Nicotine in NRT products linked to breast cancer for the first time

The substance that makes cigarettes addictive may also cause the growth of cancer tumours, scientists revealed today. It is the first time nicotine has been implicated as one of the chemicals in cigarettes that can trigger the development of breast cancer.

The findings, published in The Journal of the National Cancer Institute, could be a major blow to the NHS and makers of nicotine-based products that help smokers to quit. Normal cigarettes are known to contain at least 60 cancer-causing substances including carbon monoxide, tar and arsenic, but until now nicotine had not been on the list.

Researchers from Taipei Medical University looked looked at both breast cancer cells and normal cells to see if nicotine promoted tumour growth at a cellular level.

Dr Yuan-Soon Ho and his team found that when normal cells were treated with nicotine in the laboratory it promoted the development of cancer characteristics. Likewise reducing the level of nicotine inhibited tumour growth.

The research could have a negative impact on companies that make nicotine gum, patches and electronic cigarettes that are promoted as a 'healthy alternative' for smokers.

The authors said their study was limited by its small sample size, which looked at just a few hundred Asian patients and further study was needed.

In an accompanying editorial Dr Ilona Linnoila of the Center for Cancer Research at the National Cancer Institute, said: 'The study suggests not only that smoking could be causally related to breast carcinogenesis but also that nicotine could directly contribute to the molecular mechanism of carcinogenesis in addition to indirectly contributing by promoting addiction to smoking.'

She added: 'Better understanding of the molecular mechanisms of the cholinergic pathways will lead to more opportunities for intervention and prevention of tobacco toxicity.' 24.8.10

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NHS claims to help a record 370,000 smokers to quit... at a cost of £224 EACH

The NHS has helped a record number of people to successfully give up smoking, according to their new figures. Of the 757,537 people who used the NHS quit service during the year, 373,954 successfully gave up, marking an 11% rise on the 337,054 who gave up in 2008/09, NHS Information Centre figures revealed.

The figures related to people in England who hadn't returned to the habit when they were contacted four weeks after they had stopped.

However, the total spending on NHS stop-smoking services had increased to almost £84 million last year, up £10 million from 2008/09. The cost per quitter was £224, an increase of three per cent from the previous year.

The report also broke down how effective each quitting method was. It showed 65 per cent of people trying to give up smoking used nicotine replacement therapy of whom 47 per cent were successful.

Almost a quarter used the controversial stop-smoking drug varenicline (Champix) last year and sixty per cent of them managed to quit using the drug. The drug has been linked to reports of depressive side-effects. Of those who did not use any kind of drug therapy, 49 per cent were able to quit.

Health Secretary Andrew Lansley said: 'Smoking is the biggest preventable cause of death in England. NHS doctors, nurses and health professionals in local stop-smoking services are dedicated to tackling smoking - it's because of their excellent work that more people than ever have successfully quit. Over 50 years, we have halved the proportion of adults who smoked.'

However, a separate report showed that one in 20 hospital admissions for over-35s in 2008-09 were linked to smoking, a trend that was compounded by figures from the British Heart Foundation (BHF) which revealed that the proportion of adult smokers had remained static at 21%.

Martin Dockrell, a director at Action on Smoking and Health (ASH), said: 'This just shows what you can do when you have a proper plan to help smokers quit. Smoking costs the NHS at least £2.7 billion a year and when you include disability benefits, absenteeism and other costs it mounts up to a colossal £13.74 billion, so the small investment from the Government brings huge benefits.'

But critics said the figurers were 'misleading' as the follow up at four weeks only asks if the individual smoked within the first 14 days and the quitters were also dependent on using NRT or other drugs to suppress the desire to smoke. When the use of the products is stopped the individual usually reverts back to smoking, so they have not really quit, also the cost of £224.00 per person does not included the cost of the NRT or other products used, so the real cost is far higher'. One critic say the figures were 'spin and fudged statistics'. 19.8.10

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Expectant mothers to be given smoking breath tests

Health watchdog tells midwives to challenge all pregnant women. All pregnant women are to be put under pressure to take a breath test to check if they are telling the truth about smoking. Midwives will be told to 'encourage' mothers-to-be to have the carbon monoxide tests at their very first antenatal appointment. This will reveal whether they are being honest about whether they smoke and, if so, how much.

The 'intrusive' new guidance comes from NHS watchdog NICE and critics insist it is yet another example of nanny state meddling. NICE hopes that showing mothers how much of the toxic carbon monoxide is in their body will shock them into realising the harm they could be doing to their child.

Women who fail the test would be offered stop-smoking services. NICE says this will protect thousands of unborn babies and small children from the harmful effects of tobacco. The partners of pregnant women will also be urged to quit - over fears of the harmful effects of passive smoking on the foetus.

Last night midwives reacted with fury to the guidance - saying the tests could undermine trust by forcing them virtually to accuse new mothers of lying. And critics rounded on NICE, which was set up by Labour to assess which drugs and treatments should be available on the NHS, accusing it straying beyond its remit by seeking to influence yet more aspects of people's lives. Earlier this month the organisation was derided for telling GPs to routinely question patients on their alcohol use. 

One leading expert said 'it's another failed old style [Labour] policy, what's the point in referring people to NHS smoking cessation services which don't work? It's a subversive way of getting more people into smoking cessation classes as the numbers are falling and their funding is at stake'.

In the past week alone it has demanded that children as young as five be given sex and relationships lessons at school and called for state handouts to food companies to persuade them to produce healthier fare. NICE - the National Institute for Health and Clinical Excellence - says it has a duty to speak up because such action can save the NHS millions of pounds in treatments later.

But the latest guidance did not go down well with parents' groups. Justine Roberts of website Mumsnet, said women would be put under so much pressure to have the test that it would be virtually compulsory. 'Of course midwives should offer support to pregnant women who smoke to help them stop but a compulsory test seems intrusive,' she said. 'Most pregnant women are fully aware that smoking is bad for their unborn child and would be keen to cut down or stop and avail themselves of any help offered.'

Sue Macdonald, research manager at the Royal College of Midwives, questioned the emphasis on the carbon monoxide monitor, saying it could make women feel they were being treated as liars - and could also hinder the battle against superbugs.

'It is crucial that health practitioners, including midwives, focus on being supportive rather than making women feeling guilty, or as though they may not be truthful,' she said. 'Use of the carbon monoxide monitor has the potential to make women feel guilty and not engaged. 'There is also the cost implication of all midwives carrying monitors, issues such as safety and infection control, and whether this is the best use of funds to address smoking cessation.'

Simon Clark, director of the smokers' lobby group Forest , said: 'People need to be educated, not coerced and this seems unnecessarily intrusive. 'No one likes being lectured and it could encourage pregnant women to reach for their fags in defiance. 'We encourage pregnant women to take their GP's advice on matters such as smoking and drinking, but we wouldn't condemn anyone who refused a breath test in these circumstances. 'I'm sure there are plenty of people who will be telling midwives to mind their own business. NICE should butt out too.'

NICE says it wants to see the carbon monoxide breath tests rolled out across the Health Service because pregnant women often take no action to stop smoking and protect their baby until presented with evidence of the harm it is doing to their own bodies. It points out that around a third of women smoke while pregnant, with teenagers and those from poor backgrounds more likely to do so.

Smoking during pregnancy can increase the risk of miscarriage, premature birth, stillbirth and sudden unexpected death in infancy. Exposure to smoke in the womb is also associated with psychological problems in childhood such as attention and hyperactivity problems.

Children of parents who smoke tend to suffer from more respiratory problems such as asthma or bronchitis and have problems of the ear, nose and throat. Nearly half of all children in the UK are exposed to tobacco smoke at home. The NICE guidance also recommends that women who smoke and are either pregnant or have recently given birth, are offered a range of options to help them quit, including 'sensitive and non-judgmental' support. A spokesman for the Department of Health said it fully supported the guidance. 24.6.10

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Cigarettes cost could go up to £7.42

Tories target smoking tax. The cost of a packet of 20 cigarettes could be increased to £7.42 under the Tories. A report by the centre-right think-tank The Policy Exchange says tax on tobacco should be hugely increased to cover the cost of treating smokers on the NHS.

At the moment, the cost of smoking far outweighs the amount of money the Treasury gets from cigarette duty, the report says. A packet of 20 cigarettes currently costs an average of £6.13. The Policy Exchange wants a 5% tax hike in next week's budget, a rise of 23p.

And it is calling for further rises over the next five years until the cost of treating those with cigarette related complaints is met by the tax from tobacco. This would see the cost of a pack rise by £1.29 to £7.42 over the course of the next Parliament.

Policy Exchange has been called David Cameron's favourite think-tank - and is said to be highly influential on Tory policy making. According to the report, taxes on smoking raise £10billion a year for the Treasury but the cost of treating related illnesses is £13.74billion.

The Policy Exchange's Henry Featherstone said: "It is a popular myth that smoking is a net contributor to the economy. Our research finds that every single cigarette smoked costs the country 6.5p. "In order to balance income and costs, tobacco duty should be progressively increased until the full cost of smoking is met through tax. "As a start, the next Budget should increase tobacco duty by 5%." 18.3.10

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Willpower works better than patches if you want to quit smoking

Smokers desperate to quit should put their faith in willpower (3%success rate) rather than expensive patches and gums, researchers said last night. A review of hundreds of studies into smoking cessation has revealed that the overwhelming majority of ex-smokers gave up without resorting to nicotine replacement therapies. Old-fashioned willpower alone was enough to make them quit their habit.

What is more, studies which extol the virtues of nicotine patches, gums and pills are more than twice as likely to have been funded by drug companies than others, the Australian researchers said.

Simon Chapman, a professor of public health, said that governments were also guilty of medicalising smoking cessation and of making giving up sound harder than it actually is. The Sydney University team's analysis of 511 studies on quitting smoking published in recent years showed that two-thirds to three-quarters of ex-smokers stopped unaided and that most said they had found it easier to quit than they had expected.

Research also showed that 51 per cent of trials funded by drug companies found nicotine replacement therapies such as patches and gums to be of 'significant' benefit - compared with just 22 per cent of independent studies.

Writing in the journal PLoS Medicine, the professor said it was wrong to argue that so many smokers have quit in the past that those who remain are a 'hard-core' that need extra help.

Advising smokers to try cutting down or going 'cold-turkey' rather than relying on pharmaceuticals, he said: 'Next time you hear the message that various drugs "double the quit rate", understand that these results come from clinical trials where participants get their drugs free, where they are often called up with reminders and questions, where they develop relationships with the researchers and often want to please them, and where we know that many using the active drug are able to correctly guess they are on it or on the dummy drug.

'Studies of the use of quit drugs in "real world" settings have not demonstrated that they have such success. 'A serious attempt at stopping need not involve using nicotine replacement therapy or other drugs or getting professional support.'

The professor, who has received drug company funding in the past, said that although his review focused on nicotine replacement therapies, he also has concerns about the value of medicines such as Champix and Zyban which work by cutting nicotine cravings.

But Amanda Sandford, of anti-smoking group Ash, disagreed with Professor Chapman's interpretation of the research. She said that studies into the benefits of nicotine patches and gums were 'robust' and that 'all the evidence points to relying on willpower alone is not terribly successful'.

She added: 'Where we would agree is that a smoker really has to want to stop.  People are very different and tackle their addictions in different ways.'

A spokesman for the Department of Health said: 'This study is inconsistent with a very well established evidence-base. Smokers that attempt to quit without assistance are significantly less likely to quit successfully than those who quit with support. 'The unsupported quit rate is around 3 per cent at one year. This is doubled (6%) when a smoker uses stop smoking medicines, and quadrupled (12%) when a smoker uses the NHS Stop Smoking Services - where smokers get both medicine and behavioural support.  

'Smokers who quit with NHS support can get stop smoking medicine on prescription, including nicotine replacement therapy. 'The decision on whether to use a stop smoking medicine, and which medicine is best for an individual smoker will be made by the smoker with their health professional.' 9.2.10

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Government targets cigarette packaging

Tobacco companies may be forced to sell cigarettes in plain packaging as part of a raft of measures designed to halve the number of smokers in England by 2020.

Health Secretary Andy Burnham today pledged to cut the number of smokers from a fifth (21 per cent) of the population to one in 10 (10 per cent) in the next 10 years. The target would mean around four million of England 's estimated eight million smokers quitting.

The Government also hopes to cut the estimated 200,000 young people who start smoking every year. Mr Burnham said: "Most smokers start before they are 18, so we have to discourage children and young people from ever starting. "Now that we've banned advertising and will soon see an end to attractive displays in shops, the only remaining method of advertising tobacco is the packaging. So we will carefully consider whether there is evidence for making tobacco companies use plain packets." Plain packs would just show the brand name in text.

The Government today pledged to encourage research to further understanding of the possible links between tobacco packaging and smoking behaviours. Mr Burnham added: "Government should and will do everything in its power to protect young people. This includes putting a stop to cheap tobacco that is smuggled into the country by organised criminal gangs."

He said smokers "should never stop trying" to quit and Government would always help them. "One day, in the not too distant future, we'll look back and find it hard to remember why anyone ever smoked in the first place," he said.

Mr Burnham said the Government had made "massive progress" in the past decade in cutting the number of smokers and would now "go even further". "Today's strategy renews our commitment to virtually eradicate the health harms caused by smoking, and I firmly believe we can halve smoking by 2020."

The commitments announced today include:

* A review of the law to consider if areas like entrances to buildings should be included in the smoking ban as part of further measures to protect children which would include the promotion of smoke-free homes and cars.

* Stopping the sale of tobacco from vending machines, considered a significant source of tobacco for young people.

* Immediate investment in extra overseas officers to stop 200 million illicit cigarettes entering the UK every year.

* NHS support for every smoker who wants to give up, at times and in places that suit them.

* Government consideration of the case for plain packaging for cigarettes.

The Department of Health said 337,000 people stopped smoking last year with the help of free support from the NHS and the number of smokers fell by a quarter in the past decade. But critics said the figure was 'misleading' as NHS success rates are measured when the individual is still nicotine dependent but wearing at patch, so they are not a true reflection of the actual numbers who 'may' have quit.

In 2007 more than 80,000 deaths and 1.4 million hospital admissions were attributed to smoking and the habit costs the NHS £2.7 billion a year.

