Wednesday, January 11, 2012

Nicotine patches branded a waste of time as study finds they don't help smokers quit long-term

Nicotine patches are no better than willpower at helping smokers to quit, research shows. Earlier clinical trials had suggested nicotine replacement therapy could double a smoker’s chances of giving up the habit. But a new study of 800 patients found patches made no difference to long-term quitting rates.

Researchers said the earlier trials had failed to replicate ‘real-life’ situations. They said success and relapse rates were similar whatever method smokers adopted.

The latest study – by the Harvard School of Public Health and the University of Massachusetts, Boston – investigated patients who gave up smoking between 2001 and 2006.

It concluded: ‘The main finding is that persons who quit relapsed at equivalent rates, whether or not they used nicotine replacement therapy to help them in their quit attempts, in clear distinction to the results of randomised clinical trials.’

The results were the same for heavy and lighter smokers and whether counselling was or was not given.

Harvard’s Hillel Alpert said: ‘This study shows that using NRT is no more effective in helping people stop smoking cigarettes in the long term than trying to quit on one’s own.’

In an online report in the journal Tobacco Control, fellow author Lois Biener said the funding for NRT might be better spent on other interventions. In replacement therapy, patches, gum, nasal sprays or inhalers are used to supply nicotine to the bloodstream.

NHS figures show that quit rates – giving up for at least four weeks – are slightly better for patients using willpower than patches. However, a Department of Health spokesman said: ‘Other studies have shown that NRT is safe and effective, and can double a person’s chances of successfully quitting.’

Further American research released yesterday suggests that nicotine patches can help improve memory loss among older people.

Non-smokers with failing brainpower who used patches for six months had a 46 per cent improvement in their memory skills, according to a report in the journal Neurology about the study at Vanderbilt University School of Medicine in Nashville.

Previous research has suggested nicotine helps brainpower among Alzheimer’s sufferers.


Strokes, retina damage and trapped nerves: Is yoga doing us more harm than good?

It may be the secret to some of the most lithe and bendy bodies around, but yoga, as loved by celebrities from Matthew McConaughey to Natalie Portman, may also be the cause of a host of severe injuries.

A new book, published next month, opens the lid on some of the physical and mental stretching techniques' darker sides - and from back traumas to strokes, the discipline is not without its dangers, writes author William J Broad.

The Science of Yoga: The Risks and the Rewards, out next month, pulls together medical studies and case studies from those who have met with disastrous ends rather than the feel-good flexibility the practice normally affords.

In an adaptation of the book in the New York Times, Mr Broad recalls meeting Glenn Black, a yogi with classic Indian Iyengar training.

Mr Black, a yoga teacher of nearly 40 years, made the admission that he believes that 'the vast majority of people' should give up yoga. He recently underwent back surgery to correct decades of damage from the discipline.

The yoga guru told Mr Broad that he has seen people's Achilles tendons tear from overdoing a downward-facing dog, men's ribs breaking with 'pops' from spine-twisting moves and teachers who no longer have any movement in their hips or who are forced to teach lying down because of back problems.

But the most severe cases include a 28-year-old woman who suffered a massive stroke while attempting the 'wheel' position. Her story was documented by Willibald Nagler, of Cornell University Medical College, and published in 1973.

Neurological damage had occurred because of hyperextension of the neck, but the woman - who took two years to learn to walk again and was left with permanent arm and eye and problems - is not alone in succumbing to brain injuries brought on by wounding arteries from head, neck and back movements.

Mr Nagler's report was an early and salutary warning flag in terms of the practice's dangers, but there have been very few studies as to yoga's downsides since. In recent years, the NY Times found that Bikram yoga - in which moves are practiced in a room heated to a stifling 105F and 40% humidity - can cause muscle damage and tearing.

Another study at New York's Columbia University, cited in the book, notes that the most common injuries seen in yoga are to the lower back, knee, shoulder and neck.

And physician Timothy McCall, medical editor of Yoga Journal, told Mr Broad that the commonly-practiced headstand is 'too dangerous' for most yoga classes.

Something as apparently benign as the headstand is known to compress nerves, cause arthritis and even pressure-induced retinal tears in the eyeballs.

Mr Black's concern is particularity shocking given that, according to Mr Broad, 'the number of Americans doing yoga has risen from about four million in 2001 to what some estimate to be as many as 20 million in 2011.'

Could nearly 20 million Americans be at risk of a debilitating yoga injury?

A glut of poorly-trained practitioners and teachers as well as a discordance between the exercise's uptake in America and its origins - which means that many yoga lovers in the US spend their time at desks all day rather in the in the Indian kneeling or cross-legged styles of sitting that may make the moves more natural - have seen injury rates increase.

Despite many turning to the downwards dog and other poses from the ancient Indian practice as a healing technique, yoga can - and must be recognised to - also cause pain.

In fact, Mr Black told Mr Broad, 'Yoga is for people in good physical condition. Or it can be used therapeutically. It’s controversial to say, but it really shouldn’t be used for a general class.'


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