FRIDAY, Dec. 16 -- Not only does their health improve, but people who quit smoking get a boost in their quality of life, new research finds.

"Quitting is hard, but if you can actually do it, there are a lot of benefits that you might not have thought about," said study author Megan E. Piper.

"If you thought you'd have more stress, that quitting would put more stress on your relationships, or that you'll feel worse forever, that isn't the case," said Piper, an assistant professor of medicine at the University of Wisconsin School of Medicine and its Center for Tobacco Research and Intervention.

The findings don't make specify how much of a difference quitting makes in percentage terms. Still, they show a definite gain, she said. Three years after stopping, study participants who had quit reported fewer stressors and improved mood compared to those who continued smoking.

Piper said she and her colleagues wanted to see if they could confirm assumptions about smokers feeling better after they quit and "put some science behind what everybody thinks is true."

One way to do that is to look at how people describe their quality of life. That's tricky, Piper said, since quality of life tends to decline as people age. Even so, the researchers figured they could examine trends over time by comparing people who kept smoking to those who quit.

The study authors looked at the results of surveys of 1,504 people from Wisconsin -- 58 percent women, 84 percent white -- who took part in a smoking cessation study that began between 2005 and 2007. Participants were assigned to one of six groups, some of them using a nicotine patch, nicotine lozenges, the drug bupropion (Wellbutrin), a combination of those aids or a placebo. All also received counseling to help them quit.

Researchers followed the participants for three years and tested their blood to see if they had actually quit. They also asked about self-regard, standard of living, relationships, friendships and other measures of quality of life.

The study results were published online Dec. 9 in the Annals of Behavioral Medicine.

Overall, quality of life went down for both groups, those who quit and those who kept smoking, but it went down less for the quitters, Piper said. "This is just a little bit of additional scientific evidence that things will get better if you can get through those first couple of months."

Although the findings don't prove cause-and-effect, the authors said they suggest that life satisfaction could be used as a motivating tool for people reluctant to quit smoking. Smokers die 13 to 14 years earlier than nonsmokers on average, the U.S. Centers for Disease Control and Prevention reports.

Linda Sarna, the chair of nursing at the University of California, Los Angeles, who's familiar with the research, agreed with what the study says regarding the value of quitting smoking. "The message is that it's not just about reducing your risk of heart disease or cancer, it's also about benefits," she said. "You'll get through this and your quality of life will be probably be better than if you continue to smoke."

The message is especially important now when people are making resolutions for 2012, she said. "They will be able to get over the loss of smoking -- the loss of that friend, the cigarette," she said.

SOURCES: Megan E. Piper, Ph.D., assistant professor, medicine, Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison; Linda Sarna, R.N., DNSc, professor and Lulu Wolf Hassenplug endowed chair, School of Nursing, University of California, Los Angeles; Dec. 9, 2011, Annals of Behavioral Medicine, online

WEDNESDAY, Dec. 14 -- A new report details exactly what kind of scientific proof the U.S. Food and Drug Administration should require from the makers of electronic cigarettes and tobacco lozenges to show that what they are selling is not harmful to the overall public health.

These "modified risk" products claim to offer individuals nicotine without the health risks, namely lung cancer and heart disease, that are associated with the use of traditional tobacco products such as cigarettes.

"These products are ones that might carry a claim that they have less risk to the user than a traditional tobacco product," said Dr. Jane Henney, a professor of medicine and public health sciences at the University of Cincinnati and chairwoman of the Institute of Medicine (IOM) committee that wrote the report. "We believe that if those claims are to be approved by the FDA, the sponsor will have to bring to the agency a series of data to support that claim."

These products are sold as part of a strategy to lower tobacco-related death and disease, especially among smokers who have had trouble quitting, but not much is known about the overall health risks of these products, according to the committee.

To determine that, the IOM report suggests that the FDA require testing in the laboratory and in animals, clinical trials with people, and post-marketing studies to see if any health problems show up once the products are in widespread use.

Given the "tobacco industry's well-documented history of improper conduct," the committee believes these studies should be done by independent third parties.

The authority for this kind of oversight was included in the 2009 Family Smoking Prevention and Tobacco Control Act, which requires that modified risk tobacco products undergo an approval process similar to drugs and medical devices.

Several groups applauded the IOM report's recommendations.

