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By David Warmflash

David WarmflashIt’s been more than 57 years since U.S. Surgeon General Leroy E. Burney publicized the causal connection between tobacco smoking and lung cancer, explaining that the U.S. Public Health Service (USPHS) found the evidence to be striking. Soon after, connections between smoking and numerous other deadly and debilitating diseases were uncovered. And yet, tobacco still kills more than five million people annually worldwide. Approximately 30 percent of all cancer deaths are due to smoking. Even worse, smoking is projected to kill 8 million people per year by 2030, because tobacco use is still on the rise. Based on the current rate of youth smoking, 5.6 million people below age 18 today (1 in 13 of America’s children) are projected to die prematurely from an agent that their parents and grandparents were warned never to use.

While such horrifying statistics may make us want to scream at the tobacco companies for their continuous marketing, polling data obtained as recently as July 2013 by Gallup show that most smokers in the USA want to quit, and most have tried many times, but the success rate is low because nicotine is such a powerful addiction. As early as 1988, Surgeon General C. Everett Koop declared nicotine as addictive as cocaine and heroin, and nothing learned since then suggests he was wrong. According to the American Heart Association, nicotine is a particularly powerful and tenacious addiction.

On top of the existing and emerging pharmacologic treatments, recent progress toward a nutritional intervention against smoking is also welcome news. Conducted by researchers in Israel, progress comes in the form of a new study showing that omega-3 fatty acids are effective against tobacco addiction. Vital to a healthy diet for anybody, these agents have already been in the spotlight, as they are preventive against a wide range of health conditions.

shutterstock_38465113Omega-3 fatty acids are one of three categories of polyunsaturated fatty acids (PUFAs) important in human biology. The other two PUFA categories are omega-6, and omega-9 fatty acids. Two PUFAs are considered essential in the diet: α-linolenic acid (ALA), which is an omega-3, and linoleic acid (LA), which is an omega-6. Using ALA and LA as starting materials, body cells should be able to manufacture all other needed polyunsaturated fatty acids, In practice, however, the modern diet entails an imbalance. Characterized by a relative deficiency of omega-3 fatty acids, the imbalance prevents the synthesis of two other omega-3 fatty acids—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—from ALA, even when ALA is supplemented. The resulting deficiency of EPA and DHA is thought to increase the risk of developing a host of disorders, including cerebrovascular disease, immune disorders, Alzheimer disease, and other neurodegenerative conditions. However, EPA/DHA supplementation has shown promise in preventing such conditions.

Tobacco causes peroxidation of PUFAs, leading to particularly low levels of omega-3 PUFAs in smokers, exacerbating the effects of the dietary imbalance. This, in turn, accelerates neurogenerative processes, resulting in slowed nervous transmission in mesocortical areas of the brain, disrupting pathways involved in reward and punishment. As a result, the craving for nicotine is reinforced, interfering with smoking cessation therapy. While this mechanism constitutes a vicious cycle, the Israeli researchers found that omega-3 supplementation can bring the cycle to an end. Specifically, EPA at 2,710 mg and DHA at 2,040 mg per day for a month led to significant decreases in both smoking and tobacco craving, and the craving did not return during the month following termination of the treatment.

Rather than constituting a treatment in itself, this type of nutritional intervention is a facilitator. Used in combination with emerging pharmacologic therapies, EPA/DHA supplementation may be at the brink of ushering in a new age of addiction treatment. Perhaps this will finally bring us to a time when the number of smoking related deaths will be going down, not up.

David Warmflash, M.D., is an astrobiologist, science writer, and physician. He is principal investigator on a Planetary Society-sponsored investigation of the effects of the space environment on organisms.