The idea that there might be a link between smoking and nutrition is one that is probably not thought about very often. We do know that smokers typically have poorer diets than nonsmokers but to date no one has investigated whether ensuring optimal nutrition levels when attempting to quit smoking might be relevant and even helpful in the quit attempt process.
Quitting smoking is among the most important health promoting changes a person can make, and is the most cost-effective disease prevention intervention available. Despite the benefits, many smokers have difficulty quitting and the incidence of smoking relapse is high with many smokers failing to attempt even 24 hours of continuous abstinence after their quit date.
Our lab at the University of Canterbury has been exploring the effects of consuming additional minerals and vitamins on a variety psychological symptoms ranging from stress to low mood to attention to anxiety.
A curious observation was made in one of our studies. In the process of studying the effects of micronutrients on emotion dysregulation, one participant informed us that he no longer desired smoking and quit during the 8 week trial. As part of the experimental nature of the trial, he then stopped the nutrients and in so doing, resumed smoking and then when he went back on them, he proceeded to quit again. He told us that he simply didn’t feel like he needed them anymore.
Along came an intelligent and interested PhD student, Pip Reihana, and she decided to explore this idea in greater depth with a controlled study. The direct application of micronutrients as a treatment for addictions is novel.
Pip wondered whether given that tobacco smoking is often used to cope with stress and micronutrients have been well established to reduce stress, taking micronutrients may moderate the stress of withdrawal and increase the chance of a successful quit attempt.
Her study is the first known randomized controlled trial investigating the impact of a mineral vitamin formula for smoking cessation and reduction of smoking cigarettes. She randomized 107 smokers to either active arm or placebo arm and all participants received assistance from Quit New Zealand.
Intent-to-treat analyses (including all participants regardless of whether they completed the study) found that 28% of the micronutrient group achieved full abstinence for 12 weeks versus 18% of the placebo group. Nevertheless assessed by number needed to treat, micronutrients are comparable to other smoking cessation treatments but with far fewer side effects. This quit rate is higher than that observed with Champix (22%) as well as NRT+quitline (26%), the current funded treatments for smoking cessation in NZ.
While this group difference on abstinence wasn’t statistically significant, what was perhaps more interesting was the observation that those who were taking the active ingredients smoked fewer cigarettes during the quit attempt phase and up to 4 weeks post quit.
We do need to be cautious about over interpreting these results. We had a high dropout rate (58%) and the sample size was really small relative to drug company funded studies.
This novel trial tentatively supports the use of micronutrients to assist with quitting smoking and reducing the consumption of cigarettes, particularly during the acute stage of withdrawal. We hope these promising results lead to further funding and investment in larger trials. Afterall, who wouldn’t want to use a nutrient approach to assist with quitting given all the other health benefits we and others have observed using this treatment? Perhaps the intervention could be considered as part of the overall approach of achieving full abstinence of smoking in NZ by 2025.
This study was published on-line in Nicotine and Tobacco Research.
Julia Rucklidge is a Professor of Clinical Psychology in UC’s Department of Psychology and the Director of the Mental Health and Nutrition Research Group.
