We like to evaluate the science behind tobacco control, smoking cessation and smoking related diseases here at Unbiased. Every once in a while we come across an article that just makes us say, "Really?"
This was our response to the recent article found in Cognitive and Behavioral Neurology. It sounds like a great scientific journal doesn't it? But then you read something like this article and it makes you scratch your head.
So the title is "Smoking Cessation After Brain Damage Does Not Lead to Increased Depression: Implications for Understanding the Psychiatric Complications of Varenicline". Very long and full of promise that some wonderful revelation is forthcoming.
Here's what they said. The process of quitting smoking in patients with brain lesions, didn't lead to higher levels of depression. Okay, that's not so bad. I suppose that is good information to have. Somebody bumps their head and decides to quit smoking; depression isn't that big of a player. But then they continue with a tremendous leap of faith. They go on to "suggest" that because of this lack of increased depression, that psychiatric complications linked with the use of varenicline (Chantix) are not related to the process of smoking cessation, but are solely brought on by the drug iteself.
Wow, what a conclusion; especially given the fact that 1) varenicline was not a component of the study and 2) only 70 patients were studied, all with brain lesions.
So even though they did not study the use of varenicline in the study, they were able to conclude that all the psychiatric side effects (primarily depression) reported with a drug are related to the drug. They conclude this because the 32 quitters in the study group, had the same same depressive profile as those who did not quit. If you ask me, it sounds like brain lesions may keep depression at bay when trying to quit smoking.
I know, that is just as ridiculous of a conclusion as they came to. But it just goes to show, that not all science is good science. Not all conclusions are fair and just conclusions. The study group is too small and the variables are not set in a way to make any conclusive or suggestive statements about varenicline.
Until next time, remember to read these articles with a critical eye.
Showing posts with label depression. Show all posts
Showing posts with label depression. Show all posts
Does Anxiety or Depression Impact Nicotine Addiciton
Quite awhile ago now, bupropion (Welbutrin) was first used on people who suffered from depression. Researchers were surprised to discover a mis-intended, but beneficial side effect, that being smoking cessation. There is strong long-standing evidence that links depression with smoking behavior and nicotine addiction. I remember there were lots of patients in the 'psych ward' at our hospital that would go outside for their smoke break. I don't mean that to be a mischaracterization, but rather just an anecdotal observation from my hospital days.
Now there are questions as to whether a tendency to anxiety and depressive reactions is some how involved in the clinical presentation of someone with a nicotine addiction. Researchers in Polan sought to answer this question in a study titled, "Anxiety, depression and methods of stress coping in patients with nicotine dependence syndrome". It was published in the Medical Science Monitor: international medical journal of experimental and clinical research - [2011 May 2;12(5):CR272-276] by Pietras, T and others.
Here they compared two groups: smokers with no serious systemic co-morbidities and healthy subjects. Each individual was assessed in the same manner using the same behavioral tools for measuring anxiety, depression and coping abilities. Their results show the average intensity of anxiety as a trait and anxiety as a state were different in these two groups. Depression was also demonstrated to be more intensive in the nicotine addiction group. Finally, those with the nicotine addiction used more emotion-based coping behavior than did the healthy control group subjects.
They concluded that anxiety and depression, along with differences in coping, distinguished those who were addicted to nicotine from their non-smoking, healthy counterparts. So, which came first, the chicken or the egg?
Do people smoke because they're depressed or are they depressed, therefore, they smoke? I don't believe this study answers that rather complex question. Rather, it simply delineates the differences between these two groups. I'm sure bother ends of the argument are true. It is interesting to note, however, that there is a linking between a person's sense of well-being with oneself and his/her environment, with their nicotine addiction.
This fact tells us there is more to smoking cessation than simply quitting cold turkey. Although, for some it is that easy. For many others, it is seemingly complex weave of behavior, genetic predisposition, culture and brain chemistry. This isn't surprising, since most addictions are viewed in those terms already.
Now there are questions as to whether a tendency to anxiety and depressive reactions is some how involved in the clinical presentation of someone with a nicotine addiction. Researchers in Polan sought to answer this question in a study titled, "Anxiety, depression and methods of stress coping in patients with nicotine dependence syndrome". It was published in the Medical Science Monitor: international medical journal of experimental and clinical research - [2011 May 2;12(5):CR272-276] by Pietras, T and others.
Here they compared two groups: smokers with no serious systemic co-morbidities and healthy subjects. Each individual was assessed in the same manner using the same behavioral tools for measuring anxiety, depression and coping abilities. Their results show the average intensity of anxiety as a trait and anxiety as a state were different in these two groups. Depression was also demonstrated to be more intensive in the nicotine addiction group. Finally, those with the nicotine addiction used more emotion-based coping behavior than did the healthy control group subjects.
They concluded that anxiety and depression, along with differences in coping, distinguished those who were addicted to nicotine from their non-smoking, healthy counterparts. So, which came first, the chicken or the egg?
Do people smoke because they're depressed or are they depressed, therefore, they smoke? I don't believe this study answers that rather complex question. Rather, it simply delineates the differences between these two groups. I'm sure bother ends of the argument are true. It is interesting to note, however, that there is a linking between a person's sense of well-being with oneself and his/her environment, with their nicotine addiction.
This fact tells us there is more to smoking cessation than simply quitting cold turkey. Although, for some it is that easy. For many others, it is seemingly complex weave of behavior, genetic predisposition, culture and brain chemistry. This isn't surprising, since most addictions are viewed in those terms already.
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