To the list of deleterious effects of smoking tobacco—from cataracts, diabetes and emphysema to heart disease, lung cancer and stroke—add this: more severe outcomes from COVID-19.
“There’s good data showing smokers, especially heavy smokers, are more likely to be hospitalized and to experience more serious outcomes if they develop COVID-19,” said Scott Leischow, a professor and director of Clinical and Translational Science in Arizona State University’s College of Health Solutions.
Leischow leads a new clinical trial at the university on smoking-cessation medication.
“Smoking has a broad, negative impact, not just on the lungs but on every single organ, your cardiovascular system, your immune system, and that escalates the risk of infection from the virus that causes COVID-19,” he said. “Clearly, smokers are much more likely to end up in the hospital, and we’re trying to avoid that.”
Leischow and his staff are recruiting study participants 18 and older who are regular smokers addicted to nicotine and motivated to quit. Participants will receive either cytisinicline, a substance under study that might aid smoking cessation, or a placebo, plus behavioral therapy during weekly visits to the ASU Downtown Phoenix Campus for 12 weeks. Compensation is as much as $1,950.
Those interested in participating in the study may call 775-476-2360 to learn if they qualify.
The Centers for Disease Control and Prevention recommends that smokers younger than 65 be eligible for the COVID-19 vaccine in early phases of distribution. However, the CDC has left that decision to the states, and Arizona has not prioritized smokers for the vaccine.
Cigarette smoking remains the leading cause of preventable disease, disability and death in the U.S., accounting for more than 480,000 deaths every year, or about 1 in 5 of all deaths, according to the CDC.
ASU does not permit smoking on any of its campuses, but that does not mean that students, faculty and staff aren’t smokers.
In 2019, nearly 14 percent of U.S. adults 18 and older—an estimated 34.1 million people—smoked cigarettes. That’s down from about 21 percent in 2005. Still, more than 16 million Americans suffer from smoking-related diseases.
Leischow, instrumental in establishing the Arizona Smokers’ Helpline more than 25 years ago, and who worked in cancer prevention and control at the Mayo Clinic Cancer Center in Phoenix, is advancing research on a new option for smokers.
“If a person is really serious about quitting, the most important thing is combining an effective medication with behavioral support,” he said. “The question then becomes, what’s the best medication? Right now, it’s varenicline. But new options are needed.”
Known by its brand name, Chantix, the non-nicotine prescription medication varenicline was launched in 2006. It is designed to reduce the urge to smoke and relieve withdrawal symptoms, but it has dozens of potential side effects, from anxiety to vomiting.
ASU is hosting a Phase 3 clinical trial to assess the efficacy and safety of cytisinicline as a smoking-cessation therapy. Cytisinicline is a naturally occurring substance found in the golden rain acacia tree and, more locally, in the mescal bean plant in Arizona.
It has been used for more than 50 years in Europe, but not in the U.S. because it does not have approval from the Food and Drug Administration. Its activation is similar to that of varenicline.
“When a person stops smoking, their dopamine level drops, causing anxiety, irritability, insomnia, depression, any number of effects, due to a lowering of that level,” Leischow said. “Cytisinicline elevates dopamine levels, making it a little easier to quit because you don’t feel as bad.”
Results from a recent clinical trial in New Zealand, backed by Achieve Life Sciences, a Seattle-based pharmaceutical company, showed that cytisinicline coupled with behavioral support was as effective as varenicline, and with lower reported adverse reactions.
“The hope for many of us in the health arena is to have more options that work and that are lower cost, because so many smokers are not high-income people and cigarettes are costing them a lot,” he said.