Chief Medical Officer Sir Liam Donaldson said: "We must keep pushing hard for a tobacco free future and keep up the momentum gained by England going smoke-free in 2007. "Since then, the number of people who have given up smoking has increased, so this new strategy and targeted support will help smokers who want to quit, to give up for good. "It will also discourage children from taking up smoking and prevent a great number of unnecessary and early deaths."

Simon Clark, director of the smokers' lobby group Forest , said halving the number of smokers by 2020 will require even more laws and "will further erode our ability to choose how we wish to live our lives". 1.2.10

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Government's anti-cigarette drive to stop you smoking at the wheel and at home

• Cigarettes to be sold in plain, grey, logo-free packets
• Sale of tobacco from vending machines to be banned
• Smoking to be banned at entrances to buildings

Plans to cut the number of smokers by pressurising them not to light up at home and in cars have been unveiled. The Government's ‘tobacco control strategy' also proposes banning smoking at entrances to buildings and selling cigarettes in plain grey packets as part of a series of policies aimed at halving the number of smokers by 2020.

The plans were dismissed as ‘ meddlesome' and ‘unworkable' by critics. But Health Secretary Andy Burnham said: ‘I make no apology when it comes to protecting children and giving them the best start in life. ‘I want to see a smoke-free future, a future where people lead longer and healthier lives because they don't smoke.'

The proposals, to be announced today, include a review of the law to consider if areas such as entrances to buildings should be included in the smoking ban. Children's health forms a key part of the crackdown, which proposes running ‘smoke-free community' campaigns highlighting the benefits of smoke-free homes and cars. Social workers and other health professionals will be ‘encouraged' to talk to parents about the impact their habit has on their children.

Cigarette packaging could be stripped back to basics, with logos, colour and graphics banned and just the text of the brand of cigarettes on show against a grey background. Other plans include stopping the sale of tobacco from vending machines and a crackdown on the illegal import of cheap cigarettes.

Smoking is the leading cause of preventable death in Britain , claiming up to 80,000 lives a year. It is blamed for 1.4million hospital admissions a year and costs the NHS £2.7billion. Despite numerous anti- smoking drives, some eight million Britons smoke and around 200,000 young people take up the habit each year.

Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said: ‘We are pleased that children are a priority in this new strategy. ‘Second-hand smoke has been found to be strongly linked to chest infections in children, asthma, ear problems and cot death.'

But Tory MP Philip Davies said: ‘Given that people are well aware of the dangers of smoking, the Government should let people decide for themselves what they want to do. ‘What they don't want is Government ministers jumping into their cars with them to see whether they happen to light up a cigarette.'

Chief Medical Officer Sir Liam Donaldson said: 'We must keep pushing hard for a tobacco free future and keep up the momentum gained by England going smoke-free in 2007. 'Since then, the number of people who have given up smoking has increased, so this new strategy and targeted support will help smokers who want to quit, to give up for good. 'It will also discourage children from taking up smoking and prevent a great number of unnecessary and early deaths.'

Simon Clark, director of the smokers' lobby group Forest , said halving the number of smokers by 2020 will require even more laws and 'will further erode our ability to choose how we wish to live our lives'. He said the government has introduced 'some of the most draconian anti-smoking laws in the world' and added: 'In an allegedly free society, this is nothing to be proud of.'

Mr Clark said Forest was concerned that existing legislation may be extended to prohibit smoking in outdoor areas. 'The current smoking ban, which has had a devastating impact on community pubs and clubs, is out of all proportion to the harm allegedly caused by second-hand smoke. Further restrictions will only accelerate that trend.'

Mr Clark said Forest supports 'reasonable efforts' to stop young people smoking but said some of the Government's proposals were designed to 'denormalise' a legal activity. 'The Health Secretary says he wants to crack down on cheap illicit cigarettes, but at the same time the government says it will consider increases in tobacco duty.

'Don't they understand that one of the reasons Britain has such a problem with illicit cigarettes is because this government has increased tobacco taxation to record levels and that has encouraged criminal gangs and individuals to smuggle millions of cheap cigarettes into the country?'

Mr Clark added: 'We accept that some people wish to quit smoking and we therefore welcome the Health Secretary's comment that the NHS is there to help everyone, including smokers. 'What alarms us is that yet again the government fails to recognise that many people choose to smoke and have no intention of giving up.' 1.2.10

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Want to quit smoking? Switching to mild cigarettes will NOT improve your chances

Smokers who hope to kick the habit by first switching to a low-tar or mild brand of cigarette may actually find it harder to quit, researchers said today. They found that smokers who traded to light cigarettes were 50 per cent less likely to kick the habit.

'It may be that smokers think that a lighter brand is better for their health and is therefore an acceptable alternative to giving up completely,' said study author Dr Hilary Tindle from the University of Pittsburgh.

Her study of 31,000 smokers found that 12,000, or 38 per cent, had switched to a lighter brand. Nearly half of these said they had switched brands because they wanted to smoke a less harmful cigarette and hoped to give up smoking completely.

And although they were far more likely to have tried quitting between 2002 and 2003, they were 60 per cent less likely to actually succeed, according to Dr Tindle's team.

'Forty-three percent of smokers reported a desire to quit smoking as a reason for switching to lighter cigarettes. While these individuals were the most likely to make an attempt, ironically, they were the least likely to quit smoking,' Dr Tindle said.

Research published in The Lancet revealed smokers compensate for low tar cigarettes by taking deeper puffs more often. And a study in the British Medical Journal found  all current smokers had a far greater risk of lung cancer than people who had never smoked no matter what the tar level of their brand.

But there were no stastics on how many smokers actually quit smoking so critics said the study was a ‘waste of resources'. 4.11.09

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NHS: Smoking ban made no difference

Banning smoking in public places has made no difference to the number of people who smoke, according to an NHS report. The damning publication from the NHS Information Centre states there was “no significant difference” in the number of people who smoked before and after the law changed in 2007.

The report compared smoking in the six months before the smoking ban with the six months after its introduction. It found that men over the age of 35 smoke fewer cigarettes than before the ban, but younger men have started smoking more since it was introduced.

Positive findings from the report were that one third of smokers now stay at home to smoke instead of going out, resulting in adults being exposed to less second-hand smoke than before the ban. However there has been no difference for children exposed to ­second-hand smoke.

A spokeswoman for the Department of Health said: “The smoke-free laws have made public places more pleasant and will have had a positive effect on the health of thousands of people who are no longer exposed to second-hand smoke on a daily basis.”

Last week two studies said the public ban had a bigger impact on preventing heart attacks than expected. Journals Circulation and the Journal of the American College of Cardiology found the bans cut heart attacks by up to a third. The NHS Information Centre estimated that one in five deaths in people over the age of 35 were caused by smoking last year. 30.9.09

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One in 20 hospital admissions 'due to smoking'

One in 20 hospital admissions in England is due to smoking and treating illnesses related to the habit costs the NHS £5.2 billion a year, official statistics suggest. There were around 1.4 million hospital admissions in 2007/8 for diseases caused by smoking in people aged over 35, a report from the NHS Information Centre said.

For people aged over 35 smoking accounts for five per cent of all hospital admissions and one in five deaths in this age group is attributed to smoking, the report said. An estimated 83,900 people died as a result of smoking in 2007/8 – 18 per cent of all deaths for adults aged 35 or over.

The proportion of adults smoking has dropped slightly from 22 per cent in 2006 to 21 per cent in 2007 but many diseases take years to develop so ill health related to the high smoking rates of the 1970s and 1980s are only now manifesting. The drop is mainly due to more people never taking up the habit in the first place, the report said.

The report said 35 per cent of deaths due to respiratory diseases and 29 per cent of all cancer deaths were due to smoking. One in seven deaths from circulatory diseases was also attributed to smoking, the report said.

Public Health Minister Gillian Merron said: "These figures reveal the sad reality that over a million smokers needlessly end up in hospital each year due to their habit. Stopping smoking is hard, but thanks to free local NHS Stop Smoking Services, you are up to four times more likely to succeed. 30.9.09

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Smoking risk for middle-aged men

Middle aged men who smoke, have high blood pressure and raised cholesterol levels may shorten their lives by up to 15 years. Research published by the British Medical Journal showed improvements in blood pressure and cholesterol levels proportionate with giving up smoking.

The study of 19,000 men aged between 40 and 69 showed their average levels of blood pressure and cholesterol fell by two-thirds when two thirds of those studied gave up smoking.

Those men who smoked and had high blood pressure and raised cholesterol at the age of 50, had their life expectancy cut by ten years compared with men who had none of those risk factors.

When taking into account other risk factors such as diabetes and employment grade, the research showed the 5 per cent of men with lowest scores had their life expectancy cut by 15 years. The research suggested the government should fund more activities that promote improved heart health to increase life expectancy. 18.9.09

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Fewer smokers kicking the habit - despite the NHS spending a record £74m NHS quitting campaign

The NHS is spending more money helping people stop smoking - but fewer are quitting, say official figures. The cost per quitter was £219 in 2008/09 compared with £173 in 2007/08 and £160 in 2006/07.

The proportion of people successfully quitting last year went down four per cent. But spending went up 21 per cent last year to £74m - not including the cost of nicotine replacement therapy.

Latest figures show that - four weeks on - 337,054 people successfully quit last year, a drop of four per cent on the 350,800 in the previous year but critics warned 'these people are still using NRT products, so they haven't really quit'.

The figures also found less than half of pregnant women using NHS stop smoking services manage to quit smoking. Of the 18,928 pregnant women who set a quit date, 8,641 successfully quit (46 per cent), says the NHS Information Centre. This was a 12 per cent fall on the 9,817 successful quitters among pregnant women setting a quit date in 2007/08.

A total of 671,259 people set a quit date through the service in 2008/09, a 1 per cent fall on the 680,289 in 2007/08. The smoking ban in public places came into force in England on July 1, 2007.

The NHS Information Centre's chief executive, Tim Straughan, said: 'The report shows that fewer people successfully quit last year compared to 2007/08. 'However, 2007/08 saw the introduction of the ban on smoking in public places which would be expected to affect the number of quitters in that year.  'It is encouraging that more people quit smoking last year than in 2006/07, the year prior to the ban.'

But Liberal Democrat Shadow Health Secretary, Norman Lamb said 'The Government is wasting NHS resources which are vitally needed to save lives. 'It's extraordinary that more money is being spent for worse outcomes'. 'The incentive system for doctors has to be urgently changed. GPs shouldn't be paid just for referring people to stop smoking services, they should be paid for helping them to successfully quit.'

Janet Fyle, of the Royal College of Midwives, said: “It is disappointing to see the figures going in the wrong direction. 'There is ample evidence on the impact of smoking on the health of the pregnant mother and child, and we advice all women who are pregnant or trying to conceive to do their best to give up smoking.'

Public health minister, Gillian Merron, said 'The NHS Stop Smoking Services give people the best possible chance of stubbing out a dangerous habit for good, improving their opportunity to lead a healthy life and saving thousands of lives every year. 'We provide high quality, cost-effective support and advice that is clinically proven to work in helping people to stop smoking, and will continue to do so, with extra help for those who need it most.' Critics have said 'Ms Merron is in denial, the results are pittyful as other non-pharmaceutcal methods are much more effective to help people stop smoking'. 21.8.09

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40 per cent of teenagers know someone hurt by cannabis

Four out of ten teenagers know someone with mental health problems caused by cannabis, a report shows. More than half of youngsters questioned also believed that those smoking the drug lose motivation and do badly at school. The survey, by the Home Officefunded drugs advice service Frank, is fresh evidence that the supposedly soft drug has harmed the health, education and careers of millions of teenagers.

It comes a week after a study showed that even one-off users of cannabis show signs of behaviour linked to schizophrenia, with half of those tested having an 'acute psychotic reaction'. The results challenge the orthodoxy - followed by Frank in its guidance to youngsters - that cannabis is dangerous only to heavy users or those who already have mental health problems.

The advice service's report showed that 42 per cent of 11 to 18-year-olds knew someone who had suffered mental problems from the drug, including paranoia, panic attacks and memory loss. The figure suggests that 1.5million teenagers have had direct experience of the harm caused by cannabis.

It could be a reason why fewer youngsters have been taking the drug, with use falling since 2001. However, the number of under-25s smoking cannabis was still almost one in five last year. Among those who knew someone who had suffered damage from cannabis, 64 per cent said the harm took the form of panic attacks.

The survey of 28,000 teenagers, which was carried out through a social-networking website, also found that 56 per cent of those questioned 'associate cannabis use with losing motivation and doing badly at school or college'. Almost 15 per cent said they used cannabis, which they claimed helped them cope with life. But only 11 per cent said they thought using the drug made them look cool.

The criminal status of cannabis was downgraded to Category C by Labour in 2004, meaning it ranked alongside performance-enhancing drugs used by cheating athletes. This meant users would be arrested only rarely if caught by police. However, deepening concerns over the mental health effects of the drug - and the stronger varieties now sold on the streets - meant it was pushed back into the more serious Category B this year.But still only a few of those caught with cannabis will be arrested, with police more likely to use powers to hand out on-the-spot fines.

Frank spokesman Chris Hudson said: 'The majority of teenagers don't want to risk their health by using cannabis, however some people choose to take the risk. 'Others wrongly believe cannabis is harmless because it is a plant. Cannabis messes with your mind - and reactions can be more powerful with stronger strains such as skunk, which is around twice as potent.'

The organisation is to start an anti-cannabis advertising campaign next week, timed to catch teenagers during their summer holidays when they may be tempted to use drugs. The Frank website currently states that only regular use of cannabis is associated with the risk of mental illness. It also says that nobody knows whether stronger strains of the drug carry higher risks.

Phone lines run by the advice organisation, paid for out of a Home Office subsidy of £6.5million a year, can be even less discouraging. One caller was told earlier this year: 'Alcohol is a powerful drug in what it does to your body and how many brain cells it kills and stuff. 'Cannabis is not to be taken lightly, but it's a lot less powerful. If alcohol were illegal it would be a Class A drug. Cannabis should just be a Class C drug. In terms of its effects it's a lot less powerful than drinking.'

