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Just found this on ABC Australia
‘Anti-smoking drugs linked to mental illness
Regulators are considering stronger warnings about popular anti-smoking drugs, with statistics revealing 400 psychiatric disturbances linked to the drug Zyban in recent years.
A Therapeutic Goods Administration (TGA) spokeswoman says the agency plans to update information given to consumers about Zyban and another drug, Champix.
Last week, US authorities last week ordered the manufacturers to place warnings inside the packets.
But public health expert professor Simon Chapman has told 702 ABC Sydney that smokers are more likely to have mental health problems to begin with.
“It may be that smoking’s something that people with mental health problems … do more than people who don’t smoke,” he said.
“So that population group is going to have a background of incidents of mental health problems and it could be that some of these reports are reports about mental health episodes that may have happened anyway.”
There is currently no warning for Champix on the TGA website.’
I’m chewing this over right now… but it’s the ‘health professional’s’ statement that’s got me thinking… however, if people will use phamaceutical grade nicotine there is also this report... which relates to Champix or Chantix in the US
I’m just surprised that they are surprised at this…..
just read the comments on the link at the WSJ, very scary when mixed with alcohol
How interesting to be informed that an ‘health expert’ that smokers are more likely to have mental health problems than non smokers. I wonder what empirical evidence there is to support that assertion.
I also wonder why it is that when it comes to the addiction of smoking, all the experts insist that abstinence is the only answer, but when it comes to alcohol and other drug addiction, including prescription drugs, we are told an entirely different story.
I wonder why it is that alcohol does not carry similiar warnings to the lurid messages seen on cigarette packages. I have yet to meet a smoker with brain damage, but I’ve lost count of the number alcoholics I’ve encountered who have very serious mental problems.
I’ve yet to encounter a smoker who engaged in criminal activity to fund their habit, but know of numerous others with other addictions who do, or did.
The dangers of passive smoking have been grossly exagerated if not distorted, As Professor Sir Richard Doll, the person who first established the link between smoking and lung cancer pointed out, “I do not mind people smoking in my presence, since the risk is so minimal when compared with the toxic substances that pervade the air we breathe” A statement that ASH sought to suppress.
By the way does anyone know of any person who’s death certificate attributes their cause of death to passive smoking? Does anyone know of people with emphysema or other respiratory illness which have been medically certified as attributed to passive smoking?
I would suggest that if the vast sums of money that have been spent on seeking to prevent smoking had been invested in abstinence focused treatment for those who are addicted to alcohol and other drugs, there would be considerably less mental health problems and crime than we currently experience in this country.
Smoking causes stroke, causes brain damage. Passive smoking has plenty of evidence to show it’s dangerous.
Thorax 1999;54:357-366) (for effect on kids)
And the meta analysis (looking at all the relevant publications) published in the Australian and New Zealand Journal of Public Health
(Volume 25(3); 203-211) in 2007 found “The abundance of evidence in this paper, and the consistency of findings across domestic and workplace primary studies, dosimetric extrapolations and meta-analyses, clearly indicates that non-smokers exposed to environmental tobacco smoke are at increased risk of lung cancer”.
We need to tackle smoking as an addiction as well as other addictions. It is unhelpful to suggest that passive smoking has been exaggerated.The tragedy in the fellowships where smoking is the norm that many folk in recovery from addiction will die as a result of addiction.
As for medication for addiction; disappointing really. No such thing as a free lunch really.
i recently attended a neuroscience conference in london run by the causeway treatment center.there was a prof from the dent center usa talking about how good this drug is. a pure salesman for the company who makes it. makes you wonder does it not i sat there couldn’t say a thing to him i was in some kind of shock a dr comming out with all that crap for money.well done for this blog
Thank you for your comments Androcles, and the citation regarding the dangers of passive smoking. Whilst I appreciate that any evidence to the contrary is unlikely to change your views, I bring to your attention the following exchange which took place in the European Parliament in June 2008. Godfrey Bloom asked the following written question:
“According to the Commission green paper ‘Towards a Europe Free From Tobacco’ more than 79,000 adults die in the EU per annum from the effects of Environmental Tobacco Smoke, (ETS) could the Commission name three or four people who died from ETS within the EU in the past two years?
The answer dated July 18 is quoted below.
“The nature of the epidemiological evidence on all risk factors be they chemical or other, is such that it does not allow to identify the victims at individual level but only populations.”
