May 31, 2014 – UN No tobacco Day

Copyright © Françoise Herrmann

 

The  campaign theme for the WHO/UN World No Tobacco day is: Raise Taxes!

There is plenty of evidence that this public health strategy works. For example, California Proposition 99 Tobacco tax increase (voted in 1988), and the overwhelming defeat in 2000 of Proposition 28 Repeal of “first five” cigarette taxes, in conjunction with other public health measures was estimated in 2004 to have reduced the burden of the California state healthcare system by 86 billion dollars in reduced incidence of lung cancer and heart disease [Glantz and Balbach, 2000]

 

And for anyone with doubts about government tobacco interventions, The World Bank has also conducted research concerning the myths surrounding tobacco control, and for example, the following myths in particular [World Bank]:

1.  Governments will lose revenues if they increase cigarette taxes, because people will buy fewer cigarettes

Wrong. The evidence is clear: calculations show that even very substantial cigarette tax increases will still reduce consumption and increase tax revenues [..]

2.  Tobacco addiction is so strong that simply raising taxes will not reduce demand; therefore, raising taxes is not justified 

Scores of studies have shown that increased taxes reduce the number of smokers and the number of smoking-related deaths. Price increases induce some smokers to quit and prevent others from becoming regular or persistent smokers. [plus lots more..]

3.  Governments will lose revenues if they increase cigarette taxes, because people will buy fewer cigarettes 

Wrong. The evidence is clear: calculations show that even very substantial cigarette tax increases will still reduce consumption and increase tax revenues [..] 

4.  Smuggling and illicit production will undermine the effects of raised tobacco taxes 

Smuggling is a serious concern. But even in the face of smuggling, the evidence from a number of countries shows that tax increases still increase revenues and reduce cigarette consumption […]

5.  Tobacco control will result in permanent job losses for an economy 

[…] Studies for this report show that most countries would see no net job losses and that a few would see net gains if consumption fell. 

6.  Governments should not discourage smoking other than making its risks widely known. Otherwise, they would interfere with consumers’ freedom of choice 

[…] the choice to smoke may differ from the choice to buy other consumer goods and governments may consider interventions justified. 

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So...after May 31 ,2014...  the future has to be ...  smoke-free planet earth!

 

References

Glantz, S. A. and E. D. Balbach (2000) Tobacco war. Oakland, CA: University of California Press.

The World Bank – Tobacco

http://tinyurl.com/ncr5kcf

Oh, patents! Quitlines

Copyright © Françoise Herrmann

 

Ok, this is it.  Ready or not,  tomorrow is May 31, 2014 – UN World No Tobacco Day!

 

Just to complete the tour of patented smoking cessation treatments reviewed in this blog, here are a few quitlines and programs to support your decision to quit, and to help you handle all the psychological aspects of smoking cessation.

• The NIH - National Cancer Institute's 800-QUIT-NOW (800-784-8669)
• The American Cancer Society's Quitline at 800-ACS-2345 (800-227-2345)
• The American Lung Association Lung Helpline offers services in 150 languages, 7/7 from 8 am to 12 pm, 1-800-LUNGUSA or 1800-586-4872
•  CDC – Centers for disease control - TIPS from former smokers – I am ready to quit now! http://www.cdc.gov/tobacco/campaign/tips/quit-smoking/
•  smokEnders: addresses the psychological aspects of smoking cessation with “no scare tactics, no pharmaceuticals, no gums no patches, no shock therapy, no herbal concoctions”, at small cost. http://www.smokenders.com/
• Nicotine Anonymous – A 12-step, one day at a time program mapped onto AA – Alcohol Anonymous http://www.nicotine-anonymous.org/
• The Five Day Plan (McFarland & Folkenbeg, 1964)  of the Seventh Day Adventists Church. This is the first, and oldest, smoking cessation program in the US. Here is a link to the Online individual 5 day plan, (yes, just 5 days): http://www.starthealthcare.com/index.php/stop-smoking-5-days-plan/

There are no patents associated with Quitlines… but all of these programs and services are purported to greatly augment your chances of success and to provide best results when associated with treatments such NRTs (Nicotine Replacement Therapy) and/or medication, which are very patented, as you may have discovered in previous posts to this blog.