Anti-drug campaigners welcomed the Frank research. Mary Brett of Europe Against Drugs said: 'Frank has been stuck in a time warp. Their website still isn't up to date. 'They have always said you should steer clear of cannabis if you have a history of mental illness. It doesn't seem likely that the damaged people known to 42 per cent of teenagers all had a history of mental illness.' 6.8.09

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Smoking in middle age increases risk of dementia by 75%

Smoking in middle age increases the risk of developing dementia by nearly three-quarters, a study claims. It found that smokers aged between 46 and 70 were 70 per cent more likely to suffer from Alzheimer's in later life compared to those who had never smoked. And it revealed a strong link between ‘lifestyle-factor' diseases, such as diabetes and high blood pressure, and dementia.

Those suffering from high blood pressure were 60 per cent more likely to develop dementia while people with diabetes had more than double the risk. Dr Alvaro Alonso, of Minnesota University in the U.S., who led the research, said: ‘Our results emphasise the importance of early lifestyle modification and risk factor treatment to prevent dementia.'

The study was published in the Journal of Neurology, Neurosurgery & Psychiatry. Some 700,000 Britons suffer from dementia, with more than half diagnosed as having Alzheimer's disease. 4.8.09

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Fewer people 'planning to quit smoking'

The proportion of smokers who say they would like to give up smoking has fallen in recent years, figures from the Office of National Statistics show. In addition just over half of smokers said they had made a serious effort to quit in the past five years, a figure lower than in previous UK surveys. But the poll did find the numbers who say they would not smoke in front of a child has increased in the last decade.

There now appears widespread awareness that smoking can cause harm to others. At 67%, the percentage of smokers who said they would like to give up smoking when asked in 2008/2009 was "significantly lower" than the 74% recorded in 2007, the ONS reported, although it is in keeping with findings prior to that year.

The ban on smoking in public places introduced in England and Wales in 2007 - and in Scotland in 2006 - is seen as one key reason many more people may have expressed a desire to quit that year. But prices have risen in the meantime, and efforts to persuade the population to give up have continued.

Targets for reducing the prevalence of cigarette smoking have been set out by the government in the Smoking Kills White Paper, the Public Health White Paper and the Cancer Plan. The proportion of people smoking has in fact remained fairly constant in recent years, comprising just under a quarter of the adult population.

The number of cigarettes smoked is down from the mid-1990s, but has remained static since 2004: just over a quarter of smokers make their way through a packet or more a day.

In the last decade, the number of people who say they would not smoke in front of a child has increased dramatically - from 54% in 1997 to 77% in this latest poll.

Healthy motivation
Across non-smokers and smokers, there was generally significantly more support for the smoking ban in restaurants than pubs. Only 6% of smokers said they wanted to give up because of the ban on lighting up in public places, which was introduced in England in mid-2007, and slightly earlier in Scotland and Wales .

The vast majority of would-be quitters said they were motivated by health reasons. Nearly a third said they wanted to give up because they could not afford it or considered it a waste of money. A packet of 20 cigarettes now cost nearly £6.

Dr Jennifer Mindell from the Faculty of Public Health said the drop in the numbers wanting to quit showed 2007 was "basically a blip". "It's more or less what we would have expected. The smoking ban was a good trigger for some people but many people quickly realised they could carry on smoking. "The picture is a mixed one. There is progress being made, but the more investment we put into anti-smoking measures the better. It is money well spent and it will save us in the long-term by reducing the serious illness smoking causes."

Betty McBride, policy & communications director at the British Heart Foundation said: "Stopping people from ever becoming addicted has to be a priority. "It is still too easy for children to evade age restrictions on purchasing tobacco by using cigarette vending machines. A full ban on vending machines is the only guaranteed way stop children using them and protect them an addiction which threatens their future health."

A Department of Health spokesman said: "Smoking is at a historic low, thanks to individual efforts and Government action such as Smokefree and raising the age of sale. "This survey shows continuing high numbers of smokers who want to quit, and high levels of support for Government action to help them - and to protect children.

"We are currently taking legislation through Parliament to prohibit the display of cigarettes, with the aim of reducing the number of children and young people who take up smoking and helping smokers wanting to quit." But critics have said this is not a success story, for the millions of pounds poured into smoking cessation the results have been pitiful at just 1.6%. 29.7.09

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The cost of smoking on your wallet, health and life insurance

A survey by the Office for National Statistics shows that 44% of smokers believe smoking is the prime cause of premature death, not to mention the cost to your wallet, health and life insurance .

Wallet cost of smoking
A packet of 20 cigarettes now costs well over £5 and not surprisingly over 30% of smokers want to give up because they can't afford to smoke or consider it a waste of money. So, give up smoking and it's an immediate way to save money and help your wallet.

Health and life insurance cost of smoking
Critically there's the cost that smoking has on your health:

• can you exercise without becoming breathless?
• what about your dehydrated skin and yellow hair?
• what about the increased pressure on many of your major body organs?

Smoking has proven health risks and so life insurers charge higher premiums for smokers. You can get a life insurance quote quickly and easily - as a smoker though it will impact on your premiums, making it more expensive.

Expensive or not, life insurance is certainly worth considering to provide some financial protection for your family or dependants in the event of your death. If you give up smoking, once you have been nicotine free for 12 months, some life insurers will consider you as a non-smoker and you can start to benefit from lower insurance premiums.

If you already have a life insurance policy, as a new ‘non smoker' it could be worth contacting your insurer to see if you can take advantage of lower premiums. Be aware though that depending on the way the insurance company processes your change, your higher age may affect your premiums and could even wipe out any gain from being a non smoker.

Social cost of smoking
As a smoker, there's also the cost to you socially - many can't smoke at home, and it's banned from public places such as restuarants, pubs and the workplace. Most also won't smoke when there are children in the room, recognising the dangers of smoke to children.

So all this, coupled with the Office for National Statistics findings that 50% of smokers intend to quit in the next 12 months anyway, suggests it might be time to stop smoking now. 29.7.09

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Boy, 14, collapses after overdosing on nicotine gum handed out in school

A boy of 14 collapsed after overdosing on nicotine gum handed out by school counsellors to help smokers quit cigarettes. Aiden Williams was rushed to hospital after he chewed his way through 30 pieces of the tobacco substitute during the lunch hour.

His mother today hit out at the school, which allows children as young as 12 to be given up to a week's supply - 105 pieces – without parental consent. Caroline Williams said: ‘I couldn't believe that this gum can be given out like this without parents knowing. It is then being passed around the playground. ‘The doctors said that he could have died and he had to be kept in for 24 hours for observation.

‘I know what my son did was stupid, but if anything it proves that these kids can't be given responsibility for taking medication that could do serious harm.' Aiden said he was given the gum by a friend who had allegedly been caught smoking at Menzies High School Science College in West Bromwich, West Midlands.

Workers from Sandwell Council's Drug Education, Counselling and Confidential Advice (Decca) had been into school that morning and given out hundreds of boxes of the gum to pupils who smoke. Aiden was rushed to Sandwell General Hospital with stomach pains after he collapsed in the playground at lunchtime.

He admitted having eaten two days worth of the gum - 30 pieces - in just one hour, kept in overnight for observations and allowed home the following afternoon. Paul Harris, deputy head at Menzies School, said: ‘We have older teens in school who have issues with smoking and work directly with Decca, which offers support.

‘This is low-strength nicotine gum and there is nothing stopping youngsters from the age of 12 buying it over the counter. ‘Decca does not have to inform pupils' parents about this.' Margaret Storrie, from Decca, said: ‘Aiden overdosing on gum like this is the first time such an incident has happened and we are disappointed to hear about it.'

Another parent criticised the whole program, 'everyone knows nicotine gum doesn't work, it's a waste of time and money and obviously dangerous'. 20.7.09

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Popular Stop-Smoking Drugs to Carry Mental Health Risk Warnings

Behavioral Changes, Depressed Mood, Hostility and Suicidal thoughts reported with drugs. The U.S. Food and Drug Administration said it will immediately require boxed warnings about the risk of serious neuropsychiatric symptoms on the packaging of two popular smoking cessation drugs, varenicline (Champix) and buproprion (Zyban and generics).

Reports of behavioral changes, depressed mood , agitation, hostility and suicidal thoughts and behavior associated with use of the drugs have been submitted to the FDA's adverse event reporting system.

Throughout the marketing history of the drugs, there have been 98 suicides and 188 attempted suicides in varenicline users and 14 suicides and 17 attempted suicides in buproprion users, the agency reported. 2.7.06

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Smoking costs the NHS more than £5bn

Smoking costs the NHS over £5 billion a year, more than three times previous estimates, according to new research. Care for people who smoke accounts for over five per cent of the overall budget, they found. The cost has gone up by around five times in the last 18 years, boffins said, though the proportion of the entire budget has not changed dramatically in that time.

They said that tests to calculate the direct costs of disease were not carried out regularly meaning studies rely on figures that quickly become out of date. Recent estimates were based predominantly on 1991 data and range from around £1.4 and £1.7 billion a year. But Oxford University researchers used a new system to calculate the cost at £5.2 billion for 2005.

The annual cost is still likely to be an underestimate because it does not include indirect costs such as informal care, the costs of treating disease caused by passive smoking and the full range of conditions associated with smoking. Experts analysed three sources of data up to 2005 - 2006, when around one in four adults in Britain smoked.

They calculated that in 2005, around 110,00 people died as a direct result of smoking, accounting for almost one in five of all deaths (19 per cent). Smoking was responsible for more than one in four deaths among men (27 per cent) and around one in ten among women. The number of deaths attributable to smoking has not changed much in the past ten years, the authors said in the research published in Tobacco Control.

The researchers, led by Dr Steven Allender, of the British Heart Foundation Promotion Research Group, concluded: "Smoking is still a considerable public burden in the UK. "Accurately establishing the burden terms of death, disability and financial costs is important for informing national public health policy." 9.06.09

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Smokers cost businesses £2.1bn a year due to 'fag breaks' and sickness

Smokers are costing businesses £2.1billion each year through sickness and time-wasting cigarette breaks, a report has claimed. It found that 1.77 extra sick days a year are taken by each smoker at a cost of £1.1billion to firms. And smoking breaks during the working day were found to be just as costly, amounting to almost £1billion.

The report, by the London School of Economics, described the costs as ‘staggering' and said that firms could make major savings by helping the staff to quit smoking. Professor Alistair Mcguire, of the LSE, said: ‘The formula reveals just how much of businesses' bottom line is going up in smoke every year.

‘The £2.1billion doesn't even include the indirect costs to company image from employees smoking outside the premises, or the dissatisfaction felt by non-smoking workers who perceive smoking colleagues to be shirking as they take smoke-breaks.

‘These costs are attributed to the cost of productivity losses due to both excess sickness-absence in smoking employees and from smoking breaks taken by smoking employees, the cost of commercial fire damage attributable to smoking at work and the indirect costs imposed on employers from employee smoking.' Dr Linda Bauld, of Bath University and the UK Centre for Tobacco Control Studies, said: ‘Research has shown that offering "stop smoking" support in the workplace is an effective way to help smokers to quit. ‘What works best is a combination of support from a trained adviser, either in groups or one-to-one, and access to stop smoking medication.' However critics pointout 'Dr Bauld is out of touch, as the methods she describes are already in use but are proven not to work'. 5.6.09

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How the big pharma's influence smoking policy and the treatment YOU receive

Most of the people in charge of devising government guidelines on how to get smokers to quit also have links to either academic research funded in part by drug companies that make quit-smoking aids or have personally received large sums of money in speaking and consulting fees from those companies.

Conflict of interest? No, say some doctors who have consistently declared that they ought to use stop-smoking medicine. They say their opinions reflected in current government guidelines -- is based on scientific evidence from hundreds of studies.

Now debate is growing about that evidence, and about who should be entrusted to interpret it. Some public-health officials say industry-funded doctors are ignoring other studies that suggest cold turkey is just as effective at 3% or even superior to nicotine patches and other pharmaceuticals over the long run which are just 1.4% not to mention much cheaper and totally ignore other non-pharmaceutical treatments which are much more effective in getting smokers to quit.

At stake is one of the most important issues in the nation's public-health policy. Cigarettes kill an estimated 200,000 people a year. Helping 13 million smokers kick the addiction could save untold numbers of people. The Department of Health issued guidelines in 2001 calling for smokers to use nicotine patches, gums and other pharmaceutical aids to quit, with a few exceptions such as pregnant women. However most of doctors on the panel who created those guidelines had ties to the makers of stop-smoking products.

Those opposed to urging medication on most quitters note that cold turkey is the method used by the vast majority of former smokers. They fear the government's campaign could discourage potential quitters who don't want to spend money on quitting aids or don't like the idea of treating their nicotine addiction with more nicotine.

"To imply that NRT medications are the only way is inappropriate," says a leading expert who has surveyed former smokers in her area. "Most people don't want them. Most of the people who do quit successfully do so without them."

Pharmaceutical companies make several products to help smokers quit. Some give a nicotine fix without a cigarette, such as GlaxoSmithKline PLC's Nicorette gum and nicotine-laced Commit lozenges. Nicotine, the addictive agent in cigarettes, is considered benign relative to the carcinogens in cigarettes. Bupropion, an antidepressant, and Pfizer Inc.'s Champix -- both pills available only by prescription -- aim to reduce cravings without using nicotine.

Many clinical trials have randomly assigned smokers to take one of these products or a placebo. Such randomized trials are considered the gold standard in many medical fields, and they have consistently shown that nicotine-replacement therapy or other medicine confers a benefit, however it is only marginal and in some cases was as low as just 6%.

But these trials have limitations. They tend to compare quitters who wanted medication and got it with those who wanted medication and didn't get it -- which is a different group from quitters ready to try going cold turkey. Also, clinical trials tend to attract highly motivated quitters who may not represent the population as a whole. Even the placebo group in these trials often boasts double the success rate of the population of quitters generally.

Studies of quitters outside clinical trials have shown no consistent advantage for medicine over cold turkey, the pharmaceutical industry's primary competitor. An unpublished National Cancer Institute survey of 8,200 people who tried quitting found that at three months, users of the nicotine patch and users of bupropion remained abstinent at higher rates than did users of no medication. But at nine months, the no-medication group held an advantage over every category of stop-smoking medicine. The study was presented at a world tobacco conference last summer.

