Ragweed can bring on sneezing

August marks the start of misery for as many as one in five Americans who suffer from hay fever, also called seasonal allergic rhinitis. That's because ragweed, the main cause of hay fever, begins blooming around mid-August and in one day each plant can produce a million pollen grains that can travel for miles from its source.

"Ragweed can bring on sneezing, snuffy nose and watery eyes," says allergist James Sublett, MD, chair of the American College of Allergy, Asthma and Immunology's (ACAAI) public relations committee. "But there are lots of things people can do to find relief until the first freeze comes along."

Dr. Ellis

To avoid the more intense early reaction, people with cat, dog and dust mite allergies should try to limit their exposure to those allergens before ragweed season starts, said Dr. Ellis. Because that often is not practical when it comes to family pets, an alternative is to treat their cat, dog or dust-mite allergies, she said.

"Allergy immunizations or year-round allergy medication can provide hay fever relief to those sufferers who have ongoing symptoms from cats, dogs or dust mites, even if they think the symptoms are mild and easily tolerated," said Neil Kao, MD, chair of the ACAAI Rhinitis/Sinusitis Committee. "They'll likely find ragweed allergy season easier to endure if they're treating their perennial allergies."

Those who suspect they have hay fever or other allergies should get tested by an allergist a doctor who is expert in diagnosing and treating allergies and astma

Source: American College of Allergy, Asthma and Immunology (ACAAI)

Food allergies are adverse immune responses to food allergens

NICE has opened the consultation on its draft clinical guideline on the diagnosis and assessment of food allergies in children and young people.  Its aim is to support GPs and other health professionals in primary care and community settings in recognising the signs and symptoms of food allergy, by giving clear recommendations on taking allergy-focussed histories to assess the condition.

Food allergies are adverse immune responses to food allergens[1]. They are among the most common of the allergic disorders and are recognised as a major paediatric health problem in western countries. Reactions can be extremely severe; hospital admissions in the UK for food allergies have increased by 500%since 1990[2], and there has been a dramatic increase in prevalence in the last twenty years, ranging from 6% to 8% in children up to the age of 3 years across Europe and North America. The most common foods to which children and young people are allergic include cow's milk; fish and shellfish; hen's eggs; peanuts, tree nuts and sesame; soy; wheat and kiwi fruit.

Food allergies in children can result in a number of symptoms, therefore the draft guideline recommends that the condition should be considered if the child has one or a combination of the following, including:

- skin conditions such as eczema or acute urticaria (itchy rash)
- respiratory complaints such as sneezing or shortness of breath
- gastrointestinal problems such as vomiting, difficulty swallowing or constipation
- anaphylaxis (severe, hyper-sensitive reaction) and other allergic reactions.

Food allergies should also be considered in children who are not adequately responding to treatment for atopic (allergic) eczema, gastro-oesophageal reflux disease (where stomach contents leak out of the stomach and into the oesophagus), and chronic constipation.

If a food allergy is suspected, the GP or other healthcare professional should take an allergy-focused clinical history, tailored to the presenting symptoms and age of the child or young person. This should include a family history of allergies, an assessment of the symptoms, and feeding history as an infant. A physical examination should pay particular attention to growth, and physical signs of malnutrition.

The draft guideline also recommends offering the appropriate information based on the type of allergy suspected, the risk of allergic reaction, and the diagnostic process which may include excluding specific foods from the diet, reintroducing these foods with reoccurrence of the allergic reaction confirming diagnosis. Diagnosis may also include skin prick and blood tests for IgE (immunoglobulin) antibodies; specific antibodies suggest particular allergic reactions. Alternative methods of diagnosis such as hair analysis and kinesiology are not recommended. Referral to secondary care should be considered if the child has ongoing problems including faltering growth, vomiting, abdominal pain, loose or frequent stools, or constipation.

How To Measure Your Own Body Fat At Home

How To Measure Your Own Body Fat At Home With The One Site Skinfold
Test
Skinfold self-testing is now possible because instead of using the traditional three
or four site skinfold formulas that require a second person, the Accu Measure only
requires a skinfold to be taken at ONE SITE - the Illiac crest (also known as
"suprailliac" or top of the hip bone), and you can measure that spot yourself!
Based on this single measurement, you simply refer to a body fat interpretation
chart for an accurate estimate of total body fat.
Some people wonder whether the one site iliac crest pinch test is inaccurate,
especially if they store more fat in their lower bodies than they do around the
waist. The truth is, it doesn't matter where you store the most fat. What matters is
that you have a method you can use regularly, which gives you consistent readings
you can use to compare one week's results to the next, and the Accu Measure does
that beautifully.
Studies have shown that measuring at three or four sites does increase accuracy
slightly, but not greatly so – so don't worry that the Accu measure only requires
pinching one spot. Research has also shown that measuring more than four
skinfold sites does not always increase accuracy further. In fact, if the tester is
inexperienced, it can actually increase the margin for error).

