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Kicking the Habit Can Be a Laughing Matter

Small study finds nitrous oxide can ease nicotine cravings

THURSDAY, Sept. 27, 2001 (HealthDayNews) -- Breaking the smoking habit can be a laughing matter.

A new study shows nitrous oxide, also known as laughing gas, may ease nicotine cravings during those first few days when you struggle to stay away from cigarettes.

Doctors at a family practice center in Florida thought of using nitrous oxide as a smoking cessation therapy after reading about a small study at Cornell University and other studies in South Africa that used nitrous oxide to help alcoholics quit drinking. They say their findings show that the mild anesthetic could one day be used with other therapies to help heavy smokers quit their life-threatening habit.

"We were encouraged by the findings. Basically, it's a procedure that most people enjoy that can actually help those quitting smoking. It takes some of the agony out of it. This treatment helps them with those first few days. This takes care of one small aspect of nicotine addiction," says Dr. Jesse Haven, who will present the findings Oct. 5 at the annual meeting of the American Academy of Family Physicians in Atlanta.

His study involved 25 smoker volunteers, ages 18 to 70, many of whom had tried to quit before. None had heart disease or cardiopulmonary obstructive disease. On the day they quit, each patient went to the doctor's office and inhaled a mixture of 50 percent nitrous oxide and 50 percent oxygen over 20 minutes. They stayed in the doctor's office for another 15 minutes before heading home. At the end of 72 hours, the volunteers were asked about their cravings. Ninety-two percent reported reduced cravings, and 40 percent quit completely during the three-day period.

One smoking cessation expert says the idea is intriguing, but further study is needed before laughing gas becomes a routine treatment.

"It's got biologic plausibility. It's not a crazy idea. … That's not to say it's going to work." says Dr. Norman Edelman, consultant for scientific affairs at the American Lung Association.

Edelman says larger studies with placebo controls would have to done before laughing gas joins the ranks of the nicotine patch and the antidepressant Zyban.

"Absent a controlled trial, I'm not ready to prescribe it as a therapy or treatment yet," he says. However, he says previous studies have shown anesthetics can ease withdrawal symptoms associated with quitting addictive substances.

One expert in dental anesthesiology says using nitrous oxide in this kind of setting is safe.

"A 50-50 mix is about what the average dentist would use," says Dr. Joel Weaver, a dental anesthesiologist who also teaches at the Ohio State University College of Dentistry. "It's extremely safe as long as patients are not on sedatives. It's very, very safe as long as the drug is being used for therapeutic purposes. To give nitrous oxide for short-term exposure, the way it sounds like they're doing, should be very safe."

"Nitrous oxide goes in quickly. It's not metabolized, and it has fleeting effects," he says. "It would seem to help relax, but it would be hard to be anything to influence the person's addiction to nicotine." Weaver also warns that prolonged recreational use of nitrous oxide can lead to problems with motor control and potential asphyxiation.

The U.S. Surgeon General estimates that 70 percent of American smokers want to quit, but only 2.5 percent succeed each year. Experts say quitting usually requires several tries with a combination of treatments.

And Haven says, "Nitrous oxide can't do it all. You have to really want to quit."

What To Do

The U.S. Surgeon General answers questions about quitting smoking.

The American Lung Association offers this online program to quit smoking.

Check these facts about kicking the habit.

SOURCES: Interviews with Jesse Haven, M.D., family practitioner, Anchor Health Centers, Naples, Fla.; Norman H. Edelman, M.D., consultant, scientific affairs, American Lung Association; Joel Weaver, D.D.S., Ph.D., pharmacology, dental anesthesiologist, associate professor, Ohio State University's College of Dentistry, Columbus; Oct. 5, 2001, presentation at annual meeting of American Academy of Family Physicians, Atlanta
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