Just because an advisory panel recommends a particular treatment or product does not mean it's the best treatment option, other more important factors are in play other than patient benefits, and in most cases those making the recommendations are not independent but are paid to do so by the big pharmaceutical companies which really control the treatments we receive as patients. It's a simple process, the government set up committees to advise on treatments, those on the comittees have financial links to the pharmaceutical companies who make the products they recommend we all use, which are funded by the tax payer but more importantly make millions for the big pharma companies every single day. The NHS spends £30million a day on drugs from pharmaceutical companies, so they do 'whatever it takes' to maintain their monopoly position regarding NHS treatments. 8.5.09 (related article: Corruption? How do drug firms influence doctors to give you those happy pills?)

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Women smokers get lung cancer earlier than men, says study

Women are more vulnerable to the deadly side effects of smoking than men, a lung cancer study found. Research into patients with the disease found women tended to be diagnosed at a younger age than men  -  even though they had smoked fewer cigarettes. They were also more likely to develop one of the most common forms of the cancer, researchers said.

It adds to the growing pile of evidence suggesting that women are more vulnerable to the cancer-causing chemicals, or carcinogens, in tobacco than men. The study looked at 683 lung cancer patients treated at a Swiss clinic between 2000 and 2005. It found that female smokers were statistically most likely to develop adenocarcinoma  -  a common form of lung cancer  -  and were more likely to be diagnosed with the disease at an earlier age.

Study leader Dr Martin Frueh, from St Gallen Canton Hospital in Switzerland, said: 'Our findings suggest that women may have an increased susceptibility to tobacco carcinogens.' The research was presented yesterday at the European Multidisciplinary Conference in Thoracic Oncology in Lugano, Switzerland. Dr Enriqueta Felip, who co-chaired the meeting, said there was a growing awareness that smoking was riskier for women.

'In the early 1900s lung cancer was reported to be rare in women,' she said. 'But since the 1960s it has progressively reached epidemic proportions, becoming the leading cause of cancer deaths among women in the United States. 'Lung cancer is not only a man's disease, but women tend to be much more aware of other cancers, such as breast cancer.'

Past studies have indicated that women run a far higher risk of developing lung cancer than men. American scientists found that women are more likely to carry a gene that drives lung cancer growth. Nicotine appears to trigger the gastrinreleasing peptide receptor gene, which is also more active in women than men.

However, Henry Scowcroft of Cancer Research UK urged caution. He said: ' People should be wary of jumping to conclusions about differences between men's and women's susceptibility to cancer. 'These scientists only studied patients referred to a single cancer centre, and did not look at biological differences between men's and women's lung cancers.' 7.5.09

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Chewing nicotine gum can 'increase risk of mouth cancer'

Nicotine gum can cause mouth cancer, scientists claim. Other tobacco replacement products, including lozenges and inhalers designed to provide smokers with the nicotine their body craves but without the tar and harmful chemicals produced by smoking, are also said to increase the risk of mouth cancer if used long term.

Previously nicotine itself, the addictive chemical in cigarettes, has not been thought to be particularly carcinogenic - but the study by University of London scientist Muy-Teck Teh suggests otherwise. His research, published in the journal Public Library of Science One, focuses on the importance of a gene known as FOXM1 to the development of mouth cancer.

Analysis of 75 patients found mutations of the gene were more likely when nicotine replacement products were used, particularly when the patients already had a lesion inside their mouth. Dr Teh said: ‘This study cautions the potential co-carcinogenic effect of nicotine in tobacco replacement therapies.

‘Although we acknowledge the importance of encouraging people to quit smoking, our research suggests nicotine found in lozenges and chewing gums may increase the risk of mouth cancer.' Nicotine gum and similar products generally carry advice they should only be used for a few months - but in practice many ex-smokers are still using them years after giving up.

Around 5,000 Britons a year suffer from mouth cancer, usually blamed on smoking, chewing tobacco or drinking alcohol. Previous research suggests that nicotine can contribute to the growth of tumours. 22.4.09

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NRT Failure Rate Soars to 98.4%

New revelations confirm that Nicotine Replacement Therapy (NRT) has a documented long term failure rate of 98.4%. NRT is the Government's recommended treatment for its smoking cessation programs and is heavily funded by the tax-payer.

Pro-choice group Freedom2choose are alarmed at these revelations and the obvious waste of tax-payers' funds. Colin Grainger, vice chairman of the group states, “NRT products are obviously unfit for the purpose for which they are sold. This is fraud, wrong and immoral.”

Freedom2choose have previously highlighted alternative ways to successfully quit smoking for those choosing to give up. “More worryingly,” continues Colin Grainger “is the shock that the scientists who put the study together even work for the manufacturers of NRT. This clearly shows how the Big Pharmaceutical companies influence the outcome of studies and policy.”

The revelations were originally made public by long-term anti-smoking campaigner Professor Michael Siegel who states “With a long-term smoking cessation percentage of only 1.6%, one can hardly call NRT treatment an "effective" intervention. In fact, the logical conclusion from this paper is that NRT was a dismal intervention and a waste of tax payers money.” 3.4.2009

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Smoking ban fails to curb the habit: Figures reveal men are smoking MORE

The ban on smoking in public has failed to increase the number of people quitting, a report revealed yesterday. The proportion of men who smoke has actually risen since the ban in July last year while there was no change at all among women. The figures, coming after years of declining smoking rates, are a massive blow to Labour's public heath policy. According to the report, the average number of cigarettes smoked each day did not fall significantly

A survey of almost 7,000 across all age groups found on average there was no change in the number of cigarettes that smokers said they had. But in men aged 16 to 34, the number rose, by one and a half cigarettes a day. It had been hoped the ban would help reduce smoking rates among the poor in particular, but instead the number of cigarettes smoked by working class men has gone up. Off the shelf: Other anti-smoking plans include selling cigarettes under the counter to cut smoking rates among children

The Health Survey for England, carried out by the NHS for ministers, has raised fears that smokers are simply lighting up at home rather than in pubs and restaurants  -  potentially putting children at risk. Liberal Democrat health spokesman Norman Lamb said: 'These are pretty stark figures which demonstrate forcefully that the Government's strategy on smoking has not been successful. 'It's yet another case of the Government pursuing tough eye-catching initiatives which in the end don't succeed in tackling the real problem.'

Pro-smoking groups called the smoking ban 'an unmitigated failure' The smoking ban was introduced in England on July 1, 2007, to improve the health of those working in bars, restaurants and other workplaces through passive smoking. However, ministers also hoped it would help them meet targets to reduce smoking rates, particularly among those from more deprived backgrounds.

When she introduced the ban, the then health secretary Patricia Hewitt said: 'This is an enormous step forward for public health. It is going to make it easier for people who want to give up smoking to do so. Over time it will save thousands of lives.' But polls carried out before and after the ban show it has not had that impact.

The number of cigarettes smoked by men aged 16 to 34 has increased by one and a half cigarettes a day, from an average of 10.9 to 12.5 a day. The percentage of females who smoke remained constant at 21 per cent, while male smokers rose from 23 per cent to 24 per cent.

One in three smokers said the ban had encouraged them to stay at home, where they could still smoke. The numbers saying the ban would encourage them to quit dramatically fell after it came into force. A spokesman for the pro-smoking pressure group Forest said: 'These figures show that the smoking ban has been an unmitigated failure.' A spokesman for the Department of Health said: 'Smokefree laws were introduced to protect employees and the public from the harmful effects of secondhand smoke. 'The legislation was never intended to be a measure to reduce smoking prevalence.' 15.12.08

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Rise in young adult smokers

The number of young adult smokers in Scotland has risen in the last three years, new data shows. A report by NHS Health Scotland and the Scottish Public Health Observatory placed smoking rates among 16 to 24 year olds at 30% in 2007, compared with 25% in 2004.

The analysis, based on figures from the Scottish Household Survey, found the smoking rates of those aged 16-24 had decreased from 31% to 25% between 1999 and 2004, but rose to nearly one third in 2007. 19.12.08

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Champix anti-smoking drug linked to 10 British suicides

Health chiefs have revealed that ten people have committed suicide after taking a controversial anti-smoking drug linked to depression. The disclosure by the Government's drugs watchdog is the first time officials have revealed the link between Champix and suicide in this country. Earlier this year, US authorities announced they were investigating 37 similar cases there.

The Medicines and Healthcare products Regulatory Agency (MHRA) website says a total of 24 people taking the nicotine-replacement have died, of whom ten took their own lives. A further 213 claimed they had experienced suicidal thoughts and 407 said they were suffering depression.

There is no evidence that Champix has been a factor in any of the deaths. However, some experts are concerned that the drug, used by almost half a million people in Britain, may cause depressive thoughts and mood swings. The MHRA says the number of users reporting adverse side effects while using Champix, also known by its generic name varenicline, has doubled in the past seven months – up from 1,811 in February to 3,541 in September.

The figures are on the MHRA's website, which holds regularly updated information about the reported effects of drugs licensed for use in the UK. The information is provided by doctors, nurses and patients. The watchdog is now warning doctors and nurses to monitor the effects of the drug on smokers over the New Year, when many will try to kick the habit.

Its latest bulletin states: 'We continue to receive reports of suspected adverse reactions associated with varenicline, the most frequently reported of which are psychiatric disorders. As Christmas and the time for New Year's resolutions approach, we remind you to highlight to those taking varenicline the possibility of adverse psychiatric effects.'

Last April an inquest heard how TV producer Omer Jama, 39, slashed his wrists eight weeks after starting a course of pills. A toxicologist told the hearing: ‘There is a possibility he could have been influenced by the side-effects of the drug.' In November 2007, father of two Wayne Marshall, 36, from Doncaster, was found hanged shortly after completing a 13-week course of Champix.

Karen McGhee, 38, from Greenock in Scotland, tried to hang herself following a course of the drug. She said: ‘I don't have any doubt Champix is what caused me to try to take my own life.' Bob Rappaport, of the US Food and Drug Administration's drug-evaluation centre, has said: ‘A number of compelling cases look like they are the result of exposure to the drug itself and not other causes.'

Earlier this year all pilots and air traffic controllers in the US were banned from taking the drug because of fears about potential side effects. Champix was launched in the UK in 2006. It works on the brain's receptors to reduce the cravings and withdrawal symptoms associated with quitting. In trials, nearly a quarter of those taking Champix had given up smoking after a year compared with 16 per cent using nicotine patches.

But after monitoring adverse effects, the European Medicines Agency ruled last December that the safety leaflets in boxes of Champix be updated to include warnings about suicide and depression. Manufacturer Pfizer added the warnings in February and updated them in July. It advises patients who suspect they are experiencing side effects to stop taking the medication.

Pfizer said: ‘Stopping smoking, with or without treatment, is associated with nicotine withdrawal symptoms and the exacerbation of underlying psychiatric illness. ‘Pfizer rigorously tested varenicline in a comprehensive clinical trial programme lasting many years and involving thousands of patients. ‘Based on the results of those clinical trials, regulatory agencies in Europe, the US and elsewhere have recognised the safety and efficacy profile of varenicline and approved the medicine for use in smoking cessation in adults.' 10.11.08

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Stop smoking drug 'Champix' concerns raised

It was launched as a wonder drug. A tablet to take the pain out of kicking the killer weed. Since it appeared on the market two years ago in the UK , almost 400,000 prescriptions for Champix have been written. Across the world, that figure is currently sitting at nine million. Champix, or varenicline, to give it its clinical name, was first licensed here in December 2006.

It mimics the effects of nicotine on the body so it both reduces the urge to smoke and relieves withdrawal symptoms. In clinical trials, it proved more effective than alternative remedies at getting people to quit. For its makers - Pfizer - Champix has been a huge success.

In its first full year on the market, the drug brought in a staggering $883m for the company. But about a year ago, I became aware of stories emerging in the media in which people who had taken Champix were said to have suffered severe depression. I learned of a woman, Karen McGhee, from Greenock , who tried to kill herself just a few days after taking Champix. Her husband Robert told me of the night he found his wife hanging from the hall stairs.

Robert McGhee said: "I just got woken up with my daughter dragging me out of my bed to come downstairs. She was shouting, 'Dad, my mum's hung herself. She's hung herself'. And I just couldn't comprehend it, I thought I was dreaming.

"I ran downstairs and Karen was on the floor on her knees with a pelmet round her neck. I tried to lift her up to free the knot, but I couldn't get it loosened. I managed to cut her free and take the noose off her neck."

'Suicidal tendencies'
After several days on a ventilator, Karen McGhee pulled through. She is convinced it was Champix which led to her suicide attempt. She said: "I'll never put myself through that again and never put my family through it again. I'll always be a smoker, or, if I quit, then I'll quit naturally."

I heard of another case - Omer Jama - a young Manchester man who had killed himself while taking Champix. His brother, Ali, said: "He'd slashed his wrists. They'd found him on the floor in the landing and it was a shocking scene. There was no suicide note. It was just a random act, completely out of character, that took an instant." Omer had clearly taken his own life. But surprisingly, at the inquest, the coroner did not record his death as suicide.

Ali said: "The coroner recorded an open verdict because she couldn't record a verdict of suicide, because on the evidence of the forensic toxicologist she found that Champix was still in Omer's bloodstream and she had researched that it had possible links to suicidal tendencies. So she couldn't rule out that it didn't play a part in his suicide."

I discovered that across Britain , more than 3,000 people have complained about adverse reactions to Champix. About 260 have reported suicidal-related reactions to the drug. Of these, 16 had attempted suicide and 10 had killed themselves. But 260 reported bad reactions, no matter how severe, sounds like a drop in the ocean compared to millions of Champix prescriptions. I wanted to know whether these extreme reactions were just isolated cases.

I went to the US where the drug - marketed there as Chantix - was developed and first launched. I met James Elliott, a veteran of the war in Iraq , who had been given the drug by the US Government's department of Veterans Affairs, as part of his treatment for post-traumatic stress disorder. One night, a few days into the Chantix course, he fought with his girlfriend, grabbed a handgun, walked into the Washington DC night, and forced the police into an armed stand-off.

James told me: "I think there were nine officers there. And two of them had rifles trained on my head. Those guys would not have missed. I antagonised them. You guys got guns. You tough guys. Shoot me. It'll be alright." The police used a taser gun to subdue him, and he's lucky to be alive today.

'Psychiatric problems'
His story prompted an investigation by the US Congress. Giving evidence, he told them he was never warned about the possible side effects. He is adamant Chantix played a part in his actions that night. He said: "I put the whole community at risk. I did. The doctors did. Chantix did."