VitoSlim Best Herbal pill to increase metabolism

VitoSlim ™ is an all-natural diet supplement including 100% pure thermogenic extracts. This slimming pill helps in maximum weight loss in the shortest space of time possible.

Can Vitamin C Decrease the Incidence of Cancer?

Can Vitamin C Decrease the Incidence of Cancer?
Among all of the vitamins, perhaps vitamin C has received the most
attention as an anticancer agent. Much of the research involving vitamin
C and cancer in people has been correlation studies, which are used to
determine an association between the two or more entities. In regard to
cancer of the mouth, larynx, esophagus, and colon, as the vitamin C
content of the diet increases, the risk for these cancers decreases two to
three times. In more direct research studies it seems that individuals get-
ting less than 80 milligrams daily appear to be at greater cancer risk
than individuals with higher levels of intake. The true impact of higher
levels of vitamin C intake is difficult to assess on an individual basis and
thus a more general recommendation of 400 milligrams of vitamin C
daily seems reasonable for general health promotion. One important con-
sideration for vitamin C consumption is recognized in smokers.
Researchers have reported that it may take as much as a four to six times
greater vitamin C intake for smokers to achieve the same blood level of
vitamin C as nonsmokers. This is especially important as cigarette smoke
contains an abundant supply of free radicals and free-radical-creating
substances, and appears to increase the risk for many cancers, especially
lung cancer.

Certainly any great building

How Do We Begin to Understand Nutrition?
Certainly any great building must be constructed upon a solid foundation.
So let us go ahead and commit ourselves to building a solid scientific
foundation to explore nutrition. So, before we begin to learn how to
nourish our body, we need to have a better understanding of what needs
to be nourished. Our body is the product of nature and as such it must
adhere to the basic laws of nature. In fact, you can think of nutrition as the
scientific offspring of more basic sciences such as chemistry and biology.
Therefore, understanding the what's, why's, and how's of nutrition will
be a lot easier once a few basic areas of chemistry and biology are appreci-
ated. What follows are some fundamental principles of chemistry and
biology and a description of their relevance to nutrition and the body.
NicoNot. The anti Smoking Herbal supplement

Natural methods

All this time, I was aware of the natural methods of treatment which I had studied from the age of
30 and a few of which I had practised occassionally. I , however, dared not adopt them
wholeheartedly because of my heavy dependence on drugs. Rather late in the day, at the age of
55, I made a determined bid to do away with all drugs and take recourse to natural methods. I
began collecting and studying a greater deal of data on the subject and also consulted
naturopaths. I made drastic changes in my diet and lifestyle and started rigidly observing the
laws of nature. I was rewarded sooner than expected so much so, that for one who narrowly
escaped death at the age of 28, when my son was a year old, I can proudly say that today, at
64, when I have a nine-year-old grandson, I feel healthier, thanks mainly to my taking recourse
to nature cure methods. Of course, I do not claim that I have cured all my ailments. But I do
maintain that I have been able to control them substantially and have obtained a lot of relief
without resorting to drugs. This, I feel, is no mean achievement. I am certain that my own
success in controlling several dreaded disabilities will serve as inspiration to those readers who
are suffering from various ailments and hold out the hope of their deriving real benefits from the
natural methods of treatment outlined in this site.

THE CALORIE THEORY

THE CALORIE THEORY

A calorie is the amount of energy needed to raise the temperature of one gram of water from 14° to 15° centigrade.

The human body needs energy, first and foremost to maintain its body temperature at 98.6° Fahrenheit. But as soon as the body is active, it needs extra energy to stand vertical, to move, to speak, and so on. And on top of that yet more energy is needed to eat and digest food and carry out the basic activities of life.

The body's daily energy requirements vary according to the person's age, sex and individual needs.

Ganoderma lucidum

Ganoderma lucidum (Leyss. ex Fr.) Karst. (Lingzhi or Reishi) has been used for a long time in China to prevent and treat various human diseases. G. lucidum polysaccharides extracted from G. lucidum are one of efficacious ingredient groups of G. lucidum. A number of reports have demonstrated that G. lucidum polysaccharides modulate immune function both in vivo and in vitro. The immuno-modulating effects of G. lucidum polysaccharides were extensive, including promoting the function of antigen-presenting cells, mononuclear phygocyte system, humoral immunity, and cellular immunity. Cellular and molecular mechanisms, possible receptors involved, and triggered signaling cascades have also been studied in vitro. However, whole animal experiments are still needed to further establish the mechanism of the immuno-modulating effects by G. lucidum. Evidence-based clinical trials are also needed.

Ginger with immunosuppressants

The use of the herb, Ginger as as safe and effective remedy for many conditions.

