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Drug Alcohol Rev. 2003 Jun;22(2):203-20.
Review of bupropion for smoking cessation.

Richmond R, Zwar N.

School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia. r.richmonnsw.edu.au

The advent of bupropion hydrochloride sustained release (Zyban) has heralded a major change in the options available for smoking cessation pharmacotherapy. Bupropion is a selective re-uptake inhibitor of dopamine and noradrenalin which prevents or reduces cravings and other features of nicotine withdrawal. Bupropion is a useful oral and non-nicotine form of pharmacotherapy for smoking cessation. For this review a total of 221 papers were reviewed plus poster presentations. This review examines in detail original clinical trials on efficacy, categorised according to whether they were acute treatment trials in healthy smokers; studies in specific populations such as people with depression, chronic obstructive pulmonary disease (COPD) or cardiovascular disease; or relapse prevention studies. Overall, these studies in varying populations comprising over four thousand subjects, showed bupropion consistently produces a positive effect on smoking cessation outcomes. The evidence highlights the major public health role that bupropion has in smoking cessation. The methodological issues of published clinical trials reporting one year outcomes were examined in detail including: completeness of follow-up; loss to follow-up; intention to treat analysis; blindness of assessment; and validation of smoking status. The review discusses contraindications, adverse effects, dose and overdose, addictive potential, and the role of bupropion in reducing cessation-related weight gain. Bupropion combined with or compared to other pharmacotherapies (nicotine patch; nortriptyline) is considered. Impressive evidence exists for the use of bupropion in smoking cessation among difficult patients who are hard-core smokers such as those with cardiovascular disease, chronic obstructive pulmonary disease (COPD) and depression. Bupropion reduces withdrawal symptoms as well as weight gain and is effective for smoking cessation for people with and without a history of depression or alcoholism. Serious side effects of bupropion use are rare. The major safety issue with bupropion is risk of seizures (estimated at approximately 0.1%) and it should not be prescribed to patients with a current seizure disorder or any history of seizures. In clinical trials of bupropion for smoking cessation no seizures were reported. Allergic reactions occur at a rate of approximately 3% and minor adverse effects are common including dry mouth and insomnia.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12850907&dopt=Abstract [PubMed - in process]

Scand J Public Health. 2003;31(3):204-10.
A qualitative study on the determinants of smoking behaviour among adolescents in South Africa.

Panday S, Reddy SP, Bergstrom E.

National Health Promotion Research and Development Group, Medical Research Council, South Africa. saadhna.pandarc.ac.za

BACKGROUND: Increasing adolescent smoking rates have highlighted the need for smoking cessation programmes for adolescents. AIM: The aim of this study was to explore adolescent opinions' on the determinants of smoking, with a focus on smoking cessation. METHODS: Nine focus group discussions were conducted with grade 8 and 9 school-going smokers and ex-smokers in the Southern Cape Karoo Region, South Africa. Six schools were purposively selected based on their locality (urban or rural) and ethnicity ("black", "white", and "coloured"). The groups were homogenous in terms of gender and ethnicity. Data was analysed thematically. RESULTS: The majority of the participants declared their intention to stop smoking in the future. They reported multiple quit attempts of short duration. They perceived quitting as a difficult process and that only a few of their friends wanted to stop smoking. Participants believed that they were not addicted to nicotine even though they reported nicotine withdrawal symptoms. While "coloured" and "black" participants reported their smoking peers as obstacles to quitting, their "white" counterparts emphasized that they smoked by choice and that they would support friends who wanted to stop smoking. CONCLUSION: This study shows that the psychosocial determinants of tobacco use may vary substantially between ethnic groups and cultural contexts. A long-term strategy of poverty reduction that would create greater perceived future prospects is an important consideration for interventions in developing countries. The manifestation of withdrawal symptoms, indicative of nicotine addiction, is a common and significant hindrance for smoking cessation among these adolescents.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12850974&dopt=Abstract [PubMed - in process]

Am J Addict. 2003 May-Jun;12(3):192-7.
Assessment and diagnosisof nicotine dependence in mental health settings.

Peterson AL, Hryshko-Mullen AS, Cortez Y.

The Clinical Health Psychology Service, Wilford Hall Medical Center, San Antonio, Tex.

This study evaluated the frequency of documented assessment of smoking status and the diagnosis of nicotine dependence in a random sample of 153 mental health records and 152 medical records. The results indicated that tobacco use was routinely documented in the mental health records (88%) and medical records (87%). However, a diagnosis of nicotine dependence was given in only 2% of the mental health records (1/49) and 7% of the medical records (2/30) for those patients with documented regular tobacco use. These results suggest that clinicians do not routinely diagnose Nicotine Dependence even when diagnostic criteria are met. (Am J Addict 2003;12:192-197)

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12851015&dopt=Abstract [PubMed - in process]

Hair loss is a problem in modern soceity. Examining the factors of hair growth may shed light on how hair loss might occur. How long can hair grow before it stops growing eventually if it does? Given that the hair growth rate is quite uniform and constant, somewhere between 0.3-0.5 millimeters per day, it's believed that the length of anagen, the growth phase, differs among individuals, and this is the major determinant to the maximum hair length. For some individuals, anagen may last ten years. Of course the length of the anagen is governed by genes, and the genetic background of the individuals. Non-genetic factors such as nutritional condition, weather, seasonal changes (hair may grow a bit faster during winter), taking medications, health condition may of course influence the rate of hair growth as well as hair loss. The shape of the hair, straight or curly, is dependent on the shape of the follicle. A circular or round hair follicle would generate straight hair, while the follicle with oval or elliptical shapes (in its cross-section) would produce a curly hair.

DHEA is a natural hormone, and it is produced in our body by the adrenal glands. DHEA has been suggested to provide numerous potential benefits. DHEA (or dehydroepiandrosterone) is converted into androgens (male hormones) or estrogens (female hormones) in the cells.

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