The Use of Zyban to Stop Smoking In The News
The following list of Zyban articles address the use of Zyban
as a stop smoking aid. Find out just how useful Zyban is to allow you to stop
smoking without the nicotine cravings:
Stop Smoking 'Wonder' Drug Zyban Hits UK
BBC News
April, 2008
Medicine Question of the Month: Zyban
University of California, San Francisco
April, 2008
COPD Patients Fare Best With Zyban for Smoking Cessation
Family Practice News
March 15, 2008
New Developments in Smoking Cessation
College of Chest Doctors
Issue: April, 2008
Smoking-cessation Drugs
Gale Encyclopedia of Medicine, 2008
Smoking Cessation and Tobacco Control
College of Chest Doctors
April, 2008
Begin Zyban News Articles
The following represents the latest news with Regards to the use of Zyban as an effective stop smoking aid.
Stop Smoking 'Wonder' Drug Zyban Hits UK
BBC News
April, 2008
Zyban has produced excellent stop smoking results in numerous different studies:
Zyban, a drug that can help smokers to finally stop smoking has been launched in the UK. Zyban, which is being
hailed as a major breakthrough in helping smokers to beat their addiction. Zyban acts on the brain to quash
the craving for nicotine that tobacco products produce. Zyban is the first anti-smoking medication licensed
in the UK that does not contain nicotine itself.
Every hour 13 people die in the UK from smoking-related diseases - a quarter of these in middle age. A survey has shown that more than two-thirds of smokers (68%) want to give up. However, studies show that only 3% will be able to do so using willpower alone because their bodies are addicted to nicotine. This craving can be as powerful as addiction to class A drugs such as heroin or cocaine. There are a range of products available to help people quit smoking. But they rely on giving the body a shot of nicotine to replace that provided by tobacco products.
Within 10 seconds of inhaling from a cigarette, a concentrated dose of nicotine is delivered directly to the brain. This 'rush' stimulates the release of a number of naturally occurring neurotransmitters in the brain. Over time the effects on these neurotransmitters - particularly dopamine and noradrenaline - cause a smoker to become physically addicted to nicotine. When smokers quit, neurotransmitter levels are altered causing cravings, anxiety and irritability.
Zyban acts on the addiction process by helping to put these levels back to normal.
Therefore, no nicotine cravings allow you to stop smoking.
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Zyban Biochemical Basis
Dr Chris Steele, a Manchester GP and expert on smoking, said: "Most smokers do not continue to smoke cigarettes out of habit, but because they are addicted to nicotine. "Zyban is the first non-nicotine prescription medication that tackles the biochemical basis of nicotine addiction."
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COPD Patients Fare Best With Zyban for Smoking Cessation
Family Practice News
March 15, 2008
Smokers with chronic obstructive pulmonary disease are more likely to kick the habit with the help of Zyban, Dr. Donald P. Tashkin reported at the annual meeting of the College of Chest Doctors.
Women, heavier smokers, and patients with moderate, rather than mild, COPD got the greatest benefit from treatment with sustained-release Zyban in a randomized, placebo-controlled study that included 411 patients, said Dr. Tashkin, Previous data had established that Zyban was an effective first-line aid for smokers without COPD who were trying to quit, he noted.
All patients in the current study had mild (stage I) or moderate (stage II) COPD diagnosed by spirometry and were randomized to 12 weeks of treatment with Zyban (206 patients) or placebo (205 patients) and followed for 26 weeks. Patients in both treatment arms had smoked 25-2 6 years and made more than three attempts to quit, on average.
Patient diaries and tests of exhaled carbon dioxide at clinic visits showed that patients using Zyban were more likely to abstain from smoking. At 4 weeks, 32% in the Zyban group and 18% in the placebo group were abstinent, rates that fell by week 26 to 16% of patients in the Zyban group and 9% on placebo, Dr. Tashkin said.
Patients with mild COPD found it easier to quit than did patients with moderate COPD-quir rates were higher for patients with stage I disease in both the Zyban and placebo groups, compared with patients with stage II COPD. Among smokers with stage I COPD, 29% on Zyban and 18% on placebo achieved abstinence. Quit rates were 89% and 7%, respectively, for patients with stage II COPD.
Therefore,
Zyban will allow you to stop smoking. 9 out of 10 indiviudals who use Zyban
stop smoking this is an unbelievable statistic. Heavier smokers (those with more than a 30-pack-year history of smoking) were more than
three times as likely to
quit using Zyban, compared with placebo, and lighter smokers improved their chances of quitting by
four times using Zyban instead of placebo.