    Ginger has been used safely for thousands of years in cooking, and medicinally in folk and home remedies. Advanced technology enables the validation of these traditional experiences. The National Center for Complementary and Alternative Medicine (NCCAM) has evaluated the results of the available studies, rating the reports from "suggestive" (for short-term use of Ginger for safe relief from pregnancy related nausea and vomiting), to "mixed" (when used for nausea caused by motion sickness, chemotherapy, or surgery), and to "unclear" for treating rheumatoid arthritis , osteoarthritis, or joint and muscle pain ). NCCAM has funded investigators to study interactions of ginger with drugs (immunosuppressants), its effect of reducing nausea in patients receiving chemotherapy, and the safety and effectiveness of its use for health purposes, as well as its impact on inflammation. Upon completion of these studies, the scope of ginger's use will be clearly identified and incorporated into mainstream therapeutic options, thereby integrating east and west, old with new, to render ginger as a true " Universal Remedy ".

British scientists at the University of Exeter analyzed six studies of feverfew

Feverfew for Migraine Prevention

British scientists at the University of Exeter analyzed six studies of feverfew, concluding that the herb significantly reduces the frequency of migraine occurrence. "In my experience," Duke says, "feverfew prevents migraines in about two-thirds of those who use it consistently." Dosage is generally 50 to 150 mg per day of powdered leaves.

best liver supplement

acne granites natural treatment

best natural hair treatment

VITAMIN B5 (Panothenic Acid) Enhances stamina

VITAMIN B5 (Panothenic Acid) Enhances stamina, prevents anemia, helps wounds heal, fights infection, strengthens immune system.HERBAL SOURCES: Alfalfa, burdock root, nettle, yellow dock.

arthritis herb

beef liver supplement

best herb for diabetes

Interactions with Herbs and Dietary Supplements

Interactions with Herbs and Dietary Supplements

Natural medicine practitioners sometimes caution that echinacea may lead to liver inflammation. Although there is no clear information from laboratory or human studies, in theory echinacea may add to liver toxicity caused by other agents, such as kava. Echinacea may affect the way certain herbs and supplements are broken down by the liver.

Echinacea is sometimes used in combination products that are thought to stimulate the immune system. For example, Esberitox® (PhytoPharmica, Germany) contains  Echinacea purpurea ,  Echinacea pallida , wild indigo root ( Baptisia tinctoria ), and thuja (white cedar). Echinacea may be combined with goldenseal or other herbs in some cold relief preparations. There is a lack of high-quality human studies that have shown added benefits or interactions of these combinations.

Echinacea is sometimes sold in combination with goldenseal ( Hydrastis canadensis ), an herb that may reduce the body's ability to absorb vitamin B.

Anesthetics, antineoplastics, antioxidants, and caffeine may interact with echinacea. However, these potential interactions are not fully understood.

The more a person smokes, the lower their IQ,

Cigarette smokers have lower IQs than non-smokers, and the more a person smokes , the lower their IQ, a study in over 20,000 Israeli military recruits suggests.

Young men who smoked a pack of cigarettes a day or more had IQ scores 7.5 points lower than non-smokers, Dr. Mark Weiser of Sheba Medical Center in Tel Hashomer and his colleagues found.

"Adolescents with poorer IQ scores might be targeted for programs designed to prevent smoking," they conclude in the journal Addiction.


While there is evidence for a link between smoking and lower IQ, many studies have relied on intelligence tests given in childhood, and have also included people with mental and behavioral problems, who are both more likely to smoke and more likely to have low IQs, Weiser and his team note in their report.

To better understand the smoking-IQ relationship, the researchers looked at 20,211 18-year-old men recruited into the Israeli military. The group did not include anyone with major mental health problems, because these individuals are disqualified from military service.


According to the investigators, 28 percent of the study participants smoked at least one cigarette a day, around 3 percent said they were ex-smokers, and 68 percent had never smoked.

The smokers had significantly lower intelligence test scores than non-smokers, and this remained true even after the researchers accounted for socioeconomic status as measured by how many years of formal education a recruit's father had completed.

The average IQ for non-smokers was about 101, while it was 94 for men who had started smoking before entering the military. IQ steadily dropped as the number of cigarettes smoked increased, from 98 for people who smoked one to five cigarettes daily to 90 for those who smoked more than a pack a day. IQ scores from 84 to 116 are considered to indicate average intelligence.

Recruits aren't allowed to smoke while intelligence tests are administered, the researchers note, so it's possible that withdrawal symptoms might affect smokers' scores. To address this issue, they also looked at IQ scores for men who were non-smokers when they were 18 but started smoking during their military service. These men also scored lower than never-smokers (97 points, on average), "indicating that nicotine withdrawal was probably not the cause of the difference," the researchers say.

