New pathways for treating never-smoker lung cancer revealed

Precision medicine characterization through integration of genomic, transcriptomic, proteomic, and clinical data

NATIONAL RESEARCH COUNCIL OF SCIENCE & TECHNOLOGY

 

IMAGE: 

(LEFT) DISTRIBUTION OF GENDER AMONG NEVER-SMOKING LUNG CANCER PATIENTS ANALYZED IN THIS STUDY WITH PREDOMINANCE OF FEMALES.
(MIDDLE) SCREENING RESULTS FOR GENETIC MUTATIONS IN NEVER-SMOKING LUNG CANCER PATIENTS, SHOWING 15% OF PATIENTS WITH UNIDENTIFIED MUTATIONS IN LUNG TISSUE. A TOTAL OF 101 TISSUE SAMPLES UNDERWENT GENOMIC AND PROTEOMIC ANALYSIS.
(RIGHT) MOLECULAR CHARACTERIZATION OF KOREAN NEVER-SMOKING LUNG ADENOCARCINOMA USING MULTI-OMICS ANALYSIS.

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CREDIT: KOREA INSTITUTE OF SCIENCE AND TECHNOLOGY(KIST)

The primary cause of lung cancer is smoking. However, the incidence of lung cancer among never-smokers has been steadily increasing, especially among women. While approximately 80% of never-smoking lung cancer patients are prescribed targeted therapies that focus on mutations in proteins such as EGFR and ALK, the remaining patients often receive cytotoxic chemotherapy with high side effects and relatively low response rates, highlighting the urgent need for targeted therapies.

Dr. Lee Cheolju's team at the Chemical Life Convergence Research Center at the Korea Institute of Science and Technology (KIST), along with Dr. Kim Seon-Young's team at the Korea Research Institute of Bioscience and Biotechnology and Dr. Han Ji-Youn's team at the National Cancer Center, have elucidated the overexpression of estrogen signaling pathways in specific Korean never-smoking lung cancer cases using multi-omics analysis and proposed the anti-cancer drug saracatinib as a targeted therapeutic agent. Multi-omics integrates various molecular information, with proteomics presenting a particular challenge due to the need to analyze small amounts of proteins without loss, typically microgram-scale.

The research team obtained tissue samples from 101 Korean never-smoking lung cancer patients without identified treatment targets among 1,597 patients who visited the National Cancer Center over the past decade and distributed clinical information, genomic, transcriptomic, proteomic, and phosphoproteomic data to each omics analysis method for mutual referencing. Particularly, proteomic analysis measured an average of over 9,000 proteins and 5,000 phosphorylated proteins per sample using only 100 μg of protein, which is 10% of the amount required for conventional protein analysis, using isotopic labeling techniques.

Analysis of genetic mutations and cellular signaling pathways revealed that driver mutations of genes known to be associated with cancer, such as STK11 and ERBB2, were observed in the tissues of never-smoking lung cancer patients. Additionally, while the estrogen signaling pathway was found to be overexpressed, there were no significant changes in estrogen hormone receptors. Based on this, saracatinib, a sub estrogen signaling transduction protein inhibitor, showed statistically significant (p<0.01) cell death effects when applied to cells with mutations in STK11 and ERBB2 compared to the control group without such mutations.

Building on this, the research team is developing a molecular diagnostic technique for discriminating patients with specific expression of estrogen signaling pathways among never-smoking lung cancer patients. Additionally, they plan to conduct preclinical trials of saracatinib's therapeutic effects on never-smoking lung cancer animal models in collaboration with the National Cancer Center.

Dr. Lee Cheolju of KIST stated, "This successful case of discovering new therapeutic targets for refractory cancer through multi-omics analysis is based on purely domestic research and the collaborative efforts of hospitals and research institutions, which holds significant meaning. Building on this experience, we will lead the expansion of multi-omics research on human diseases."