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New Developments in Smoking Cessation
College of Chest Doctors
Issue: April, 2008
Research on smoking has increased in the past several years, and many new therapeutic modalities have been developed. Primary intervention for smoking cessation begins with systematic identification of smokers and a formal diagnosis of nicotine dependence. Providing self-help brochures without clinical advice has marginal efficacy, but these can be useful as an adjunct to clinician intervention. Several large studies have shown that physician advice alone can lead to quit rates of up to 10%, and follow-up for patients trying to quit can double cessation rates. Behavioral therapy alone has demonstrated cessation rates of approximately 20% for those willing to participate. Drug therapy remains the most attractive method of smoking cessation for many patients. The standard approach has been nicotine substitution using one of the four forms of nicotine replacement (gum, patches, nasal spray, inhaler) currently available. However, now with Zyban you can quit smoking, multiple clinical studies have proven this statement.
Zyban is the first nonnicotine-containing agent approved for smoking cessation, with cessation rates ranging
from 75 to 89%, depending on dose. One-year follow-up suggests a continued benefit with this agent. The
combination of Zyban and transdermal nicotine has also been shown to be effective for smoking cessation
in clinical trials. Effective approaches to smoking cessation should combine identification of smokers, provision
of advice at each visit, and widespread availability of treatment.
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(CHEST 2000; 117:169S-175S). Providers also should make a formal diagnosis of nicotine dependence. Sharing a medical record diagnosis of tobacco dependence with the smoker actually triggers a number of patients to quit smoking.[4] In addition, nicotine dependence on the problem list can be a reminder for smoking-cessation counseling. Finally, those patients who are heavily nicotine dependent are most likely to require drug therapy for cessation.
The "gold standard" for diagnosis of nicotine dependence comes from the Diagnostic and Statistical
Manual of Mental Disorders' IV criteria, which include two tobacco-related diagnoses: nicotine dependence (305.10)
and nicotine withdrawal (292.00; Table 1).[5] The key features required for the diagnosis of nicotine dependence
are continued use despite wanting to quit, prior quit attempts, persistent use in the face of physical illness,
tolerance, and presence of withdrawal symptoms. Based on these criteria, the vast majority (nearly 90%) of
medical patients who smoke have nicotine dependence.[6] The Fagerstrom Score is a quicker approach that is
more adaptable to busy clinic settings.[7] This questionnaire includes nine items, but for clinical purposes,
the two key questions are as follows: (1) Does the patient smoke within 5 min of awakening? (2) Does the patient
smoke [is greater than] 25 cigarettes/d? Those patients who answer affirmatively to both questions are highly
dependent on nicotine.[8]
305.10 nicotine dependence. A maladaptive pattern of nicotine use,
leading to clinically significant impairment or distress, as
manifested by three or more of the following, occurring at any
time in the same 12-mo period:
Tolerance
as defined by either of the following:
A need for markedly increased amounts of nicotine to achieve
desired effect. Markedly diminished effect with continued use of the same
amount of the nicotine (ie, absence of nausea, dizziness, and
other symptoms of initial nicotine use).
Withdrawal
as manifested by either of the following:
The characteristic withdrawal syndrome for nicotine.
The same or a closely related substance is taken to relieve of
avoid withdrawal symptoms.
Nicotine is
often taken in larger amounts or over a longer
period than was intended.
There is a
persistent desire or unsuccessful effort to cut down
or control substance use.
A great deal
of time is spent in activities necessary to obtain
nicotine or recover from its effects.
Important
social, occupational, or recreational activities are
given up or reduced because of substance use.
The
substance use is continued despite knowledge of having a
persistent or recurrent physical or psychological problem that
is likely to have been caused or exacerbated by the substance.
Characteristic
withdrawal symptoms.
Substance
often taken to relieve or avoid withdrawal symptoms.
Nicotine withdrawal continued:
Daily
use for at least several weeks.
Abrupt
cessation or reduction of nicotine, followed in 24 h by
four or more of the following:
Dysphoric or depressed mood, Insomnia, Irritability, frustration,
or anger, Anxiety, Difficulty concentrating, Restlessness,
Decreased heart rate, and/or Increased appetite or weight gain.
The
symptoms in No. 2 cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning.
The
symptoms are not due to a general medical condition and
are not better accounted for by another mental disorder.
