UNMC tests new vaccine to help quit smoking

The University of Nebraska Medical Center is entering its final phase of testing on a vaccine which seeks to curb nicotine addiction not by reducing dependence, but by diminishing pleasure.

UNMC is one of approximately 20 institutions nationwide to conduct tests on NicVax, a nicotine vaccine produced by Nabi Biopharmaceuticals. The final 1,000-subject trial, funded in part by the U.S. National Institutes of Health, will determine whether the Food and Drug Administration will approve marketing the vaccine.

UNMC's portion of the study will see approximately 40 to 50 men and women at least 19 years old receive vaccines and counselling throughout a year.

"(NicVax) is different because it does not work at the brain level like most other smoking treatments do," said Mary Carlson, an advanced practice nurse practitioner in UNMC pulmonary and critical care and study coordinator.

"Nicotine attaches to receptacles in the brain, and most products or medications act as nicotine replacement which attach to and block those receptors. (NicVax) is a nicotine molecule attached to a protein to make it large enough so that when it is injected as a vaccine, the body takes notice and builds antibodies to the cut off the nicotine before it reaches the brain," Carlson said.

The effect is something of a nicotine immunity, hoping to dampen the psychological benefits of smoking.

"(Smoking) helps me relax," said Logan Pietz, a senior theater major at the University of Nebraska-Lincoln. "It's like my comfort food."

The tests will determine whether or not, with the proper frequency and dosage of vaccine, antibodies can interrupt enough nicotine molecules to significantly reduce those feelings of relaxation and pleasure.

Building antibodies is a long-term process, estimated to take six injections across six months, Carlson said. Subjects are not encouraged to quit smoking or enter counselling sessions until 14 weeks and four vaccines into the test.

Two previous studies at UNMC have shown a roughly 28 to 30 percent success rate for the combination of NicVax and counselling, roughly equivalent to competitor product Zyban. The tests also identified the ideal frequencies and dosages of the vaccine for the final trial.

Compared to a five to 15 percent quit rate for placebo groups, the differences in NicVax bodes well for its future.

"By decreasing the need for smoking, people aren't replacing their craving with something else," Carlson said. "In quitting cold turkey, some people eat or drink more to help balance out. I think being funded by NIH speaks very well for our results and chance for success."

Yet even if tests are successful and the vaccine is marketed, it will be far from the end of the tobacco or tobacco treatment industries.

"I wouldn't be interested (in vaccines like NicVax). I know one day I'm going to have to quit, but for now it's something I enjoy," Pietz said.

Carlson stressed that no matter the success rates of the treatment, individual success would require time commitment, a bit of luck, and an overwhelming desire to quit.

"It's just another tool in the arsenal," Carlson said. "Nicotine patches aren't for everybody. (NicVax) isn't for everybody. It just offers another individual approach."

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dailynebraskan.com