Representative Features and Identification of Mutant Genes in Patients with Unidentified Mutations 

(Left) Increased expression of genes associated with estrogen hormone response observed in tissues from patients with unidentified mutations in both genetic and protein analyses.
(Right) Patients with driver mutations in STK11 and ERBB2 show significant differences in smoking history, and high estrogen response shows similar results to known KRAS mutations.

(Left) Validation of proteins associated with estrogen response using tissue immunostaining, identifying Saracatinib as the most effective drug in inhibiting the expression of related proteins using public bio big data and cross-analyzing its mechanism with genetic expression in Korean never-smoking lung cancer patients to predict positive anticancer effects.
(Right) Selection of cell lines with mutations identical to those found in patients among lung cancer cell lines, treated with Saracatinib alongside a control group without these mutations, demonstrating excellent anticancer effects from low to high concentrations and confirming the anticancer effects of Saracatinib.

CREDIT

Korea Institute of Science and Technology(KIST)

KIST was established in 1966 as the first government-funded research institute in Korea. KIST now strives to solve national and social challenges and secure growth engines through leading and innovative research. For more information, please visit KIST’s website at https://eng.kist.re.kr/

This research was supported by the Ministry of Science and ICT, Korea, under the KIST's main projects and the Bio-Medical Technology Development Program (2022M3H9A2096187). The research results have been published online in the latest issue of the international journal Cancer Research (IF 11.2, JCR field 10.6%).

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JOURNAL

Cancer Research

DOI

10.1158/0008-5472.CAN-23-1551 

ARTICLE TITLE

Proteogenomic Characterization Reveals Estrogen Signaling as a Target for Never-Smoker Lung Adenocarcinoma Patients without EGFR or ALK Alterations

Ban on disposable vapes would affect one in seven young adults in Great Britain

A ban on disposable vapes, currently being considered by the UK Government, would affect one in seven young adults (aged 18-24) in Great Britain, and one in 20 adults overall, according to a new study led by UCL researchers.

Peer-Reviewed Publication

UNIVERSITY COLLEGE LONDON

A ban on disposable vapes, currently being considered by the UK Government, would affect one in seven young adults (aged 18-24) in Great Britain, and one in 20 adults overall, according to a new study led by UCL researchers.

The study, funded by Cancer Research UK and published in the journal Public Health, looked at survey responses from 69,973 adults in England, Wales and Scotland between January 2021 and August 2023.

The researchers found the proportion of adults using disposable e-cigarettes rose from 0.1% to 4.9% during that period. The increase was particularly pronounced among 18- to 24-year-olds, with 14.4% using disposable vapes in 2023, as well as among smokers (16.3%) and people who had stopped smoking in the past year (18.2%).

Use among people who had never regularly smoked was relatively rare (1.5%) but was higher among 18- to 24-year-olds, of whom 7.1% used disposable e-cigarettes and had never regularly smoked tobacco.

Lead author Dr Sarah Jackson (UCL Institute of Epidemiology & Health Care), said: “Our study suggests a ban on disposable e-cigarettes would affect an estimated 2.6 million people in England, Wales and Scotland.

“This group includes about 316,000 18- to 24-year-olds who currently use disposables but who have never regularly smoked tobacco. However, it also includes 1.2 million people who currently smoke and would benefit from switching to e-cigarettes completely, and a further 744,000 who previously smoked and may be at risk of relapse.

“While banning disposables might seem like a straightforward solution to reduce youth vaping, it could have substantial unintended consequences for people who smoke.

“In the event of a ban, it would be important to encourage current and ex-smokers who use disposables to switch to other types of e-cigarettes rather than going back to just smoking tobacco.

“In addition, we found disposable use to be particularly prevalent among recent ex-smokers with a history of mental health conditions. This group may require targeted support to help them avoid relapse.”

The research team used data from the Smoking Toolkit Study, in which a different sample of 2,450 adults in Great Britain (who are representative of the general population) are interviewed each month.

They found disposable e-cigarette use was significantly higher among adults living in England than Wales or Scotland (5.3% vs. 2.0% and 2.8% at the end of the study period) and among those from less (vs. more) advantaged social grades (6.1% vs. 4.0%), those with (vs. without) children (6.4% vs. 4.4%), and those with (vs. without) a history of mental health conditions (9.3% vs. 3.1%).

