Effects of omega-3 fatty acid supplementation on cigarette craving and oxidative stress index in heavy-smoker males: A double-blind, randomized, placebo-controlled clinical trial.

BACKGROUND: Smoking-induced oxidative stress is thought to contribute to lower levels of omega-3 fatty acids in plasma and brain tissue. This lower level leads to impaired function in a dopaminergic system related to dependence and craving. AIMS: The aim of this study was to evaluate the effects of omega-3 fatty acid supplementation on cigarette craving and oxidative stress index in heavy-smoker males. METHODS: In this double-blind, randomized clinical trial, 54 heavy-smoker males (smoke ⩾20 cigarettes per day) were randomly selected to receive either five capsules of fish-oil-derived omega-3 fatty acid supplements ( n = 27, each 1 g capsule containing 180 mg of eicosapentaenoic acid and 120 mg of docosahexanoic acid) or a placebo ( n = 27) for 3 months. The psychometric evaluations (nicotine dependence and cigarette craving), biochemical markers (urinary cotinine, serum total antioxidant capacity and total oxidant status) and self-reported smoking status were used to assess the cigarette craving and oxidative stress index (oxidative stress index = total oxidant status/total antioxidant capacity). RESULTS: There was a greater reduction in levels of nicotine dependence, cigarette craving and cigarettes smoked per day in the omega-3 fatty acid group compared to the placebo group, and the difference between the two groups increased from baseline to 3-month follow up. The model estimated that these differences were statistically significant ( p < 0.001, p < 0.001 and p < 0.001, respectively). Also, a significant decrease was observed in levels of total oxidant status ( p = 0.008) and oxidative stress index ( p = 0.011) in the omega-3 fatty acid group after intervention. CONCLUSIONS: This study showed that high-dose omega-3 fatty acid supplementation appears to be useful in reducing cigarette craving and oxidative stress index in heavy-smoker males.

The relationship between omega-3 and smoking habit: a cross-sectional study.

BACKGROUND: Omega3 polyunsaturated fatty acids (PUFAs) are related to several diseases, including smoking. The aim of this study was to evaluate the relationship between omega-3 intake and tobacco smoking, taking into account the qualitative differences in dietary intake between smokers and non-smokers, the amount of the ingested PUFA and their red blood (RBC) contents. We also looked for an association between omega-3 RBC content and smoking, and also between omega3 intake and the level of nicotine dependence. METHODS: Using a cross-sectional study, we included 50 current smokers (group I) and 50 lifetime non-smokers (group II), aged 18-75 years. We screened them at the Toronto Western Hospital and the Centre for Addiction and Mental Health (Toronto, Canada). The subjects completed a questionnaire with demographic data, lifestyle habits and details of food intake. The PUFAs measured in the RBC membranes were alphalinolenic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid and docosahexaenoic acid (DHA). In order to perform an adjusted comparison between smokers and non-smokers we used the ANCOVA model. RESULTS: After adjusting for confounding factors, non-smokers showed higher consumption of PUFAs, especially salmon: 800 g (0-7.740) than smokers 430 g (0-2.150) P < 0.001. They also had higher DHA levels compared to smokers: 4.81% (2.79-10.21) and 4.13% (2.33-7.73), respectively, p < 0.05. The other PUFAs showed no significant differences between the two groups. CONCLUSIONS: Smokers ate less fish rich in omega3 fatty acids than non-smokers, showing and inverse and significant relationship between omega3 intake and smoking. Smokers had lower levels of DHA and EPA, a not previously reported finding. Considering that PUFAs probably interfere in smoking habit, the increase in omega-3 consumption may become a perspective in prevention or treatment of smoking. However, this inference must be evaluated through specific studies.

Omega-3 Levels and Nicotine Dependence: A Cross-Sectional Study and Clinical Trial.

