Smoking rates

Rohsenow DJ, Monti PM, Colby SM, et al Naltrexone treatment for alcoholics effect on cigarette smoking rates. Nicotine Tob Res 5 231-236, 2003 Rose JE, Levin ED Concurrent agonist-antagonist administration for the analysis and treatment of drug dependence. Pharmacol Biochem Behav 41 219—226, 1991 Rose JE, Behm FM, Westman EC, et al Mecamylamine combined with nicotine skin patch facilitates smoking cessation beyond nicontine patch treatment alone. Clin Pharmacol Ther 56 86-99, 1994... 

Eigures 1 and 2 present the smoking rates among men and women globally (detaUs are in Table 1). Many observations can be made from these data. 

The smoking rates among adult women present a very different picture (Fig. 2). Less than 10% of women smoke in Africa and much of South-East Asia and China, and in only a few countries do more than 20% of women smoke (Russian Federation, most of Central and Western Europe, Turkey, New Zealand, Argentina, Venezula, and a few other Latin American countries). In general, smoking rates among women are closer to those among men in developed countries (42% men. 

Bupropion is an atypical antidepressant drug that is the only nonnicotine-based prescription medicine approved for smoking cessation by the FDA. Its mechanism of action is presumed to be mediated by its capacity to block neuronal reuptake of dopamine and/or norepinephrine (Fiore et al. 2000). Relative to other antidepressants, bupropion has a relatively high affinity for the dopamine transporter (Baldessarini 2001). There is also evidence that bupropion acts as a functional nicotine antagonist, suggesting another potential mechanism by which bupropion could reduce smoking rates (Slemmer et al. 2000). 

The U.S. study included mortality records from twelve chemical plants. In only two of those twelve plants was there any information about smoking, and in those two plants the smoking information was collected in the 1980s. To me, it is simply unimaginable that in a study that ended up focused on respiratory cancers so little information was obtained about smoking, which is associated with some 90 percent of respiratory cancer. In particular, there is no information about the smoking rates in men who died before the 1980s, who are, after all, the source of much of the data in a mortality study. 

However, the 2001 smoking rate of 25% is markedly decreased from the height of the smoking epidemic in 1965, when 42% of adults over 18 years old smoked. More than half of the smokers in the United States since the mid-1960s have quit. However, following years of steady decline, rates showed only modest declines in the 1990s. 

Of the more recently introduced methods for smoking cessation, bupropion (an antidepressant with dopaminomimetic properties) has recently been introduced. Clinical trial data, in which the nicotine patch, bupropion at 300 mg, and a combination of the two drugs were compared with placebo treatment, have shown cessation of smoking rates of 36% for the patch, 49% for bupropion and 58% for the combined treatments following 7 weeks of treatment. The placebo response rate was 23%. All subjects received relapse prevention therapy. Thus bupropion appears to be a reasonably safe and effective treatment for nicotine dependence. It is however contraindicated in those subject to epilepsy its main side effects are dry mouth and insomnia. 

Racial/ethnic identity also relates to smoking rates. Whites have the highest rates of the three groups in Table 7.2 in the 12-17 and 18-25 age groups, but Blacks have a slightly higher rate among those who arc 26 and older. 

Throughout the age ranges, men have higher smoking rates than women do. 

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