Failure to Quit Smoking Attributed to Genetics
By Michael Smith
BALTIMORE, 04 jun 2008-- Smokers who can't seem to quit no matter how hard they try may look to their genomes for 99 reasons, researchers here said.
Ninety-nine autosomal genes are differently expressed in those who successfully quit smoking in clinical trials than in those who couldn't do it, according to George Uhl, M.D., Ph.D., of the NIH's molecular neurobiology branch, and colleagues.
The findings are based on genome-wide association studies of 550 smokers taking part in trials that tested either nicotine replacement therapy or bupropion (Zyban), Dr. Uhl and colleagues reported in the June issue of Archives of General Psychiatry.
The study "helps us understand why some people are able to quit smoking more easily than others," Dr. Uhl said. It may one day allow clinicians to match smokers with particular cessation treatments.
The researchers analyzed blood samples from three cohorts:
Participants in a double-blind placebo-controlled trial of bupropion or an open-label trial of a nicotine nasal spray versus a nicotine patch. The 126 volunteers who were biochemically confirmed to have abstained from smoking for at least seven days before the end of treatment and at a 24-week assessment were contrasted with the 140 smokers who were not abstinent at either time.
Those in a placebo-controlled trial of nicotine skin patches. Fifty-five participants were confirmed by carbon monoxide levels to be abstinent six weeks after the quit date and 79 were not.
Individuals in a second double-blind placebo-controlled trial of bupropion, in which smoking cessation was assessed using point abstinence, defined by self-reporting and saliva cotinine levels. The 60 participants with biochemically confirmed abstinence for at least seven days before the end of treatment and at a 24-week assessment were contrasted with the 90 individuals who were not abstinent at either time.
Dr. Uhl and colleagues looked for clusters of single-nucleotide polymorphisms (SNPs) in more than two independent samples that had significant P-values based on Monte Carlo simulation trials.
The 99 genes they identified are likely to alter cell adhesion, enzymatic, transcriptional, structural, and DNA, RNA, or protein-handling functions, Dr. Uhl and colleagues reported.
Among those, 41 were specific for bupropion and 26 for nicotine replacement therapy, the researchers found. The finding makes sense because the two cessation approaches have different biochemical mechanisms, Dr. Uhl and colleagues said.
"This takes us a big step forward in being able to tailor treatment to individual smokers to provide the therapies that are most likely to benefit them," said co-author Jed Rose, Ph.D., director of Duke's Center for Nicotine and Smoking Cessation Research.
"In a few years, a simple blood test may provide physicians with enough information to recommend one treatment over another," Dr. Rose said.
The genes identified in the study overlapped -- but weren't identical -- with genes found in studies looking at who develops an addiction in the first place, Dr. Uhl and colleagues found. In fact, the authors reported less overlap for smokers than other substances to which dependency develops.
For instance, cadherin 13, a cell adhesion molecule, is expressed in neurons in several brain regions, can inhibit neurite extension, and can activate several signaling pathways, "rendering it a strong candidate for roles in brain mechanisms important for both developing and quitting addictions," the researchers said.
The study may be limited by its relatively small sample size, Dr. Uhl and colleagues said, and by its focus on autosomal genes, which may miss sex-related differences. Also, participants were in "demanding" clinical trials, indicating they may not be representative of all smokers.
The study was supported by the NIH, the Pennsylvania Department of Health, and GlaxoSmithKline, Inc. Dr. Uhl reported that several authors may have proprietary interests in a provisional patent filed (after the study was accepted) by Duke University related to the use of genetic markers to predict smoking cessation success.
Primary source: Archives of General PsychiatrySource reference:Uhl GR, et al "Molecular genetics of successful smoking cessation: convergent genome-wide association study results" Arch Gen Psychiatry 2008; 65(6): 683-693.
Showing posts with label quit smoking. Show all posts
Showing posts with label quit smoking. Show all posts
Wednesday, June 04, 2008
Saturday, September 01, 2007
How four women quit smoking -- and you can too
By Kristyn Kusek Lewis
Everybody knows that smoking isn't good for you. But if you're a woman? "Hands down, smoking is the absolute worst thing you can do to your body," says Phyllis Greenberger, president and CEO of the Society for Women's Health Research in Washington, D.C.
