Champix/Chantix Warnings

Champix is the trade name for Chantix in the UK.

There have been a number of reports recently regarding the safety of Chantix for patients operating machinery or driving. Chantix is known to cause some drowsiness and the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) has issued new guidance regarding its use. Specifically, they have suggested that people taking Chantix should not operate machinery or drive whilst undertaking the course of the drug.

Chantix treatment regimens typically last between 12 and 24 weeks. The drug works by interfering with the action of nicotine in the brain. The results of which lead to smokers having reduced cravings for nicotine and little pleasure from smoking.

There are more details regarding chantix side effects at the following website:

In another case in the UK, a man on a course of chantix to overcome smoking committed suicide, apparently out of the blue and there is growing evidence that suicidal thoughts should be listed as a possible side effect of taking the drug.

Over 4 million Americans, 500,000 Europeans and about 20,000 Brits have taken the anti-smoking drug which allegedly doubles a smokers chance of quitting.

The MHRA has had 46 reports of depression associated with the use of Chamtix and 16 reports of patients experiencing suicidal thoughts. It is well known that stopping smoking can exacerbate existing psychiatric conditions though.

The prescribing information leaflet already contains warnings that it should be used with care in people with a previous psychiatric illness such as depression.

It is thought that so long as patients are fully aware of the potential side effects of the drug, and are of sound mind, they should have no difficulty managing side effects and thus increasing their chances of becoming smoke free.

Smoking rates stop falling

The CDC has reported that smoking rates in the US have remained the same over the last few years after having fallen year on year for the previous 7 years (1997-2004).

The government’s target is to have only 12% of the adult population smoking by 2010 but the figures suggest that they will miss the target by a long shot.

Statistics show that 20.8% of the adult population smoked last year representing a total of 45 million adults. The statistics also show that a total of 91 million Americans have been smokers at some point in their lives (defined as smoking over 100 cigarettes in their lives).

The report indicated that 80% of smokers smoked every day and 44% of smokers had tried at least once to quit smoking.

Evidence suggests that quitting smoking is the single most advantageous change a smoker can make in their lives to improve their health and lower risks of smoking related disease, such as cancer, emphysema, bronchitis, heart disease and stroke.

Unlocking the secrets of cot death

Exclusive: A major new report seen by the IoS has revealed that smoking holds the key to a mystery that has baffled doctors and brought heartache to thousands.

Nine out of 10 mothers whose babies suffered cot death smoked during pregnancy, according to a scientific study to be published this week. The study, thought to be one of the most authoritative to date on Sudden Infant Death Syndrome (SIDS), says women who smoke during pregnancy are four times more likely than non-smokers to see their child fall victim to cot death.

The comprehensive report will make a strong case for the Government to increase the scope of anti-smoking legislation. It even suggests a possible move to try to ban pregnant women from getting tobacco altogether.

The study, produced by Bristol University’s Institute of Child Life and Health, is based on analysis of the evidence of 21 international studies on smoking and cot death. The report, co-authored by Peter Fleming, professor of infant health and developmental physiology, and Dr Peter Blair, senior research fellow, will be published this week in the medical journal Early Human Development.

The report urges the Government “to emphasise the adverse effects of tobacco smoke exposure to infants and among pregnant women”. It also warns that this year’s ban on smoking in public places must not result in an increased exposure of infants or pregnant woman at home – smoking in their presence should be seen as being “anti-social, potentially dangerous, and unacceptable”.

The study points out that many mothers and mothers-to-be have not heeded warnings about smoking and may need to have their access to tobacco restricted. “Given the power that tobacco addiction holds over its victims, there is grave concern as to whether it will be a successfully modifiable risk factor without fundamental changes in tobacco availability to vulnerable individuals,” it states.

Scientists are working to the theory that exposure to smoke during the pregnancy or just after birth has an effect on brain chemicals in the foetus or in infants, increasing the risk of SIDS.

The Government is considering whether it should change its advice on smoking. It recommends that pregnant women should not drink alcohol at all, but simply recommends that mothers and fathers “cut smoking in pregnancy”.