BACKGROUND: High oxidative stress, which is caused by smoking, can alter omega-3 fatty acid concentrations. Since omega-3 fatty acids play a role in dopaminergic neurotransmission related to dependence, it is important to understand their effects on nicotine dependence. METHODS: This research comprised 2 studies. The first one consisted of a cross-sectional evaluation, in which the levels of the most important omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), were compared between smokers and non-smokers in a sample of 171 individuals; of them, 120 were smokers and 51 were non-smokers. The other study was a clinical, double-blind, randomized, placebo controlled, in which 63 smokers received daily treatment with capsules of fish oil (a source of omega-3/3 g/day) or mineral oil (used as placebo, also 3 g/day), taken 3 times a day for 90 days. Each fish oil capsules contained approximately 210.99 mg EPA and 129.84 mg of DHA. The outcome was evaluated by means of psychometric and biological measures as well as self-reports of tobacco use. The evaluations were carried out at the beginning of treatment and once a month thereafter (total of 4 times). OUTCOMES: The omega-3 fatty acid lipid profile showed that smokers present lower concentrations of DHA. After treatment, the omega-3 group showed a significant reduction in their levels of dependence. INTERPRETATION: Smokers showed lower peripheral levels of omega-3, and treatment with the most important omega-3 fatty acids brought about a reduction in nicotine dependence.

Non-enzymatic antioxidant status and biochemical parameters in the consumers of Pan Masala containing tobacco.

BACKGROUND: Tobacco consumption is one of the leading causes of oral submucous fibrosis, oral cancer and even premature death. The present study was designed to compare the biochemical parameters and non- enzymatic antioxidant status and the lipid peroxidation products in pan masala tobacco users as compared with age-matched non-user controls. METHODS: Pan masala and tobacco users of age 33.2±9.94 years and age-matched controls (31.2±4.73 years) were enrolled for the study. Plasma levels of vitamin E, vitamin C, albumin, bilirubin, uric acid, glucose, urea, creatinine, aspartate amino transferase (AST), alanine amino transferase (ALT) were measured by standard methods. Serum malondialdehyde (MDA) levels were estimated as a measure of lipid peroxidation. RESULTS: In the pan masala tobacco users, as compared to the controls, the level of vitamin C (68.5±5.9 vs 97.9±9.03 µmol/L, p≤0.05) vitamin E (18.4±5.3 vs 97.9±9.03 µmol/L, p≤0.001), albumin (37.5±7.01 vs 44.3±9.99 g/L, p≤0.001), and malondialdehyde (10.8±1.29 vs 1.72±1.15 nmol/ml, p≤0.001 ) were found to be significantly altered. Malondialdehyde was significantly correlated with vitamin E (r=1.00, p<0.001) and vitamin C (r =1.00, p<0.001) in pan masala tobacco users. Serum levels of AST (31.0±16.77 IU) and ALT (36.7±31.3 IU) in the pan masala tobacco users were significantly raised as compared to the controls (AST, 25.2±9.51 IU, p=0.038; ALT, 26.2±17.9 IU, p=0.038). CONCLUSION: These findings suggest that pan masala tobacco users are in a state of oxidative stress promoting cellular damage. Non-enzymatic antioxidants are depleted in pan masala tobacco users with subsequent alteration in the biochemical parameters. Supplementation of antioxidants may prevent oxidative damage in pan masala tobacco users.

Comparing effects of auricular acupressure with and without an internet-assisted program on smoking cessation and self-efficacy of adolescents.

OBJECTIVES: This study aimed to develop an Internet-assisted smoking cessation program accompanied with auricular acupressure, and compare the quit rate and self-efficacy of youth smokers receiving auricular acupressure with and without the Internet-assisted smoking cessation program. DESIGN: A Website was constructed on IBM Websphere 5.0 and DB2 database using HTML, Javascript, and JSP. A quasiexperimental research design was adopted. Subjects were assigned nonrandomly to two groups. Group 1 received auricular acupressure plus the Internet-assisted smoking cessation program, whereas group 2 received auricular acupressure only. MEASUREMENTS: The data of demographic factors, serum cotinine, quitting rate, nicotine dependence, and self-efficacy of subjects were collected before and after a 4-week intervention. RESULTS: After intervention, the quit rate was 15.78% in group 1 and 2.56% in group 2. Nicotine dependence was significantly lowered in group 1, but remained unchanged in group 2. The improvement of self-efficacy between groups 1 and 2 was significantly different. CONCLUSIONS: The combination of auricular acupressure and Internet-assisted smoking cessation program was more efficacious than auricular acupressure alone in terms of quit rate.

Enhanced prolactin levels in opium smokers.