During my investigation, I also met one of the country's leading personal injury lawyers. Marc Grossman has launched five law suits against Pfizer and has 20 more cases ready to go. He said: "We have a 40-year-old man with three children who has no prior history of psychiatric problems who, out of the blue, went and put a shotgun to his mouth and killed himself. "And another case is of a man who shot himself in the head. "We have a woman with kids who hung herself. "All the cases are just the most shocking, bizarre scenarios where someone just out of the blue commits suicide without any prior depression."

I suggested to him that it wasn't unusual for people to commit suicide out of the blue with no history of depression. He told me: "It doesn't happen as often as with the people taking Champix. It happens far more often that you'd ever expect and far more often than is acceptable."

Champix is big business, but it is also designed to be the answer to one of the most serious health issues facing the world, and especially Scotland . Here, 13,000 people die every year from smoking-related illnesses, and it's the single biggest preventable cause of death. Against that backdrop a drug which stops people smoking would be welcomed, and even a small decrease in smokers would loosen up resources across the Scottish health service.

Pfizer declined to speak to the programme, but a statement from the company said the packs carry warnings about the reported side effects, and point out that there's no proof the drug has any links with suicidal behaviour. The body which licenses pharmaceuticals for use across the whole of the European Union tells us it's monitoring the drug closely, but at the moment feels the benefits of Champix far outweigh any current potential risks.

Monitoring programme
Dr Hans-Georg Eichler, senior medical officer with the European Medicines Agency (EMEA), told me: "This drug is designed and has been shown to be effective in helping patients quit smoking. "Now we all know that there are several hundred thousand premature deaths across the European Union every year. "This is a major public health issue. We know that a large proportion of smokers want to quit but they find it difficult.

"So against that background any drug, and I emphasise any drug, that has a positive benefit risk profile is valuable and welcome. "I think the public is justified to be concerned and we're extremely concerned. "But being concerned is not the same as being convinced that there is a causal relationship. "So that's why we have implemented a high alert monitoring programme.

"We have here in the agency weekly meetings where we would analyse all the incoming data, and would alert the committee that is relevant, the working party, that is charged to specifically look at these events and see what action is required.' 26.11.08

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'Smoking police' hit the streets to shock people into quitting

Smokers will be stopped in the street and asked to take a carbon monoxide test in London's most hard-hitting anti-smoking campaign. 'Smoking police' will target people at betting shops, bus stops and shopping centres to shock them into giving up cigarettes. They will be asked to breathe into a monitor to show how much carbon monoxide is in their bodies, and could then be signed up to local stop-smoking services and given access to counsellors.

Pro-smoking group Forest described the campaign as a humiliating infringement of civil liberties. Ealing Primary Care Trust, which is funding the £75,000 scheme, said it could help 2,400 people to give up. A team of 11 young people have been employed to approach smokers, in a similar way to charity fund-raisers  -  nicknamed 'chuggers'  -  who ask passers-by for donations.

Project spokeswoman Fran Pearce admitted: 'They will have to be careful when approaching smokers in case they become aggressive, but we are interested to see how it pans out. If someone says no, they will not pressure them to take the test.' Project manager Phil Robinson of Ealing Stop Smoking-Service said: 'The law to ban smoking in public places was hugely effective, but since then some focus has been lost.

'We want to put stopping smoking back on the agenda, so 50 per cent of our current activity is about personalising and localising our campaign and taking our message direct to smokers.' He added: 'We will be focusing on betting shops, transport stops, walk-throughs, shopping centres and leisure areas where most smoking takes place.'

There are 75,000 smokers in Ealing, and it is hoped 7,500 will take the new test, with 2,400 going on to quit completely. Forest spokesman Neil Rafferty said: 'It shows the authorities think they have a blank cheque to treat smokers how they want  -  to harass, humiliate and victimise them. 'This is an outrageous abuse of freedom and privacy. It is the health Nazi equivalent of chuggers.' 17.9.08

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NHS suspects fraud in £61m stop smoking programme

Counter-fraud specialists are investigating claims that pharmacists are stealing money from the NHS by fiddling figures on the number of people they have helped to give up smoking. The Guardian has learned of inquiries in five primary care trusts in London into allegations that chemists have fraudulently claimed thousands of pounds, claiming cash rewards of up to £85 for each patient they help to stop smoking for at least four weeks.

The NHS counter-fraud team is considering a nationwide exercise to establish the extent of the problem. The Liberal Democrat spokesman for health, Steve Webb, said fraud was now a multi-million pound problem for the NHS. At one trust the fraud being investigated is estimated at more than £15,000. If the inquiries confirm fraudulent activity police will be called in to prosecute.

Anti-smoking charities have written to the chancellor to lobby for a simple monitoring system to scan pharmacists' claims and protect the government's £61m programme to help people give up cigarettes. The five areas cannot be named as in some cases the pharmacists do not know that they are being investigated. But it is understood that one pharmacist in north London had claimed nearly 100% success rates when research suggests that the best rates that can be expected is 55% of smokers continuing to abstain after four weeks.

An NHS counter-fraud service spokes-man said: "Our pharmaceutical fraud team is also exploring the possibility of undertaking an exercise to uncover similar fraudulent behaviour throughout England and Wales." Mr Webb said: "There is already evidence of serious fraud in the NHS. To lose even a small percentage of the NHS's £80bn budget is big money. I have no doubt that there's much more fraud in the NHS than we've learned about today."

The quit smoking programmes provide support groups and access to nicotine replacement therapies to encourage people to quit smoking. Some areas opt to have pharmacists deliver the programmes which include monitoring of carbon monoxide levels in blood to prove they have quit. Typically they provide six meetings, providing patches and testing carbon monoxide levels each time to make sure people are not slipping.

Pharmacists receive cash bonuses of between £50 and £85 for every person who has continued to abstain from smoking four weeks after starting the programme, as proved by two consecutive low carbon monoxide readings. A pharmacist who treats 600 patients in a year stands to make up to £85,000 gross profit.

A Royal Pharmaceutical Society spokesman said: "Any person found guilty of misconduct by the society's disciplinary committee will be removed from the register and prevented from working as a pharmacist." 28.12.06

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Report says smoking costs NHS £2.7 billion pounds a year

Smoking costs the NHS £2.7 billion pounds a year, one billion more than a decade ago, according to a report by an anti-smoking group. Action on Smoking and Health (ASH) said the cost would have risen to more than 3 billion pounds annually had action not led to a fall in the number of smokers from 12 to nine million.

The report called for the government to take more action in health legislation to be unveiled in December, with demands for plain packaging of tobacco products and a ban on shop displays. Since 2003 it has been illegal for manufacturers to use any trademark or sign to suggest that one product is less harmful than another but ASH said more needed to be done to curb misleading branding and messages being given to young people.

It cited research from the University of Nottingham which found that using the word "smooth" or lighter coloured branding misled young people into thinking the product was not as bad for their health. "The government could save thousands of lives and hundreds of millions from the NHS budget with an ambitious new tobacco control strategy," said Deborah Arnott, director of ASH.

"More than anything we need to protect young people from the aggressive marketing techniques employed by the tobacco industry." Pro-smoking groups argue that measures such as banning tobacco displays and vending machines would not work. Instead, they advocate stronger enforcement of a ban on selling tobacco to those under 18. "Far from being a drain on society, smokers make an enormous financial contribution," said Simon Clark, director of the lobby group Forest told the BBC.

"Each year smokers pay over £9 billion pounds in tobacco taxation, a figure that dwarfs the alleged cost of smoking to the NHS." According to figures from ASH, over 80,000 people die from smoking related diseases every year, while one in seven 15-year-olds was a regular smoker. 7.10.08

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Health chiefs axe 200 beds... then fork out £350,000 on 'stop smoking' advisers

Health service chiefs have been attacked for hiring 12 ‘smoking cessation' advisers and managers on salaries of up to £38,300 only a year after it was announced that as many as 200 hospital beds were being cut to save money.

Nine counsellors and three administrators are being paid a total of up to £350,000 a year to encourage Leicester's estimated 68,000 smokers to quit. But critics say much of their work could be done far more cheaply by GPs, health visitors and district nurses who come into daily contact with smokers as part of their normal duties.

Among its counsellors the stop-smoking unit – run by the primary care trust NHS Leicester City – has one specialist adviser for pregnant women, another for people with mental health problems and another for young people and families. They are backed up by a team manager, administrator and office manager plus a varying number of part-time staff brought in when required.

Specialist advisers in the NHS are in the £24,103-£32,653 salary band while team managers get between £29,091 and £38,352. Leicester's programme – called STOP! – is expected to cost £476,844 in the current financial year. But one GP who has a long-established practice in the city said smokers should have to do more to kick the habit themselves.

‘Willpower costs nothing. It would be better to cut out all this bureaucracy and free up the cash to care for cancer patients,' he said. Michael Summers, vice-chairman of the Patients Association, said: ‘The NHS constitution states that it is down to patients who drink to excess or smoke to take responsibility for their own health. I am all for anti-cigarette advertising and health warnings on packets.

‘But it cannot be right for a trust to be spending nearly half-a-million pounds on a project which has little to do with front-line patient care when bed closures are announced.' The cutbacks are being made in an attempt to tackle a predicted £32million shortfall by health organisations across Leicestershire.

They were announced by University Hospitals of Leicester Trust – which runs Leicester Royal Infirmary, Leicester General and Glenfield Hospital – and include the axing of up to eight wards and 900 jobs. Despite the financial crisis, NHS Leicester City – which is responsible for non-hospital health issues – also employs an £85,000-a-year director of equality and human rights and two people with the intriguing job titles of ‘cause for concern manager' and ‘cause for concern administrator'.

Some other trusts do have quit-smoking advisers, but far fewer. Heart of Birmingham Teaching Primary Care Trust has five counsellors while Liverpool Primary Care Trust has none and relies instead on a community-based organisation called Fag Ends. Smoking is the main cause of preventable and premature death in Britain and the Department of Health encourages NHS trusts to run anti-smoking programmes. A spokesman for NHS Leicester City said: ‘Smoking cessation is one of the most cost-effective interventions to promote better health.

‘Last year the STOP! service exceeded its annual target, helping more than 2,400 people to give up smoking. The team has been strengthened recently to focus on several key areas, including smokers in vulnerable groups. ‘A considerable part of the team's time is also spent on training healthcare workers and others about how they can contribute to reducing Leicester's smoking rates.' 22.8.08

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Drug taken to stop smoking is linked to traffic accidents

WASHINGTON -- Daniel Williams hoped Chantix would help him quit smoking and become healthier. Instead, he believes, it nearly killed him. Daniel Williams was driving his pickup on a country road in Louisiana when, according to his passenger, his eyes rolled back in his head and he swerved left — into a bayou. His doctor later made the connection to Chantix, which Williams had just begun taking.

Daniel Williams decided he'd listen to his girlfriend and his 8-year-old son and finally quit smoking, with the help of a new prescription drug called Chantix. He started taking the medication, and a couple of nights later, as he was driving his pickup truck on a country road in Louisiana, Williams suddenly swerved left.

His girlfriend, Melinda Lofton, who was with him, later told him that his eyes had rolled back in his head and that it had seemed as if he was frozen at the wheel, accelerating. Moments later, they were in a bayou, struggling to escape the murky water, Williams said.

"Since I was a kid, never had anything like this ever happened before," he said. "It never happened before, and it hasn't happened since. And all the tests I've taken say I have nothing wrong with me at all."

The nonprofit Institute for Safe Medication Practices last week linked Chantix to more than two dozen highway accidents reported to the Food and Drug Administration, saying the mishaps may have resulted from such drug side effects as seizures.

The FDA had earlier issued a warning about suicidal thoughts and suicides among patients taking Chantix and is now evaluating whether it needs to expand and strengthen that precaution. Pfizer, the drug's manufacturer, said that as early as May of last year, it had added a warning to the prescribing literature for Chantix that patients should exercise caution when driving or operating machinery until they know how the medication affects them.

But such admonitions apparently didn't get much notice from busy doctors. Even some government transportation agencies missed them. The Federal Aviation Administration continued, until last week, to list the drug as approved for pilots. The federal truck safety agency was also unaware of the risk.

"That is a problem," said Janet Woodcock, head of the FDA's drug evaluation center, adding that her office needs to find ways to communicate safety information more effectively.

The military, which bans Chantix for flight and missile crews, is considering whether other precautions are needed, Pentagon officials said. Woodcock said the FDA believes the medication should remain on the market as an option for smokers trying to quit.

Approved two years ago, it differs from other smoking-cessation drugs by acting directly at sites in the brain affected by nicotine, blocking the pleasure that comes from smoking as well as the cravings. But Williams, 28, said he was surprised that a drug he had hoped would help turn him into a healthier person instead, he believes, caused an accident in which he could have been seriously hurt, even killed. Lofton is still struggling with a neck injury she suffered.

Williams, a telephone service technician, lives near Rayville, La., between Shreveport and the Mississippi River. He said he went to see his doctor last year for help quitting his nearly two-pack-a-day habit. He'd started smoking in high school and had failed in previous attempts to quit. But he knew people who recommended Chantix. 27.5.08

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Sky Sports executive slashed wrists after taking controversial stop-smoking drug - Champix

A television executive killed himself just weeks after starting to take a controversial smoking cessation drug linked to depression. Omer Jama, 39, a Sky Sports editor who had no history of mental illness, was found dead at his home just two months after he began a course of drugs to help him quit his 20-a-day habit. Mr Jama, a video editor with Sky Sports, had slashed both his wrists and stabbed himself in the thigh and stomach.

Julie Evans, a forensic toxicologist, told the inquest into his death: "There is a possibility he could have been influenced by the side effects of the drug." Fears are growing over the safety of the so-called "wonder drug" which has been used by more than 200,000 people in the UK .

Now the family of Mr Jama from Bolton called for more investigations into its safety of the drug after a coroner returned an open verdict into his death. His brother, Ali Jama, 41, said: "It is clear from the evidence of the toxicologist that Champix's influence could have played a part.

"I would like to see more investigation done." Catherine Jama, his wife of 12 years, told the inquest the couple had recently separated on a trial basis but they met regularly and he was his "usual self" and friends said he was happy in the days before his death. He had booked a holiday to Cuba with a friend just days previously to celebrate is 40th birthday and the keen amateur golfer was still on a high after winning a trophy.