These findings will add weight to calls from doctors earlier this year for a ban on parents smoking indoors where children are present. Professor Robert West, of University College London, the Government’s most senior smoking adviser, said: “We can apply powerful social pressure on parents not to smoke in the house.”

Speaking about the new report, Dr Blair said: “If smoking is a cause of SIDS, and the evidence suggests it is, we think that if all parents stopped smoking tomorrow more than 60 per cent of SIDS deaths would be prevented.”

According to the Foundation for the Study of Infant Deaths (FSID), at least 300 babies in the UK each year die suddenly and unexpectedly, mostly between the ages of one month and four months. SIDS is the biggest killer of babies over a month old, claiming more deaths than traffic accidents, leukaemia and meningitis put together.

The issue has prompted a number of high-profile criminal convictions against mothers such as Angela Cannings and Sally Clark. Mrs Cannings suffered the deaths of three babies who died in their cribs. Mrs Clark had two infants who were taken by SIDS. Both women were jailed but later had their convictions overturned and were released in 2003. Mrs Cannings, whose family smoked, was too upset by personal matters to comment yesterday on the findings of this latest study. Mrs Clark, a non-smoker, died last March.

Although scientists are still trying to understand precisely why babies die so young, medical research is providing effective steps that parents can take to reduce the risk of it happening.

Anti-smoking messages have provided some benefits: in the past 15 years, researchers found that the proportion of smokers among all pregnant mothers in the UK has fallen from 30 to 20 per cent.

Nevertheless, according to another study, in 1984 57 per cent of babies who died from SIDS had mothers who smoked during pregnancy. This had increased to 86 per cent by 2003. It is thought that the huge rise in the proportion of SIDS mothers who smoke is at least to some degree a result of the Back to Sleep campaign which was launched in 1991, and which appears to have had a dramatic effect in reducing cot death.

The key message of this campaign was that parents should put their baby on its back to sleep. Since then, the number of SIDS deaths has fallen by three-quarters. The proportion of SIDS babies found lying face down has fallen from 89 per cent to 24 per cent.

The campaign has also changed the social profile of parents whose infants have died from SIDS. Before the Back to Sleep campaign, fewer than half were from lower socio-economic classes, considered to be “deprived”. Now, this proportion has risen to 74 per cent.

The researchers now believe that laying babies face down has been largely removed as the main reason for SIDS. The remaining primary dangers are exposure to tobacco smoke and other factors possibly linked to deprivation.

“The risk of unexpected infant death is greatly increased by both prenatal and postnatal exposure to tobacco smoke,” said Dr Blair. “We should aim to achieve a ‘smoke-free zone’ around pregnant women and infants.

“Reduction of prenatal exposure to tobacco smoke, by reducing smoking in pregnancy, and of postnatal exposure to tobacco, by not allowing smoking in the home, will substantially reduce the risk of SIDS.”

There are a number of theories to explain how smoking could affect the baby. Babies exposed to tobacco could have breathing problems. Lung development in the growing foetus could be hindered. Another theory is that levels of brain chemicals are affected by smoke exposure.

“Exposure to tobacco smoke, either prenatally or postnatally, will lead to a complex range of effects upon normal physiological and anatomical development in foetal and postnatal life, together with an increased incidence of acute viral infection that places infants at greatly increased risk of SIDS,” says the Bristol University study.

Deborah Arnott, the director of ASH, the anti-smoking charity, said that this report should provoke a strong government campaign to highlight the risks of women smoking while pregnant, and of parents smoking in the home.

“Because of other advice on avoiding cot death, smoking has become an increasingly important trigger and we are very concerned that there is a lack of understanding of how important it is,” she said.

A YouGov poll commissioned for ASH at the end of August showed only 17 per cent of respondents thought second-hand smoke had a big impact on cot-death risk, and 26 per cent that it had “some impact”. But Ms Arnott does not believe the public ban will necessarily increase smoking at home. She added: “About 85 per cent of smoke is invisible and people think it isn’t having an impact if they smoke in a room where the baby isn’t, but it moves around the house. Our advice is, if you have a baby and cannot give up, don’t smoke in the home or car and use nicotine gum or patches for cravings. Being realistic, banning smoking in the home isn’t something we can do.”

