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Antidepressants,
Nicotine
Help Women Quit Smoking
Excerpt
By
Deena Beasley, Reuters
Health
ANAHEIM (Reuters) - Women
who smoke--the single biggest risk factor for heart disease--are
likely to need help from drugs and nicotine replacement therapy
to kick the habit, researchers said the American Heart Association's
meeting in Anaheim, California.
A study conducted at the University of California, San Francisco
(UCSF) looked at why women who ended up in the hospital with cardiovascular
disease continued to smoke.
All 277 women in the study were smokers (average age 61 years)
who said they were willing to quit. The women were also mostly
white, quite ill, had smoked for about 40 years and were highly
addicted to tobacco, Erika Froelicher, professor at UCSF's School
of Nursing and Medicine, said at the meeting.
Researchers also found that nearly 57% of the women were depressed
based on a commonly used index. Forty percent of the women studied
were married.
``Smoking acts as an antidepressant. A lot of women self-medicate
for depression by smoking,'' Froelicher said Monday.
She also said women may be more prone than men to fear weight
gain after quitting tobacco and are influenced by advertising.
``Ads and even movies associate cigarettes with being cool. Until
we have a campaign to counter that we have an uphill struggle,''
the UCSF researcher said.
Another study presented at the conference looked at the effectiveness
of Zyban, made by GlaxoSmithKline Plc, which also markets the
drug as an antidepressant under the brand name Wellbutrin. This
trial of 629 heavy-smoking patients with heart disease found that
47% of patients given the drug for 7 weeks, along with motivational
counseling, were able to quit tobacco, compared with 19% on an
inactive placebo.
After 12 weeks, 34% of the Zyban group did not smoke, compared
with 15% on placebo. The split narrowed to 27% and 11% at 26 weeks,
according to Dr. Andre Perruchoud of University Hospital of Basel
in Switzerland, the study's lead investigator.
``The rate of abstinence was three times that of placebo,'' he
said. Perruchoud said Zyban, which inhibits the brain's uptake
of dopamine, works to combat depression in the same way smoking
does.
Side effects of Zyban include insomnia and dry mouth, but the
rate of withdrawal from the study due to these issues was about
the same in both groups, 5% for Zyban patients and 6% for placebo.
The investigators also found no increase in blood pressure from
use of the drug in these heart patients.
Perruchoud noted that two tablets of Zyban cost about the same
as a pack of cigarettes.
In a separate UCSF study of 127 female smokers, researchers discovered
that nicotine replacement therapy is highly underused in women
smokers with cardiovascular disease. Only 9% to 22% of women for
whom nicotine therapy was indicated actually used it to quit smoking.
Until recently, US government guidelines called for caution in
use of nicotine replacement therapy in cardiac patients. The advice
now is that the benefit of nicotine replacement therapy outweighs
the risk of continued smoking.
Froelicher said nicotine patches are probably a better bet than
nicotine gum, which needs a slow release in the mouth in order
for it to work. ``Most gum chewers will just chomp away at them--they
don't get the slow release,'' she said.
The researchers said recent data highlights the need for more
education and counseling of highly addicted women, including instruction
in the use of smoking cessation aids.
Smoking tops the list of the American Heart Association's list
of the six major modifiable habits that contribute to cardiovascular
disease. The other five are high blood pressure, high blood lipids,
inactivity, obesity and diabetes.
Reference
Source 89
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