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NicVAX, a nicotine vaccine (3'AmNic-rEPA), has been clinically evaluated to determine whether higher antibody (Ab) concentrations are associated with higher smoking abstinence rates and whether dosages and frequency of administration are associated with increased Ab response. This randomized, double-blinded, placebo-controlled multicenter clinical trial (N = 301 smokers) tested the results of 200- and 400-µg doses administered four or five times over a period of 6 months, as compared with placebo. 3'AmNic-rEPA recipients with the highest serum antinicotine Ab response (top 30% by area under the curve (AUC)) were significantly more likely than the placebo recipients (24.6% vs. 12.0%, P = 0.024, odds ratio (OR) = 2.69, 95% confidence interval (CI), 1.14-6.37) to attain 8 weeks of continuous abstinence from weeks 19 through 26. The five-injection, 400-µg dose regimen elicited the greatest Ab response and resulted in significantly higher abstinence rates than placebo. This study demonstrates, as proof of concept, that 3'AmNic-rEPA elicits Abs to nicotine and is associated with higher continuous abstinence rates (CAR). Its further development as a treatment for nicotine dependence is therefore justified.

ABSTRACT Objective: To assess the efficacy of a combined oral contraceptive (COC) containing 3 mg drospirenone (drsp) plus 20 [micro]g ethinylestradiol (EE) administered in 24 days of active treatment followed [...]

Numerous public education programs aimed at improving the knowledge and behavior of populations with respect to health issues such as blood pressure, cholesterol levels, and cardiovascular disease have been conducted in the last 20 years. These programs have been conducted with the assumption that behavioral change would follow education and motivation provided by campaigns. To determine if knowledge and behavior do improve following such programs, health consciousness was surveyed during the Pawtucket Heart Health Program in a city where no similar program had been implemented. Cross-sectional surveys were conducted four times in an eight-year period, and one cohort of respondents was resurveyed. Increased awareness of the influences on health and cardiovascular disease of salt and fat intake, exercise, of cholesterol and blood pressure levels, and of smoking were demonstrated. The resurveyed cohort had higher levels of health awareness, which may have been related to the resurvey process. The results indicate that in the absence of specifically directed programs, awareness and behavior with respect to these health factors are nevertheless improving. This was attributed to information available through the mass media. Since a significant portion of respondents spoke a foreign language at home, their actual health awareness may have been underestimated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health educators are interested in whether people's opinions of their risk for illness matches the actual risk. Previous research has shown that people base their perceived risk on their physical condition, but tend to underestimate their chances of developing serious diseases. The authors report the results of two surveys including a total of 4,171 adults. The participants' perceived cardiovascular disease (CVD) risk, encompassing risk of heart attack and stroke, was compared to their objective (actual) CVD risk. Objective risk calculations were derived from weight for height, blood cholesterol, blood pressure, and, for women, estrogen level. Results showed that there was poor agreement between perceived and objective CVD risk; many participants underestimated their risk. Closer agreement between objective and perceived chance of stroke or heart attack was found in certain groups. Greater accuracy was associated with being younger, female, better educated, thinner, and being a non-smoker. Many of these factors indicate low objective risk for CVD; those at low risk tended to be more accurate in their perceived risk level. An exception to this trend was that hypertensives (persons with high blood pressure) showed greater accuracy, apparently because they are aware of the relationship between hypertension and CVD. Health educators are concerned that many people underestimate their CVD risk and that this optimism reduces their willingness to make healthy behavior changes.

This study compared the efficacy of a low-dose combined oral contraceptive (COC) containing 3-mg drospirenone and 20-microg ethinyl estradiol (3-mg DRSP/20-microg EE) administered in a 24-day active pill/4-day inert pill (24/4) regimen and placebo in women with moderate acne vulgaris during 6 treatment cycles. A total of 534 participants were randomized and dispensed study medication (n = 266 [3-mg DRSP/20-microg EE 24/4 regimen COC group]; n = 268 [placebo group]). Women of reproductive age were eligible for inclusion in the study. Treatment with the 3-mg DRSP/20-microg EE 24/4 regimen COC was associated with a greater reduction from baseline to end point in individual lesion counts (papules, pustules, open and closed comedones) compared with placebo. The mean nodule count remained essentially constant throughout the study and was low in both treatment groups. There was a significantly higher probability that a participant had an improved assessment on the investigator's overall improvement rating scale (odds ratio [OR], 4.02; 95% CI [confidence interval], 2.29-7.31; P < .0001) and participant's overall self-assessment rating scale (OR, 2.82; 95% CI, 1.60-5.13; P = .0005) in the 3-mg DRSP/20-microg EE 24/4 regimen COC group than in the placebo group. The COC 3-mg DRSP/20-microg EE 24/4 regimen is a suitable option for women with moderate acne vulgaris who require contraception.