Catherine Parker-Littler, a midwife and founder of, said that her confidential service has received emails from smokers who lost infants to cot death. “In our ‘Ask a Midwife’ service, we have definitely had emails from a small number of parents who smoke about their experience in terms of a cot death,” she said. “Some are about feelings of guilt.”

A spokeswoman from the Department of Health said: “This is an interesting report which we will study carefully and consider whether we need to change our advice. At the moment, our advice on how best to reduce the chances of cot death is based on the best available scientific evidence. We advise parents to cut out smoking in pregnancy and not to share a bed with your baby if you are a smoker.”

Early Test for Lung Cancer Developed

By Daniel J. DeNoon, WebMD Medical News
Reviewed by Louise Chang, MD

Sept. 18, 2007 — A new blood test promises to detect lung cancer at its earliest, most curable stages.

The test is under development by Panacea Pharmaceuticals, Gaithersburg, Md. It detects a recently discovered protein called HAAH. People with at least 20 different kinds of cancer — including lung cancer — have much higher than normal HAAH levels in their blood.

The test does not prove that a person has cancer. But it does identify people who need additional, more definitive tests, says Panacea research scientist Mark Semenuk.

“The important thing is that we can pick up even stage I lung cancer,” Semenuk tells WebMD. “To diagnose lung cancer really early provides the opportunity for curative treatment. Unfortunately, lung cancer does not cause symptoms until fairly late in the disease process.”

Semenuk presented studies of the new lung cancer test to this week’s American Association for Cancer Research second international conference on Molecular Diagnostics in Cancer Therapeutic Development, held Sept. 17-20 in Atlanta.

In their first study, Semenuk and colleagues obtained 160 blood samples from 160 patients at all four stages of lung cancer and from 93 people who did not have lung cancer.

The HAAH test was positive in 99% of the lung cancer samples but was nearly undetectable in people without cancer. This study allowed the researchers to set an HAAH cutoff level — 3 ng/mL (nanograms/milliliter) — that maximizes the number of cancers detected while minimizing the number of false-positive test results.

In a second study, the researchers tested how well the HAAH test could tell people with various stages of lung cancer from smokers without lung cancer. Previous blood tests for lung cancer have been unable to differentiate smokers — who are at very high risk of lung cancer — from patients with early-stage lung cancer.

The result: Average HAAH levels were about the same for patients at all four stages of lung cancer, ranging from 16 ng/mL to 22 ng/mL. Average HAAH levels for smokers not known to have cancer were zero. However, about 10% of the smokers tested positive for elevated HAAH levels.

“These results are very encouraging, because they point to those patients who are most likely to need further testing,” Semenuk says. “Elevated levels of HAAH cannot confirm whether a person has lung cancer, but can be used as a routine screening test for recommending further diagnostic evaluation. That is the way most cancer biomarker tests … are meant to work, and this may be one of the most effective to date.”

Panacea already offers the three versions of the HAAH test: LC Detect for lung cancer, PC Detect for prostate cancer, and TK Sense to test whether patients with chronic myelogenous leukemia respond to the drug Gleevec. Doctors can send specially prepared blood samples to the Panacea laboratory for testing. The cost of the lung cancer and prostate cancer tests is $125. The TK Sense test costs $500.

Semenuk says that the company is working on possible cancer treatments based on HAAH.

Smoking women get more acne!

Women who smoke have been found to be four times more likely to get acne than their non-smoking counterparts. In a study conducted on 1000 women between the ages of 25 and 50, 42% of smokers were found to have acne compared with only 10% of the non-smokers in the group.

This ‘smokers’ acne’ is characterised by blocked pores and large blackheads but less inflamed spots than normal acne.

Smokers who had suffered from acne in their teens were found to be 4 times more likely to suffer from this smoker’s acne.

Dr Bruno Capitanio, one of the study’s authors, said:

“Our study demonstrates that NIA affects a high percentage of women, and is especially high among smokers. Recognizing this form of acne is fundamental to providing correct information about the effects of tobacco on the skin.

Dr Colin Holden, President of the British Association of Dermatologists, said:

Dermatologists have long associated smoking with premature ageing of the skin, wrinkles and a leathery complexion.

