Smoking Cessation with E-Cigs in Smokers with Depression [Caponnetto, IJCM]

[Tom09]

P Caponnetto, R Polosa, R Auditore, C Russo, D Campagna: Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses. International Journal of Clinical Medicine 2(3), July 2011, in press. (open access)

ABSTRACT
The association between nicotine dependence and affective disorders, particularly major depressive disorder (MDD), is well known with high prevalence rates being reported for smokers. The reason for this association is not clear, but, it has been argued that smoking may help individuals to cope with stress or medicate depressed mood. Smoking cessation programs are useful in helping smokers to quit, but smoking is a very difficult addiction to break, especially for people suffering from depression, and the need for novel and effective approaches to smoking cessation interventions for this special population is unquestionable. The e-cigarette is a battery-powered electronic nicotine delivery device (ENDD), which may help smokers to remain abstinent during their quit attempt. Here, we report for the first time objective measures of smoking cessation in two heavy smokers, suffering from depression, who experimented the e-cigarette.

Small article, adds actual e-cig users to the scientific literature.
Note that co-author Ricardo Polosa is leading the Italian e-cig trial (e.g. this thread).

 

[Demarko]

Interesting read. Sounds like basically any one of our success stories, but with clinical history to back it up.

 

[rothenbj]

The remarkable success stories of these two smokers, suffering from depression, requires justification. The widely acknowledged beneficial role of pharmacotherapy in smoking cessation is likely to be due to their ability to address the physical component of tobacco dependence. However, taking pills or patches for nicotine addiction is unlikely to resolve the psychological components (cogni- tive, social and behavioural) associated with tobacco dependence. As a matter of fact smoking is much more than the addicting effect of nicotine; the smoking habit is also the rituals that each smoker associates with his/her habit [6]. For example, smoking gestures (e.g. the tactile sensations of the cigarette and other sensations associated with smoking gestures) can play an important part in tobacco addiction as they are usually performed in a pre- dictable, ritualistic manner that act to signal a mental context shift. When the smoker stops smoking, those rituals are no longer there, but the need for the ritual still exists and this is an important cause of relapse. Smoking cessation products cannot replace the rituals associated with the act of smoking. Counselling for smoking cessation is intended to help smokers in coping with this important aspect of their life by implementing personalized replacement rituals, but even counselling for smoking cessation lacks high levels of efficacy.
Therefore, it is likely that the smokers described in our case series coped successfully with the psychological components associated with their tobacco dependence by using a device resembling a cigarette, which—although being mainly designed for the purpose of nicotine deliv-ery to the respiratory system—it has the additional advantage of being a valid substitute for the tactile sensations of the cigarette and other sensations associated with smoking gestures.

Although the present findings cannot be generalized, high quit rates would be desirable in a population that generally respond poorly to smoking cessation efforts like smokers suffering from depression. Larger con- trolled studies are needed to confirm this interesting findings, particularly for those smokers for whom handling and manipulation of their cigarettes play an impor- tant part of the ritual of smoking.

Emphasis mine

Yes, these fellows needed to spend research dollars for what we've been saying for years.

Some points, "widely acknowledged beneficial role of pharmacotherapy in smoking cessation"- Pharmacotherapy may have a widely "acknowledged" beneficial role, but at a 2% success rate after 20 months, the word "ineffective" somehow should have been placed in that sentence.

Acknowledgement of the habit and ritual was at least brought to the forefront for a change and the lack of effectiveness of counseling was spelled out.

And yes, there could be a major on smoking rates with some honesty on the smokeless front!

 

[Vocalek]

There is also this sentence:

Although there is little doubt that currently-marketed smoking cessation products increase the chance of committed smokers to stop smoking, they reportedly lack high levels of efficacy—particularly in the real life setting [14].

And the reference is something they wrote:

[14] G. Casella, P. Caponnetto and R. Polosa, “Therapeutic Advances in the Treatment of Nicotine Addiction: Present and Future,” Therapeutic Advances in Chronic Disease, Vol. 1, No. 3, 2010, pp. 95-106.