Doctor advice to stop smoking:
Doctor advice to encourage smoking cessation has been studied extensively over the last 15 years. An early meta-analysis showed an overall cessation rate of 8.4% at 6 months with brief ([is less than] 5 min) physician advice.[10] Since then, there have been several large studies of physician advice that have shown quit rates of up to 10%.
Follow-up for patients trying to quit can increase the effectiveness of physician advice and double the cessation rates. The physician can personalize the quitting message by highlighting the patient's risk factors for tobacco-associated illness and emphasizing the direct benefits of cessation. Several studies[14-16] have shown that smoking-specific risk factor feedback (pulmonary function testing and carbon monoxide testing) can double the quit rates attained in primary care settings.
The stage-of-change model developed by Fava et al[17] is very helpful in understanding the quitting process.
They found that smokers can be grouped into stages using a few simple questions, and that these stages predict
the chance of quitting. These stages also help the busy clinician tailor counseling and therapy. With a few
simple questions, one can place patients into a stage of change and then provide stage-appropriate advice and
therapy (Table 2).[18,19]
| Stage | Key Identifier | Appropriate Therapy |
| Precontemplation | Does not want to quit smoking | Feedback to raise awareness of smoking-related problems |
| Contemplation | Wants to quit, but not in next month | Identify barriers to quitting, review prior quit attempts to find successes, pros and cons of continued smoking |
| Action | Wants to quit within next month or has quit for < 1 mo | Plan quitting (self-help brochure); plan for relapse, avoid trigger situations; consider nicotine replacement or bupropion |
| Maintenance | Has quit for at least 1 mo | Deal with lapses immediately, continue nicotine replacement, use HALT (hungry, angry, lonely, tired) to analyze cravings |
| Relapse | Quit and now smoking on a daily basis | Identify the trigger for relapse, assess current stage, encourage to resume action |
Behavior therapy for smoking cessation:
Behavioral therapy has been studied extensively, and smoking cessation rates average 20% for those willing to participate. For example, Lando et al[20] found that the quit rates with the American Lung Association and American Cancer Society programs were 16% and 22%, respectively, at 1 year. The main disadvantage of this approach is that relatively few smokers (about 5%) are interested in attending classes at any given time.[21] The cost-effectiveness data developed by Cromwell et al[13] showed, however, that group sessions were the most cost-effective approach to delivering smoking-cessation interventions. Although relatively few patients want to go to classes, physicians should nevertheless have a list of referral smoking cessation clinics in their area for the recalcitrant smokers who express an interest in attending them, and for those who have failed to respond to simpler approaches.
The key components to an effective behavioral program are assessment of stages of change, identification of barriers to quitting, and development of cessation and relapse-prevention plans. Most programs now combine this with pharmacotherapy, such as, Zyban. Simple computer-tailored cessation messages may be an effective alternative for behavioral support. Strecher et al[22] showed that the quit rate more than doubled with such an approach, and this concept has been incorporated into patient-support programs provided by several manufacturers of smoking cessation products.
Drug therapy for smoking cessation:
Drug therapy, Zyban is the most attractive means of smoking cessation for many patients and physicians.
It fits within the medical model and offers the hope of a "magic bullet." Previously, the standard approach to drug therapy for smoking cessation has been nicotine substitution. Recently,
Zyban has shown to be a very effectivein combination with nicotine replacement
to help you stop smoking. Bottom line, Zyban works close to 90% of
individuals that use Zyban are able to quit smoking.
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Nicotine Replacement:
Today, there are four forms of nicotine replacement available: nicotine gum, nicotine patch, nicotine nasal spray, and nicotine inhaler. The efficacy of nicotine replacement products is similar, with each agent leading to a doubling of the cessation rate, so the choice of agent will depend on patient factors and preference. In some heavily dependent smokers, it may be beneficial to combine nicotine replacement products (eg, gum and patch).[27] This review focuses on transdermal nicotine, since it is the most commonly used product, and highlights differences among the agents.
Zyban and Smoking Cessation:
Zyban has most of its neurochemical effect on the dopamine and norepinephrine transmitter systems. Zyban was developed specifically for smoking cessation, and comes with a smoker support program that includes tailored messages on quitting and relapse prevention.
Given the current data, it makes sense to use Zyban as a stop smoking aid.