The researchers also compared IQs for 70 pairs of brothers in the group in which one brother smoked and the other did not. Again, average IQs for the non-smoking sibling were higher than for the smokers.

The findings suggest that lower IQ individuals are more likely to choose to smoke, rather than that smoking makes people less intelligent, Weiser and his team conclude.

The greater their risk of taking a puff

The more that teens see cigarette ads, the greater their risk of taking a puff.

A new study shows that the particular content of tobacco marketing resonates with youth and that the vivid imagery in tobacco advertising captures their interest, although teens typically are more resistant to the promotional seduction of other products.

"Cigarettes have created a brand for every personality trait," said study lead author Reiner Hanewinkel, Ph.D., director of the Institute for Therapy and Health Research in Kiel, Germany.

"If you are looking to project independence and masculinity, think of the lonely cowboy in the Marlboro ads," added Hanewinkel, who collaborated with Dartmouth Medical School. "On the other hand, if you're looking to project a desire for romantic relationships, and friendships are playing a role, then you will choose Lucky Strike if you are a man and Virginia Slims if you are a woman."

Kids with high exposure to tobacco advertising were twice as likely to have tried smoking and three times as likely to have smoked in the past month, compared to those with low exposure. Exposure to tobacco advertising also was associated with higher intent to smoke in the future among the never-smokers, suggesting that it affects how adolescents perceive smoking even before they start.

The study, which appears online and in the April issue of the American Journal of Preventive Medicine, has relevance for the United States and other nations with partial advertising bans similar to Germany's restrictions.

The 2008 survey involved 3,415 German schoolchildren, ages 10 to 17, in rural and urban areas. Students saw images (with all the writing and brand logos removed) of six cigarette ads and eight commercial products such as clothing, cars, candy and detergent.

With the brand information missing, researchers measured adolescents' ad recognition by applying psychological assumptions about attention and memory. They inquired about how frequently students had viewed each ad image and asked about smoking habits and intentions.

"We were amazed at how often they had seen the images and could correctly recall the cigarette brand," said study collaborator James Sargent, M.D., a professor of pediatrics at Dartmouth. "For example, 55 percent had seen the Lucky Strike image and almost one quarter correctly decoded the brand."

After analyzing the data, the researchers assessed how likely nonsmokers were to try smoking. Researchers classified survey participants as current smokers if they reported smoking at least once a month.

"This is a well-done study. They controlled for all the things they needed to control for," said Stanton Glantz, Ph.D., director of the Center for Tobacco Control Research & Education at the University of California, San Francisco. Among the outside variables was whether a parent or peers smoke.

"It's a nice contribution to the literature showing that cigarette advertising is very powerful," Glantz said, noting the strong link between the amount of ad exposure and the level of youth response.
http://www.medicalnewstoday.com/articles/180902.php

Varenicline (Champix)

Varenicline (Champix) is the first non-nicotine drug developed specifically to help smokers give up, and was licensed in the UK in 2006.

The National Institute for Health and Clinical Excellence said the drug should normally be given alongside counselling and support.

Final guidance is due in July - the start of the smoking ban in England.

Varenicline, produced by Pfizer, is unusual as it both stimulates and blocks specific nicotinic receptors in the brain.

Graphic: How Varenicline works

It is thought that by stimulating the receptor it mimics the effects of nicotine to reduce cravings.

At the same time, it partially blocks the receptor preventing nicotine from binding to it, resulting in a weaker response in people who give in to temptation and have a cigarette.

Trials have shown the drug was effective after a 12-week course, with 44% of smokers managing to stop.

This compares with 18% of those given a placebo and 30% of those taking another anti-smoking drug, bupropion, which is also available on the NHS.

The main side-effect of the drug, which costs about $5.55 a day or $184.80 for a 12-week course, seems to be nausea.

'Good way'

The charity Action on Smoking and Health (ASH) had issued interim guidelines following discussions with the Department of Health to help health professionals prescribe the new treatment, while awaiting a decision from NICE, whose draft recommendations are still subject to appeal.

A spokeswoman for NICE said: "Having looked at all the evidence, our independent committee have concluded that varenicline appears to be a good way to help people who want to quit smoking.

"The draft guidance also recommends that varenicline should normally be provided in conjunction with counselling and support, but if such support is not available, this should not stop smokers receiving treatment with varenicline."

From 1 July, there will be a ban on smoking in virtually all enclosed work and public places in England.

Experts have predicted a surge of smokers attending NHS stop-smoking services in the run-up to the ban.

'Tremendous'

Nicotine replacement therapy and buproprion - an antidepressant that has been found to help smokers quit - are already widely available on the NHS.

Amanda Sanford, spokesperson for ASH, said the NICE guidance would push PCTs to offer varenicline as an alternative.

"It's important smokers are offered a choice as some people have tried nicotine replacement therapy and been unsuccessful.

