Ellen Campbell-Grizzle - PHARMACY TODAYTHE WORLD Health Organisation (WHO) estimates that tobacco use accounted for more than four million annual deaths in 1998 and that the yearly figure will rise to 8.4 million deaths by 2020.
Despite these statistics, over one billion adults worldwide continue to smoke. Most tobacco use begins during childhood or adolescence. In the 2001 household survey commissioned by the National Council on Drug Abuse (NCDA), one out of every five persons aged 12 to 55, reported having used tobacco in the form of cigarettes, cigars or tobacco pipe. Of this 22 per cent of the population, 12 per cent are current users.
Males were four times more likely to smoke tobacco. The estimated use among age cohorts is one per cent at 12-17, eight per cent in the 18-24 year group and 19 per cent in the 35-33 group. Current use is 12 per cent in Central Jamaica, 12 per cent in the Western parishes and 11 per cent in the Eastern region. Comparative data indicate that Jamaican youth are being initiated into tobacco use at earlier ages than 10 years ago.
Against this backdrop, there is an urgent need in Jamaica and worldwide to stamp out tobacco use. Nicotine is the main addictive component of tobacco. It causes long-term human damage and financial burden. Second-hand smoke is a problem for non-smokers who also inhale the nicotine and cancer-causing tar. Asthmatic children who are exposed to tobacco smoke suffer more frequent attacks.
Data from Jamaica's treatment and rehabilitation centres confirm tobacco as a gateway drug to other addictions. There is now new hope that an effective nicotine vaccine will prevent and treat tobacco addiction. According to the results of a recent study, funded in part by the National Institute on Drug Abuse (NIDA), National Institutes of Health, this new method offers promise.
The purpose of the vaccine is to prevent nicotine from reaching the brain so as to reduce its effects and help keep people from becoming addicted. When injected in laboratory animals, the vaccine stimulates the immune system to produce proteins called antibodies that bind tightly to nicotine. The antibody-bound nicotine is too large to enter the brain, thereby preventing nicotine from producing its effects. The antibody-bound nicotine is eventually broken down to other harmless molecules.
"A nicotine vaccine may be useful for preventing and treating tobacco addiction because vaccinated persons would not be able get a 'kick' from the nicotine in tobacco smoke or chewing tobacco," says NIDA Director Dr. Alan I. Leshner.
A vaccine would expand the range of smoking cessation medication that is currently available. These include the nicotine patch, a type of trans-epidermal system designed to deliver nicotine into the blood stream. A nasal spray and inhaler have also been developed. In Jamaica, a gum is available without a prescription. All products work best when supported by therapeutic counselling and support groups. Other types of smoking cessation therapies are:
Bupropion an antidepressant that reduces effects of tobacco on brain tissue and reduces craving and withdrawal symptoms. It can be used together with nicotine replacement products.
Buspirone a tranquiliser that appears to be effective in helping smokers deal with feelings of anxiety resulting from tobacco withdrawal.
Alternative methods results from acupuncture and hypnosis are promising.
Nicotine is a very potent substance and interacts with many other drugs.
If you smoke, always let your doctor or pharmacist know. Set a date when you will quit smoking and get help from your physician to set up your programme. Your pharmacist can help you to adhere to your treatment. If you want to know more about how tobacco works to destroy your body and treatment options that are available in Jamaica, ask your pharmacist, you have the right to know!
Ellen Campbell-Grizzle, President, Caribbean Association of Pharmacists (CAP), Director, Information and Research, National Council on Drug Abuse; email: yourhealth@gleanerjm.com.