However, scientists are now increasingly linking the habit with acne. For people who suffered acne as teenagers, the probability of also suffering acne in adulthood is four times higher in smokers than non-smokers. This suggests that smoking could be a major contributing factor for adult acne if you are already predisposed to the disorder.

This study also shows an interesting link between a specific type of acne and smoking. All of these findings will hopefully provide people with an extra incentive to quit.

About 70 per cent of smokers say that they want to stop smoking, but most believe they are unable to. However, around half of all smokers eventually manage to give up.

NHS Should not treat smokers according to Tories

Failing to follow a healthy lifestyle could lead to free NHS treatment being denied under the Tory plans.

Patients would be handed “NHS Health Miles Cards” allowing them to earn reward points for losing weight, giving up smoking, receiving immunisations or attending regular health screenings.

Like a supermarket loyalty card, the points could be redeemed as discounts on gym membership and fresh fruit and vegetables, or even give priority for other public services – such as jumping the queue for council housing.

But heavy smokers, the obese and binge drinkers who were a drain on the NHS could be denied some routine treatments such as hip replacements until they cleaned up their act.

Those who abused the system – by calling an ambulance when a trip to the GP would be sufficient, or telephoning out of hours with needless queries – could also be penalised.

The report calls for a greater emphasis on the “citizen’s responsibility” to be healthy and says no one should expect taxpayers to fund their unhealthy lifestyles.

Yet while the Health Miles Card would award points for giving up smoking and losing weight, it could penalise those who are already fit and well because they would receive no benefits under the scheme.

Also, the NHS already demands that obese patients lose weight before receiving hip replacements.

And any moves to impose compulsory cards on patients would provoke a backlash from civil liberties groups.

The Dorrell report also calls for a consultation on raising the smoking age to 18 and for shops to be stripped of their licences if they sell tobacco and alcohol to minors.

It proposes a fully-trained nurse to be made available to every school to offer advice on sexual health – but Tory officials stressed they would not be offering children contraceptives.

Ministers should divert more attention and funding to public health epidemics which are costing the NHS billions a year, the report says.

Smokeless Tobacco Not a Safe Alternative for Cigarettes

By Charles H. Weaver, MD
August 27, 2007

According to the results of a study published in Cancer Epidemiology Biomarkers & Prevention, urine levels of a potent carcinogen found in tobacco appear to be at least as high in users of smokeless tobacco as in cigarette smokers.

Smokeless tobacco refers to chewing tobacco and snuff. Both these types of smokeless tobacco contain cancer-causing agents, and users of smokeless tobacco have an increased risk of oral cancer. Oral cancer includes cancers of the lip, tongue, cheeks, gums, and the floor and roof of the mouth.

Because smokeless tobacco does not involve exposure to the harmful components of tobacco smoke, some have suggested that it may be less harmful than cigarettes.

To evaluate this claim, researchers assessed levels of a strong carcinogen (cancer-causing agent)—known as NNK—in 420 cigarette smokers and 182 users of smokeless tobacco. All study participants were seeking treatment for tobacco dependence.

NNK exposure was assessed by measuring NNK metabolites (total NNAL) in urine. The researchers also assessed levels of cotinine—a marker of nicotine exposure.

Urine NNAL and cotinine levels were higher in users of smokeless tobacco than in cigarette smokers.

While the processing of NNK by the body may differ between users of smokeless tobacco and cigarette smokers, the researchers state that these results “indicate that exposure to NNK is at least comparable in smokeless tobacco users and smokers.”

The researchers conclude: “These findings do not support the use of smokeless tobacco as a safe substitute for smoking.”

Reference: Hecht SS, Carmella SG, Murphy SE et al. Similar exposure to a tobacco-specific carcinogen in smokeless tobacco users and cigarette smokers. Cancer Epidemiology Biomarkers & Prevention. 2007;16:1567-72.

Fire at car-storage facility linked to teenagers’ cigar

SIDNEY — Teenagers who carelessly smoked a cigar sparked a fire that leveled a century-old building Friday night, officials said, destroying an inventory of classic-car parts and dealing a business its second major blow in 14 months.

