Nicotine vaccine could help consign smoking to ashtray

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About three quarters of Britain’s smokers want to quit. Grace Hammond asks if science could be on the brink of a breakthrough.

Smoking-related diseases are one of the biggest preventable causes of death in the world. Yet, despite the huge risks, most smokers find it tough or impossible to quit.

While 74 per cent of Britain’s 9.6 million smokers say they want to give up, and 40 per cent try to do so every year, only five to six per cent (about 200,000 people) succeed.

One of the biggest reasons for failure is simply that nicotine is extremely addictive. However, hope may be on the horizon with scientists working on a new vaccine that could stop people becoming addicted to nicotine in the first place.

The formula has been successfully tested on mice, but further tests are needed before it can be tried on humans. Nevertheless, the American scientists who have created the vaccine, which is designed to make the liver continuously produce antibodies that gobble up nicotine before it reaches the brain and heart, are extremely hopeful about its potential.

“As far as we can see, the best way to treat chronic nicotine addiction from smoking is to have these Pacman-like antibodies on patrol, clearing the blood as needed before nicotine can have any biological effect,” says the project’s lead investigator Dr Ronald Crystal, a professor of genetic medicine at Weill Cornell Medical College in New York.

Dr Crystal says studies show that 70-80 per cent of smokers who try to quit light up again within six months, but he points out: “While we have only tested mice to date, we are very hopeful that this kind of vaccine strategy can finally help the millions of smokers who have tried to stop, exhausting all the methods on the market today.”

Demand for help is certainly there, and if a “magic solution” does become a reality, it could certainly make a significant dent in NHS costs, for starters.

For now, as well as going cold turkey and using nicotine replacement therapies (NRT), increasing numbers of smokers are thought to be trying electronic cigarettes (e-cigarettes) in an attempt to stop smoking real cigarettes. These battery-operated devices – designed to simulate smoking by producing a vapour that feels like the real thing, minus the health risks of tobacco – recently caused a bit of a frenzy, when one was mistaken as a bomb on a bus.

E-cigarettes have been around for a while; they were patented in 2003, with the aim of being marketed as a healthier alternative to smoking real cigarettes because they don’t expose smokers to the 4,000 chemicals present in tobacco smoke. However, they do still contain nicotine.

At present, there’s little evidence on their safety or effectiveness as a quitting aid, but that could change. A small Boston University study by Michael Siegel, published last year, found that of 222 respondents who used e-cigarettes, 31 per cent were abstaining from smoking real cigarettes six months later.

Many (66.8 per cent) reported a reduction in the number of cigarettes they smoked, and almost half (48.8 per cent) reported not smoking real cigarettes for a period of time.

Of those who weren’t smoking after six months, more than a third were no longer using e-cigarettes or any nicotine-containing products.

However, there is a downside. The market is unregulated and they vary enormously in their quality, content and ability to deliver nicotine.

Professor John Britton, director of the UK Centre for Tobacco Control Studies, hopes that within the year the Medicine Healthcare Products Regulatory Agency will have issued guidance that requires minimum standards for such products.

“The fact that so many people use e-cigarettes demonstrates that there’s a desire among smokers to switch to something less hazardous. But we don’t have the minimum standards on e-cigarettes’ safety, purity and performance that any of us would like.”

As far as a nicotine vaccine is concerned, Prof Britton says several have been unsuccessfully tested in the past, and while the success of the latest vaccine on mice is a sign of promise, he believes the biggest treatment opportunity is to provide smokers with alternative sources of nicotine.

“I see e-cigarettes as the first generation of a potentially huge market for such sources,” he says.

“If we accept that the great majority of smokers don’t want to smoke and want help to quit, but can’t or aren’t ready to do so, it’s in their interests that they should be able to walk into a shop and be able to buy alternative products that give them a hit but don’t kill them.”