In fact, new research shows that the carcinogens in cigarettes, while harmful to everyone, are more dangerous for women, who are three times as likely as men to get aggressive forms of lung cancer and more likely to develop it at an earlier age. They're also more likely to die of lung cancer than breast cancer.
So why, oh, why do 20 million American women still light up?
Because quitting, as we also know, is really, really hard -- so hard that, while roughly two-thirds of all current smokers want to quit, only 5 percent actually succeeded last year, says the Centers for Disease Control and Prevention. And women, it turns out, have an even harder time quitting than men: They seem to experience stronger withdrawal symptoms, perhaps because of hormones or the bigger nicotine dose delivered to smaller female bodies.
The news isn't all bad, though. In spite of the challenges, some women are finding creative ways to kick the butts for good. We have four of their inspiring stories here, along with a list of some of the newest stop-smoking tricks. And if you need company to help you or someone you know quit? Visit Health.com/stopsmoking to share your story.
Weaning away
Liz Marr smoked off-and-on throughout her 20s and picked it up again in her early 30s. "I didn't smoke all the time," she says. "Usually, only while socializing with other smokers."
But then she fell in love with mountain-biking and cross-country skiing. After all, Liz lives near Boulder, Colorado, and could literally walk out her door to go mountain-biking. "Trust me," she says, "you can't smoke and ride a bike up a mountain!"
Rather than stop cold turkey ("That all-or-nothing mind-set made me want to smoke more," she says), Liz gradually tapered off by avoiding the situations that made her want to smoke. "For a while, I actually stopped hanging out with friends who smoked," she says. Liz built activities into her life where smoking wouldn't fit: exercising, going to smoke-free restaurants, hanging out with her son. "Within a year I naturally drifted into a nonsmoking lifestyle,: she says. Health.com: Help for quitters
Why it worked: Liz's tactic of cutting back is an effective way to break free of smoking routines and eventually stop altogether, according to a University of Vermont review of 19 studies. The hard part is staying committed. But Liz knows that's doable -- she hasn't smoked in 10 years. "I used to love it, but now the smell makes me sick," she says. "It's not who I am anymore."
Taking a class, and help from the patch
Natasha Gruppo loved lighting up. "Cigarettes were always there for me," she says. "Fortunately, I realized that smoking was really like having a friend who's holding a gun behind her back."
She got her wake-up call two years ago when a severe asthma attack sent her to the ER. "I thought, 'How far does this have to escalate for me to stop?'" she says.
Soon after, she saw an advertisement about a smoking-cessation class in the employee newsletter published by the university where she works as a finance counselor. Natasha figured trying to quit in a group would provide her with some much-needed support, so she joined. In the classes she learned about nicotine-replacement-therapy options and strategies for coping with withdrawal. She started wearing the patch and quit along with her classmates, who kept her accountable. And when cravings hit, she used a breathing technique she'd learned: "I closed my eyes and inhaled and exhaled three times," she says. "When I opened my eyes, the desire had passed." (Deep breathing is a craving-busting technique recommended by the American Cancer Society.) Eight weeks later, Natasha started forgetting to put on her patch.Health.com: Keep your heart healthy
"I realized that I was becoming a nonsmoker," she says. She's been smoke-free for almost a year.
Why it worked: Counseling programs like the one Natasha joined can triple success rates, according to the National Cancer Institute. To find a program or "quit coach" in your area, call 800-QUITNOW (800-784-8669), a free government service that connects you to helpful resources in your state. A coach can help you develop a personalized plan, offer self-help materials addressing cravings and nicotine-replacement therapy, and discuss online support.
Creative visualization
Thirteen years ago, on her 28th birthday, Claire Celsi smoked herself sick. "I puffed 10 cigarettes in one hour," she says. Afterward, she crumpled up her almost-empty pack, threw it away, and never lit up again. She found the strength for this drastic move with something decidedly healthier -- visualization.
Four months before that smoky birthday, Claire started using a technique she had read about in "Creative Visualization," a book by Shakti Gawain. First thing in the morning and whenever she caught a quiet moment, she imagined a huge cigarette wearing boxing gloves, bullying her. Next, she visualized being equals and punching back. Finally, she pictured herself growing larger than the cigarette -- she was wearing the gloves, knocking it out. "The technique took only a few minutes and helped me realize that I was in control, not my cravings," she says.