In Iran, opium is smoked for pleasure or as a medication by some people. It is a complex mixture of 40 different alkaloids, including morphine and codeine along with many impurities. Although it is well established that opioids or tobacco affect many physiological functions in humans, to our knowledge there has been no specific study looking at these effects in opium smokers. To assess that, we investigated the circulating levels of prolactin, TSH, LH, FSH and testosterone in male opium smokers who also smoke cigarettes (n=23, aged 28.4+/- 4.1 years), and comparing this with the corresponding values for nicotine abusers (n=12, 15-25 cigarettes/day) or a healthy control group (n=20) of the same age. Our results showed that 86.96% of the opium-dependent and 41.67 % of the nicotine-dependent group displayed high prolactin values (p<0.002). In addition, there was a positive correlation between the dose of opium and the plasma prolactin level of opium dependents (p=0.748, p<0.001). Low FSH was detected in 43.48% of the opium smokers and 50% of the cigarette smokers (p<0.001) with normal LH and testosterone levels. TSH of the opium smokers was also lower than that of the other two groups (p<0.002). In conclusion, the present data indicate that chronic opium and cigarette smoking may synergistically influence pituitary hormone production through the effects on neuropeptides produced either locally or systemic.

Magnesium influence on nicotine pharmacodependence and smoking.

We followed the magnesium effect (Magne B(6)R, Sanofi-Synthelabo) with internal administration in 53 adult neurotic smoking patients (more than 10 cigarettes/day) of both genders admitted into psychiatric hospital. The nicotine dependence was assessed by the Fagerstrom test, initially and after 28 days of magnesium intake. Plasmatic magnesium level was determined before any therapy and at 28 days. All patients received benzodiazepines during the trial. Our data show that patients that received magnesium therapy showed a significant decrease in the number of cigarettes smoked and Fagerstrom test after 4 weeks [Fagerstrom score 7.93 +/- 0.17 before magnesium therapy versus 6.78 +/- 0.18 (P < 0.05) after 28 days of magnesium therapy]. In the group of smokers who did not receive magnesium, the Fagerstrom score did not change significantly [Fagerstrom score 7.48 +/- 0.22 initial versus 7.24 +/- 0.19 after 28 days]. Magnesium supplementation raised plasmatic levels (17.2 +/- 1.2 mg/L before versus 26.1 +/- 1.6 mg/L after 28 days of magnesium intake, P < 0.01). The results suggest that this cation might be a useful adjuvant in treatment of nicotine pharmacodependence.

Effects of acupuncture on smoking cessation or reduction for motivated smokers.

BACKGROUND: This study was undertaken to examine the effects of acupuncture on smoking reduction and possibly also cessation and to examine whether some acupoints are more effective than others for smoking cessation. METHODS: A total of 46 healthy men and women, 39 +/- 9 years of age (mean +/- SD), who smoked 20 +/- 6 cigarettes per day and had smoked for 23 +/- 8 years, and who wanted to quit smoking, volunteered to participate. The subjects were randomly assigned to two groups. One group was given acupuncture treatment at points previously used for anti-smoking (test group, TG). The other group was given acupuncture treatment at points assumed to have no effect for smoking cessation (control group, CG). Before each treatment and after the last treatment each subject answered questionnaires about his or her smoking habits and attitudes. In addition the concentrations of serum cotinine, serum thiocyanate, serum peroxides, and plasma fibrinogen were measured before the first and after the last acupuncture treatment. RESULTS: The daily cigarette consumption fell during the treatment period in both groups, but the reduction was larger for TG than for CG (P < 0.002). Altogether 31% of subjects in TG had quit smoking completely at the end of the treatment, compared with none in CG. For TG the concentrations of cotinine and thiocyanate were reduced significantly after the treatment period (P < 0.001), but no significant reductions were observed for CG. For both groups the taste of tobacco worsened during the treatment period, but the effect was more pronounced for TG than for CG (P < 0.05). The desire to smoke fell significantly in both groups after treatment, and the reduction was larger for TG than for CG (P < 0.001). No significant changes in serum peroxides and plasma fibrinogen concentrations were observed during the treatment period for either group. CONCLUSIONS: This study suggests that acupuncture may help motivated smokers to reduce their smoking or even quit smoking completely. Different acupoints appear to have different effects for smoking cessation and reduction.