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Varenicline decreases alcohol consumption in heavy-drinking smokers.  

• Anti-Smoking Drug Decreases Alcohol Consumption in Heavy-Drinking Smokers 

The smoking cessation drug varenicline significantly reduced alcohol consumption in a group of heavy-drinking smokers, in a study carried out by researchers at the Ernest Gallo Clinic and Research Center at the University of California, San Francisco.

“Alcohol abuse is a huge problem, and this is a big step forward in identifying a potential new treatment,” said senior author Howard L. Fields, MD, PhD, professor of neurology and director of the Wheeler Center for the Neurobiology of Addiction at UCSF.

The study was published on May 1 in the journal Psychopharmacology.

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• Cardiovascular safety concerns over smoking-cessation drug misleading 

A popular smoking cessation medication has been under a cloud of suspicion ever since the Canadian Medical Association Journal (CMAJ) published a study in July 2011 reporting "risk of serious adverse cardiovascular events associated with varenicline." Varenicline, also known as Chantix, blocks the pleasant effects of nicotine on the smoker's brain and lessens nicotine withdrawal symptoms.

UCSF researchers, however, question the way the previous study was conducted, and their new analysis, scheduled to be published May 4 in BMJ, reaches a very different conclusion.

"We found no clinically or statistically significant increase in serious adverse cardiovascular events associated with using varenicline," said lead author Judith J. Prochaska, PhD, MPH, an associate professor in UCSF's Department of Psychiatry and researcher with the Center for Tobacco Control Research and Education. "The findings from 22 trials with more than 9,200 participants indicate a difference in risk of only 0.27 percent between those on varenicline versus placebo, or about a quarter of one percent."

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O'REILLY: Cigarettes: I'm giving up my first love... at 30  

Looking back at all those movie and music stars, only a few have survived (I would never have put money on Keith Richards being one.) The ones still walking the earth -- their faces are maps of excess, of fragility; their bodies weathered and beaten.

So, on my 30th birthday, our 16th anniversary, rather than celebratory inhalations of smoke and the draw of heat at my fingertips, it is a funeral I give to you, my love.

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Cell Phone System Achieves High Smoking Cessation Rate 

Smokers struggling to stay quitters! 

Colorado returns millions of dollars to fight tobacco, cancer 

A looser state budget will hand about $46 million back to cancer-fighting groups who had lost money for tobacco cessation and medical screening for the past three years.

Eroding state budgets pushed the legislature to confiscate Amendment 35 cancer-fighting money for emergency funds. The new 2012-13 state budget restores the money to the pots voters intended when they approved a higher cigarette tax in 2004.

The money will quickly boost tobacco "quit lines" for Colorado, and restore screening for breast, cervical and colorectal cancers, as well as treatments for the uninsured when those tests discover illnesses.

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MORRIS: 10 surprising benefits of quitting smoking 

Now that I've been without tobacco for the past couple months (63 days, to be exact), I've noticed some changes in the way I'm living.

All are positive and are in direct relation to my body's depletion of those nasty chemicals I've called friends for the last 12 years.

So I thought I would list those changes and explain how I have been affected by each. Though my list is restricted to 10, it is by no means an exhaustive one.

1. No more chronic cough: All smokers know what "smoker's cough" is. I didn't realize how annoying this was until I stopped coughing all the time. After about a week being smoke-free, I noticed I didn't have to clear my throat every few minutes.

I recall plenty of times when I was at a function or meeting and needed to cough so badly, but couldn't because I knew it would be rude and interrupting to those around me. It's like an insect hovering in your throat – not touching, just drying everything between your tongue and your stomach – and you can't do a darn thing about it.

2. The smell: I didn't know I smelled so badly until I was around other smokers.

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• EDITORIAL: State Grabs Money Meant For Quitting Smoking 

When it comes to tobacco addiction, Connecticut's state government has been nearly as exploitative and venal as the tobacco companies it went after more than a dozen years ago.