"They just weren't the actions of a man who was contemplating suicide," said Mr Jama, aged 41, of London . "He's got no history of depression and was never the sort of person you would see feeling sorry for himself." Coroner Jennifer Leeming said she would be writing to the Committee for Medicinal Products for Human Use which has been monitoring the drug since it was first authorised in September 2006.

Last year the body received 839 reports of adverse reactions and figures showed 46 were linked to depression and 16 patients claimed to have suffered suicidal thoughts. She said she would register Mr Jama's death as an "adverse event" but was satisfied he inflicted the injuries on himself.

She said: "For me to register he took his own life I would have to be satisfied he did the act which led to his death and he knew what he was doing. "On the evidence before me I cannot say that was the case."

The European Medicines Agency, the drug's licensers, issued guidance on Champix's active ingredient varenicline to doctors two months after Mr Jama's death that "updated warnings" were needed to increase awareness of cases of suicidal thoughts.

Champix is the first non-nicotine anti-smoking treatment and works on brain receptors to relieve cravings and nicotine withdrawal symptoms. Manufacturer Pfizer has insisted a direct link between Champix and psychiatric problems has not been officially established and that nicotine withdrawal can lead to mood swings and behavioural changes. A spokesman for Pfizer said: "Depression, rarely including suicidal ideation, has been reported in patients undergoing a smoking cessation attempt.

"These symptoms have also been reported while quitting with varenicline. "A relationship between varenicline and the reported symptoms hasn't been established, but in some reports a link couldn't be excluded."

Anti-smoking drug, Zyban, which is made by GlaxoSmithKline, has also been linked to a number of suicides among patients. 15.4.08

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Council sparks fury as it becomes first in Britain to ban smoking outside pubs

The first town in Britain looks set to ban smoking outside pubs and cafes but furious landlords have vowed to fight the extreme council plans. Bar and cafe owners have said they are prepared to go to court if the local authority's decision to ban smoking on pavements outside their businesses goes ahead.

By April, smokers in Barnsley , South Yorkshire may find there are few places where they can light up. Under the new regulations smoking will only be allowed outside in private beer gardens. The move has caused uproar among the town's licensees who have seen trade dwindle since the indoor smoking ban came into force. Publican Paul McNicholas, chairman of the town centre Pubwatch scheme said: "I feel so strongly about this I would be prepared to go to court. "There is no other place in the country even contemplating it. It would be difficult to enforce."

Mr McNicholas has spent £9,000 on awnings, tables and heaters so customers can sit outside his Irish pub and enjoy a pint and a cigarette. He said: "Having the outside area has compensated me and evened things out since the smoking ban. These new guidelines could be the difference between bars surviving and not." Walkabout bar manager Greg Harding said: "I think it is ridiculous." He has a street drinking area in front of the town-centre premises and was offered the lease of the land by Barnsley Council. He said: "It gets people out front and brings a bit of colour to the town. This rule would make it untenable for us to continue taking this space from the council."

Barnsley Council's environment department came up with the scheme in a document entitled "Guidelines for street cafes" in Barnsley town centre. The new rule states: "As of April 1 the licensed cafe area will be a no-smoking area. "It will be the responsibility of the applicant to ensure that customers are reminded of this. "If it is noted that on three separate occasions customers are witnessed to be smoking, then the licence will be revoked."

Councillor Roy Miller, Barnsley 's environment committee head said consultations were still taking place and input would be welcomed from licensees. He said: "We are awaiting the responses and I am having a meeting with several landlords."

The move has been attacked by the pro-smoking organisation FOREST which says the scheme is "dubious, difficult to enforce and a potential death knell for businesses without space for a beer garden." Director Simon Clarke said: "It is the first time we have heard of such a plan anywhere in the country. "If the council wants smokers off the streets it would be more productive to use resources for smoking rooms. "If this is brought in I will come to Barnsley myself and light up even though I don't smoke." 22.2.08

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Woman tries to kill herself while taking Champix: Is this smoking pill safe?

When Karen McGhee woke up in a hospital bed and saw her teenage daughter looking anxiously at her, she was completely flummoxed. "My arm was bandaged and the left side of my mouth and neck felt numb, as if I had been to the dentist - but I had no idea why I was in hospital," says the 38-year-old.

"Then Jenna told me I'd tried to kill myself. She said her nine-year-old sister, Aynslie, had found me in the middle of the night hanging from the banisters with the pelmet from the curtains tied around my neck." Karen listened in horror as her daughter recalled how she had turned blue through lack of oxygen, and her heart stopped five times in the ambulance on the way to hospital. The doctors were convinced Karen had brain damage, and after three agonising days her family had decided to turn off her life support machine. She was expected to die within minutes, but instead miraculously began to breathe on her own. With absolutely no memory at all of what she'd done, Karen says her daughter's account of what had happened was like hearing about another person. "My last recollection was of being extremely happy," she says.

In fact, the mother-of-three from Greenock , Scotland , had developed severe depression and tried to hang herself after taking Champix - a pill designed to help reduce nicotine withdrawal symptoms and stop cravings. Yesterday, the Mail reported how Wayne Marshall, a 36-year-old father-of-two from Doncaster , was found hanged shortly after completing a 13-week course of the same drug. Last October, TV editor Omer Jama, 39, committed suicide after starting using Champix.

Medical watchdogs are being urged to investigate the drug to ensure it is safe to use. The drug works by binding to nicotine receptors in the brain. Nicotine stimulates the production of dopamine, which is the "pleasure" chemical in the brain. By attaching itself to the receptors normally used by nicotine, Champix fools the brain into thinking it's had nicotine - so satisying the craving for a cigarette.

The drug has modest success rate. After 12 weeks, 22 per cent of those taking Champix have given up smoking. However, since the drug's launch in Britain in December 2006, the Government's drug safety watchdog, the Medicines and Healthcare products Regulatory Agency (MHRA), has received 1,513 reports of adverse reactions, including 62 reports of suicidal feelings.

As Jenna told her mother what had happened, Karen began to wonder if the medication she'd been taking in the weeks up to the fateful event had played a part in it. "After Robert's heart attack last July, his consultant recommended Champix to him," she says. "He smoked 60 a day and had never been able to quit. "I decided I would also try to quit my 20-a-day habit. My husband's heart attack had hammered home to me just how dangerous smoking can be."

The couple were given a standard 12-week course of Champix tablets and told to try to give up cigarettes ten days into the course. However, just days after starting on Champix, Karen realised something wasn't quite right. "I started to feel really grouchy all the time, and would shout and scream at my family for no good reason, which is totally out of character."

Indeed, she became so moody that even her mother-in-law noticed something was wrong and suggested she should stop taking the pills. But Karen thought it was probably nicotine withdrawal that was causing the problem - and so continued. However, she began to feel even worse. "I started being sick about three times a day," says Karen. "Looking back, I was stupid to think it was because I'd quit smoking, but I'd had no idea what to expect.

"I also became really depressed. I felt so low that I couldn't see the point in doing anything. Normally, I am an active person, but I started spending the whole day slumped on the sofa. I had no enthusiasm for anything." Karen had suffered from mild depression on and off for the past 20 years and started taking antidepressants in 2005. However, she says Champix made her feel lower than ever.

In September, just under two months after she'd started taking the drug, her husband became very concerned. "Robert said he wanted his wife back - and pleaded with me to stop taking the tablets," says Karen. He was so worried by the effect the pills were having on his wife that he had stopped taking them himself. He had also become irritable. Despite this, Karen was still convinced the pills were not the problem, and put her symptoms down to nicotine withdrawal. "I was so low that my mother said to me: 'I would rather you started smoking again than continue like this'." she says.

"Robert kept trying to do things to cheer me up, such as taking me out for dinner, but I could not shift this deep depression. I did not bother talking to my GP about it because I thought it was just something I had to endure after giving up smoking."

On October 17, following a meal out, the family went to bed as normal. The next thing that Karen remembers is waking up in hospital. The following day a psychiatrist came to see her. Karen says: "Robert showed him the Champix and said : 'Do you think this made her do what she did?' The psychiatrist said: 'It won't have helped'." Karen stopped taking the pills immediately. She was kept in hospital for a week, where her mood improved drastically. Her husband said he felt as if the "old" Karen had come back.

She now has a six-inch scar on her arm where it was burnt on the radiator during her suicide bid. But the mental scars are much deeper. Her daughter Aynslie is so traumatised by what happened that she refuses to go up the stairs alone. "I try each day to be as nice to my children as possible, to make up for what I put them through," says Karen.

"Aynslie said to me recently: 'Don't feel guilty about what happened, Mummy. It wasn't you - it was the pills'. "I am convinced Champix is to blame for what happened to me. "A week after my suicide bid, I opened the paper to read about Wayne Marshall, who did kill himself after taking Champix.

"It sent chills though me. It could so easily have been me, and the idea of leaving Robert and the children is just unthinkable. "I am ashamed to say that a week after leaving hospital, I started smoking again. No one has criticised me for it. They would all rather have me smoking than dead. "I suspect I will smoke for the rest of my life. After everything that has happened, I am just too frightened to give up."

Dr Alex Bobak, a GP from Wandsworth, is the only doctor in the country to have a specialist interest in smoking cessation and has helped conduct trials on Champix (though he is not paid by the makers). He believes the drug is safe. "I am convinced it is giving up smoking, and not the effects of Champix, which have caused some people to feel suicidal," he says.

"Without nicotine, many people do become irritable, grouchy and depressed - even suicidal. "This is because nicotine stimulates the production of dopamine in the brain, a chemical which induces feelings of happiness. Without it, some people can become down. "Interestingly, in trials on people trying to quit smoking, those taking Champix reported feeling much less irritable and depressed than those taking a placebo pill.

"I think that for most people Champix does help reduce all the bad feelings, but for some people - and I believe only a small minority - it does not do this enough. "I would urge people not to be put off taking this drug. Remember, more than 50 per cent of long-term smokers will die prematurely as a result of a smoking related disease."

Pfizer, the makers of Champix, said in a statement: "We are working closely with the EMEA ( European Medicines Agency) to review reports of depression and suicidal thoughts in patients attempting to stop smoking and taking Champix. "There is no scientific evidence establishing a casual relationship between varenicline (Champix) and these reported events."

However, Pfizer, who make the smoking cessation drug Champix (varenicline), have updated the drug's labelling in the United States to reflect the fact patients may experience "serious neuropsychiatric symptoms", including suicidal behaviour. 23.1.08

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Widow claims father-of-two driven to suicide by 'quit smoking' drug champix

A widow claimed yesterday that a drug designed to help smokers quit may have played a role in her husband's suicide. Father-of-two Wayne Marshall, 36, was found hanged shortly after completing a 13-week course of Champix, which it is feared may have depressive side effects. His death is the second in the UK to be linked to the newly-licensed drug.

Mr Marshall's widow Emma said he was prescribed the drug by his GP last August to help him quit his 20-a-day habit, but quickly went downhill, cutting himself off from his family and friends. Mr Marshall, a welder, from Rossington near Doncaster, died in November. Last month, an inquest in Doncaster recorded a verdict that he killed himself.

Mrs Marshall, 28, said she believed the drug had played a part in his death and has reported the case to the Medicines and Healthcare Products Regulatory Agency. "I don't want anybody to go through what myself, his children and his family and friends are facing," she said. "It is horrendous. "People need to think about going on this drug, particularly if they have a history of depression.'

After her husband's inquest, Mrs Marshall, a distribution coordinator, discovered Champix has been linked to depression. Mrs Marshall, who said her husband had once before attempted suicide when he was a teenager, had moved out of the couple's home a month before the tragedy.

His previous attempts to give up smoking had failed, but he did not smoke while taking Champix. He became quiet and withdrawn, however, and one day she found him sobbing uncontrollably. "I don't understand how he went downhill so quickly," she said. "He was not the type of person who needed picking up but his whole personality changed. He closed himself off completely from everybody. "These tablets did seem to be working. It was just his moods."

He had finished the drug course a week before she last saw him, but had started smoking immediately. "He was more positive than when I saw him previously," she said. "Never ever could I have dreamt he would have done something like that." Last October, TV editor Omer Jama, 39,was found dead at his home in Bolton. He slashed his wrists weeks after starting a course of Champix. Mr Jama had just booked a foreign holiday and had no history of depression.

The European Medicines Agency last month ordered improved warnings to patients over the twice-daily prescription medicine following reports it could lead to depression. Figures from the MHRA show one patient has taken his life while on the drug, two others have attempted suicide and there have been 60 other "suicidal-type suspected adverse reactions" reported.

About 200,000 patients have been prescribed the drug in the UK since December 2006 and it was approved by the Health Service last July.

An MHRA spokesman said Champix, which is made by Pfizer, was being closely monitored. He said: "Giving up smoking can be very stressful. The side effects are suspected. It does not necessarily mean the drugs caused the reaction." 21.1.08

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Stop smoking NHS clinics don't 'work'

NHS "stop smoking" clinics have been hailed a success by some after figures showed particular progress in deprived areas. The study found that just 8.8% of smokers in poorer areas had quit at the four-week mark (4 weeks is the date when the information is compiled, 2 weeks is the period in question while using NRT products), compared with 7.8% elsewhere. The comparison is particularly relevant as smoking is a key factor in health inequalities with those from deprived backgrounds more likely to smoke. The Bath University-led team compiled the data from the 1.5m people using the clinics in England from 2003 to 2006.

Smoking cessation clinics, offering counselling and treatment in the form of nicotine replacement therapy, were set up in 1999. Lead researcher Dr Linda Bault, who worked with experts from Edinburgh University , said: "Our study shows that the NHS stop smoking services are helping to reduce the health gap between rich and poor, which is good news for the overall health of the nation." But she added stop smoking services had to be accompanied by the continued successful implementation of smoking bans and rises in tobacco prices to have a wider effect.

The study, published in the Tobacco Control journal, compared data from smokers who accessed services in officially designated disadvantaged areas, called spearhead areas which have received extra funds and cover just over a quarter of the population, and compared them with other areas of the country. The study found that quit rates were slightly lower for smokers from spearhead areas, at 53% at four weeks compared with 58% elsewhere.

But it added the services were treating them in larger numbers as a proportion of overall smokers than their more affluent neighbours, 17% compared with 13% elsewhere. The overall effect was that a higher proportion of smokers in the more disadvantaged areas were successful in quitting. Although previous research has shown that of those who quit after a month, less than one in four were still not smoking by the year-mark.

