[Times photo: Dirk Shadd]
Dr. Jesse H. Haven, left, and Dr. Allen R. Kuhn, residents at Bayfront Medical Center, believe nitrous oxide, or laughing gas, can help those who want to quit smoking.

By WES ALLISON

ST. PETERSBURG -- Gabriele Ritzheimer had tried it all. The patch, the gum, hypnosis. Acupuncture. Cold turkey. But after 25 years of smoking, nothing helped break her addiction.

Then she noticed a flier at her doctor's office seeking smokers for a little experiment involving nitrous oxide. Laughing gas.

Ritzheimer, a St. Petersburg police officer whose job stress sabotaged past attempts to quit, was one of 25 people enrolled in an intriguing study at Bayfront Medical Center meant to investigate how well laughing gas may ease the ornery symptoms of nicotine withdrawal.

That was six weeks ago, and she hasn't had a cigarette since.

"I won't say it was wonderful, because the laughing gas doesn't last that long, but for me it was easier than any other time I had tried before," Ritzheimer, 48, said before a shift last week.

"There were a couple of times I would say, 'I could use a cigarette now.' Then I would busy myself and it would pass."

Like most doctors, Dr. Jesse Haven has too many patients who smoke. Sometimes they seek help, and he gives it, offering tips and prescribing nicotine patches, gums or pills to ease their cravings.

And usually, his patients fail. According to the U.S. Surgeon General, although 70 percent of smokers want to quit, just 2.5 percent succeed each year.

But Haven, a third-year resident in the family medicine program at Bayfront in St. Petersburg, remembered reading about a doctor at Cornell University who used laughing gas to ease withdrawal symptoms. A study presented at the American Psychiatric Association meeting showed it helped, although the study included just seven smokers.

In his research, Haven also learned nitrous oxide is commonly used in South Africa to ease the withdrawal symptoms of alcoholics as they dry out. Apparently, the gas gives the brain a shot of happy hormones, such as dopamine, that also are released when smokers light up or when alcoholics drink.

Nitrous oxide is commonly used as an anesthesia in dental surgery and other procedures and is considered safe, as long as it's properly used. Haven and a fellow resident, Dr. Allen Kuhn, decided to try it.

Bayfront approved a small trial and recruited smokers interested in quitting. The treatment wasn't designed to end dependence on cigarettes, but rather determine how the gas affected their withdrawal symptoms the first few days after quitting, when cravings, agitation and irritability are sharpest.

The 25 people accepted ranged in age from 18 to 70 and in smoking habits from several cigarettes a day to three packs a day. All had tried to quit before.

Each got a 20-minute treatment of nitrous oxide and oxygen, which provides a pleasant buzz that fades soon after the gas stops. They then were asked to record the amount they smoked in the next 72 hours.

The results were encouraging. Haven said 85 percent smoked less in that time. About 40 percent did not smoke at all, and followup calls revealed most still weren't smoking after about a month.

Patients also reported feeling less irritable and agitated than during past attempts to quit.

"Before, I wouldn't be able to stand up to it all. The first time I was stressed or I was hanging out with my friends, it was over with. It didn't take much," said Mandy Chambers, 21, an Eckerd College junior from Harrisonburg, Va., who had tried to quit several times.

She credits the laughing gas for making it easier to stay off cigarettes. "It's still difficult, and there are times when it crosses your mind, but it's not as difficult.'

Her boyfriend, Chris Short, 23, also of Harrisonburg, was similarly encouraged after smoking a pack and a half a day for several years.

"When I walked out of the place, I didn't want a cigarette, and that night I didn't want a cigarette, and the next morning when I woke up, I didn't want a cigarette," he said. "If it can take away my cravings for three days, I should be strong enough to take care of the rest of it."

But Haven and Kuhn stressed that nitrous oxide is not a panacea, and some people will react better than others.

Quitting usually takes several tries, often over a span of years. Increasingly, research has supported taking a broad approach, combining counseling or support groups with lifestyle changes, such as exercise, and nicotine replacements or anti-depressants such as Zyban.

Haven sees nitrous oxide not as a miracle cure but as another tool.

"These people really have to want to quit," he said. "This is not a magic gas; it won't make it easy to quit, but it might make it easier."

Dr. Carolyn Schlede, who oversees the smoking cessation program at Veterans Administration hospitals in south Georgia, Florida and Puerto Rico, agreed, although more study is needed, she said. Other therapies on the market, when coupled with counseling and other techniques, help 15 percent to 30 percent of smokers quit permanently. The smoking cessation program at James A. Haley VA Hospital in Tampa has a success rate of 41 percent.

The gold standard for measuring success is quitting for one year.

"It's intriguing, and we're looking for anything more that we can add to help people out with quitting," said Schlede, an associate professor of medicine at the University of South Florida in Tampa.

Haven and Kuhn have submitted the results of their study to the American Academy of Family Practice in hopes of presenting it at the group's scientific conference later this year. If it's well-received, the study could be published in one of the academy's journals.

"The weakness of the study is it's still small. And it's not really placebo-controlled," Haven said.

Haven, whose residency ends in July, hopes to do more research at his new practice in Naples. He would like to compare the quitting rates of people who use laughing gas and a common anti-smoking aid, such as Zyban, to rates among those who use just the aid, and to follow them over six months or a year. It's also unclear if one treatment is enough or if heavy smokers would need more.

"A lot of people quit smoking with the methods that we have, but there are still people out there who need something more, and that may be a helpful thing," Schlede said.

"The bottom line on this whole thing is motivation . . . regardless what methods are used. The person has to be at the point where they want to quit more than they want to keep smoking."

On the Internet:

American Lung Association

U.S. Centers for Disease Control

U.S. Surgeon General

American Cancer Society

Thinking about quitting?

Smoking still kills more than 430,000 Americans every year, and preventing tobacco use is one of the nation's top public health priorities. Here are some things to consider if you're thinking about quitting:

Join a stop-smoking program or a support group at your local hospital.

Talk to your doctor about nicotine-replacement therapy or other medical options, including anti-depressants.

Pick a good time to quit. Don't try to quit during the holidays or when you're under a lot of stress.

Exercise every day to calm frayed nerves and reduce cravings. Eat well and drink lots of water.

Ask family, friends and co-workers to help. Avoid situations that may make you want to smoke. Plan diversions to distract you.

For a free copy of a stop-smoking booklet from the U.S. Centers for Disease Control, call 1-800-358-9295 or log onto the Web site, www.cdc.gov.

Back to Tampa Bay area news

Back

Contact the Times | Privacy Policy
Standard of Accuracy | Terms, Conditions & Copyright

Special Links

Mary Jo Melone

Howard Troxler

Headlines
From the Times
local news desks