Study looks at efficacy of nicotine inhalers

Karen C. Tully Arizona Daily Wildcat Scott Leischow, the director of Arizona Program for Nicotine and Tobacco Research, holds a promotional jar of cigarette butts. Leischow heads a program that operates a smokers' hotline and conducts experiments on new anti-smoking products.

The group is seeking subjects for three studies funded by the National Institute of Drug Abuse.

One of these studies examines the efficacy of nicotine inhalers as a medication distributed over-the-counter.

Currently unavailable without a prescription, nicotine inhalers work like miniature pipes enabling smokers to puff on nicotine. The nicotine delivered is 10 percent of that delivered by a cigarette and smokers may obtain the nicotine in a motion similar to that used while smoking.

"The use of this inhaler and this delivery system helps to ease the nicotine withdrawal and takes care of the behavioral aspect of smoking," said Dr. Scott Leischow, associate professor of health education and director of the Arizona Program for Nicotine and Tobacco Research.

Over-the-counter studies examine the success rate of such pharmacological aids when dispensed without behavioral intervention or much counseling beyond written instructions on the medication's use.

"We run it as store-like and as pharmacy-like as possible Ü no intervention," said Louise Strayer, clinical coordinator for the Arizona Program for Nicotine and Tobacco Research.

A recently completed similar study on the nicotrol patch conducted by the group found a low-success rate.

Leischow said much of this low-success rate may be attributed to improper use of the medication and lack of behavioral intervention.

"With behavioral intervention in conjunction with pharmacological intervention the quit rates rise by 50 percent," Leischow said.

A report from the Agency for Health Care Policy and Research, summarizing findings from all studies to date, also noted that behavioral support dramatically increased quit rates.

Behavioral intervention can be obtained through group treatment, classes and helplines. Group treatment is offered through the American Cancer Society and the American Lung Association. Smoking cessation classes also began last week at University Medical Center.

The Arizona Program for Nicotine and Tobacco Research also offers the Arizona Smoker's Helpline, funded by the Tobacco Tax. The call is free from anywhere within Arizona and counseling is available in English or Spanish.

Counselors help smokers identify the reason for their wanting to quit as well as their reasons for having started. Then the counselors help smokers identify the triggers that sent them searching for a cigarette.

Zenen Salazar, the helpline program coordinator said the greatest impetus for many callers is "realizing that you have to quit to live a better quality life."

Once a four-pack-a-day smoker for 20 years, graduate student Jake Mullins said this realization came after suffering smoking-related heart pains and near-congestive heart failure while her husband was dying of smoking-related emphysema.

"My doctor told me if I didn't quit I wouldn't live to see my kids grow up," she said.

She said she then gained the determination to quit for good after several struggles and relapses.

Without such iron determination, attempts to quit smoking often fail, said occasional smoker and family, consumer and retail studies sophomore Robyn Stoller.

She tried to quit last year but failed, she said, because the attempt was half-hearted.

Painful, overpowering withdrawal symptoms often paralyze many smokers' attempts to quit, Salazar said. This can manifest in many ways, physically and emotionally.

"Cigarettes were like a companion, and I actually went through grieving for loss of a companion and loss of my identity," Mullins said.

Because of these withdrawal symptoms, Mullins retreated to an understanding and tolerant friend's house for three weeks to quit cold turkey.

Prior to that successful attempt, she said she had tried over-the-counter quitting aids with little success.

With over-the-counter aids, success may vary between individuals and aids, Leischow said.

The primary point of difference between success rates in quitting aids distributed over the counter is whether the aid is easy to use, said Leischow.

"Basically every nicotine replacement product works about the same when used as directed," he said.

Results from the nicotine inhaler study will be used by the Food and Drug Administration as part of their deliberations on whether to approve the nicotine inhaler for over-the-counter use.

The group is seeking 500 participants for the study.

Subjects are also sought for two other studies determining whether a relationship exists between efficacy and the cost of the inhaler or nicotrol patch. Subjects will be randomized to one of three cost groups.

All participants in any of the three studies must be smokers more than 18 years old and preferably in good health. Interested individuals may contact the Arizona Program for Nicotine and Tobacco Research at 621-9907.