"The American Lung Association commends the IOM for its recognition that if a tobacco product is allowed to be marketed as 'safer' that the product must actually be safer," Charles Connor, president and CEO of the American Lung Association, said in statement.

"Decades ago, the tobacco industry developed light and low tobacco products that were no less harmful than those already on the market. Millions of Americans, who switched to those so-called 'light' and 'low-tar' products instead of quitting, died as a result of these claims. The scientific standards recommended by this expert panel are designed to prevent a repeat of similar attempts to deceive the American public. We encourage the FDA to heed these lessons and never lose sight of the deception and fraud perpetrated for decades by Big Tobacco," Connor said in the statement.

"This report lays out a comprehensive scientific roadmap for the FDA to follow in reviewing applications for modified risk tobacco products," Matthew Myers, president of the Campaign for Tobacco-Free Kids, said in a statement.

"It demonstrates the need for rigorous science, conducted and evaluated independent of the tobacco industry, before the industry is allowed to market any modified risk products," he added. "It underscores the importance of the FDA considering the broad public health impact of introducing such products, and not just the impact on individual tobacco users. And it properly puts the burden on tobacco manufacturers to produce adequate scientific evidence before allowing them to claim that any tobacco product reduces the risk of disease."

David Abrams, executive director of the Schroeder Institute for Tobacco Research and Policy Studies at the Legacy Foundation, said he believes the IOM report is right on target.

"These products are worthwhile, provided the overall public health message is adhered to," he said. "It could cause, overall, long-term public health damage. For example, if it was more appealing to youth and young adults it might have a little less harm, but a lot more people would use it and that would violate the public health standard."

According to the report, among the things studies should look at are whether the product is addictive and whether the components of the product are harmful to health. In addition, these products should be tested on current and former smokers, new smokers, adolescents and groups at high risk for tobacco use.

Tests also have to "evaluate whether this product would draw people to the use of this product who now don't smoke, or who might have quit smoking and would be drawn back into this habit and therefore increase their risk," Henney said. "These products should only be targeted to individuals who absolutely have been unable to stop smoking."

The process should also be transparent, the report stated, with the companies and the FDA making all the data available to the public.

However, Ray Story, CEO of the Tobacco Vapor Electronic Cigarette Association, doesn't see safety and public health as the driving factors behind the IOM recommendations, but thinks instead it is a conspiracy by tobacco companies, drug companies and the federal government to keep these products off the market.

"I've been fighting this issue for quite some time, but you are fighting much larger groups," he said, noting that electronic cigarettes deliver nicotine without the risk of fire. "It does the same thing as a cigarette, without the 7,000 harmful chemicals and 65 carcinogens."

SOURCES: Jane E. Henney, M.D., professor, medicine and public health sciences, University of Cincinnati, Ohio; Ray Story, CEO, Tobacco Vapor Electronic Cigarette Association; David Abrams, Ph.D., executive director, Schroeder Institute for Tobacco Research and Policy Studies, Legacy Foundation; Dec. 14, 2011, Institute of Medicine report, Scientific Standards for Studies on Modified Risk Tobacco Products; Dec. 14, 2011, statement, American Lung Association; Dec. 14, 2011, statement, Campaign for Tobacco-Free Kids

SUNDAY, Dec. 11 -- A study assessing intravenous infusion of the drug salbutamol in patients with acute respiratory distress syndrome was halted because the treatment did not improve patient outcomes and was associated with an increased risk of death, researchers say.

Acute respiratory distress syndrome ( ARDS) occurs in about 14 percent of patients who require being placed on mechanical ventilation. The death rate among patients with ARDS is high -- 40 to 60 percent -- and survivors have a substantial decrease in their quality of life.

However, "routine use of [beta-2] agonist therapy in mechanically ventilated patients with ARDS cannot be recommended," the researchers wrote in an article published in the Dec. 12 online edition of The Lancet.

The British study included 326 patients who received either salbutamol (also known as albuterol) or a placebo within 72 hours of developing ARDS, and the treatment continued for up to seven days. But the study was stopped after 55 (34 percent) of the 161 patients in the salbutamol group died, compared with 38 (23 percent) of the 163 patients in the placebo group.

Overall, the death rate was 47 percent higher in the salbutamol group than in the placebo group, the report indicated.

