New Target for Smoking Cessation without Weight Gain
Posted by on July 27, 2011 - 6:14am

A new study uncovers a brain mechanism that could be targeted for new medications designed to help people quit smoking without gaining weight. This research, funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, shows that a specific subclass of brain nicotinic receptor is involved in nicotine’s ability to reduce food intake in rodents. Prior research shows that the average weight gain after smoking is less than 10 pounds, but fear of weight gain can discourage some people who would like to quit.

In the study, to be published in the June 10 issue of Science, researchers found that a nicotine-like drug, cytisine, specifically activated nicotinic receptors in the hypothalamus — a brain center that controls feeding. This resulted in the activation of a circuit that reduced food intake and body fat in a mouse model. This effect was very specific, since a drug that prevented cytisine from binding to its hypothalamic receptors blocked the reduction in food intake.

Through the use of tobacco, nicotine is one of the most heavily used addictive drugs and the leading preventable cause of disease, disability, and death in the United States. Despite the well-documented health costs of smoking, many smokers report great difficulty quitting.

"These mouse models allow us to explore the mechanisms through which nicotine acts in the brain to reduce food intake," said Dr. Marina Picciotto, of Yale University, New Haven, Conn. and senior author for the article.

"These results indicate that medications that specifically target this pathway could alleviate nicotine withdrawal as well as reduce the risk of overeating during smoking cessation," said NIDA Director Dr. Nora D. Volkow. "Although more research is warranted, such a highly selective compound might be more effective than drugs that act on more than one type of nicotinic receptor."

For information on tips to maintain a healthy weight while quitting smoking go to Forever Free: Smoking and Weight, a publication of the National Cancer Institute. For additional information on resources to help quit smoking, go HERE

The study can be found online at: www.sciencemag.org/.

 

Women, Smoking and Weight Gain
Posted by on September 21, 2010 - 4:01pm

Today,more than 200 health professionals attended the Institute for Women's Health Research at Northwestern University's first educational research forum of the 2010-2011 school year that  featured Bonnie Spring, PhD, a behavioral psychologist at Northwestern.   Her lecture entitled  "Untangling the Web of Women, Smoking and Weight"  made me realize how much we still need to learn about the power of addiction.  Here are some interesting notes about smoking cessation and weight gain from her lecture:

  • Reasons women continue to smoke:   mood and stress management, addiction/craving, social network, weight management.
  • Fear of weight gain discourages 50% of women and 26% of men who smoke  from quitting.   The reality is that 80% of people who quit smoking gain weight but the actual weight gain is about 6-10 lbs. , not the 15 lbs. that people assume.
  • The major cause of post cessation weight gain:   decreased metabolism (from nicotine cessation) and increased energy intake from snacks. Evidently, when we take away something the body values or provides pleasure (e.g., nicotine), we tend to substitute it with something else that we value (e.g. food).
  • Education about the benefits of not smoking is not enough to change behavior;  exercise alone to keep weight off while quitting smoking does not work.
  • Drugs sometimes used during smoking cessation to keep weight down work while they are being used, but once they are stopped, the weight returns.
  • Several studies have been conducted to determine if weight loss programs should be done simultaneously during smoking cessation therapy; shortly after smoking cessation has begun;  or completely after the person quits.  The results vary and it is not yet clear what the best approach is.
  • A lot of controversy persists around the question:   Do weight management efforts undermine tobacco abstinence?  Despite several national guidelines that state so, there is no study that demonstrates that trying to prevent weight gain while trying to quit smoking makes it less likely that a woman will succeed at quitting smoking, according to Dr. Spring.

Some promising approaches that are being evaluated include:

  • Sequential behavioral treatment (cessation, then diet and activity change) more effective than simultaneous treatment because it is  less overwhelming to the patient.
  • Exercise alone does not suppress weigh gain
  • Bupropion, varenicline, NRT suppress weight gain in the short term, but not long-term (after medications discontinued)
  • Weight acceptance (but so far tested only among very weight concerned smokers)

So the jury is still out on the best way to quit smoking.  Dr. Spring also shared some of the early advertising campaigns that were highly successful in raising the number of women smokers.   She noted, "Perhaps the best way to get women to quit smoking is to hire the companies that have been so successful in getting women addicted!"