By the time her birthday arrived, Claire felt so confident that once she stubbed out her last cigarette, that was that. She's never smoked again.
Why it worked: Some people think visualization sounds goofy, but research supports it. In a University of Akron College of Nursing study, researchers found that two years after ending the habit, twice as many of the creative-visualization users remained smoke-free, compared with those who hadn't used the technique. Proponents say it helps reduce the stress and anxiety associated with quitting, so quitters feel more confident and motivated to stop. "Whatever it was, it gave me what I needed to quit," Claire says. (Find out more about visualization from the Academy for Guided Imagery.)
Tiffany Huda
Four years ago, Tiffany Huda lost her mother, a lifelong smoker, to lung cancer. Pregnant at the time, Tiffany knew she couldn't smoke. But after her son was born, she started smoking again. "It's what I used to cope," she says.
Then last year, unable to bear the thought of not being there for her son, Tiffany decided enough was enough. She set a quit date, a technique that experts recommend because it helps you mentally prepare. She would stop on her 35th birthday and gear up by getting healthier. She joined a gym and started eating more fruits and vegetables, and less meat.
The first three weeks after quitting were more difficult than Tiffany anticipated. "I had wild mood swings, so my doctor prescribed an antianxiety medication, which helped tremendously," she says.
Shaking up her routines helped, too. She temporarily swore off favorite cigarette accompaniments like coffee and red wine. And because her old "smoke break spot" was on the front porch, she didn't use her front door for six months.
Why it worked: Diet and exercise changes can help quitters avoid weight gain, one thing that makes quitting difficult for women, says Erik Augustson, Ph.D., MPH, a behavioral scientist at the National Cancer Institute. And a new Duke University study says cutting out caffeine and meat is important because they can make cigarettes taste better. Fruits, vegetables, and dairy products, on the other hand, don't mask cigarettes' nasty taste. Tiffany's lifestyle changes gave her more energy than she could have imagined. "If I'd known life would be this good as a nonsmoker," she says, "I would have quit a lot sooner!"
By Kristyn Kusek Lewis
Everybody knows that smoking isn't good for you. But if you're a woman? "Hands down, smoking is the absolute worst thing you can do to your body," says Phyllis Greenberger, president and CEO of the Society for Women's Health Research in Washington, D.C.
In fact, new research shows that the carcinogens in cigarettes, while harmful to everyone, are more dangerous for women, who are three times as likely as men to get aggressive forms of lung cancer and more likely to develop it at an earlier age. They're also more likely to die of lung cancer than breast cancer.
So why, oh, why do 20 million American women still light up?
Because quitting, as we also know, is really, really hard -- so hard that, while roughly two-thirds of all current smokers want to quit, only 5 percent actually succeeded last year, says the Centers for Disease Control and Prevention. And women, it turns out, have an even harder time quitting than men: They seem to experience stronger withdrawal symptoms, perhaps because of hormones or the bigger nicotine dose delivered to smaller female bodies.
The news isn't all bad, though. In spite of the challenges, some women are finding creative ways to kick the butts for good. We have four of their inspiring stories here, along with a list of some of the newest stop-smoking tricks. And if you need company to help you or someone you know quit? Visit Health.com/stopsmoking to share your story.
Weaning away
Liz Marr smoked off-and-on throughout her 20s and picked it up again in her early 30s. "I didn't smoke all the time," she says. "Usually, only while socializing with other smokers."
But then she fell in love with mountain-biking and cross-country skiing. After all, Liz lives near Boulder, Colorado, and could literally walk out her door to go mountain-biking. "Trust me," she says, "you can't smoke and ride a bike up a mountain!"
Rather than stop cold turkey ("That all-or-nothing mind-set made me want to smoke more," she says), Liz gradually tapered off by avoiding the situations that made her want to smoke. "For a while, I actually stopped hanging out with friends who smoked," she says. Liz built activities into her life where smoking wouldn't fit: exercising, going to smoke-free restaurants, hanging out with her son. "Within a year I naturally drifted into a nonsmoking lifestyle,: she says. Health.com: Help for quitters
Why it worked: Liz's tactic of cutting back is an effective way to break free of smoking routines and eventually stop altogether, according to a University of Vermont review of 19 studies. The hard part is staying committed. But Liz knows that's doable -- she hasn't smoked in 10 years. "I used to love it, but now the smell makes me sick," she says. "It's not who I am anymore."