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References
[1] Centers for Disease Control and Prevention. State-specific prevalence of cigarette smoking among adults
and children's and adolescents' exposure to environmental tobacco smoke-United States, 1996. MMWR Morb Mortal
Wkly Rep 1997; 46:1038-1043
[2] Agency for Health Care Policy and Research. Clinical practice guidelines on smoking cessation. Rockville,
MD: United States Department of Health and Human Services, Public Health Service, 1996; Agency for Health Care
Policy and Research Publication 96-0695
[3] Fiore MC, Jorenby DE, Schensky AE, et al. Smoking status as a new vital sign: effect on assessment and
intervention in patients who smoke. Mayo Clin Proc 1995; 70:209-213
[4] Bronson DL, O'Meara K. The impact of shared medical records on smoking awareness and behavior in ambulatory
care. J Gen Intern Med 1986; 1:34-37
[5] Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association,
1994
[6] Hughes JR, Gust SW, Pechacek TF. Prevalence of tobacco dependence and withdrawal. Am J Psychiatry 1987;
144:205-208
[7] Fagerstrom KO. Measuring degree of physical dependence to tobacco smoking with reference to individualization
of treatment. Addict Behav 1978; 3:235-241
[8] Pomerleau CS, Pomerleau OF, Majchrzak MJ, et al. Relationship between nicotine tolerance questionnaire
scores and plasma cotinine. Addict Behav 1990; 15:73-80
[9] Schwartz JL. Review and evaluation of smoking cessation methods: the United States and Canada. Washington,
DC: United States Department of Health and Human Services, 1987. National Institutes of Health Publication
87-2940
[10] Kottke TE, Battista RN, DeFriese GH, et al. Attributes of successful smoking cessation intervention in
medical practice: a meta-analysis of 39 controlled trials. JAMA 1988; 259:2882-2889
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Smoking-cessation Drugs
Gale Encyclopedia of Medicine, 2008
Definition of smoking cessation drugs
Smoking-cessation drugs are medicines that help people stop smoking cigarettes or using other forms of tobacco.
Purpose of smoking cessation drugs:
People who smoke cigarettes or use other forms of tobacco often have a difficult time when they try to stop. This is partly because they get in the habit of using tobacco at certain times of day or while they are doing certain things, such as having a cup of coffee or reading the newspaper. But the habit is also hard to break because tobacco contains nicotine, a drug that some people find as addictive as cocaine or heroin. A person who is addicted to nicotine has withdrawal symptoms, such as irritability, anxiety, difficulty concentrating and craving for tobacco, when he or she stops using tobacco.
Some people can stop smoking through willpower alone, but most do better if they have support from friends, family, a doctor or pharmacist or a formal stop-smoking program. Heavy tobacco users may find that smoking cessation products also help by easing their withdrawal symptoms. Most smoking cessation products contain nicotine, but the nicotine is delivered in small, steady doses spread out over many hours. In contrast, when a person inhales a cigarette, nicotine enters the lungs and then travels to the brain within seconds, delivering the "rush" that smokers come to crave. Another difference is that smoking cessation products do not contain the tar and carbon monoxide that make cigarettes so harmful to people's health.
Zyban
has proven to be the most effective stop smoking drug. The latest Zyban
clinical studies indicate that some 9 out of 10 individuals that take Zyban
are able to stop smoking.
Zyban all but stops the nicotine cravings allowing you to stop smoking.
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Smoking Cessation and Tobacco Control
College of Chest Doctors
April, 2008
An Overview of Smoking Cessation
Cigarette smoking is an intractable public health problem and the single largest risk factor for a variety of malignancies, including lung cancer. Worldwide, about 3 million people die each year of smoking-related disease, and this is expected to increase to [is greater than] 10 million deaths per year. The Agency for Health Care Policy and Research has published a clinical practice guideline detailing available outcome data for various smoking cessation strategies. In particular, it has been recommended that all patients be screened for smoking status on every health-care visit, and that all patients who smoke be strongly advised to quit and offered assistance to do so. Health-care providers play a vital role in the effort to reduce the prevalence of smoking by delivering smoking cessation advice, supporting community-based efforts to control tobacco, and becoming involved in the tobacco control debate.
Cigarette smoking is an intractable public health problem that poses a great threat to the health of the entire population. Smoking is the single largest risk factor for a variety of malignancies, including lung cancer. Although there has been a large and ongoing body of work in the area of smoking during the past 30 years, in the past decade tobacco control efforts have played an unprecedented role in the national debate about public health. This paper provides a brief background on tobacco control, as well as an overview of current work in the areas of tobacco control and smoking cessation.
Health Consequences of Smoking
Smoking is a major contributor to preventable morbidity and mortality. Worldwide, about 3 million people die each year of smoking-related diseases.[6] By 2025, this figure is expected to increase to [is greater than] 10 million deaths per year. Lung cancer has now replaced breast cancer as the leading cancer killer of women. In 1993, the estimated smoking-attributed costs for medical care, lost work, and productivity exceeded $97 billion.