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Good luck in your resolve!

Remember, if at first you don’t succeed, then try again. 

And as President Obama is fond saying: "Yes you can".

 

References

MedinePlusStop smoking support programs

http://www.nlm.nih.gov/medlineplus/ency/article/007440.htm 

McFarland, W.J. & E.J. Folkenberg (1964) The five day program to help individuals stop smoking: A preliminary report. Conn Med, 1964, Dec. 28:885-90. 

http://legacy.library.ucsf.edu/documentStore/t/y/o/tyo81b00/Styo81b00.pdf

http://www.uhs.wisc.edu/health-topics/tobacco/documents/Five_Day_Plan.pdf  

Kerkvliet, J.L and N.L. Fahrenwald (2014) Tobacco quitline outcomes by service. SD Med, 67(1)25-9. 

http://www.ncbi.nlm.nih.gov/pubmed/24601063

Oh, patents! Oral transmucosal NRTs

Copyright © Françoise Herrmann

 

Ok, May 31, 2014 – UN World No Smoking Day,  minus 36 hours! Or, what you really want, without the pain of withdrawal…!

Nicotine replacement therapies (NRTs) are recommended by the NIH (National Institutes of Health), the ACS (American Cancer Society) and the ALS (American Lung Association) as first line approaches to smoking cessation. NRTs  include patches, lozenges, sprays and gum. (See a previous post on .. for Transdermal nicotine patches). Research indicates that NRTs in association with counseling double your chances or quitting (Pierce et. al, 2012)

 If your Doctor skipped town, or has already given up on you… then you can always go to Walgreens to pick up some nicotine gum or lozenges, marketed under the brand name Nicorette®, one of the first FDA-approved NRTs.

 

Nicotine gum marketed as Nicorette®  uses a “park and chew” technology. Using the “park and chew” technology, a consumer “bites” on the gum to release nicotine, and then “parks” the gum inside their cheek, and then ”bites” again when more nicotine is needed. This prevents excess nicotine release, and the ensuing undesirable side effects such as dizziness, nausea or stomach problems.

The original (and expired) Nicorette® nicotine replacement patents from the 1970s are US3877468 titled Chewable tobacco substitute composition, disclosing “Chewable smoking substitute composition comprises at least about 40 percent by weight of a gum base and a tobacco alkaloid dispersed in said gum base in an amount sufficient to provide smoking satisfaction.”; US3901248 titled Chewable smoking substitute composition and US3845217 titled Buffered smoking substitute compositions. More recent Nicorette® patents include the nicotine lozenge patent  US2011110880 titled Nicotine Lozenge compositions, and  a flavoring patent,  US2006275344 titled Flavoring of drug-containing chewing gum.

Incidentally, nicotine gum is  a very patented product! The EPO returned 184 patents for a search on “nicotine gum”. There are in fact many different sorts of nicotine gums, that is, different formulations of the gum base and of the non-toxic active nicotine ingredient; different oral transmucosal delivery systems or release technologies for the nicotine in the gum; and different flavors that may be added to the gum to make it palatable or compatible with release of the active ingredient.