Taking a class, and help from the patch
Natasha Gruppo loved lighting up. "Cigarettes were always there for me," she says. "Fortunately, I realized that smoking was really like having a friend who's holding a gun behind her back."
She got her wake-up call two years ago when a severe asthma attack sent her to the ER. "I thought, 'How far does this have to escalate for me to stop?'" she says.
Soon after, she saw an advertisement about a smoking-cessation class in the employee newsletter published by the university where she works as a finance counselor. Natasha figured trying to quit in a group would provide her with some much-needed support, so she joined. In the classes she learned about nicotine-replacement-therapy options and strategies for coping with withdrawal. She started wearing the patch and quit along with her classmates, who kept her accountable. And when cravings hit, she used a breathing technique she'd learned: "I closed my eyes and inhaled and exhaled three times," she says. "When I opened my eyes, the desire had passed." (Deep breathing is a craving-busting technique recommended by the American Cancer Society.) Eight weeks later, Natasha started forgetting to put on her patch.Health.com: Keep your heart healthy
"I realized that I was becoming a nonsmoker," she says. She's been smoke-free for almost a year.
Why it worked: Counseling programs like the one Natasha joined can triple success rates, according to the National Cancer Institute. To find a program or "quit coach" in your area, call 800-QUITNOW (800-784-8669), a free government service that connects you to helpful resources in your state. A coach can help you develop a personalized plan, offer self-help materials addressing cravings and nicotine-replacement therapy, and discuss online support.
Creative visualization
Thirteen years ago, on her 28th birthday, Claire Celsi smoked herself sick. "I puffed 10 cigarettes in one hour," she says. Afterward, she crumpled up her almost-empty pack, threw it away, and never lit up again. She found the strength for this drastic move with something decidedly healthier -- visualization.
Four months before that smoky birthday, Claire started using a technique she had read about in "Creative Visualization," a book by Shakti Gawain. First thing in the morning and whenever she caught a quiet moment, she imagined a huge cigarette wearing boxing gloves, bullying her. Next, she visualized being equals and punching back. Finally, she pictured herself growing larger than the cigarette -- she was wearing the gloves, knocking it out. "The technique took only a few minutes and helped me realize that I was in control, not my cravings," she says.
By the time her birthday arrived, Claire felt so confident that once she stubbed out her last cigarette, that was that. She's never smoked again.
Why it worked: Some people think visualization sounds goofy, but research supports it. In a University of Akron College of Nursing study, researchers found that two years after ending the habit, twice as many of the creative-visualization users remained smoke-free, compared with those who hadn't used the technique. Proponents say it helps reduce the stress and anxiety associated with quitting, so quitters feel more confident and motivated to stop. "Whatever it was, it gave me what I needed to quit," Claire says. (Find out more about visualization from the Academy for Guided Imagery.)
Tiffany Huda
Four years ago, Tiffany Huda lost her mother, a lifelong smoker, to lung cancer. Pregnant at the time, Tiffany knew she couldn't smoke. But after her son was born, she started smoking again. "It's what I used to cope," she says.
Then last year, unable to bear the thought of not being there for her son, Tiffany decided enough was enough. She set a quit date, a technique that experts recommend because it helps you mentally prepare. She would stop on her 35th birthday and gear up by getting healthier. She joined a gym and started eating more fruits and vegetables, and less meat.
The first three weeks after quitting were more difficult than Tiffany anticipated. "I had wild mood swings, so my doctor prescribed an antianxiety medication, which helped tremendously," she says.
Shaking up her routines helped, too. She temporarily swore off favorite cigarette accompaniments like coffee and red wine. And because her old "smoke break spot" was on the front porch, she didn't use her front door for six months.
Why it worked: Diet and exercise changes can help quitters avoid weight gain, one thing that makes quitting difficult for women, says Erik Augustson, Ph.D., MPH, a behavioral scientist at the National Cancer Institute. And a new Duke University study says cutting out caffeine and meat is important because they can make cigarettes taste better. Fruits, vegetables, and dairy products, on the other hand, don't mask cigarettes' nasty taste. Tiffany's lifestyle changes gave her more energy than she could have imagined. "If I'd known life would be this good as a nonsmoker," she says, "I would have quit a lot sooner!"
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