Tim Crayford, of the Association of Directors of Public Health, said: "This study shows that extra NHS cash really has managed to get more people to stop smoking. That is good news for the health of the country. "Better still, the NHS has worked with smokers from deprived communities, and this will reduce health inequalities." He called for more money to be put into NHS services after recent predictions show the health service was heading for a £1.8bn surplus this year.

A Department of Health spokeswoman said NHS smoking cessation services had been "highly effective". And she added: "Narrowing the inequalities gap is a major challenge, but it is achievable." 5.12.07

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Smoking at the wheel could lead to conviction

Drivers who smoke at the wheel could face prosecution under changes to the Highway Code. Lighting-up at the wheel has been added to the list of "distractions" which police and lawyers can cite in court when seeking a conviction for a traffic offence.

It joins eating and drinking, "inserting a cassette or CD or tuning a radio", "arguing with your passengers or other road users", trying to read maps, and - even playing loud music - most, if not all, of which have featured in successful prosecutions. High-profile cases have involved motorists eating apples, Kit-Kats and sausage rolls.Up to one in four UK adults smoke, which could mean more than eight million of the nation's 33 million motorists are at risk.

Brian James, road traffic chairman of the Magistrates Association, said that although the code carries no legal force, failure to observe its advice could be used as evidence that an offence had been committed. The new Highway Code, the first for eight years, has increased in size by about 50 per cent and contains 29 more rules. There is also a new section for novice drivers.

Andrew Howard, the AA's head of road safety, said last night: "The Highway Code is the definitive guide to safe and lawful road use. "It has grown since 1931 from 18 pages to 135, reflecting the complexities of modern motoring. "A major change is the inclusion of smoking at the wheel as behaviour that police may interpret as a distraction and failure to be in proper control of the vehicle. "It can - and no doubt will - be used in court as corroborating evidence."

A recent report by academics at Brunel University warned that car crashes could rise as the ban on smoking in public places leads more people to take a drag at the wheel. It said smokers drive 23 per cent faster and are more inconsistent than non-smokers.

The report for insurance company Privilege reinforced growing calls for smoking while driving top be made a criminal offence like using a mobile phone, which now attracts three penalty points and a £60 fine. Supporters say holding a cigarette is equally dangerous.

The code's new section for novice drivers tells them:
If you are driving with passengers, you are responsible for their safety;
Don't let them distract you or encourage you to take risks;
Never show off or try to compete with other drivers, particularly if they are driving badly.
Only one in 20 accidents are caused by drivers breaking the speed limit, Government figures showed yesterday.

A failure to look properly at the road and traffic is a bigger reason. It was a contributory factor in more than a third of accidents and one in five deaths last year, according to the Transport Department. 28.9.07

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Cannabis use among young offenders rockets by 75 per cent in just three years

The number of young criminals using cannabis has shot up since Labour downgraded the drug's legal status. Figures suggest that use of cannabis among juvenile offenders has roughly doubled in three years.

In some parts of the country that means nine out of ten teenage criminals have been using the drug. Links between cannabis and crime have been causing concern since former Home Secretary David Blunkett decided to label it a Class C drug rather than Class B - a switch that meant police are highly unlikely to arrest anyone caught with it.

That 2004 decision appears to have intensified use of cannabis among the youngest criminals. Yesterday's figures come from a survey for local Youth Offending Teams, which run probation and attempt reform of teenage criminals.

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Doctors refuse to fix builder's broken ankle unless he quits smoking

A man with a broken ankle is facing a lifetime of pain because a Health Service hospital has refused to treat him unless he gives up smoking. John Nuttall, 57, needs surgery to set the ankle which he broke in three places two years ago because it did not mend naturally with a plaster cast.

Doctors at the Royal Cornwall Hospital in Truro have refused to operate because they say his heavy smoking would reduce the chance of healing, and there is a risk of complications which could lead to amputation. They have told him they will treat him only if he gives up smoking. But the former builder has been unable to break his habit and is now resigned to coping with the injury as he cannot afford private treatment. He is in constant pain from the grating of the broken bones against each other and has been prescribed daily doses of morphine.

Mr Nuttall, of Newlyn, Cornwall, broke the ankle in a fall in 2005. Initially he refused surgery because he had caught MRSA at a different hospital four years earlier, and was terrified of history repeating itself. He hoped the fractured bones would knit together with a standard plaster cast to immobilise his ankle. But six months and three plaster casts later, it became clear that an operation to pin the bones was the only solution.

However, the hospital told Mr Nuttall, who no longer works because of smoking-related chest problems, that he would have to give up smoking before an operation could be carried out. Mr Nuttall said: '"I am in agony. I have begged them to operate but they won't. I have tried my hardestto give up smoking but I can't. I got down to ten a week at one point but they said that was not good enough. "I spent 12 months trying to give up and used patches and everything, but nothing works. "I have smoked for over 40 years and it's not going to happen. "We were brought up at a time when cigarette advertisements were everywhere and there were no warnings.

"I want to warn other smokers that they could be denied medical treatment and there is nothing we can do about it. "I have paid my dues as a taxpayer-and now the NHS won't treat me." Mr Nuttall, who is single, uses a walking stick to get around and fears his bones will now be so 'calcified' that an operation would not work even if he were allowed to have it. "It is very painful," he said. "If I walk more than a few steps I can feel it grinding."

A spokesman for the hospital trust said: "Smoking has a very big influence on the outcome of this type of surgery, and the healing process would be hindered significantly." 14.9.07

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Dramatic fall in heart attacks in wake of smoking ban in Scotland

The number of people rushed to hospital with a heart attack has fallen sharply since the start of Scotland's smoking ban, a report has found. Researchers have found a 17 per cent fall in hospital admissions for heart attacks in the first year of the ban. Before it came into effect in March last year, the annual reduction over the preceding decade had been just 3 per cent.

The figure was published in research papers discussed today at a conference studying the impact of the ban on smoking in enclosed public spaces. Organisers said a national evaluation also found a 39 per cent reduction in second-hand smoke exposure in 11-year-olds and among adult non-smokers.

There was no evidence of smoking shifting from public places into homes, and there was high public support for the ban even among smokers. The two-day conference at the Edinburgh International Conference Centre has attracted an international audience of health experts and policy-makers.

Scotland's Deputy Chief Medical Officer, Professor Peter Donnelly, said research presented at the conference showed the "significant" public health benefits the smoking ban was already having. "It provides evidence that the legislation is improving the health of everyone in Scotland - including smokers, non-smokers, children and bar workers," said the professor. "One of the most important findings is the reduction in heart attacks. We believe that the smoking ban was a large contributory factor to this drop. "I am confident that we will continue to see the positive effects of the ban in years to come."

The evaluation was said to be the most comprehensive yet conducted into the impact of anti-smoking legislation. Heart attack admissions to the nine hospitals studied accounted for nearly two-thirds of all Scottish hospital heart attack admissions.

Public Health Minister Shona Robison, who will close the conference tomorrow, said: "I am delighted that public health experts from across the world have come to Edinburgh to hear first-hand how the ban has benefited the nation. "More and more countries in Europe and across the rest of the world are now following suit by banning smoking in public places and I am proud that Scotland led the way in the UK.

"We want to continue the work to make Scotland a smoke-free society and that is why next month, subject to Parliamentary approval, we will be raising the age of cigarette sales from 16 to 18." 10.9.07

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Tenants who can't light up at home

Smokers could be banned from lighting up in their own homes under plans drawn up by bureaucrats. Those who live in council-run housing in Liverpool will be asked to stop smoking at least half an hour before official staff such as social workers and carers visit their homes.

Town hall bosses hope the policy - due to be debated by the Liberal Democrat-run council tomorrow - will help protect all their staff in line with the ban on smoking in public places from July 1. They claim the ban is voluntary and that those who insist on smoking will not be denied access to vital council services.

Last night the pro-smoking pressure group Forest condemned the policy. Its director, Simon Clark, said: "It is a cheek to expect people to stop smoking in their own homes. "The idea that staff could be at risk from going into the home of someone who smokes is utter nonsense and is scaremongering."

One of those affected by the ban, 27-year-old Craig Hesketh, reacted angrily. "Next thing they'll be telling us not to mow the lawn when there is a council official visiting in case they suffer from hayfever," he said. 19.6.07

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Third of bosses to axe cigarette breaks when smoking ban arrives

More than a third of employers are planning to axe cigarette breaks when the smoking ban comes into force in England next month. Lighting up in an enclosed public places will be illegal from July 1, with those caught flouting the law facing a £50 on-the-spot fine or being summoned to court. Premises that allow smoking - including 200,000 pubs and restaurants - will be fined up to £2,500. It will bring an end to 'smoking rooms' in the workplace, with staff ordered outside if they want to have a cigarette break.

But many bosses will use the ban as an opportunity to end the practice, stopping their employees from taking time out during the working day to get their nicotine fix. A survey of over 250 firms revealed that 36 per cent planned to axe smoking breaks when the ban becomes law. But business leaders said such a move would be 'excessive', while trade union officials warned it could spark unrest and encourage staff to break the law.

TUC General Secretary Brendan Barber said: "Lots of smokers see the ban as an opportunity to quit or cut down, but hardened nicotine addicts might not find giving up so easy. If employers decide to crack down on fag breaks, the danger is that some hardened smokers may try to find ways of flouting the ban. "If going outside to smoke isn't an option, they may be tempted to smoke in secret on company premises.

"Employers should take a sensible approach to the ban and not use 1 July as a stick with which to beat their employees who smoke. Bosses should be thinking about ways of helping their staff stop smoking. Banning them from going outside for a quick puff is not the answer." The ban, which will also apply to outdoor areas where bystanders are affected - such as bus shelters, football grounds, and train platforms - means staff must smoke in the open, outside their workplace.

A spokesman for the British Chambers of Commerce (BCC) said: "There is a danger that the new smoking legislation could become more onerous than it needs to be. "It is not illegal to smoke outside and, although non-smokers may find it annoying to see their colleagues nip out for a quick ciggie, it seems excessive to actually ban people from going to smoke." The report, by employment law advisors Consult GE, says there is little the nation's 12 million estimated smokers can do if their employers end cigarette breaks as they are not protected by law.

Stuart Chamberlain of Consult GEE said: "Although there has never been a contractual right to smoke at work, companies seem keen to eradicate smoking among staff, and the ban is giving them the impetus to do just that. "Employees will struggle to fight any bans on their smoking breaks because they are not entitled to them." Smoking is the biggest cause of death and illness in the UK, with more than 120,000 people dying every-year from smoking-related diseases. It is estimated one in five smokers will try and kick the habit once the ban is introduced next month.

Despite widespread backing, not everyone supports the smoking ban. Antony Worrall Thompson, celebrity chef and patron of smokers' lobby group Forest, said: "July 1 will be a sad day. Supporting smokers is worth doing. Nobody else wants to because they want to be politically correct." He has said previously: "When you're an adult, life is about the freedom to choose. I think we're becoming more and more nannyish." 18.7.06

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Smokers told to quit or surgery will be refused

Smokers are to be denied operations on the Health Service unless they give up cigarettes for at least four weeks beforehand. Doctors will police the rule by ordering patients to take a blood test to prove they have not been smoking. The ruling, authorised by Health Secretary Patricia Hewitt, comes after medical research conclusively showed smokers take longer to recover from surgery. It is thought that 500,000 smokers a year will be affected.

However patients' groups argue that the move is about the NHS saving money rather than improving patient care. They claim that health trusts do not want to operate on smokers because they stay in hospital longer, blocking beds and costing more to treat. The ruling applies to routine operations such as hip replacements and heart surgery for conditions that are not immediately life-threatening. If smokers refuse to give up, they are still likely to be treated but may have to wait longer.

Leicester City Primary Care Trust will become the first health authority to introduce the "quit or wait" rule this summer. Other health trusts are consulting on the idea. Rod Moore, the trust's assistant director of public health, said: "If people give up smoking prior to planned operations it will improve their recovery. It would reduce heart and lung complications and wounds would heal faster. "Our purpose is not to deny patients access to operations but to see if the outcomes can be improved."

Patricia Hewitt has described the ruling as "a perfectly legitimate clinical decision". Yesterday her spokesman explained: "Trusts commission surgery services based on their assessment of the needs of their local population and availability of service capacity. "The provision and availability of a particular surgical intervention should be dependent on the clinical needs of the individual patient."

The European Commission is considering a proposal to extend the forthcoming ban on smoking in enclosed public places to cover doorways. Officials have been studying the Canadian province of Quebec, where smoking is banned within nine metres of the doorway into any healthcare-related building, school or social services building. The experiment is thought to have shown positive health benefits.

A spokesman for the Department of Health said the Health Act 2006, which covers the July 1 ban, contains reserve powers to extend the law to outside areas. Sports stadia, bus shelters and train platforms are already classed as enclosed public spaces under the Act and it would not have to go back to Parliament to be extended to doorways.

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Smokers face £80 fine for dropping butts in the street

Smokers were warned today that they face on-the-spot fines for littering if they drop cigarette butts in the street. It means that smokers trying not to be penalised for breaking England's ban on smoking in enclosed public places from next month could be hit by a different fine. Alan Woods, Chief Executive of Keep Britain Tidy, said: "Smokers will think they are avoiding a fine by lighting-up outside. "If they don't dispose of their cigarette stub responsibly, by putting it in a bin or portable ashtray, they are risking being issued with a fine of up to £80 for littering instead."

Nearly 80 per cent of streets are blighted by cigarette stubs - 20 per cent more than five years ago, according to KBT. The annual clean-up bill stands at £200 million just for cigarette ends. An estimated 122 tonnes of cigarette ends, matchsticks and other bits of smoking litter are dropped every day. KBT is now urging smokers to bin their butts.

Tesco is to start selling portable ashtrays.The Ashcan, is the size and shape of a cigarette, fits into a cigarette packet where it can be used to extinguish stubs. From 1 July it will be against the law to smoke in virtually all enclosed and substantially enclosed public places and workplaces.

Premises will be considered enclosed if they have a ceiling or roof and are wholly enclosed either on a permanent or temporary basis. The law also applies to public transport and work vehicles used by more than one person. "No Smoking" signs will have to be displayed in all smoke-free premises and vehicles.