"There's no reason varenicline can't be offered as a first-line treatment as it has been shown to be cost-effective," she said.

Dr Alex Bobak, a GP in Wandsworth, south London, and a smoking cessation expert, said more people were asking about stopping smoking in the run-up to the ban.

"It's tremendous we can offer this option for smokers who want to quit. "I've been using [varenicline] an awful lot and people have been asking about it."

1. Nicotine from a cigarette stimulates the release of dopamine - a substance produced by the body which triggers feelings of pleasure
2. When a smoker quits, the lack of nicotine leads to reduced levels of dopamine, causing feelings of craving and withdrawal
3. Varenicline both blocks the nicotine receptors (reducing the addictive power of the drug) and triggers moderate dopamine release to alleviate withdrawal symptoms

Champix tablets to give up smoking

Buy Champix tablets



How does it work?

Champix tablets contain the active ingredient varenicline, which is a medicine used to help people who are addicted to nicotine to give up smoking. It acts in the brain, but is not the same as nicotine replacement therapy.

Varenicline is a type of medicine called a nicotinic acetylcholine receptor partial agonist. This means that it acts on the same receptors in the brain as nicotine.

Varenicline works by stimulating the nicotinic receptors in the brain. This produces an effect that relieves the craving and withdrawal symptoms you can get when you stop smoking.

At the same time, varenicline blocks nicotine from acting on the nicotinic receptors. This prevents any nicotine inhaled in tobacco smoke from having a rewarding and enjoyable effect.

You should set a date on which you will stop smoking and start taking this medicine one to two weeks beforehand. This is because the medicine needs time to start working.

The dose is increased gradually in the first week of treatment (follow the instructions given by your doctor or pharmacist) and the medicine should then be taken twice a day for 12 weeks. If you have successfully managed to stop smoking at the end of 12 weeks, your doctor may offer you a further 12 week course of treatment.

The tablets should be swallowed whole with a drink of water. They can be taken with or without food.

You should seek help and support as much as possible while giving up smoking, even while taking this medicine, as this will increase your chance of success. Your doctor, practice nurse or local pharmacist can all provide this support.
What is it used for?

* Aid for giving up smoking in adults.

Warning!

* This medicine might make you feel dizzy or sleepy and so could impair your ability to perform potentially hazardous tasks such as driving or operating machinery. You should avoid driving or operating machinery until you know how this medicine affects you and are sure that it won’t affect your ability to perform such activities safely.
* There have been reports of suicidal thoughts or behaviour in people taking this medicine to help them give up smoking. It is very difficult to know if this is due to the medicine, as giving up smoking itself can make people depressed, especially if they already have a mental health problem, and depression is associated with suicidal thoughts. However, not all people experiencing depression and suicidal thoughts while taking this medicine had a previous history of psychiatric illness, or had stopped smoking. For this reason, if you begin to feel agitated or depressed, or experience any changes in your behaviour or thoughts about suicide or harming yourself during treatment with this medicine, you should stop taking it and consult your doctor immediately.
* Some people may find that when they stop taking this medicine their urge to smoke returns. They may also feel irritable, depressed or have difficulty sleeping. To avoid this, your doctor may consider reducing your dose slowly when you finish treatment with this medicine, rather than stopping it abruptly. Discuss this with your doctor.

Use with caution in

* Decreased kidney function.
* History of psychiatric illness, eg depression, schizophrenia, bipolar disorder.
* Epilepsy.

Not to be used in

* Pregnancy.
* This medicine is not recommended for children and adolescents under 18 years of age, as there is no information regarding its safety and efficacy in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.
Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

* The safety of this medicine for use during pregnancy has not been established. It should not be used by pregnant women. Seek further medical advice from your doctor.
* It is not known if this medicine passes into breast milk, but it is possible that it may. As a result, it is not recommended for mothers who are breastfeeding. If you have been unable to give up smoking using any other method, you should discuss with your doctor whether it may be appropriate to stop breastfeeding in order to try this medicine. This will depend on factors such as the importance of breastfeeding to the child, how much smoke the child is being exposed to and how likely this medicine is to help you stop smoking. Seek medical advice from your doctor.

Side effects

Giving up smoking with or without treatment can cause various symptoms. These include changes in mood (such as feeling depressed, irritable, frustrated or anxious), difficulty sleeping or concentrating, decreased heart rate and increased appetite or weight gain.

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with using this medicine to help give up smoking. It is not known if these side effects are a result of using the medicine, or a result of giving up smoking. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.
Very common (affect more than 1 in 10 people)

* Nausea.
* Headache.
* Difficulty sleeping (insomnia).
* Abnormal dreams.

