this:How addicted are you? One of the most widely used questionnaires designed to measure the strength of addiction to...

Reply: Marijuana smoker of 7 years recently clean for 1 m...

Your lungs are in the process of expelling all the gook that has accumulated keep on working out and do...

Posted by angel272559

1 Reply | Reply | Watch This Discussion Report This | Share this:Marijuana smoker of 7 years recently clean for 1 month. At times coughing up phlegm with dark brown specs. help please? Your lungs are in the process of expelling all the gook that has accumulated keep on working out and do...

hypnosis and quitting smoking

I would like to know just how effective is Hypnosis on helping you quit smoking??

Posted by angel272559

0 Replies | Reply | Watch This Discussion Report This | Share this:hypnosis and quitting smoking I would like to know just how effective is Hypnosis on helping you quit smoking??

day 1

Tomorrow is my quit day and I already feel like im getting setence to time in prison. I decided 2 weeks ago...

Posted by Donnab6903

0 Replies | Reply | Watch This Discussion Report This | Share this:day 1 Tomorrow is my quit day and I already feel like im getting setence to time in prison. I decided 2 weeks ago...

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Reply: Acne after Quitting???

Is there an end to this acne? I smoked for 18 years... and it's been almost 3 mths cigarette free. How much...

Posted by BeauJolie

19 Replies | Reply | Watch This Discussion Report This | Share this:Acne after Quitting??? Is there an end to this acne? I smoked for 18 years... and it's been almost 3 mths cigarette free. How much...

Acne is nonstop since I quit smoking....

I quit smoking almost 3 months ago.... I feel fantastic. I smoked for 18 years. But since I quit smoking,...

Posted by BeauJolie

0 Replies | Reply | Watch This Discussion Report This | Share this:Acne is nonstop since I quit smoking.... I quit smoking almost 3 months ago.... I feel fantastic. I smoked for 18 years. But since I quit smoking,...

Reply: quit smoking..

Thanks for the post. Just turned 51 and run on n off. I'm a yoga teacher n yoga therapist. I really want...

Posted by GoingtoIndia

2 Replies | Reply | Watch This Discussion Report This | Share this:quit smoking.. Thanks for the post. Just turned 51 and run on n off. I'm a yoga teacher n yoga therapist. I really want...

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Reply: Electronic Cigarettes?

Hi everyone, I'm currently considering purchasing an e-cigarette. Im unsure as to what strength of 'e...

Posted by diannedo

49 Replies | Reply | Watch This Discussion Report This | Share this:Electronic Cigarettes? Hi everyone, I'm currently considering purchasing an e-cigarette. Im unsure as to what strength of 'e...

Reply: Need to quit......NOW!!!

Hi plc! Good to hear back from you too! Its nice to know we really aren't alone. Beginning day 4 and I too have...

Posted by kam6400

8 Replies | Reply | Watch This Discussion Report This | Share this:Need to quit......NOW!!! Hi plc! Good to hear back from you too! Its nice to know we really aren't alone. Beginning day 4 and I too have...

Reply: Nicotine/Cotinine

Nicotine has an average "half-life" of 2 hours in the human body, but it can range from 1 to 4...

Posted by Jonathan Foulds, PhD

1 Reply | Reply | Watch This Discussion Report This | Share this:Nicotine/Cotinine Nicotine has an average "half-life" of 2 hours in the human body, but it can range from 1 to 4...

side effect from the patch???

Proud to say it has been two days smoke free on the patch. However I have IBS and since on the patch the...

Posted by plc111111

0 Replies | Reply | Watch This Discussion Report This | Share this:side effect from the patch??? Proud to say it has been two days smoke free on the patch. However I have IBS and since on the patch the...

Reply: quit smoking

You will be feeling sleepy and have a lack of energy due to your body adjusting to the lack of nicotine in...

Posted by dazsmith10

22 Replies | Reply | Watch This Discussion Report This | Share this:quit smoking You will be feeling sleepy and have a lack of energy due to your body adjusting to the lack of nicotine in...

New CDC Smoking Education Ads: What Do You Think?

The Centers for Disease Control and Prevention (CDC) just launched a set of new TV ads that can be...

Posted by Jonathan Foulds, PhD

Take the Poll

Which of the new CDC smoking education ads do you think is most effective in motivating smokers to quit?

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Reply: Anne when quitting smoking

HI Anne, I experienced the same thing, not on my face but actually in my arm pits. Believe it or not...

Posted by nosmokingtoday

2 Replies | Reply | Watch This Discussion Report This | Share this:Anne when quitting smoking HI Anne, I experienced the same thing, not on my face but actually in my arm pits. Believe it or not...

Reply: Chantix - Smoking in my car...help

Hi Alzinny, I think your main problem is about the habit not the addiction to nicotine. So, in my opinion, to...

Posted by roshan007

2 Replies | Reply | Watch This Discussion Report This | Share this:Chantix - Smoking in my car...help Hi Alzinny, I think your main problem is about the habit not the addiction to nicotine. So, in my opinion, to...

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Reply: Nicotine patch safe but not effective for smoking ...

Jonathan thanks for your post. I have found that one of the issues that affect compliance may be the...

Posted by Michael_Myers_TTS

1 Reply | Reply | Watch This Discussion Report This | Share this:Nicotine patch safe but not effective for smoking cessation in pregnancy. Jonathan thanks for your post. I have found that one of the issues that affect compliance may be the...