Until recently, the researchers noted, very few adult vapers in Great Britain used disposables, but in 2021 new disposable e-cigarettes entered the market with designs and branding that appealed to young people, causing use of disposables to quickly rise in the UK and elsewhere. These products are available widely, for instance in corner shops, and are promoted via colourful in-store displays.

While they are convenient to use, with a very low upfront cost, they have also become an environmental problem, with millions of the devices reportedly thrown away in the UK each week.

Senior author Professor Jamie Brown (UCL Institute of Epidemiology & Health Care), said: “There is a need for action to reduce disposable vaping among young people who have never smoked. However, trade-offs need to be carefully considered. A ban may discourage use of e-cigarettes among people trying to quit smoking and may induce relapse among those who have already used disposables to quit. Cigarettes are far more harmful to our health and are not currently banned and a ban on disposable e-cigarettes may signal to large numbers of people that these products are worse for our health or that their harm is comparable to that caused by smoking tobacco. I favour a range of alternative policies, in the first instance, allied with rapid evaluation to judge whether these are sufficient to achieve reductions in youth vaping.”

In the paper, the researchers outlined other measures to strengthen the regulation of disposable vapes that had a reduced risk of unintended consequences, such as causing relapse among ex-smokers.

These included prohibiting branding with appeal to children (e.g., bright colours, sweet names, and cartoon characters), prohibiting promotion of e-cigarettes in shops, putting e-cigarettes out of sight and reach of children, and putting an excise tax on disposables to raise the price to the same level as the cheapest reusable e-cigarettes. Defining disposables may prove problematic so a minimum unit price may be more a straightforward alternative to reduce their affordability and is something that could be implemented quickly.

The researchers noted that their data might under-estimate prevalence of disposable vape use. This is because survey respondents were asked which type of e-cigarette they mainly used, so people who used disposables as a secondary product were not captured.

In addition to Cancer Research UK, the study received support from the UK Prevention Research Partnership.

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JOURNAL

Public Health

DOI

10.1016/j.puhe.2023.12.024 

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Who would be affected by a ban on disposable vapes? A population study in Great Britain

ARTICLE PUBLICATION DATE

24-Jan-2024

Avoiding cloudy messaging: Vape prevention campaigns face challenges

Flinders University researchers say that cohesive and collaborative action from preventive health communicators and organisations is needed to inform young people about the devastating harms of vaping.

Peer-Reviewed Publication

FLINDERS UNIVERSITY

 

IMAGE: 

VAPING PREVENTION HEALTH COMMUNICATION CAMPAIGN EXAMPLE MATERIALS: (A) NSW HEALTH CAMPAIGN MEDIA AND TOOLKIT, ADAPTED, BASTION AGENCY; (B) LUNG FOUNDATION AUSTRALIA CAMPAIGN, ADAPTED, SABIO AGENCY AND (C) US FOOD AND DRUG ADMINISTRATION CAMPAIGN, ADAPTED, FDA RESOURCE LIBRARY.

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CREDIT: HEALTH PROMOTION INTERNATIONAL -HTTPS://ACADEMIC.OUP.COM/HEAPRO

Flinders University researchers say that cohesive and collaborative action from preventive health communicators and organisations is needed to inform young people about the devastating harms of vaping.

“Despite awareness of the potential harms, recreational vaping is increasing among younger people with our South Australian participants seeing vaping as ‘cleaner’ and less harmful than cigarettes,” says Flinders University’s Dr Joshua Trigg.

“We know that nicotine vapes are highly addictive and expose people to harmful chemicals, respiratory irritants, and toxic substances.  In order to discourage young people from picking up a vape, we need to understand what messaging they will best respond to,” says Dr Trigg.

Vapes, or e-cigarettes, are lithium battery-powered devices that heat liquids containing solvents, nicotine, flavourings and other chemicals, volatile compounds, and ultrafine particles into an aerosol that are inhaled into the lungs.