Common (affect between 1 in 10 and 1 in 100 people)

* Sleepiness or fatigue.
* Dizziness.
* Change in taste.
* Dry mouth.
* Disturbances of the gut such as constipation, diarrhoea, vomiting, abdominal discomfort or bloating, indigestion, wind (flatulence).
* Increased appetite.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

* Decreased appetite.
* Inflammation of the nose and throat (nasopharyngitis), sinuses (sinusitis) or lungs (bronchitis).
* Feeling thirsty.
* Shortness of breath, cough or hoarseness.
* Throat irritation.
* Runny nose.
* Snoring.
* Mood swings.
* Abnormal thinking.
* Changes in sex drive.
* Tremor.
* Abnormal co-ordination.
* Problems with speech.
* Restlessness or agitation.
* Awareness of your heartbeat (palpitations) or abnormal heartbeats.
* Abnormal intolerance of the eyes to light.
* Skin reactions such as rash, itching or sweating.
* Watery eyes.
* Increased urination.
* Chest pain.
* Increased blood pressure or heart rate.
* Increased weight.
* Joint stiffness.
* Feeling cold.

Unknown frequency (cases have been reported since the medicine has been on the market)

* Depression.
* Suicidal thoughts.
* Heart attack.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

The safety and benefits of taking this medicine in combination with other medicines for stopping smoking have not been studied. Other smoking cessation medicines are therefore not recommended while you are taking this one. Using nicotine replacement therapy (NRT) in combination with this medicine has been shown to increase nausea, headache, vomiting, dizziness, indigestion, fatigue and a drop in blood pressure compared to NRT alone.

If you have severe kidney problems you should not take cimetidine in combination with this medicine, as it may increase the amount of varenicline in the blood.

The components of tobacco smoke can cause certain medicines, for example those listed below, to be removed from the body faster than normal. When you stop smoking, they are removed slower, so their blood levels may increase. This means that if you are taking any of these medicines, your doses may need adjusting after you stop smoking:

* clozapine
* dextropropoxyphene
* flecainide
* fluvoxamine
* olanzapine
* pentazocine
* phenylbutazone
* some benzodiazepines, eg oxazepam
* some beta-blockers, eg propranolol
* tacrine
* theophylline
* tricyclic antidepressants, such as imipramine
* warfarin.

People with diabetes who smoke normally need more insulin, as smoking reduces the amount of insulin that is absorbed into the blood from an injection under the skin. If you have diabetes and are giving up smoking, you may subsequently need a reduction in your insulin dose. Discuss this with your doctor.
Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain varenicline as the active ingredient.

Smoking - health risks

Smoking - health risks

Reviewed by Dr Gavin Petrie, consultant chest physician

You can eat five portions of fruit and veg a day and exercise regularly, but healthy behaviour means little if you continue to smoke.

The message that 'smoking is bad for you' is an old one, so not everyone gives it their full attention. Below we list the health risks of smoking.

Why quit smoking?

Most people know that smoking can cause lung cancer, but it can also cause many other cancers and illnesses.

Smoking kills around 114,000 people in the UK each year.

Of these deaths, about 42,800 are from smoking-related cancers, 30,600 from cardiovascular disease and 29,100 die slowly from emphysema and other chronic lung diseases.
How do cigarettes damage health?

Cigarettes contain more than 4000 chemical compounds and at least 400 toxic substances.

When you inhale, a cigarette burns at 700°C at the tip and around 60°C in the core. This heat breaks down the tobacco to produce various toxins.

As a cigarette burns, the residues are concentrated towards the butt.

The products that are most damaging are:

* tar, a carcinogen (substance that causes cancer)
* nicotine is addictive and increases cholesterol levels in your body
* carbon monoxide reduces oxygen in the body
* components of the gas and particulate phases cause chronic obstructive pulmonary disorder (COPD).

The damage caused by smoking is influenced by:

* the number of cigarettes smoked
* whether the cigarette has a filter
* how the tobacco has been prepared.

Smoking affects how long you live

Research has shown that smoking reduces life expectancy by seven to eight years.

Of the 300 people who die every day in the UK as a result of smoking, many are comparatively young smokers.

The number of people under the age of 70 who die from smoking-related diseases exceeds the total figure for deaths caused by breast cancer, AIDS, traffic accidents and drug addiction.

Non-smokers and ex-smokers can also look forward to a healthier old age than smokers.
Major diseases caused by smoking
Cardiovascular disease

Cardiovascular disease is the main cause of death due to smoking.

Hardening of the arteries is a process that develops over years, when cholesterol and other fats deposit in the arteries, leaving them narrow, blocked or rigid. When the arteries narrow (atherosclerosis), blood clots are likely to form.

Smoking accelerates the hardening and narrowing process in your arteries: it starts earlier and blood clots are two to four times more likely.

Cardiovasular disease can take many forms depending on which blood vessels are involved, and all of them are more common in people who smoke.

