Can herbal and mineral supplements help smokers quit – and still keep the weight off?

Researchers from Birmingham and Oxford are looking for volunteers for a new study, which will investigate whether St John’s wort, a herb which is popular in health supplements, can help people stop smoking. The trial, which is jointly run by the Oxford Smoking Research Group, the University of Birmingham and Oxford Brookes University, will also investigate whether chromium supplements can prevent weight gain once people give up.

The team are looking for volunteers from Oxfordshire and Buckinghamshire to attend clinics in their local areas, starting on May 22nd. The sessions will run on Monday evenings in Buckingham, Tuesday afternoons in Aylesbury and Thursday evenings in Thame.

Dr Paul Aveyard from the University of Birmingham’s Department of General Practice said: "For most people the first few weeks after stopping smoking are extremely difficult, particularly without medication. We know that the nicotine withdrawal can cause irritability and depression, because it affects two signalling compounds in the brain, dopamine and serotonin. This study will help us discover whether St John’s wort can help reverse this process and make the process of quitting easier."

 The trial is set up so that volunteers who are trying to give up smoking will receive either St John’s wort or a dummy pill (placebo) over a period of 14 weeks. Volunteers will not know whether they are receiving the active pill or placebo. Giving people active or placebo pills is standard in medical research: by comparing how people respond researchers can see whether medical treatments work or not.

The second part of the trial will test how effective chromium is in suppressing the appetite of people who have given up smoking. On average smokers gain around a stone in weight during the first year after giving up. Chromium acts by stimulating an area of the brain (the hypothalamus), which makes us feel full, so this trial will test for the first time whether it can be effective as a treatment for smokers.

Volunteers who sign up for the study will make weekly visits to a local health centre where they will see a research nurse. These short visits will be to check how people are doing and pass on hints and tips about how to stay off cigarettes.

Research nurse Avril Alexander said: ‘We have done other trials to help people stop smoking and we find that these weekly visits really help people – it seems to keep their motivation up. Of course we realise that some people will be getting a placebo, so, if they haven’t managed to stop smoking, we will also give them some nicotine replacement treatment, like patches, prescribed on the NHS. No one will lose out by joining this trial.’

People who are interested in the trial can phone research co-ordinator, Amanda Parsons, on 0121 414 8611 or her deputy, or email on sjw@contacts.bham.ac.uk who will send them more information to help them to decide whether to take part.

The phone lines are open from Friday 12 May and are open from 9am-8.30pm. The research will begin on May 22. St John’s wort is not suitable for people prescribed antidepressants, some drugs for epilepsy, and some other drugs. In addition, it can prevent hormonal contraception working, so you would need to take other precautions. If you are unsure, ask Amanda Parsons.

For further information for media, contact: Ben Hill, University of Birmingham Press Office, Tel: 0121 4145134, Tel: 07789 921163. Dr Paul Aveyard is available for interview.

Notes to Editors

• The trial is being run by the Department of Primary Care, University of Birmingham and the Oxford Smoking Research Group. These groups have conducted several large-scale trials on ways of helping smokers give up. In addition, the research group looks at the genetic basis of nicotine addiction. The research is funded by Cancer Research UK.

• Almost all smokers have made at least one determined attempt to stop by the age of 35 years, and the reason people go on smoking after that is because these attempts to stop smoking fail. Nicotine addiction is known to be the main reason why smokers fail to stop despite the health problems and financial cost. Overcoming nicotine addiction by using medication to help make stopping easier is probably the most important aid to stopping smoking, but ongoing support from a health professional is also known to increase the success rates. After an attempt to stop smoking using willpower alone, about 85–90 per cent of smokers resume smoking within four weeks of giving up. With support from a health professional and medication such as NRT, only around 40 per cent will be back smoking within four weeks of giving up.

• The researchers predict that taking St John’s wort will be about as effective as nicotine replacement. St John’s wort is available to buy over the counter without prescription. Even though Nicotine Replacement Therapy (NRT) is widely prescribed on the NHS, most people who try to stop smoking and use NRT buy it over the counter, where it costs £15-20 week, and many do not use enough of it or for long enough as a consequence. St John’s wort is much cheaper than NRT and will provide what many people see as a natural alternative, so if the trial shows it to be effective it would have advantages over NRT.

• This is a phase II clinical trial. This means it is a short-term small trial to examine the success rates of the medicines to see if they have promise. If the medicines prove effective, the next stage will be to mount larger scale, longer, and consequently more expensive phase III trials with St John’s wort and chromium to see if there are long term benefits. Phase II trials provide only preliminary data to justify the expense of the phase III trials.