 

[Vocalek]

I have added the document to CASAA's collection http://www.casaa.org/files/Polosa-E-Cig-Smoking-Cessation-Depression.pdf

And listed it as one of the references on the E-Cigarettes page in the Harm Reduction Section: Casaa.org - Harm Reduction

 

[Bill Godshall]

Excellent Case Report, and it was published in the International Journal of Clinical Medicine.

This and similar articles will help convince open minded healthcare professionals and public health advocates to support (or at least to not oppose) e-cigarettes. We also should send this article to elected officials and/or Board of Health members who are considering proposals to ban e-cig sales and/or e-cigarette usage where smoking is banned).

Unfortunately, the only reason WHO, CTFK, ALA, AHA, AMA, Legacy, Winickoff, Hahn, Blumenfeld or other e-cigarette prohibitionists would acknowledge the existance of this article would be to claim that it provides evidence in support of FDA's unsuccessful attempt to regulate e-cigarettes as smoking cessation drug devices (which of course was nothing more than an attempt to ban e-cigarettes under the guise of protecting public health).

 

[rolygate]

Somebody should tell them that their PDF reveals the title from its metadata as, "Dust Effect on the Performance of Wind Turbine Airfoils".

The meta in Word docs and PDFs has caught a lot of people out

 

[Vocalek]

OK, I sent an email to Dr. Polosa about the title and explained how to correct it. My guess would be that they had a Word document that they have been using as a template for new article submissions. You're right. The metadata does carry over from Word to Adobe.

Thanks, Roly.

 

[Tom09]

Virtually thousands of different scientific papers on "Dust Effect on the Performance of Wind Turbine Airfoils" here. Appears like a trademark of the publisher (Scientific Research Publishing, scirp.org)

 

[Vocalek]

Yes. I received this reply from Dr. Polosa:

Dear elaine,

The mistake was on editor's side. It will be' corrected soon

RP

 

[pineapplestrawberrygirl]

I have depression and smoking help but was getting out of control i had tried to quit everyway you could imagne and felt like killing my self. That to totally changed on the ecig i have been stinky free since august 2013 and has not changed my depression loving vaping it rocks. My ashma as improved to the point i don't need my ventolin everyday its fantastic

Sent from my RM-821_eu_euro1_342 using Tapatalk

 

[drtwain5]

Excellent Case Report, and it was published in the International Journal of Clinical Medicine.

This and similar articles will help convince open minded healthcare professionals and public health advocates to support (or at least to not oppose) e-cigarettes. We also should send this article to elected officials and/or Board of Health members who are considering proposals to ban e-cig sales and/or e-cigarette usage where smoking is banned).

Unfortunately, the only reason WHO, CTFK, ALA, AHA, AMA, Legacy, Winickoff, Hahn, Blumenfeld or other e-cigarette prohibitionists would acknowledge the existance of this article would be to claim that it provides evidence in support of FDA's unsuccessful attempt to regulate e-cigarettes as smoking cessation drug devices (which of course was nothing more than an attempt to ban e-cigarettes under the guise of protecting public health).

Modest quit rates, (~ 7% for ecig vs ~ 6% nic patch, p=0.46 at 6 months post-trial initiation) have been reported in a larger population (ca. 650 subjects), conducted as a randomized controlled trial (1). Indeed, quit rates at 6 month follow-up time periods between ecig and nic inhaler NRT are comparable (ca. 15%), and some antidepressants, but not all, improve the odds of cigarette smoking quit rates (2). While intriguing, the high success found in the 2 cases reported needs to be confirmed in larger studies, but an argument is emerging that vaping is at least as effective as conventional NRT and possibly pharmacotherapy (less clear in at-risk populations) in reduction of risk for tobacco smoking. Of course, the evidence is meaningless and easily dismissed by paternalistic prohibitionists, political ideologues and tax revenue obsessed bureaucrats.

(1) Bullen et. Al., http://dx.doi.org/10.1016/S0140-6736(13)61842-5
(2) Hughes JR et. al., Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000031