Flinders University researchers investigated the impact of different vaping prevention public health media campaigns among young South Australians aged 16–26 years to help determine what will work best in vaping risk messaging.

Participants of the study were shown example materials from three vaping prevention campaigns and resource  sets: ‘The Real Cost, ‘Do you know what you’re vaping’ and ‘Unveil what you inhale’ to assess whether they were easily understood, appropriate, relevant, credible and effective.

“We know that health communication campaigns are an established tool for emphasising the dangers associated with vaping.  By studying the impact of these campaigns more closely, we can improve future messaging to reduce and deter the use of vapes by young people,” he says.

Those who do vape and those who don’t, reacted in different ways to the campaigns. Those who didn’t already vape responded better to explicit messaging and shock tactics about the health risks associated with vaping.  Whereas those who already vaped responded better to information challenging the notion that vapes are healthier than smoking cigarettes.

“We found that young people are likely to engage more with campaigns that consider the real life experiences, social contexts, and negative consequences associated with vaping.  These experiences drew more interest and were more thought provoking to young South Australians,” Dr Trigg says.

“Bright visual design elements that represented health and wellbeing drew the attention of both groups of young people, with participants reiterating the benefits of using online and media resources to deliver preventative media campaigns. Campaigns now tend to adopt a ‘mobile first’ design approach, to target their audiences where they consume media” he says.

“In future, it is important that vaping prevention messaging considers those who already vape and those who do not, and clearly address the potential dangers and side-effects of inhaling a combination of chemicals.  Young people need to understand that nicotine vaping is not a risk-free alternative to smoking cigarettes,” he adds.

The research – “Vaping harms awareness messaging: exploring young South Australians’ responses to vaping prevention campaign materials”, by Joshua Trigg, Ola Ela, Jacqueline Bowden, Ashlea Bartram, Clinton Cenko, and Billie Bonevski – has been published in the journal Health Promotional International. https://doi.org/10.1093/heapro/daad145

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JOURNAL

Health Promotion International

DOI

10.1093/heapro/daad145 

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Vaping harms awareness messaging: exploring young South Australians’ responses to vaping prevention campaign materials

It’s time to address the high rate of Australians with disabilities addicted to smoking

Peer-Reviewed Publication

FLINDERS UNIVERSITY

According to a new analysis, almost a quarter of Australians with disabilities smoke when compared to just 12.6% of the wider population.

While the number of Australians smoking is declining, the barriers for people with disabilities mean targeted support is needed to develop healthier habits.

Flinders University and Cancer Council NSW health experts are recommending new strategies to tackle the alarming smoking rate through targeted government policies, data collection on smoking and training for disability support workers on tobacco prevention strategies.

The experts have assessed strategies that can address increased risk factors that result in higher rates of smoking among people with disabilities. These include socioeconomic challenges that make nicotine replacements unaffordable such as higher unemployment and living on income support.

Physical restrictions and a shortage of trained professionals to support their efforts to quit make the challenge even harder, according to the researchers.

Cancer Council NSW Tobacco Cessation Coordinator and lead author of the paper, Tiana Vourliotis, said a comprehensive approach including smoking cessation services, co-designed programs, and targeted policy initiatives is imperative to reduce the prevalence of tobacco use.

Published in the Australian & New Zealand Journal of Public Health, the researchers recommend innovative prevention strategies that can close the disparity in smoking rates, including:

• Offering support to stop smoking within disability services
• Training for healthcare providers and support workers on effective strategies
• Consistent policy across Australian states
• Further collection of smoking data

Flinders Health and Medical Research Institute Director and study co-author, Professor Billie Bonevski, says the decrease in the numbers of people who smoke in Australia is not consistent across the whole of society and there remains a significantly higher smoking prevalence among people experiencing social, economic, or cultural disadvantage.

 

“People with disabilities encounter various obstacles, including lower socioeconomic status, unemployment, and difficulties accessing affordable quit-smoking support. Physical barriers and a shortage of trained professionals make the challenge even greater, hindering their ability to quit smoking,” says Professor Bonevski.

