Treatments for nicotine addiction should be a top priority

Abstract

Cigarette smoking is a leading cause of death in the USA. The practice has been linked to 440 000 preventable deaths per year, mainly due to lung cancer (123 836), coronary heart disease (86 801), and respiratory disease and chronic obstructive pulmonary disease (90 582). 1 Bonnie RJ Stratton K Wallace RB Ending the tobacco problem: a blueprint for the nation. National Academies Press, Washington, DC2007 Google Scholar , 2 Centers for Disease Control and PreventionAnnual smoking-attributable mortality, years of potential life lost, and productivity losses—United States, 1997–2001. MMWR Morb Mortal Wkly Rep. 2005; 54: 625-628 PubMed Google Scholar These deaths are the outcome of nicotine addiction, which compels individuals to use tobacco despite the known adverse health consequences. Sadly, priorities for investment in clinical trials are directed at treatment of diseases caused by continued tobacco use, rather than addressing the root cause of the diseases: nicotine addiction (figure). Moreover, clinical trials for smoking cessation and treatment of nicotine addiction are not even within the top 25 therapeutic categories in development by the drug industry; anticancer treatments are the first priority. 3 Informa HealthcareTherapy analysis—pharma R&D annual review. http://www.pharmaprojects.com/therapy_analysis/annual-review-0508-therapeutic-areas.htmDate: May, 2007 Google Scholar 174 pharmacotherapy trials were done for smoking cessation (46 supported by industry) compared with 1490 for lung cancer (544 supported by industry). (A) Number of deaths per year attributable to smoking-related diseases in USA. 2 Centers for Disease Control and PreventionAnnual smoking-attributable mortality, years of potential life lost, and productivity losses—United States, 1997–2001. MMWR Morb Mortal Wkly Rep. 2005; 54: 625-628 PubMed Google Scholar (B) US clinical trials (including treatment, diagnostics, prevention, and supportive care) related to smoking and associated diseases (data from ClinicalTrials.gov, 1987–2008). *Bronchitis, emphysema, and chronic airway obstruction. †Other heart disease, aneurysm, atherosclerosis, other arterial disease, influenza or pneumonia, perinatal conditions, and burn deaths.