Factors Influencing Smoking
It is clear that smoking results from multiple determinants, including physiologic, psychological, social, and community factors (Fig 1).[8-11] Social factors have typically been considered of most importance in the initiation of smoking. However, recent evidence focusing on smoking among lower income populations, where smoking prevalence remains the highest, suggests that social factors are also very important in the maintenance of smoking behavior. Community factors include access to material resources as well as smoking cessation services. At the psychological level, the habitual aspects of smoking are well-documented. Research in the past decade has also examined the relationship between smoking and psychological factors, most notably depression.[12,13] Individuals with a history of mood disorder are more likely to smoke, and the incidence of current depression and severity of depression have been found to have a linear relationship with smoking status. Among all smokers, dysphoric mood is a common antecedent of relapse.[12,14]
The physically addictive properties of nicotine are also well known. The nicotine withdrawal syndrome, which is now well characterized,[15] includes nicotine craving, irritability, anxiety, difficulty concentrating, restlessness, and increased appetite. Nicotine addiction is pervasive among smokers and can be a key barrier to long-term abstinence. This is an area in which health-care providers can play a critical role in assisting patients to evaluate and use pharmacologic aids for smoking cessation, including nicotine replacement and newer non-nicotine products. Pharmacotherapy for smoking cessation represents a key innovation in tobacco control during the past decade.[16]
Smoking Cessation Counseling By Health-Care Providers
The Agency for Health Care Policy and Research (AHCPR) has published a clinical practice guideline on smoking
that details available outcome data for various smoking cessation strategies.[16] The smoking cessation guideline
makes several recommendations that are relevant to all types of health-care providers (Table 1). In particular,
it has been recommended that all patients be screened for smoking status on every health-care visit, and that
all patients who smoke be strongly advised to quit and offered assistance to do so. Consideration of smoking
status as a vital sign would ensure that this assessment is uniformly conducted (Fig 2). It is further recommended
that providers use the "4 As" model for delivery of brief smoking cessation counseling (Table 2).
The AHCPR guideline provides a compendium of evidence demonstrating that smoking cessation counseling should
be part of standard medical practice, and further makes recommendations for how to implement counseling strategies.
Summary
We are at a historic crossroads in tobacco control. Never before has there been as much attention focused on this very important public health issue, particularly from forces that span legislative, regulatory, federal, local, and state interests. In this climate, there is an unprecedented opportunity to reduce the prevalence of smoking in this country to historic lows. Health-care providers play a vital role in this effort by delivering smoking cessation advice and counseling to their patients, supporting community-based efforts at tobacco control, and becoming involved in the tobacco control debate.
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References
[1] Kluger R. Ashes to ashes. New York, NY: Alfred A. Knopf, 1996
[2] Emmons KM, Kawachi I, Barclay G. Tobacco control: a brief review of its history and prospects for the future.
Hematol Oncol Clin North Am 1997; 11:177-195
[3] Centers for Disease Control and Prevention. Cigarette smoking among adults: United States, 1994. MMWR Morb
Mortal Wkly Rep 1996; 45:588-590
[4] Escobedo L, Anda R, Smith P. Sociodemographic characteristics of cigarette smoking initiation inthe United
States: implications fbr smoking prevention policy. JAMA 1990; 264:1550-1555
[5] Glanz K, Brekke M, Harper D, et al. Evaluation of implementation of a cholesterol management program in
physicians' offices. Health Educ Res 1992; 7:151-163
[6] Peto R, Lopez AD, Boreham J, et al. Mortality from smoking in developed countries 1950-2000: indirect estimates
from national vital statistics. Oxford, UK: Oxford University Press, 1994
[7] US Department of Health, and Human Services. Reducing the health consequences of smoking: 25 years of progress;
a report of the surgeon general. Atlanta, GA: US Department of Health and Human Services, Public Health Service,
Centers for Disease Control and Prevention, Center for Chronic Disease Prevention and Health Promotion, Office
on Smoking and Health, 1989
[8] Orleans CT, Slade J. Nicotine addiction: principles and management. Oxford, UK: Oxford University Press,
1993
[9] Abrams DB, Emmons KM, Niaura RD, et al. Tobacco dependence: an integration of individual and public health
perspectives. In: Nathan PE, Langenbucher JW, McCrady BS, et
(*) From the Dana-Farber Cancer Institute and Harvard School of Public Health, Boston, MA.
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