The state led the nation in suing Big Tobacco, with then-Attorney General Richard Blumenthal demanding compensation for the high cost of Medicaid patients who are prone to smoke. The idea was that tobacco companies would give states money to care for the ill — and prevent others from becoming addicted.

The argument won the day. Connecticut and 45 other states won billions of dollars in 1998 as part of the historic tobacco settlement. But hypocrisy soon followed.

This income stream of $100 million-plus annually will end in 11 more years. It has become little more than a slush fund to pay for practically everything but quitting smoking. . . .

Between 2000 and 2009, according to an excellent Yankee Institute study (bit.ly/tobaccoct), of the $1.3 billion sent to Connecticut from the settlement, only $134 million went to the Tobacco and Health Trust Fund. But it gets even worse: The state government raided that "trust fund" of all but $9.2 million for other goals.

Mr. Blumenthal, now U.S. senator, says, "We should be embarrassed and ashamed that one of the nation's leading states in public health is failing to use the money to help people quit. "

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KRAMER: Up in Smoke 

Of all the vices I have overindulged in, smoking is the only one I will admit has an addictive spell over me. Only cigarettes — or the lack of them — have changed my personality and taken my body and mind out of my own control. When I was younger and tried to quit, I had horrible physical responses to the nicotine deprivation. Tunnel vision, anxiety attacks, general numbness would take over my body. My wife would often tell me to go out and start smoking again, as she couldn’t bear to watch me fall to pieces.

Since then, quitting has been a constant project with me. I quit all the time. But often, when I am overwhelmed with work, I find it almost impossible to not light up. I know, I know… It’s an excuse. But when I am filled with anxiety I simply find it so much easier to feed the beast. Trying not to smoke takes way too much effort. Of all the vices I have overindulged in, smoking is the only one I will admit has an addictive spell over me. Only cigarettes — or the lack of them — have changed my personality and taken my body and mind out of my own control. When I was younger and tried to quit, I had horrible physical responses to the nicotine deprivation. Tunnel vision, anxiety attacks, general numbness would take over my body. My wife would often tell me to go out and start smoking again, as she couldn’t bear to watch me fall to pieces. . . .

But of course my doctor was concerned about my smoking and wanted to help. He told me about an antidepressant (Bupropion) that had an interesting side effect: it seemed to make cigarettes totally unpalatable. . . .

I found an old pack of cigarettes lying around and I decided to have one to see if it would be as disgusting as the last. It was not.

The cigarette tasted just as good as all the others I’d had before taking the drugs. I laughed out loud to myself and thought, “No wonder I wanted to kill myself. I wasn’t smoking!”

I had my sense of humor back. All was right again with the world. I could live with my anxiety, as long as I had my vices to help me through.

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• Which ads are winners? Your brain knows  

Advertisers and public health officials may be able to access hidden wisdom in the brain to more effectively sell their products and promote health and safety, UCLA neuroscientists report in the first study to use brain data to predict how large populations will respond to advertisements.

Thirty smokers who were trying to quit watched television commercials from three advertising campaigns, which all ended by showing the phone number of the National Cancer Institute's smoking-cessation hotline. They were asked which commercials they thought would be most effective; they responded that advertising campaigns "A" and "B" would be the best and "C" would be the worst.

The UCLA researchers also consulted experts who work in the anti-smoking field and who have been involved in creating anti-smoking advertisements. These experts agreed that campaigns "A" and "B" were the best and "C" was the worst.

While the smokers watched the advertisements, they underwent functional magnetic resonance imaging (fMRI) brain scans at UCLA's Ahmanson-Lovelace Brain Mapping Center, and the neuroscientists focused on part of the medial prefrontal cortex — located in the front of the brain, between the eyebrows — a region that they have found to be especially important in previous persuasion studies.

The researchers found that activity in the medial prefrontal cortex increased much more during advertising campaign "C" than it did during campaign "A," and somewhat more than it did during campaign "B."