“Despite these big challenges, we know that informed policymaking and a dedication to positive health outcomes can drive meaningful reductions in smoking rates for people with disabilities.”

The federal government last year introduced new laws aimed at curbing smoking and addiction to tobacco in Australia using health warnings on packaging.

But this research has recognised the importance of providing choice for people with disabilities with the aim of fostering supportive environments for quitting, particularly in health and residential settings where they reside.

“Our commitment to addressing high smoking rates among people with disabilities in Australia can set a precedent for global efforts when it comes to developing targeted strategies and paving the way for a healthier future for the entire population.”

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JOURNAL

Australian and New Zealand Journal of Public Health

DOI

10.1016/j.anzjph.2023.100110. 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

People

ARTICLE TITLE

High tobacco smoking rates in people with disability: An unaddressed public health issue

ARTICLE PUBLICATION DATE

1-Feb-2024

 

E-cigarettes are not a gateway into smoking

Peer-Reviewed Publication

QUEEN MARY UNIVERSITY OF LONDON

The most comprehensive study to date investigating whether e-cigarettes are a gateway into or out of smoking finds that, at the population level, there is no sign that e-cigarettes and other alternative nicotine delivery products promote smoking.

The study, led by Queen Mary University of London and funded by the National Institute of Health and Care Research (NIHR), also found some evidence that these products compete against cigarettes and so may be speeding up the demise of smoking, but this finding is only tentative and more data are needed to determine the size of this effect.

The study compared the time course of use and sales of electronic cigarettes with that of smoking rates and cigarette sales in countries with historically similar smoking trajectories, but differing current e-cigarette regulations. It compared the United Kingdom and United States with Australia, where sales of nicotine containing e-cigarettes are banned. It also looked at interactions between smoking and nicotine alternatives that are popular in other countries, including the use of oral nicotine pouches in Sweden and products that heat rather than burn tobacco in Japan and South Korea where they are widely used.

The decline in smokers in Australia has been slower than in the UK, and slower than in both the UK and the USA among young people and in lower socioeconomic groups. The decline in cigarette sales has also accelerated faster in the UK than in Australia. The increase in heated tobacco product sales in Japan was accompanied by a significant decrease in cigarette sales.

Researchers note that because people may use both cigarettes and alternative products, prevalence figures for these products overlap, and so longer time periods are needed to determine any effects of exclusive use of the new products on smoking prevalence. They also say that the indications that alternative nicotine products are replacing smoking – especially the size of this effect – need to be confirmed when more data become available. As further prevalence and sales data emerge, the analyses will become more informative.

Professor Peter Hajek, Director of Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, said:

"The results of this study alleviate the concern that access to e-cigarettes and other low-risk nicotine products promote smoking. There is no sign of that, and there are some signs that they in fact compete against cigarettes, but more data over a longer time period are needed to determine the size of this effect."

Co-author, Professor Lion Shahab, Co-Director of the UCL Tobacco and Alcohol Research Group, said:

"This comprehensive analysis provides reassurance that countries which have adopted a more progressive stance towards e-cigarettes have not seen a detrimental impact on smoking rates. If anything, the results suggest that - more likely than not - e-cigarettes have displaced harmful cigarettes in those countries so far. However, as this is fast moving field, with new technologies entering the market every year, it remains important to continue monitoring national data."

Professor Brian Ferguson, Director of the Public Health Research Programme (NIHR) commented: 

"The initial findings from this study are valuable but no firm conclusions can be drawn yet. More research is needed in this area to understand further the impact that alternative nicotine delivery products, such as e-cigarettes, might have on smoking rates.”

This research, published in the journal Public Health Research, was funded by the National Institute for Health and Care Research. 

END

NOTES FOR EDITORS

• Pesola F, Phillips-Waller A, Beard E, Shahab L, Sweanor D, Jarvis M, Hajek P. Effects of reduced-risk nicotine-delivery products on smoking prevalence and cigarette sales: the GIRO observational study. Public Health Res 2023;11(XX). https://doi.org/10.3310/RPDN7327
• For more information on this release, to receive a copy of the paper or to speak with the researcher, please contact Laurence Leong in Queen Mary’s press office: l.leong@qmul.ac.uk

About Queen Mary University of London

At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable.