The Natural History of Quitting Smoking

A new research study has recently been published in the journal Addiction, by Professor Ron...

Posted by Jonathan Foulds, PhD

A new research study has recently been published in the journal Addiction, by Professor Ron Borland and an international team of researchers which gives perhaps the best data on the smoking cessation process yet seen. This study conducted telephone interviews with approximately 2000 smokers in Australia, Canada, UK and USA each year from 2002 to 2008. They attempted to recall those who quit smoking in subsequent years, resulting in a sample of almost 22,000 people. At each interview, participants were asked detailed questions about their quit attempts both in the past and since their last interview. At the first wave of interviews, 82% reported having made a prior quit attempt, reaching 94% among those who participated in all 7 waves of interviews. 43% reported a quit attempt in the prior 12 months. Over a 5 year period, 69% of those starting as smokers had reported quit attempts of at least a month, and overall 16% managed to quit and remain quit for at least a year. The study shows that quit attempts are very common, with around 40% of smokers trying to quit each year, each making an average of 2 attempts per year. Thoughts of quitting that do not result in serious attempts are even more common, with an additional 30% of smokers having "serious thoughts" about quitting but not making a serious attempt. One other finding from this study is that smokers tend to forget their short-lived quit attempts, with 20% being forgotten within a year. Based on detailed analyses of their longitudinal data, the authors estimate that the average 40 year-old smoker who started smoking in their teens will have made more than 20 failed quit attempts. More than half of current smokers have succeeded in quitting for at least a month, and a majority of these for over 6 months.
This study, perhaps the most detailed of its kind, reminds us that quitting smoking is best conceptualized as a process requiring efforts, often repeated, over a long period of time, rather than as a single event.
Reference: Borland et al (2012). How much unsuccessful quitting activity is going on among adult smokers? Data from the International Tobacco Control Four Country Cohort Study. Addiction, 107, issue 3. P673-682.View Thread

Posted by Jonathan Foulds, PhD

0 Replies | Reply | Watch This Discussion Report This | Share this:The Natural History of Quitting Smoking A new research study has recently been published in the journal Addiction, by Professor Ron...

Smoking in Men Speeds Up Mental Decline!

Study: More Rapid Mental Decline Seen in Male Smokers, Not Females Feb. 6, 2012 -- Smoking is...

Posted by Chris_WebMD_Staff

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Reply: Sleepless Nights

It has been 5 months since I quit and I still have at least 2 nights a week that are significantly sleep...

Posted by Aquarius1234

1 Reply | Reply | Watch This Discussion Report This | Share this:Sleepless Nights It has been 5 months since I quit and I still have at least 2 nights a week that are significantly sleep...

Reply: Time to prepare for New Year Quitting

Check out my comments on the recent study claiming to show that nicotine replacement therapy...

Posted by Jonathan Foulds, PhD

Take the Poll

When are you planning to quit?

3 Replies | Reply | Watch This Discussion Report This | Share this:Time to prepare for New Year Quitting Check out my comments on the recent study claiming to show that nicotine replacement therapy...

Join In On Our Community Talk Show!

Great Topic Today on Smoking! Smoke, But do it outside!

Posted by Chris_WebMD_Staff

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Sore Throat & Excess Drainage

Is this something common and how long does it last?

Posted by An_242417

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Emotional Effects?

What does one expect emotionally when they quit smoking and how long do these symptoms typically last? I...

Posted by An_242417

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Reply: Is father-in-law chewing again?

You can't help him-he has to have his own mind set to do it for his self. Don't know anything about...

Posted by BethAnncares

1 Reply | Reply | Watch This Discussion Report This | Share this:Is father-in-law chewing again? You can't help him-he has to have his own mind set to do it for his self. Don't know anything about...

Reply: Odd Withdrawal Symptoms?

Some people using the nicotine patch report an unusual taste in their mouth (more often described...

Posted by Jonathan Foulds, PhD

1 Reply | Reply | Watch This Discussion Report This | Share this:Odd Withdrawal Symptoms? Some people using the nicotine patch report an unusual taste in their mouth (more often described...

Reply: Cessation

yes..thats why im affraid to quit because i have to work and go to school and im not usualy that emotional...

Posted by strwbrybabe

7 Replies | Reply | Watch This Discussion Report This | Share this:Cessation yes..thats why im affraid to quit because i have to work and go to school and im not usualy that emotional...

Reply: Need to quit.....

Have you tried electronic cigarettes?

Posted by ecigdomaincom

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I'm kinda biased :-)

Well guys as far as smoking goes I have to declare a personal interest here...I used to be a heavy smoker...

Posted by ecigdomaincom

0 Replies | Reply | Watch This Discussion Report This | Share this:I'm kinda biased :-) Well guys as far as smoking goes I have to declare a personal interest here...I used to be a heavy smoker...

Reply: How to Live with a Family Member who Smokes

Hiya and welcome! That is a good question and it's not easy to live with anyone that smokes!! All...

Posted by Chris_WebMD_Staff

1 Reply | Reply | Watch This Discussion Report This | Share this:How to Live with a Family Member who Smokes Hiya and welcome! That is a good question and it's not easy to live with anyone that smokes!! All...

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