In addition, patients in the salbutamol group had fewer ventilator-free days and organ failure-free days than those in the placebo group.

"Our findings show that intravenous salbutamol given to patients with early ARDS significantly increased 28-day mortality, and reduced ventilator-free days and duration of organ support compared with those given placebo," Fang Gao Smith and Gavin Perkins of the University of Warwick, and colleagues, explained in a journal news release.

The authors added that the therapy was "poorly tolerated" by patients because it was linked to heart rhythm abnormalities and lactic acidosis (a dangerous buildup of lactic acid in the blood). "These findings were unexpected," the researchers noted.

The findings of the cancelled study may be sufficient to change treatment of patients with ARDS, Dr. B. Taylor Thompson, of Massachusetts General Hospital and Harvard Medical School, wrote in an accompanying editorial.

"[Beta-2] agonist treatment in patients with ARDS should be limited to the treatment of clinically important reversible airway obstruction and should not be part of routine care," Thompson recommended.

-- Robert Preidt

SOURCE: The Lancet, news release, Dec. 11, 2011

WEDNESDAY, Dec. 7 -- The best states for smokers trying to kick the habit are Maine and North Dakota, while the least quit-friendly states are Georgia and Louisiana, according to a report released Wednesday.

The annual American Lung Association report examines quit-smoking programs and treatments offered in each state and by the federal government.

Providing smokers with easy access to smoking cessation counseling and medications through health insurance plans and telephone quit-lines is essential for success. While some states and the federal government have taken important steps in helping smokers quit, significant gaps persist, according to the report.

"Progress in helping smokers quit brings real results: It saves lives and saves money," American Lung Association President and CEO Charles Connor said in an association news release.

The five most quit-friendly states are Maine, North Dakota, Delaware, Oklahoma and Wyoming. The five least quit-friendly states are Georgia, Louisiana, Alabama, Maryland and New Jersey, according to the report.

The investigators found access to quit-smoking treatments and services varied throughout the United States.

"The level and type of assistance available to smokers is inconsistent state-to-state, insurance plan-to-insurance plan, and smoker-to-smoker," Connor said in the news release. "By not helping all smokers, too many people are missing out on longer, happier, more productive lives."

The report called for a comprehensive approach that includes unrestricted access to the seven medications and three types of counseling recommended by the U.S. Public Health Service as proven ways to help smokers quit.

Tobacco use is the leading preventable cause of death in the United States, with 443,000 deaths each year from tobacco-related illnesses and secondhand smoke exposure. The economic costs of tobacco are $193 billion a year, according to the American Lung Association.

-- Robert Preidt

SOURCE: American Lung Association, news release, Dec. 7, 2011

THURSDAY, Dec. 1 --Americans' awareness of chronic obstructive pulmonary disease (COPD) is rising, but many of those at risk don't talk to their doctor about symptoms, according to a new survey by the U.S. National Heart, Lung, and Blood Institute.

Symptoms of COPD -- the third-leading cause of death in the United States -- include shortness of breath, chronic coughing or wheezing, excess sputum production and a feeling of not being able to take a deep breath.

COPD affects 24 million people in the United States, but as many as half of them haven't been diagnosed.

The NHLBI Internet survey of almost 4,200 adults found that 71 percent of respondents said they are aware of COPD, compared with 65 percent in 2008.

Awareness was highest among those most at risk, current and former smokers. Awareness was 78 percent among current smokers and 76 percent among former smokers, compared to 69 percent and 68 percent, respectively, in 2008.

The survey also found that 27 percent of current smokers said they had suffered from a chronic cough or wheezing, or had been too short of breath to do normal activities in the past year. That's more than double the rate in the general population (13 percent).

However, 40 percent of smokers who said they had these COPD symptoms had not discussed them with a doctor or other health care provider.

"COPD is surpassing other diseases as a major killer in this country. We want to reverse this trend by educating people about the symptoms, so they can get proper treatment as early as possible," James Kiley, director of the NHLBI Division of Lung Diseases, said in an institute news release.

"It is not enough to have heard of COPD. Those at risk need to know the signs so they can talk to their health care provider about any breathing problems they are having and, hopefully, find relief," he added.

-- Robert Preidt

SOURCE: U.S. National Heart, Lung, and Blood Institute, news release, Nov. 21, 2011