Throughout our history, we’ve fostered social justice and improved lives through academic excellence. And we continue to live and breathe this spirit today, not because it’s simply ‘the right thing to do’ but for what it helps us achieve and the intellectual brilliance it delivers.

Our reformer heritage informs our conviction that great ideas can and should come from anywhere. It’s an approach that has brought results across the globe, from the communities of east London to the favelas of Rio de Janeiro.

We continue to embrace diversity of thought and opinion in everything we do, in the belief that when views collide, disciplines interact, and perspectives intersect, truly original thought takes form.

About UCL – London’s Global University

UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world's best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

We are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

www.ucl.ac.uk | Follow @uclnews on Twitter | Read news at www.ucl.ac.uk/news/ | Listen to UCL podcasts on SoundCloud | Find out what’s on at UCL Minds

About the University of Ottawa 

Rooted in our bilingual and Francophone DNA, we are evolving at the intersection of many cultures. Located in Canada’s capital, a gateway to the world, we possess a unique platform to respond with energy, creativity, and scale to the global challenges and opportunities our world offers. With an active focus on equity, diversity, and inclusion, we will thrive like never before. 

Already in this new millennium we have rocketed into the top 1% of the world’s 20,000+ universities with our research reputation. We have doubled our enrolment with students from across Canada, as well as from 147 countries around the globe, choosing uOttawa. 

Our international influence is surging, with institutional partnerships in Europe, Asia and Africa multiplying rapidly – including membership in the U7 Alliance of world universities. 

Meanwhile our research and programs in Cybertech, health, science, social justice, sustainability, education, and entrepreneurship continue to impact communities across Canada and around the globe every single day. Our scientists and academicians are driving progress in ethical AI and technology development, in clean growth and innovation and in action- oriented research on aging, active and healthy living, lifelong learning, and well-being, to name but a few. 

At uOttawa we are driven by the urge to challenge the status quo, the will to make an impact, and the ambition to become a catalyst for change.

About The National Institute for Health and Care Research (NIHR)

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:

· Funding high quality, timely research that benefits the NHS, public health and social care;

· Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;

· Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;

· Attracting, training and supporting the best researchers to tackle complex health and social care challenges;

· Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;

·  Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

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JOURNAL

Public Health Research

Researchers discover potential treatment for nicotine dependence

Theta-burst transcranial magnetic stimulation therapy may reduce cigarette cravings

Peer-Reviewed Publication

UNIVERSITY OF MISSOURI-COLUMBIA

New research from the University of Missouri School of Medicine suggests there may be another way to treat cigarette cravings. Researchers found that theta-burst transcranial magnetic stimulation (TBS) – strong, rapidly fluctuating magnetic field pulses that can affect brain activity – can lead to improved self-control, reduced cravings and as a result, less smoking.

People with nicotine dependence tend to have significant structural and functional differences in the brain, compared to healthy non-smokers. Smoking cigarettes has been shown to be associated with less grey matter, which means they have less neurons and other cells in the brain.

Research suggests these differences may affect inhibitory control (IC), which is our control over automatic urges and response to stimuli – what enables humans to stop an impulsive reaction to something.

“Having difficulties with IC may make it harder to avoid smoking when the urge arises, in response to all the cues and contexts in the environment that trigger the behavior to light a cigarette,” said lead author Brett Froeliger, PhD, professor of Psychiatry.

TBS refers to when magnetic pulses are applied to the brain in bursts of three and come in two forms: continuous TBS (cTBS) and intermittent TBS (iTBS). cTBS consists of applying these three bursts repeatedly for 40 seconds, whereas iTBS applies the same number of pulses irregularly for more than 190 seconds.

Magnetic stimulation has been used to treat other mental illnesses and disorders. cTBS has been experimentally tested to treat generalized anxiety disorder, whereas iTBS to the left dorsolateral prefrontal cortex – a part of your brain responsible for cognitive processes – is FDA-approved for treating major depressive disorder.