But firefighters were able to save nine automobiles and a number of mechanics’ tools from the parts and service center of Whitaker & Sons Inc. Buick Chevrolet, said James Olmstead, Delaware County’s deputy fire coordinator. “Some of them were driven out, and some of them were pushed out, but all the cars on the ground floor were saved,” Olmstead said.

They were not, however, able to save the four-story business, a former silk mill a local family has owned for generations. Nor were they able to save 1920s- and ’30s-era car parts stored on upper floors, he said. Two boys discarded a cigar in a cardboard box in an enclosed ramp to the business Friday, triggering a blaze that burned for 35 to 40 minutes before it was reported at 5:58 p.m., Olmstead said.

No injuries were reported.

Chemicals used in the auto-repair business fueled the flames, which shot from windows into the evening. Demolition of the building took about four hours after the fire was extinguished; firefighters were on the scene until 6:30 a.m. Saturday.

The boys, a 14-year-old and a 15-year-old whose names were not released, face charges of reckless endangerment and criminal mischief. They admitted smoking near the business before the blaze, Olmstead said.

The business was heavily damaged in the June 2006 floods, he said, meaning many tools inside the business Friday had replaced those lost a year earlier.

Scottish smoking ban has improved public health.

There has been a significant improvement in public health according to the most recent research carried out in Scotland.

Comparisons of heart attack rates at nine hospitals showed a 17% drop in the number of heart attack victims since March 2006 when the smoking in public places ban was implemented.

The research also suggest that the air quality found in pubs is now as good as that outside.

The report also states there has been a reduction of 40% in the number of adults exposed to second-hand tobacco smoke (also known as environmental tobacco smoke)

The main findings of the study were;

  • The ban has reduced second hand smoke exposure in both children and adult.
  • Among primary school children, levels of a by-product of nicotine fell by more than a third (39%) following the ban.
  • In adults, cotinine (a metabolite of nicotine) levels fell by almost half (49%) in non-smokers from non-smoking households.
  • Non-smokers living in smoking households continued to have high levels of second hand smoke exposure in the home.
  • And the authors suggest that further action is urgently required to support smoking households to implement smoke-free homes and cars.

The scientific research is based on routine health data, as well as research projects undertaken by government scientists and Scottish universities into the effects of the smoking ban.

The Scottish deputy chief medical officer, Professor Peter Donnelly, said the results were proof that the ban had produced major health gains.

Professor Jill Pell, who headed the research team which made the findings, said:

“The primary aim of smoking bans is to protect non-smokers from the effects of passive smoking.

But Scottish publicans claim that many of the benefits could have been achieved without a ban and complain that bar sales have declined because of it.

Jill Pell said

“Previous studies have not been able to confirm whether or not that has been achieved. What we were able to show is that among people who are non-smokers there was a 20% reduction in heart attack admissions. This [research] confirms that the legislation has been effective in helping non-smokers.”

After the Scotland banned smoking in enclosed public spaces, Wales and Northern Ireland followed suit in April 2007 and England did the same in July 2007.

Is this 1984?

Smoking has become such a hated pass time that in the UK, hospital managers are telling patients off for smoking in hospital grounds – which strictly speaking isn’t illegal. Here is an article I found from the Observer…

Nick Cohen, Sunday August 19, 2007
The Observer

Last week, a young NHS psychiatrist, who blogs under the pseudonym Shiny Happy Person, described how she ‘was just taking five minutes out, enjoying the sunshine in the surprisingly pleasant grounds of my new hospital, when the flowerbed spoke to me’.

She went on to reassure her readers: ‘No, I’m not neuroleptic-deficient. Other people heard it too. One moment, all was quiet and the next a disembodied voice was bellowing from somewhere in the vicinity of the begonias. Strictly speaking, it wasn’t actually addressing me and I know this because it said, “This is a no-smoking area. Please put your cigarette out. A member of staff has been informed.” I gave up smoking six weeks ago. But, really, how Orwellian is that?

