US Nicotine Addiction Reaches 15...( Modified Smoking Ces...),Health

Modified Smoking Cessation Strategy Needed

PHILADELPHIA, Oct. 28 /PRNewswire/ -- Nicotine dependence has reached a 15-year high, with nearly 75 percent of people currently seeking tobacco-dependence treatment categorized as highly nicotine dependent. New research, presented at CHEST 2008, the 74th annual international scientific assembly of the American College of Chest Physicians (ACCP), reports that nicotine dependence severity has increased 12 percent between 1989 and 2006, while the proportion of people classified as highly nicotine dependent has increased 32 percent.

The study's lead author, David P. Sachs, MD, of the Palo Alto Center for Pulmonary Disease Prevention, was not surprised by the findings. "After treating tobacco-dependent patients for the last 25 years and conducting many tobacco dependence clinical treatment trials, I began to see a shift in severity of physical, nicotine dependence that required me to develop more intensive treatment plans for my patients," he said.

Dr. Sachs joined forces with colleagues from the Palo Alto Center for Pulmonary Disease Prevention in Palo Alto, CA and St. Helena Hospital in Napa, CA, to identify if there had been a true shift in nicotine dependence in the last 15 years. To do this, they compared pretreatment nicotine dependence severity, as measured by the Fagerstrom Tolerance Questionnaire (FTQ) scale (0 to 11 points), in three different cohorts from 1989 to 2006: (1) Nicotine Patch Study (NPS), n=220, enrolled December 1989 through April 1990; (2) Bupropion SR Study (BSRS), n=206, enrolled September 1994 through December 1994; and (3) St. Helena Hospital Center for a Smoke-Free Life (CSFL), n=204, enrolled February 2005 through October 2006.

The analysis showed that pretreatment FTQ scores increased by 12 percent over the 15-year study period: 1989 (NPS), 6.65+/-1.72; 1994 (BSRS), 7.02+/- 1.80; and 2006 (CSFL), 7.44+/-1.80. Also, the proportion of patients with a
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