The study involved 37 participants, mostly in their late 40’s, and examined the effects of both cTBS and iTBS to the right inferior frontal gyrus, a brain region heavily involved with IC. Researchers found that cTBS improved IC, whereas both cTBS and iTBS reduced cravings and, subsequently, smoking.

“Identifying treatments that improve IC may help reduce smoking and can potentially help with preventing relapse following when a person attempts to quit smoking,” Froeliger said. “Treatments that improve IC may also help disrupt the cycle of drug use among individuals with other substance use disorders; however, further research is needed to examine the clinical value of TBS for treating substance use disorders.”

“Effects of Hyperdirect Pathway Theta-Burst Transcranial Magnetic Stimulation on Inhibitory Control, Craving, and Smoking in Adults with Nicotine Dependence: A Double-Blind Randomized Crossover Trial” was recently published in Biological Psychiatry CNNI.

In addition to Froeliger, study authors include Muaid Ithman, MD, associate professor of clinical psychiatry; MU PhD student Spencer Upton; TBS technician and data analyst Alexander Brown and other researchers from the University of South Carolina and Stanford University. The authors claim no conflicts of interest.

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JOURNAL

Biological Psychiatry

DOI

10.1016/j.bpsc.2023.07.014 

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Effects of Hyperdirect Pathway Theta-Burst Transcranial Magnetic Stimulation on Inhibitory Control, Craving, and Smoking in Adults with Nicotine Dependence: A Double-Blind Randomized Crossover Trial

UK

Swap-to-stop’ but let us shop - say vapers

Peer-Reviewed Publication

UNIVERSITY OF EAST ANGLIA

A Government scheme to give out free vapes to smokers appeals to most but not all, according to new research from the University of East Anglia (UEA).

The 'Swap-to-Stop' scheme was announced earlier this year - providing a million e-cigarettes to disadvantaged people who smoke.

A new study published today supports the scheme, with people who vape saying that this type of approach might have helped them if it had been available when they attempted to quit.

But the research also shows that accessing vapes via the NHS might not be appealing to everyone, because some people don't see e-cigarettes as treatments but more as consumer products that they can shop for themselves.

The team says there is a place for both commercial and medical routes to vaping for quitting smoking to satisfy people's personal preferences.

Lead researcher Dr Emma Ward, from UEA’s Norwich Medical School, said: “The vast majority of people who have quit smoking via vaping will have done so without any support from healthcare professionals.

“However, using vapes to quit smoking has been supported by the NHS and there are guidelines for healthcare professionals to support patients looking to quit smoking with vaping.

“In April 2023, the Government announced a 'Swap-to-Stop' scheme – to help achieve its Smokefree 2030 target of less than 5 per cent of people smoking in England by 2030.

“The scheme will be the biggest Government supported stop smoking scheme to date using e-cigarettes. The scheme will use vaping products that are also available to buy commercially.

“We wanted to better-understand how well it might work.”

The team interviewed 136 people from across the UK – nearly all of whom had quit smoking via vaping.

They asked them how helpful they would have found e-cigarettes being provided by the NHS when they were attempting to quit. They also asked for their views on different ways to access vaping for quitting smoking.

Dr Ward said: “Our research shows that people who quit smoking using commercially purchased vapes believe they might have benefitted from the NHS providing e-cigarettes and support if it had been available to them when they were quitting.

“Vaping being available via healthcare professionals offers reassurance around the effectiveness of e-cigarettes in helping people quit smoking and potential harms.

“However, it is unlikely that one type of e-cigarette will suit everyone seeking to quit and our research highlights how important being able to choose vaping products in a commercial environment is for some quitters.

“People who vape believe they have benefited from being able to choose vaping products in shops to get the right mix of device and flavours to work best for them to help them to permanently stop smoking.

“Even those who do achieve success with vapes given to them by the NHS are likely to continue to use shops to buy ongoing vaping supplies.