Bloom responded, “thank you for your response. For press purposes I can therefore take the answer ‘None’. I am only interested in facts not speculation by interested parties, either the Commission or the Tobacco Industry”. http://euobserver.com/9/26515
There is a twist to the above. Following the death of Mario Labate, an employee of the Commission, his widow claimed damages on the grounds that exposure to secondary smoke at work caused his death from lung cancer. Although he was employed by the Commission for 29 years, Mrs Labate was told that it was impossible to connect her husband’s illness with his duties and that her claim was manifestly unfounded.
So there we have it, passive smoking is the cause of death but not if one is employed by those who would have us believe that. Those, who are unable to offer any documented evidence to support their claim.
I wonder how strong the evidence is that passive smoking causes mental problems? Strong enough for a successful claim for damages?
My initial purpose in posting this was to show again the continued medicalisation of the “addiction” field Peele, Szasz and to some extent Alexander do a much better job on exposing this.
For me this article led me in this direction to ask again can and do drugs treat addiction? and are they safe.
Data and the models created out of that data allow some to become apologists for the pharma industry and the statement made by the ‘public health expert’ is a good example (even if its in a newspaper).
It was an easy potshot in linking side effects with Mental Health issues when these issues are well documnted under its other name of Wellbutrin. Its perhaps this use of the drug he’s referring to.We just have to be cleverer and clearer in our thinking about how drugs for addiction issues are presented within recovery and are they safe to use.
Thank you Alistair for your comment, I am inclined to agree your views regarding the way the pharmaceutical industry present the benefits of their products, whilst actively seeking to suppress their side affects..
It is highly unlikely that the ‘health expert’ who claimed that smokers have mental problems, or the professor John Gillen heard, made mention of the fact that in America, the smoking-cessation drugs varenicline (Chantix, Pfizer) and bupropion (Zyban, GlaxoSmithKline) must carry a boxed warning in their labelling that use of the drugs has been associated with serious mental health events, Nor is it likely that either of those gentlemen mentioned the fact that the drugs’ makers must also develop patient medication guides highlighting the risk for serious neuropsychiatric symptoms in patients who use the products. Reported symptoms include changes in behaviour, hostility, agitation, depressed mood, suicide ideation, and attempted suicide. http://www.medscape.com/viewarticle/705163
It seems to me that much of the so called research supporting the exaggerated claims of the damage caused by passive smoking has been funded by the pharmaceutical industry and those with vested interests, ideological or otherwise, therein.
Peter
this site may interest you:
http://www.fdable.com/aers/advanced_query/c00b9d7b425e
Thank you Alistair. Interesting reading indeed. Having studied the report it occurs to me that if smokers are concerned about their mental health as the anti smoking lobby would have us believe, smoking might be the ‘lesser of the evils.’
Whilst the link between smoking and lung cancer is indisputable, the grossly distorted manner in which that evidence has been presented as a reason for introducing a smoking ban, I.E, ‘90 percent of lung cancers are caused by smoking’ is shameful in its implication, which of course is that those who smoke are at a very high risk of developing lung cancer, whereas the medical studies show that only a small percentage of those who smoke actually develop it.
One of the largest studies on the link between smoking and lung cancer was carried out between 1993 and 2005 by International Early Lung Action Investigators and spanned the USA Europe, Israel, China and Japan. The study involved 31,567 asymptomatic persons considered at high risk for lung cancer. Initial screening by CT scanning was followed by repeat screening of 27,456 of these individuals, all of whom were 40 years or older and were current or former smokers, or had been exposed to second hand smoke, or had occupational exposure to asbestos, beryllium, uranium or radon.
Of the 27,000 plus, just 484 were shown to have lung cancer, of which 412 had clinical stage 1 lung cancer. (http://www.medscape.com/viewarticle/546661.)
In the light of that evidence I suggest it is apparent that not only is the risk of lung cancer among smokers far smaller than we have been led to believe, the likelihood of developing it from passive smoking is so infinitesimal that had it been taken into consideration by our legislators, the law depriving smokers of their rights under the EU’s Charter of human rights which in Article 20 states ‘Equality before the law, everyone is equal before the law, would never have been passed. The anti smoking lobby have, through continuous misrepresentation of medical and scientific evidence, managed to usurp that right for smokers and succeeded in ostracising them.
Now if that isn’t bad enough, guess who sponsored a closed conference organised by the Smoke Free Partnership in Brussels last year calling for an outright ban on smoking? The answer is the pharmaceutical company who manufacturers the anti smoking drug which now carries mental health warnings, Pfizer.
Who led the conference? No less a person than Avril Doyle, leader of the Fine Gael group of MEPS who stated that whilst she has never favoured a ‘nanny state’, or the over regulation of our citizens dictating to anyone on what anyone can or cannot do, the one area she was willing to make an exception in was smoking.
