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January 12th, 2009:

Brain Scans Reveal Why Smokers Struggle To Quit

January 12, 2009 – Tech Journal South

DURHAM, NC Just seeing someone smoke can trigger smokers to abandon their nascent efforts to kick the habit, according to new research conducted at Duke University Medical Center.

Brain scans taken during normal smoking activity and 24 hours after quitting show there is a marked increase in a particular kind of brain activity when quitters see photographs of people smoking.

The study, which appears online in Psychopharmacology, sheds important light on why it’s so hard for people to quit smoking, and why they relapse so quickly, explains Joseph McClernon, an associate professor in the department of psychiatry and behavioral sciences at Duke University Medical Center.

“Only five percent of unaided quit attempts result in successful abstinence,” says McClernon. “Most smokers who try to quit return to smoking again. We are trying to understand how that process works in the brain, and this research brings us one step closer.”

The Duke researchers used a brain-imaging tool called functional MRI to visualize changes in brain activity that occurs when smokers quit.

The smokers were scanned once before quitting and again 24 hours after they quit. Each time they were scanned while being shown photographs of people smoking.

“Quitting smoking dramatically increased brain activity in response to seeing the smoking cues,” says McClernon, “which seems to indicate that quitting smoking is actually sensitizing the brain to these smoking cues.”

Even more surprising, he adds, is the area of the brain that was activated by the cues.

“We saw activation in the dorsal striatum, an area involved in learning habits or things we do by rote, like riding a bike or brushing our teeth. Our research shows us that when smokers encounter these cues after quitting, it activates the area of the brain responsible for automatic responses.

“That means quitting smoking may not be a matter of conscious control. So, if we’re really going to help people quit, this emphasizes the need to do more than tell people to resist temptation. We also have to help them break that habitual response.”

New treatment options at Duke are aiming to do just that. One area of research is focusing on the use of a nicotine patch prior to quitting smoking.

In previously published research, Jed Rose, Director of the Duke Center for Nicotine and Smoking Cessation Research and co-author of this paper as well, showed that wearing the patch and smoking a cigarette with no nicotine proved successful at breaking the learned behavior.

“The smoking behavior is not reinforced because the act of smoking is not leading them to get the nicotine,” Rose said. “Doing this before people actually quit helps them break the habit so they start smoking less. We’re seeing people quit longer this way.”

Should The Smoking Ban Be Delayed?

Jan 12th 2009 – SCMP

As a non-smoker, I do not think the smoking ban should be delayed.

As everyone knows, smoking harms our health, and in this regard it affects smokers and non-smokers.

Smokers talk about their rights being infringed.

But what about the right of non-smokers not to be exposed to second-hand smoke?

I do not see smoking rooms as a solution to the problem, as some of the smoke is bound to escape. And what about the health of people who use them and are in smoke-filled rooms.

Some people argue that it is up to individuals whether or not they wish to work or eat in a restaurant that allows smoking.

However, some people may have no choice but to work in a restaurant or bar where people smoke, especially during the present economic downturn.

Employees exposed to this kind of environment will put up with it if the alternative is not working and therefore receiving no income.

Laws exist to protect the public. The government should implement the full smoking ban and then it is up to smokers to light up in the privacy of their own homes.

Emily Lau Lai-fan, Ngau Tau Kok

Should The Smoking Ban Be Delayed?

Jan 12th 2009 – SCMP

In my view it should not, and this seems to be the view of the majority of correspondents. But we should be looking well beyond July this year.

The current trend will continue: smokers will find fewer and fewer places where they can smoke.

In time, smoking will be banned not only in all public places, but also in private homes; whether smokers like it or not it will happen, eventually.

Some radical thinking has to be done now in order to plan for that future; and the plan must accommodate two facts: first, there are a substantial number of smokers who will never give up; and second, many young people will start to smoke unless they are prevented from doing so.

First, smokers must have somewhere to smoke legitimately; refusal to accept this simple fact is unrealistic.

Smoking rooms in some bars have been suggested by some and rejected by the hardliners.

I have experienced a few smoking rooms at airports (from the outside), some that are unpleasant to be near, others that appear to work reasonably well.

If the demand is there they will be developed to meet the needs of those inside and those who prefer to stay outside.

Second, and more radically, the only way to stop young people from starting to smoke is to make it illegal. Nothing else will work.

Let Hong Kong lead the world by setting a date, maybe the last day of this year, after which it will be illegal to start smoking.

It will be very difficult and probably futile to attempt to prosecute anyone who will be over 18 years of age at the time the legislation comes into force, but very simple to prosecute those under that age at the time.

While many will claim that such a law is discriminatory, others might welcome the legislation as a good reason to resist pressure from their peers.

Peter Robertson, Sai Kung

Taipei Bans All Indoor Smoking

Agence France Presse in Taipei – Updated on Jan 12, 2009

Taiwan yesterday banned smoking in all indoor public places in what campaigners say is a milestone in creating a smoke-free island.

Smoking had previously been banned in hospitals, schools, theatres, libraries, offices and lifts.

Under the new law, it is also banned in hotels, restaurants, karaoke bars and internet cafes.

Those caught lighting up in smoke-free spots will face fines of up to NT$10,000 (HK$2,300).

“The new law is a milestone in making Taiwan a smoke-free country,” said Lin Ching-li, a spokeswoman for the John Tung Foundation, one of the lobby groups behind the campaign.

Airports have closed their smoking rooms and local air carriers are barred from selling cigarettes during flights under the law.

Health authorities estimate that half a million establishments could be affected by the law, which became effective after its 18-month grace period expired. The legislature passed the amended law in June 2007.

The Taipei city government said its inspectors had found that five out of 2,740 public places had failed to post anti-smoking signs at their entrances, for which they could be fined up to NT$50,000.

The law also doubled the “health tax” to NT$500 for every 1,000 cigarettes and 1kg of tobacco and cigars, to raise money for the island’s cash-strapped national health insurance programme.

Authorities hope higher cigarette prices will help curb smoking and reduce related diseases.

Lung cancer has long been a leading cause of death in Taiwan.

Each year, around 20,000 islanders die of the effects of smoking or second-hand smoke.

By 2020, the number of victims could surge to 67,000 yearly, according to the National Health Research Institutes.

There were about five million smokers on the island, it said.