“So, we argue that there is a place for both commercial and medical routes to vaping to help people stop smoking.”

This research was carried out in collaboration with London South Bank University. It was funded by Cancer Research UK.

‘Medicalisation of Vaping in the UK? E-cigarette users’ perspectives on the merging of commercial and medical routes to vaping’ is published in the journal Perspectives in Public Health.

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JOURNAL

Perspectives in Public Health

METHOD OF RESEARCH

Survey

SUBJECT OF RESEARCH

People

ARTICLE PUBLICATION DATE

7-Aug-2023

SILVER LINING

The health risks of COVID-19 spurred more smokers to quit

New UC San Diego Rady School of Management study is first to track smoking behavior at the individual level during the pandemic

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - SAN DIEGO

 

IMAGE: SALLY SADOFF, THE RAFAEL AND MARINA PASTOR CHANCELLOR’S RADY SCHOOL OF MANAGEMENT ENDOWED FACULTY FELLOWSHIP AND ASSOCIATE PROFESSOR OF ECONOMICS AND STRATEGY. view more 

CREDIT: UC SAN DIEGO'S RADY SCHOOL OF MANAGEMENT

Being a smoker makes it more likely for a person to have severe COVID-19 symptoms, require hospitalization or die, which may explain a sharp decrease in smoking behavior among the Danish population during the pandemic, according to new research.

The study from the University of California San Diego’s Rady School of Management. reveals that cigarette purchases among regular smokers decreased by about 20-30% and quitting rates increased by about 10 percentage points from March 2020 to January of 2021. Regular smokers not only purchased cigarettes less frequently, they also cut down on the quantity.

“The pandemic led to reductions in physical activity, increases in stress and declines in mental well-being, all factors commonly associated with triggering higher tobacco use; however, we find evidence of sustained decreases in smoking, which could be a bright spot in the pandemic,” said Sally Sadoff, corresponding author of the study and associate professor of economics and strategy at the Rady School of Management. “The health risks associated with COVID-19 and smoking may help some smokers overcome a key barrier to quitting – that the enjoyment of smoking is felt in the present and health costs are usually felt in the future.”

The paper published in the journal Communications Medicine, shows that declines in smoking were sustained for at least the first year of the pandemic and quitting rates lasted at least six months. These findings suggests COVID-19 may lead to a persistent decline in smoking.

In Denmark, about 17% of the population smokes and in the U.S., about 12.5% percent of the population are smokers.

“Though we cannot make an apples-to-apples comparison to the U.S. due to data limitations, we suspect there was a decline in smoking in this country and others during the same time period,” Sadoff said.

This study is the first to utilize cigarette sales data for both smokers and non-smokers during the pandemic, rather than survey information. The data in the study were made available through Spenderlog, an app that allows users to track their spending on groceries.

Sadoff and co-authors analyzed the grocery purchasing data of 4,042 Danish residents who use the Spenderlog app. The sample is largely representative of the Danish population in terms of age, ethnicity, socioeconomic status and education level.

The researchers find that weekly cigarette purchase rates declined by 24% and average quantities declined by 12% between March 2020 and the end of that year.

However, the data also reveals that social smoking had a slight increase during this same time.

“Contrary to some assumptions, social distancing was not reason there was a drop in smoking because our data reveals that regular smokers, those more likely to smoke alone and those at the highest health risk from smoking, had the strongest reaction to the threat of COVID-19,” Sadoff said.

She continued, “If the decline in smoking we document persists, not only could it help decrease the risks from COVID-19 as new variants emerge, but also have meaningful, longer-term benefits on population health and life expectancy beyond the pandemic.”

The paper “Sustained decline in tobacco purchasing in Denmark during the COVID-19 pandemic” was co-authored by Toke R. Fosgaard of the University of Copenhagen and Alice Pizzo of the Copenhagen Business School.

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JOURNAL

Communications Medicine

DOI

10.1038/s43856-022-00160-1 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Sustained decline in tobacco purchasing in Denmark during the COVID-19 pandemic

ARTICLE PUBLICATION DATE

1-Aug-2022