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UW awarded US$10 million for smoking study

By Karen Herzog of the Journal Sentinel

Jan. 2, 2013

The University of Wisconsin has been awarded a $10 million federal grant to continue a comprehensive study helping smokers quit and to assess how quitting affects their health, lifestyle and well-being.

While research has established that smoking is dangerous, less is known about how quitting affects health vs. continuing to smoke.

The study will recruit 600 to 800 adult smokers in the Milwaukee and Madison areas and give those selected for the study free coaching and medications to help them quit.

It will offer participants potentially lifesaving tests – including artery scans that can signal impending risk of a stroke or heart attack – at one- to three-year intervals throughout the study, free of charge, to assess their health over time. That’s literally thousands of dollars in benefits.

The new study recruits will join several hundred patients from the original Wisconsin Smokers’ Health Study launched in 2005, allowing researchers to collect health data spanning several years. Everyone from the previous study – whether they are now smoking or not – will be invited to continue in the next phase of the study, bringing the total number of participants to roughly 1,500.

“It’s the most comprehensive study of smokers ever to help patients quit and to follow them over time,” said Michael Fiore, director of the UW Center for Tobacco Research and Intervention, which was founded in 1992 to research the nature of tobacco dependence and develop evidence-based treatments for smokers. The center is part of the UW School of Medicine and Public Health in Madison.

The five-year grant announced Wednesday is from the National Heart, Lung and Blood Institute, part of the National Institutes of Health, or NIH. The first phase of the study received $8 million from the NIH.

Among the free exams that participants will receive are ones that track cholesterol levels in addition to artery scans, blood counts, diabetes tests, lung function tests and monitoring for cancer.

The first phase of the study saw a 35% smoking cessation rate – seven times better than the rate for smokers who try to quit on their own, said Fiore. Typically, those who quit for a year do not resume smoking, he said. Most relapse in the first couple weeks after trying to quit.

Each study participant will receive one of three medications to help them quit smoking: Varenicline (Chantix), the nicotine patch plus nicotine lozenges, or just the nicotine patch.

Chantix and the nicotine patch with nicotine lozenge treatments have demonstrated the highest quit rates of all quit-smoking medications, according to Timothy Baker, a study investigator along with Fiore and James Stein of UW Preventive Cardiology. However, the two treatments have never been compared head-to-head.

“We’ll not only determine which works better,” Baker said in a prepared statement, “but also whether one approach works better with some types of smokers than does the other.”

At the end of the study, researchers hope to enhance the understanding of how to treat smoking optimally, how quitting smoking helps participants to reduce their risk of heart disease, stroke and cancer, and the mechanisms by which these health benefits occur.

Wisconsin currently has about 800,000 smokers. And funding for the state’s smoking cessation hotline can help only about 12,000 smokers a year, according to Fiore. “We believe 30,000 or more would take advantage” if more funding were available, Fiore said. “We know from research that every dollar spent on helping people to quit smoking has a $2 to $3 return on investment within three years.”

The smoking rate among Wisconsin Medicaid recipients is double the smoking rate for adults in general, Fiore said.

Cutting down smoking among those on Medicaid will “help the bottom line of one of the biggest cost drivers in Wisconsin,” he said.

“We know that, paradoxically, people below the poverty level smoke at a rate two times the rate of those above the poverty line,” Fiore said. “It’s primarily the poor, least educated and people with psychiatric or substance abuse challenges who smoke.”

The study will actively seek participants who fall below the poverty line.

“It’s a misconception that the poor don’t want to quit smoking,” said Fiore.

© 2013, Journal Sentinel Inc. All rights reserved.

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