Managers of smoke-free premises and vehicles will be responsible for preventing staff and customers from smoking. Failing to comply with the law is a criminal offence. The fixed penalty notices and maximum fine for each offence are:

Smoking in smoke-free premises or vehicles: fixed penalty notice of £50 - or a maximum fine of £200 - imposed on the person smoking.

Failure to display "No Smoking" signs: fixed penalty notice of £200 or maximum fine of £1,000 imposed on whoever manages or occupies the premises or vehicle.

Failing to prevent smoking in a smoke-free place: a maximum fine of £2,500 imposed on whoever manages or controls the premises or vehicle. 1.6.07

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Anti-smoking pill has been approved by drugs watchdogs despite clear evidence of low success rates

Champix, described as the most effective treatment yet to help people quit, was cleared after trials showed almost half of those who took it managed to give up. The draft approval comes just weeks before England goes smoke-free on July 1, when there will be a ban on smoking in virtually all enclosed work and public places.

The prescription only twice-daily pill received approval from the National Institute for Health and Clinical Excellence (Nice), which advises the NHS on which drugs it should supply. Champix tablets contain the active ingredient varenicline, which is a medicine used to help people who are addicted to nicotine to give up smoking.

It works by providing relief from cravings and the withdrawal symptoms experienced by smokers. It also reduces the satisfaction a smoker will get from further cigarettes if they have a relapse. Trials have shown the drug was effective after a 12-week course, with 44 per cent of smokers managing to stop.

A spokeswoman for Nice said: 'Having looked at all the evidence, our independent committee have concluded that varenicline appears to be a good way to help people who want to quit smoking. The draft guidance also recommends that varenicline should normally be provided in conjunction with counselling and support, but if such support is not available, this should not stop smokers receiving treatment with varenicline.

'Nice follows an open and transparent process which includes genuine consultation so changes in draft recommendations can occur. Stakeholders now have the opportunity to appeal against the draft guidance. Subject to any appeal, final guidance is expected to be issued to the NHS in July 2007.

However the evidence supplied to NICE is in direct conflict to that of the trials conducted in the States where Champix tablets were tested for 12 weeks with an average success rate of 22%, which was follow by another 12 weeks course with another 22% success rate, the combined success rate is then claimed to be 44% (2 x 22%) after nearly 6 months and not 12 weeks as reported in the media.

In addition over 1,000 hardened smokers were denied access to the trials while those who did participate also received 16 counselling sessions and a course of NRT following the 12 week use of champix which then achieved the claimed 20% (1 in 5) success rate. Critics claim it's another example of drugs being approved when all the evidence is not disclosed, information suppressed and PR is being used to create public interest in drug which does not live it up to public expectations. 31.5.07

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Give smokers paid time off work to quit

Businesses are being urged to give workers extra time off to attend stop smoking clinics ahead of Enland 's ban on July 1. The guidance body on public health recommends workers - many of whom already enjoy cigarette breaks throughout the day - should not lose pay if they need help in giving up. The National Institute for Health and Clinical Excellence ( Nice ) believes that businesses will benefit by a subsequent boost in productivity.

"For example, a business with 20 employees, of which typically five would smoke, could spend just £66 on providing brief advice (including employees' time) and see an overall saving of around £350 based on improved productivity," a spokeswoman for Nic said.

Currently, smoking costs the NHS an estimated £1.5 billion each year, and costs industry an estimated £5 billion in lost productivity, absenteeism and fire damage. Andrew Dillon, chief executive of Nice , said: "Going smokefree is a win-win situation for both employers and employees, and our advice sets out the best approach to making it happen."

He added: "Our advice is based on the best evidence of which workplace approaches are effective for smokers and make business sense for employers." But Simon Clark, director of Forest, the Freedom Organisation for the Right to Enjoy Smoking Tobacco, said it was "absolutely ridiculous" that workers should attend stop smoking clinics during working hours .

"It's wrong to expect employers to accept employees taking time off, and I imagine their non- smoking colleagues will be very unhappy about it," he said.

"It's generally acknowledged these quit smoking courses are not very successful - it's a matter for willpower. And they are likely to be open to abuse - people will take advantage as they have an excuse to take time off work". 25.4.07

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Anti-smoking 'wonder pill' launched

An anti-smoking "wonder pill" that claims to be the most effective treatment yet was launched on Tuesday. Nearly half (44%) of patients who took Champix gave up in just three months, making it twice as successful as other methods. The new drug - which costs £2 a day - works in a unique way on the pleasure centre of the brain to cut the satisfaction smokers get from a cigarette.

This means if those people taking the drug have a lapse and smoke a cigarette, they'll find it less enjoyable and are more likely to carry on trying to quit. The prescription-only pill - which is expected to get the go-ahead for use on the NHS - also provides relief from cravings and withdrawal symptoms, and doubles the odds of quitting compared with the only other oral medication available.

After three months of treatment, 44 per cent of patients using Champix had given up compared with 30 per cent taking Zyban, the current gold standard anti-smoking drug. Around one in five smokers who start using Champix will still be shunning cigarettes a year later. Doctors say the launch of the drug could not be more timely as smoke-free legislation in public places is due in April in Wales and Northern Ireland, and in England in July. It is already enforced in Scotland.

Dr Alex Bobak, a London GP with a special interest in smoking cessation who has carried out trials on the drug, said 70 per cent of smokers would like to give up. He said "With smoke-free legislation throughout the whole of the UK fast approaching, the availabality of this drug gives smokers an even better chance of stopping smoking.

"There are over 12 million daily smokers in the UK and this new medicine gives NHS Stop Smoking Services and healthcare providers another weapon in their fight against smoking addiction which costs the NHS £1.5 billion in direct costs each year. "It's more effective than current alternatives and is a significant advance. "Having more than 20 per cent of smokers still stopped after a year is very good, although it's important to stress the need for support from healthcare professionals while you're doing it," he added.

Champix, also known by its generic name varenicline tartrate, has been developed by Pfizer, the global pharmacuetical giant behind the anti-impotence drug Viagra and the cholesterol-busting drug Lipitor. If successful, the pill could generate millions of pounds worldwide - it is already licensed in the US and some other countries.

Although the Government's "rationing" body, the National Institute for Health and Clinical Excellence, will not be considering the drug for official approval until early next year, doctors expect it to get the go-ahead. Smoking cessation is a major plank of preventive health policy, and smokers who want to kick their habit can visit their GP and be prescribed various nicotine replacement therapies such as skin patches, gum and special inhalers.

These work by supplying the body with a steady stream of nicotine after the user has stopped smoking which allows the cravings to gradually diminish. Zyban works differently - it is actually an antidepressant that lessens ex-smokers' desire to take up the habit again.

Champix is also nicotine-free but works in an entirely different way, by binding to nicotine receptors in the brain which reduces the severity of cravings and other withdrawal symptoms. This also reduces the satisfaction gained from smoking, partly by interfering with the release of the "pleasure" brain chemical dopamine. The cost of the drug at around £2 a day could result in cost savings because of the higher success rates, it is claimed.

A two-month course of Zyban is £1.33 a day - but those taking Champix are twice as likely to quit. Clinical trials show the drug is effective after a 12-week course, with 44 per cent of smokers stopping - four times higher than those taking a dummy pill. Trial results of more than 2,000 treated smokers found 22.5 per cent who used Champix were smoke-free over a year from the start of treatment. This compared with 15.7 per cent on Zyban and 9.4 per cent on placebo.

Smokers can take it for longer than 12 weeks if necessary and the overall quit rates are then higher than for 12 weeks. The nost common side effect is nausea, which was generally mild and transient, and less than three per cent of smokers discontinued treatment because of this.

Each year about 114,000 deaths in the UK are attributed to smoking. London-based marketing consultant and writer Anne Dettmer, 53, got hooked on cigarettes when she was 18. She has tried a range of aids including patches and Zyban over the years to quit a 60-a-day habit without lasting success. But her health became increasingly affected by smoking, which caused breathlessness and problems with her teeth and skin. She said: "I was conscious of smelling of smoke and the last straw came one night as I lay in bed listening to the cat wheezing - when I realised it was me."

Almost two years ago she enrolled on a trial and ended up being given Champix, which she immediately knew could make a difference. "You have to start using it a week before the Quit date and halfway through the week I found I was stubbing out half-finished cigarettes which I had never done before. All of a sudden I wasn't enjoying it anymore," she recalls. She said "For me this drug really did work. It took away the dreadful withdrawal feeling and I can enjoy breathing again. "Sometimes I take a deep breath just for the pleasure of being able to." 16.1.07

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Smoking ban meets resistance in "tolerant" Germany

BERLIN (Reuters) - When a German magazine ran a story about new efforts to ban public smoking, the reactions of many of its non-smoking readers were fierce -- and surprising. "I don't want to be deprived of the relaxed company of smokers in restaurants and bars," wrote David Harnasch of Freiburg in a letter to Der Spiegel weekly. "If my clothes stink of smoke, I can wash them -- where exactly is the problem?"

Yvonne Deim from Munich wrote: "Sitting in a smoke-filled room for a few hours bothers me less than it would if smokers were forced to get up every few minutes to go smoke outside." Governments across Europe are cracking down on smoking in public places. But resistance to new limits is strong in Germany, where the right to smoke became a cherished mark of tolerance and freedom after World War Two. Polls show a majority of the population and one in two non-smokers opposed a proposed ban on smoking in restaurants and bars.

Some politicians have said the proposals are too draconian, and Germany's powerful cigarette, restaurant and hotel lobbies are working to ensure they never see the light of day. Der Spiegel made clear where it stood by putting a picture of a broken cigarette on its cover alongside the title "Smoking -- The End of Tolerance".

Lother Binding, a member of the parliament and a former smoker, stoked the debate by pressing for a new law that would ban smoking in all public places. Binding, 56, told Reuters he felt compelled to press for stricter laws after reading a study from the Heidelberg-based German Cancer Research Centre, which laid out in stark terms the dangers of "passive smoking" or second-hand smoke. "That convinced me that the current law simply doesn't go far enough," he said, referring to a two-year-old measure to phase in no-smoking zones in hotels and restaurants. 26.6.07

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£50 Million bill for nicotine patches 'that keep smoker addicted'

The NHS is spending more than £50 million a year on nicotine patches and gums despite alarming new evidence that they do not help smokers quit the habit. A Treasury report into public health spending questions the success rates that supposedly justify the use of nicotine replacement therapy (NRT) in clinics and a leading anti-smoking expert is urging smokers to sue the NHS for the poor quality of advice. Clinics using the NRT claim that more than 100,000 smokers who attended last year managed to quit.

'Only a fraction give up' But the report last week by former NatWest bank chief Derek Wanless reveals that a smoker has to stop for only two weeks in the first four to be defined as a quitter. Mr Wanles says this is an unreliable test of whether a smoke has genuinely given up.

He adds: 'Given the addictive nature of tobacco, only 30 to 40 percent of smokers truly abstinent at four weeks are likely to be abstinent at one year.' This supports the views of NRT critics, who say that nicotine patches, gums and lozenges make hundreds of million of pounds a year for drug companies but help only a tiny fraction of smokers give up. A renowned quit-smoking guru is urging smokers prescribed NRT to sue the NHS.

He said yesterday: 'Nicotine patches and other forms of NRT don't replace nicotine - they are nicotine. All these products do is help keep many smokers physically and psychologically addicted to the substance that's causing their problems in the first place 'Giving them nicotine in another form just subtly reinforces the idea that they really can't manage without it - which is why NRT rarely works". 'Staggering 94% failure rate'

Manufacturers say NRT is clinically proven to 'double' a smoker's chances of giving up. But critics point out that this is still only an improvement from three percent with no assistance at all to six percent with NRT. Despite this high failure rate - 94 per cent - the NHS has paid Novartis, Pfizer and GlaxoSmithKline around £80 million for patches and other forms of nicotine therapy since they became available on the NHS prescription four years ago, and spent a further £90 million on smoking clinics that rely heavily on NRT.

'Public funding to increase by £138 million for a product that produces a 94% failure rate'. Over the next three years the Government plans to increase funding to these clinics by £138 million however this is an insignificant amount when compared to the £13 billion raised in tobacco duty.

Health Secretary John Reid, the Government-funded QUIT campaign and the anti-smoking lobby group ASH all defend the use of NRT as the centrepiece of all publicly funded quit-smoking programmes.

'Despite £50 million a year spent on NRT the number of smokers remain the same at 27%.

But the Wanless report says that despite all the efforts to tackle the problem, including heavy investment in NRT, the number of smokers has remained relatively stable over the past ten years, at around 27 percent of the population, and anti-smoking efforts have not been successful. 7.3.04

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Government considers raising smoking age

The Department of Health (DoH) announced on Monday it was considering whether to raise the age limit for buying cigarettes or tobacco from 16 in a bid to cut the level of smoking among teenagers. A consultation exercise has been launched to look at whether the age limit should be increased to 17 or 18, which would bring it into line with the sale of alcohol.

The government is also looking at whether there should be tougher measures introduced at shops that sell cigarettes to under-age children. "Smoking is dangerous at any age, but the younger people start, the more likely they are to become life-long smokers and to die early," Health Minister Caroline Flint said.

"Someone who starts smoking aged 15 is three times more likely to die of cancer due to smoking than someone who starts in their late twenties." The government said about 9 percent of children aged between 11 and 15 smoke. Raising the age limit to the same required to buy alcohol would bring Britain into line with the likes of Canada, Australia and the United States.

It is also pondering new sanctions including banning shops that regularly sell cigarettes to children from being allowed to sell tobacco at all. The DoH said there was evidence that nearly 70 percent of underage smokers bought cigarettes from small local shops and newsagents.

"Access to cigarettes by under-16s is not as difficult as it should be and this is partly due to retailers selling tobacco to those under the legal age," Flint said. "If a particular shop is known locally as the place for children and teenagers to easily buy tobacco, we want to stop that shop selling it."

Anti-smoking campaign groups welcomed the proposals but warned they might not have much effect. "I don't think it will affect the number of young smokers as children smoke because it is seen as an adult habit, so in a way you are giving children even more incentive to start," Ian Willmore, of Action on Smoking and Health (Ash) told the BBC.

The consultation comes after MPs voted in February to ban smoking in pubs, restaurants and work places from the middle of next year.

The ban has already been introduced in Scotland and Ireland. 3.7.06