Ms Doyle went on to say, that their ultimate goal is to make tobacco use a thing of the past. Now as a personal issue Avril Doyle has the right to express her views and personal aversion to smoking, but she is not a private person, she is an EU official, albeit unelected, and also a public servant. In making her statement she has disregarded the EU’s Charter of Fundamental Rights which clearly states that no individual or group of individuals may be singled out for different treatment. Yet that is precisely what she is proposing and is exactly what the ban on smoking has achieved through misrepresentation of the true facts and the willingness of rabid anti smokers such as Ms Doyle to contravene the rights of millions of individuals.
Meanwhile it seems that not only are the anti smoking lobby willing to contravene the human rights of those individuals in order to achieve their goal of prohibition for a drug which the vast majority of people can use without developing either lung cancer or mental health problems, they are also willing to accept financial support from pharmaceutical companies who are hell bent on foisting medication on smokers which has been shown to induce serious neuropsychiatric symptoms What was that about protecting our health, and living in a democracy?
As a doctor who’s spend much of his life in general practice, I’ve looked after too many people who have died of smoking related diseases to keep quiet. (Forgive me Alistair, I know that’s not what the blog is really about!) The suffering smoking related diseases causes to individuals and their families is considerable and smoking places a great burden on our health service.
I have to say that the evidence for the dangers of passive smoking is pretty convincing. However if that’s a worry, then take a look at the evidence of the other risks associated with smoking.
Smoking is causally related to many diseases:
Bronchitis
Emphysema
Coronary artery disease
Cerebrovascular disease
Kidney disease
Peripheral vascular disease
Lung Cancer
Bladder cancer
Cancer of the gullet
Cancer of the cervix
Cancer of the kidneys
Oral cancer
It has been found to reduce fertility; increase risk of macular degeneration and blindness; cause peri-odontal disease; cause impotence and in pregnant mothers is associated with low birth weight and early delivery.
Children of smokers have higher incidence of asthma, cot death and respiratory tract infections.
Social scientists have shown that smokers take more time off work than non-smokers and are less productive at work. Health statisticians have shown that long term smokers will die on average 10 years sooner than non-smokers.
I could go on, but it seems to me that setting a goal of reducing smoking should be seen as a good thing and not a bad thing. Indeed, other research shows that most smokers want to quit. There are complex moral arguments to be had around encroaching on the rights of smokers and protecting the health of the public (including children) and saving taxpayers’ money.
Where addicts in early recovery are able to stop smoking, relapse rates to their other drugs are reduced. There are many reasons to support the cessation of smoking in those who are concerned by this pernicious addiction.
People with mental health problems smoke more than those that don’t. (About twice the rates of the general population). Is it cause or effect?
While rates of smoking are reducing in the general public they are not in psychiatric populations. It’s been postulated that those of us with mental health problems smoke more to relieve those symptoms. Of course the irony is that it has been shown that smoking increases stress, anxiety and sleep disorders, so it may be making things worse.
Take a look at the Mind website for references: http://www.mind.org.uk/Information/Factsheets/Smoking+giving+up+and+mental+health.htm#_ftn10
Some of the arguments I’m seeing above seem to me to be similar to the rationalisations my clients give me over their illicit drug use. (e.g. the risk of adverse outcomes is exaggerated; being encouraged to stop is an infringement of my rights; there’s a conspiracy/conflict of interests afoot).
Am I the only one to see the irony here that we’re effectively getting a rationale for allowing smokers to continue, on a website devoted to supporting addicts to recover?
Peapod this is a good review
http://www.utexas.edu/neuroscience/Neurobiology/AdronHarris/pdfs/Dani_NN_2005.pdf
Unfortunately their answer is more drug intervention.
At the moment I do smoke, but I cannot agree with Peter on the issue of rights, and I agree with David on consequences and responsiblity.
What Im still chewing over are the concepts of:
the (misguided) medical search for a drug intervention and
Natural recovery from nicotene dependence
found a link that might interest those looking at the pharmaceutical industry and risk/benefits ratios
http://content.nejm.org/cgi/reprint/358/3/252.pdf
Thank you Alistair. At first sight a higly interesting view of how they work and therefore worthy of further study. If first impressions are correct, it seems like a case of history repeating itself as so well documented by Charles Medwar In ‘Power and Dependence’
Thanks Peter
thats an interesting site linked with him. Ive few friends who’ll be interested and will send them the links.
alistair