Here is an additional short list of the nicotine gum patents:

• US2014099269 Chewing gum having sustained release of nicotine
• US2013323184 Method of providing fast relief to a user of nicotine chewing gum
• US2012039981 Coated nicotine-containing chewing gum, manufacture and use thereof
• WO2013059592 Excipients for nicotine containing therapeutic compositions
• WO2014091631 Method of releasing nicotine from chewing gum
• US6344222B1 Nicotine, hydrophilic and hydrophobic polymer, buffer time-release agents (to improve release rates of nicotine)
• US8658200 Flavoring of drug-containing chewing-gums

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Finally, here is a cessation quote to ponder:

“Nicotine is an addictive poisonous alkaloid C₅H₄NC₄H₇NCH₃, derived from the tobacco plant. Nicotine is also used as an insecticide. Approximately 40 milligrams* of nicotine is able to kill an adult (Merck Index).” (Extracted from US2006275344)

 *40 mg = 1 US teaspoon 

Reference

John P. Pierce, Sharon E. Cummins, Martha M. White, Aimee Humphrey, and Karen Messer (2012)

Quitlines and nicotine replacement for smoking cessation: Do we need to change policy? Annual Review of Public Health, 33:341-356.
http://www.annualreviews.org/doi/abs/10.1146/annurev-publhealth-031811-124624

Oh, patents! Bupropion Hcl

Copyright © Françoise Herrmann 

Just three days till May 31 – The UN World No Smoking Day! And just enough time for your physician to perhaps decide on prescribing bupropion hydrochloride in sustained release (SR) form, commercially marketed as Zyban® by GalxoSmithKline as an effective aid to smoking cessation.

This pharmacotherapy for smoking cessation differs from nicotine and nicotine-replacement therapies in that it is an active ingredient  completely un-related to nicotine.  It is the third and most recent approach to smoking cessation. As a reminder the other combination lines of treatment are behavioral and nicotine-replacement-type therapies, such as transdermal patches, gum and lozenges.

The active ingredient bupropion hydrochloride was initially marketed in the United States as an antidepressant under the brand name Wellbutrin®, manufactured by GlaxoSmithKline. The structure of the active ingredient bupropion hcl is similar to diethylpropion, an appetite suppressant. Clinical testing of the drug demonstrated its effectiveness as a cessation drug as it doubles the success rate of the cessation, and is as effective as nicotine replacement therapies in conjunction with behavioral therapies (Roddy, 2004). It is unclear how bupropion hlc actually supports cessation although the effects of the drug on brain activity are known. It is hypothesized that inhibition of the reduction of dopamine and noradrelanine levels occurring with nicotine withdrawal is probably responsible. (Roddy, 2004).

Bupropion hlc is a highly patented compound. The search term “bupropion” returned 453 hits at the EPO!

The discovery of the compound is patented in US3819706 titled Meta chloro substituted alpha-butyl-amino propiophenone, as well as many of  its various formulations, for example US2011020446 titled Method and formulations for making pharmaceutical compositions containing bupropion.

  The various properties of the compound (including smoking cessation) are patented:

• as an anti-depressant, for example, US2009304786 titled Stable dosage forms of an antidepressant
• as appetite suppressant, for example, US2011144145 titled Methods of treating visceral fat conditions or US 2011098289 titled Method for treating obesity
• as treatment for sexual dysfunction,  for example WO2012028834 titled Use of bupropion in the treatment of sexual dysfunction
• as an aid to smoking cessation: for example US2003064092 titled Pharmaceutical composition containing two active ingredients for smoking cessation or US2004225020 titled Methods and compositions for aiding smoking cessation and for treating pain and other disorders using optically pure (-)-bupropion

 And the mode of delivery of the compound (in SR- Sustained release form) and its manufacture are patented, for example in US2010008987 titled Modified release pharmaceutical composition of bupropion hydrochloride, considering all the severe side effects that occur at peak plasma levels.

There are however warnings associated with the use of this therapy, as it is linked to neuropsychiatric reactions, suicidal thoughts and behaviors, particularly with younger populations. (GSK – Zyban)

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So, with just a couple days left before the big Q day, Carpe Diem!

 References

Roddy, E. (2004) Buproprion and other non-nicotine pharmacotherapies. BMJ Feb. 20, 2004, 328(7438):509-511.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC351853/

GlaxoSmithKline – Zyban  - Highlights of prescribing information

https://www.gsksource.com/gskprm/htdocs/documents/ZYBAN-PI-MG.PDF