* Coronary thrombosis: a blood clot in the arteries supplying the heart, which can lead to a heart attack. Around 30 per cent are caused by smoking.
* Cerebral thrombosis: the vessels to the brain can become blocked, which can lead to collapse, stroke and paralysis.
* If the kidney arteries are affected, then high blood pressure or kidney failure results.
* Blockage to the vascular supply to the legs may lead to gangrene and amputation.

Smokers tend to develop coronary thrombosis 10 years earlier than non-smokers, and make up 9 out of 10 heart bypass patients.



Cancer

Smokers are more likely to get cancer than non-smokers. This is particularly true of lung cancer, throat cancer and mouth cancer, which hardly ever affect non-smokers.

The link between smoking and lung cancer is clear.

* Ninety percent of lung cancer cases are due to smoking.
* If no-one smoked, lung cancer would be a rare diagnosis - only 0.5 per cent of people who've never touched a cigarette develop lung cancer.
* One in ten moderate smokers and almost one in five heavy smokers (more than 15 cigarettes a day) will die of lung cancer.

The more cigarettes you smoke in a day, and the longer you've smoked, the higher your risk of lung cancer. Similarly, the risk rises the deeper you inhale and the earlier in life you started smoking.

For ex-smokers, it takes approximately 15 years before the risk of lung cancer drops to the same as that of a non-smoker.

If you smoke, the risk of contracting mouth cancer is four times higher than for a non-smoker. Cancer can start in many areas of the mouth, with the most common being on or underneath the tongue, or on the lips.

Other types of cancer that are more common in smokers are:

* bladder cancer
* cancer of the oesophagus
* cancer of the kidneys
* cancer of the pancreas
* cervical cancer

COPD

Chronic obstructive pulmonary disease (COPD) is a collective term for a group of conditions that block airflow and make breathing more difficult, such as:

* emphysema - breathlessness caused by damage to the air sacs (alveoli)
* chronic bronchitis - coughing with a lot of mucus that continues for at least three months.

Smoking is the most common cause of COPD and is responsible for 80 per cent of cases.

It's estimated that 94 per cent of 20-a-day smokers have some emphysema when the lungs are examined after death, while more than 90 per cent of non-smokers have little or none.

COPD typically starts between the ages of 35 and 45 when lung function starts to decline anyway.

In smokers, the rate of decline in lung function can be three times the usual rate. As lung function declines, breathlessness begins.

As the condition progresses, severe breathing problems can require hospital care. The final stage is death from slow and progressive breathlessness.
Other risks caused by smoking

* Smoking raises blood pressure, which can cause hypertension (high blood pressure) - a risk factor for heart attacks and stroke.
* Couples who smoke are more likely to have fertility problems than couples who are non-smokers.
* Smoking worsens asthma and counteracts asthma medication by worsening the inflammation of the airways that the medicine tries to ease.
* The blood vessels in the eye are sensitive and can be easily damaged by smoke, causing a bloodshot appearance and itchiness.
* Heavy smokers are twice as likely to get macular degeneration, resulting in the gradual loss of eyesight.
* Smokers run an increased risk of cataracts.
* Smokers take 25 per cent more sick days year than non-smokers.
* Smoking stains your teeth and gums.
* Smoking increases your risk of periodontal disease, which causes swollen gums, bad breath and teeth to fall out.
* Smoking causes an acid taste in the mouth and contributes to the development of ulcers.
* Smoking also affects your looks: smokers have paler skin and more wrinkles. This is because smoking reduces the blood supply to the skin and lowers levels of vitamin A.


Smoking and impotence

For men in their 30s and 40s, smoking increases the risk of erectile dysfunction (ED) by about 50 per cent.

Erection can't occur unless blood can flow freely into the penis, so these blood vessels have to be in good condition.

Smoking can damage the blood vessels and cause them to degenerate: nicotine narrows the arteries that lead to the penis, reducing blood flow and the pressure of blood in the penis.

This narrowing effect increases over time, so if you haven't got problems now, things could change later.

Erection problems in smokers may be an early warning signal that cigarettes are already damaging other areas of the body - such as the blood vessels that supply the heart.
Smoking and others

There are many health-related reasons to give up cigarettes - not just for smokers, but to protect those around you.

Babies born to mothers who smoke during pregnancy are twice as likely to be born prematurely and with a low birth weight.
Passive smoking

The 'side-stream' smoke that comes off a cigarette between puffs carries a higher risk than directly inhaled smoke.

Children who grow up in a home where one or both of their parents smoke have twice the risk of getting asthma and asthmatic bronchitis. They also have a higher risk of developing allergies.

Infants under two years old are more prone to severe respiratory infections and cot death.

For adults, passive smoking seems to increase the risk of lung cancer, but the evidence for an increased risk of heart disease is not yet conclusive.
Thinking about quitting?