‘The smokers looked understandably alarmed, glanced furtively around and then scarpered. I can’t help questioning the wisdom of installing a talking flowerbed to tell people off in the grounds of a psychiatric hospital, of all places.’One of the many difficulties in reporting on the NHS is that doctors cannot speak freely about the idiocies of their managers. Threats of dismissal mean I can’t identify the junior psychiatrist or say where she works. But it is on the record that hospitals have banned smoking and some, such as the University Hospitals Coventry and Warwickshire Trust, have put smoke alarms outdoors to catch patients who nip outside for a quick fag.

The makers of a new generation of alarms say their trade doesn’t stop with the NHS. They are doing good business with local authorities, drug rehabilitation centres and government departments. Their Cig-Arrete (geddit?) detector provides ‘a visual and audible re-enforcement of your commitment to creating a smoke-free environment’.

Sensors pick up the whiff of illicit smoke and a voice cries: ‘This is a no- smoking area. Please extinguish your cigarette. A member of staff has been contacted.’ Which sounds very like what Shiny Happy Person said she heard.

You might think there’s nothing wrong with alarms blaring out threats when smoking is the biggest cause of preventable death. But then it’s not illegal to smoke in hospital grounds or any other open space. NHS managers are going way beyond the law and not thinking about the likely effects on the mentally ill of having flowerbeds shout at them when they do it.

Their hectoring is hardly novel. Last week, we had example after example of British bureaucrats, grown fat on extra powers and extra funds, using an ever-more audacious authoritarianism to hide their manifold shortcomings.

As psychiatric patients were fleeing from talking begonias, the Metropolitan Police threatened to use anti-terrorist legislation against climate-change protesters at Heathrow, even though the demonstrators were not, in fact, terrorists. A few days earlier, the West Midlands Police and Crown Prosecution Service had referred Channel 4 to the media regulator, Ofcom, for exposing Islamists who preached hatred of unbelievers and called for homosexuals ‘to be thrown off mountains’.

As Joanne Cash, a distinguished libel lawyer, said at a meeting in defence of the programme makers, the police and CPS have ‘no power and no jurisdiction’ to censor investigative journalism. ‘They have overstepped their powers into the realm of freedom of expression.’

Meanwhile, the Chief Constable of Cheshire, Peter Fahy, gave the clearest sign yet that drinking was replacing smoking as the vice the 21st century can’t tolerate. He responded to the arrest of four teenagers for the alleged murder of Garry Newlove by calling for the legal age for drinking alcohol to be raised to 21. Three of the accused are under 18 and were, allegedly, drinking before the killing.

But the accusation that they had broken an existing law his officers failed to enforce did not deter Mr Fahy from demanding a new law and, indeed, the overturning of the basic principle of English law. ‘At the moment, you can drink anywhere you like unless the local authority has designated that you can’t drink in that area,’ he continued. ‘I would like to see the emphasis changed and that we say drinking in public is not permitted apart from in those areas where a local authority says, “Yes, in this particular park, this particular location, people can drink.”‘

It is alarming to realise that a chief constable charged with upholding the law has no respect for the 800-year-old common law principle that any act which isn’t specifically illegal is legal. He and others want to turn it on its head so that all acts are illegal except those the authorities specifically say are legal.

The alternative would have been to promise to break up gangs and remove the licences of pubs and shops that sold to underage drinkers. But that would require hard police work and the sending of more criminals into an overcrowded prison system that doesn’t want more prisoners.

The seduction of authoritarianism is that it is easier, much easier, to install screaming smoke detectors than persuade patients to stop smoking; to shoot the messengers rather than investigate totalitarian religion; to stop law-abiding people from drinking or protesting rather than take action against teenage gangs or real terrorists.

I suspect the overbearing streak in government is going to get worse. As Labour’s public spending increases slow down, the incentive to lash out will grow among institutions such as the NHS and the police which need to conceal how much public money they have wasted.

More insidious is the notion that people can be forced to be good. If you are a puritan, you can believe we would be a happier society if cigarettes and alcohol had never been invented. If you can close your eyes and sink into the daydreams that there is no need to protest about climate change or that sexist, racist and homophobic preachers are the invention of the media, you will be happier still.

Any assault on freedom becomes justifiable if it will help lead us to a clean-living, conflict-free, multicultural Utopia. The shrieking from the flowerbeds is only going to get louder.