Dr Brent Caldwell
“There's a real need to find better ways to stop the high failure rate by hitting the urge to light up.”
In spite of years of education campaigns and steadily rising tobacco prices, 22 per cent of New Zealand's adult population continue to smoke, a figure that has not changed significantly in two decades. In some groups these figures are higher, with nearly 50 per cent of Māori still smoking. Between 4,500 and 5,000 people die from tobacco-related illness in New Zealand every year.
Recent increases in the excise tax on tobacco and focus on the Māori Affairs Select Committee inquiry into tobacco have brought extra urgency to research at the University of Otago, Wellington, into ways of helping smokers quit through the use of nicotine replacement therapy.
“We've been trialling new methods of nicotine replacement therapy to be used in addition to those which are currently available through the government-funded Quit programme,” says Dr Brent Caldwell (Department of Medicine).
“The problem is that some people still feel the sudden urge to smoke even when they use the free nicotine patches or gum. The other big issue is that only about 10 per cent of smokers who try to quit stay smoke-free long-term. There's a real need to find better ways to stop the high failure rate by hitting the urge to light up.”
So far, the results of Caldwell's research have been encouraging. He has found two nicotine replacement products in the form of tea-bag-like sachets, by which the nicotine is absorbed through the side of the mouth, and which are preferred by many smokers to nicotine gum.
“We investigated 63 smokers and provided two types of sachets: a Swedish product called Snus, which is essentially oral tobacco, and a synthetic product, Zonnic, which contains pure nicotine, but flavoured to make it more palatable,” he says.
“We found that 40 per cent of the smokers preferred Zonnic, 40 per cent Snus and 20 per cent nicotine gum in assisting tobacco withdrawal over six weeks.”
The researchers were pleased to find that smoking was also reduced by 42 per cent for Zonnic users, 37 per cent with Snus and 33 per cent with gum. The results of this pilot study have been published in Nicotine and Tobacco Research.
Smokers have also shown strong interest in a second trial using a peppermint-flavoured nicotine mouthspray. Currently more than 500 smokers have been recruited in Wellington and Christchurch to use the mouthspray in addition to nicotine patches, and a further 500 smokers are invited to take part over the next six months. Kokiri Marae Health and Social Services is also about to start a study centre and enrol a further 500 people at Seaview and Porirua.
“The response has been excellent. There's a huge unmet demand out there among people who are desperate to stop smoking and they seem to really like the spray,” Caldwell says. “The mouthspray method appears to be very good in suppressing the urge to light up because it works so quickly.”
Caldwell and colleague Professor Julian Crane are now planning a third study, using inhalers similar to those used to deliver asthma medication to the lungs – potentially an even more effective nicotine hit. They are now working with New Zealand pharmaceutical company Argenta to make the aerosols, which will be a world-first in smoking cessation drug development.
The hope is that this new arsenal of approaches will improve the long-term quitting rates of addicted smokers in New Zealand.
Funding
- Health Research Council