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UC San Diego Researchers Review Cessation Studies and Call for Change in Policy 

In the 2012 edition of the prestigious Annual Review of Public Health, researchers at the University of California, San Diego School of Medicine have reviewed the landscape of smoking cessation over the past 20 years. During this time period, there have been improvements in pharmaceutical medications to aid cessation, and free telephone cessation coaching has become available in every state. However, recent trends in smoking cessation are troubling to tobacco control researchers.

“For the past decade, attempts to quit smoking have increased, but the proportion of people who become successful quitters has gone down” said John P. Pierce, PhD, professor of Family and Preventive Medicine and director of Population Sciences at UC San Diego Moores Cancer Center. “Widespread dissemination of cessation services has not led to an increase in the probability that a quit attempt will be successful."

The problem does not appear to be with the cessation services themselves. “ . . .

recent evidence suggests that part of the problem may lie in how cessation aids are marketed by pharmaceutical companies: many such ads suggest that quitting smoking may be as simple as putting on a patch. It appears that younger smokers in particular are now more likely to underestimate the amount of work needed in order to quit smoking successfully. . . .

Pierce and colleagues noted that some of the earliest texts in psychology – written more than 100 years ago – include chapters on breaking habits such as smoking. In 1890, William James laid out a series of maxims that were widely recognized then and that still hold true today: smokers need to make a strong resolution to change; they need to act quickly on that resolution; they will be more successful if they make a personal commitment to another to be successful; and finally, it is important to understand the danger of having even a single cigarette during a quit attempt.

The researchers suggest that policy makers join those in academia for a serious review of tobacco cessation policy.

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• VIDEO: Hooked: Why bad habits are hard to break  

In the battle against addiction, "just say no" is magical thinking, says Dr. Nora Volkow. She's the head of the National Institute on Drug Abuse, and after spending decades studying the brains of addicts, Dr. Volkow has determined that drug addiction is a chronic disease that physically changes the brain. Dr. Volkow has found that even images of an addictive substance, such as alcohol or drugs, can produce a dopamine response in an addict's brain, and some foods can trigger a similar reaction. Morley Safer reports on Volkow's revolutionary research into addiction, as well as on her revolutionary family history.

The following is a script of "Hooked" which aired on April 29, 2012. Morley Safer is the correspondent. David Browning, producer. . . .

Nora Volkow: We're seeing consistently a reduction in the levels of these dopamine receptors, in this case heroin, alcohol, methamphetamine, cocaine, but also marijuana and cigarette smokers.

Problem is the brain just isn't wired to handle the intense high that drugs give. A kind of shutoff valve kicks in: reducing the number of receptors in the brain that receive dopamine's feel good message.

Nora Volkow: What happens with repeated administration of these drugs is that the ability of them to generate a sense of pleasure decreases and decreases and decreases. And there's a point where the person starts to take them, not to feel good. But to feel normal.

And other changes in the brain explain why so many addicts -- no matter how hard they try -- just can't quit.

Morley Safer: There is that school of thought that says, "Look, all you need is to be strong-willed. Your problem is you're weak. Show some determination and you can beat this addiction.

Nora Volkow: There are certain areas of the brain that are directly implicated in our capacity to exert free will. The frontal cortex is one of them: crucial, crucial. So if drugs damage the areas of the brain that we need in order to exert free will then it's like driving a car without brakes. You don't want to hit someone. But if you don't have brakes how do you stop the car?

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• Smoking Thwarts Positive Outcomes in Opioid Addiction 

Opioid-addicted patients who were also nicotine dependent achieved better outcomes if they did not smoke during methadone detoxification, new research shows.

Paolo Mannelli, MD, from the Department of Psychiatry, Duke University, in Durham, North Carolina, presented the findings here at the American Society of Addiction Medicine (ASAM) 43rd Annual Medical-Scientific Conference.

"These results question the 'harm reduction' argument that an attempt to quit smoking may interfere with a concurrent attempt to discontinue other drug use," Dr. Mannelli told Medscape Medical News.

According to Dr. Mannelli, studies suggest that tobacco use may offset the benefit of existing effective interventions for opioid addiction (OA).

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LETTER: B.C.’s stop-smoking program comes with a few conditions