As well as reducing your risk of getting a smoking-related illness, there are other benefits to quitting smoking.

* General health improves - tiredness and headaches can be linked to smoking.
* Your sense of taste and smell improve.
* Your heart will be less strained and work more efficiently.

Stopping smoking is the single biggest thing you can do to improve your health, but it's a difficult task.

Smokers who are trying to kick their habit may be disappointed to find there's no single quit method that guarantees success.

The weight of evidence suggests that smokers should set a date to stop, and do their best to quit completely from this point.

On average it takes four to five attempts to give up, and there are a number of things that can help willpower:

* nicotine replacement treatment (NRT) in the form of gum, skin patches or nasal spray
* Zyban (bupropion) is a medicine that's licensed to help smoking cessation
* behaviour modification programmes
* alternative therapies such as acupuncture and hypnosis.

Smoking a shisha

Smoking a shisha pipe is as bad for people as smoking tobacco, the Department of Health and the Tobacco Control Collaborating Centre has found.

People who smoke shisha, or herbal tobacco, can suffer from high carbon monoxide levels, its research revealed.

It found one session of smoking shisha resulted in carbon monoxide levels at least four to five times higher than the amount produced by one cigarette.

High levels of carbon monoxide can lead to brain damage and unconsciousness.

Shisha is a water-pipe, popular in many Arab countries, in which fruit-scented tobacco is burnt using coal, passed through an ornate water vessel and inhaled through a hose.

The Department of Health said it was difficult to know exactly how much carbon monoxide one cigarette produced, due to the differences in smokers' inhalations.

But measuring carbon monoxide in exhaled breath showed a normal non-smoker's level to be three parts CO per million parts of air (ppm) (less than 1% of blood not working properly), a light smoker to have 10-20 ppm (2-4% of blood not working properly), and a heavy smoker 30-40 ppm (5-7%).

The study found shisha smokers had 40-70 ppm of CO in their breath - affecting 8-12% of their blood.

Dr Hilary Wareing, director of the Tobacco Control Collaborating Centre, told the BBC's Asian Network she was shocked by the results of the research.

"Our mouths opened at the level of harm - none of the tests we did showed anything other than shisha is hazardous to health."

Paul Hooper, regional manager at the Department of Health, said the findings made the dangers of shisha a "major issue".

He said many people regard shisha "as not even smoking".

Misconception

Shisha bars, which are typically decked out with low stools and soft cushions to create an inviting atmosphere, have become popular in cities across the UK, particularly in London, Manchester and Birmingham.

At the worst, shisha was 400 to 450 times more dangerous than having a cigarette Dr Hilary Wareing Tobacco Control Collaboration Centre

An activity largely associated with Middle Eastern customers and a young crowd, there is a growing trend of themed shisha parties.

Many people who go to "shisha evenings" think it is a safer alternative to smoking cigarettes.

"You never see it in the news - 'that is terrible, don't do it' - there's no shock tactics like (there is with) cigarettes," said one young woman.

"If my mum sees me smoking shisha, she isn't going to take it as seriously as if I was smoking cigarettes," said a British Pakistani man.

It was this misconception - and finding dangerous levels of carbon monoxide in a pregnant woman who had stopped smoking tobacco, but continued to smoke shisha - which prompted the research.

"We found one session of smoking shisha - that's 10 milligrams (of fruit tobacco) for 30 minutes - gave carbon monoxide levels that were at the lowest four and five times higher than having a cigarette," said Dr Wareing.

"But at the worst, shisha was 400 to 450 times more dangerous than having a cigarette," she added.

Informed choice

Shisha smokers in a cafe in Edgware Road, London, said the findings would make them think twice about smoking.

"You know you can die from cigarettes, but you don't know you can die from shisha," said one.

"I'm now going home to research it," said another.

But not everyone is convinced.

Akram, a 27-year-old who runs a restaurant and shisha bar in Birmingham, has his own views.

"There is a health risk but it's all down to consumption and all the evidence I've seen is that smoking shisha is nothing like smoking even one cigarette," he said.

He said he did not actually inhale shisha smoke.

It is not just the level of carbon monoxide that is causing concern.

Qasim Choudhory, a youth worker at the NHS Stop Smoking Service in Leicester, said sharing a shisha pipe could pass around infections.

"There's a heightened risk of getting TB, herpes and infections like that," she said.

"Now you know swine flu is on the top of the agenda right now - there's no kind of direct correlation, but at time when we're up on our hygiene, it's not the best type of activity to be taking part in."

Dr Wareing said more research on exactly how dangerous shisha was needed to be conducted to enable people to make an informed choice.

Paul Hooper said the department was working hard at "how best to get the message - that it is dangerous - across to the consumer".

"But how do you label the tobacco and the shisha pipe? It's not as simple as labelling a packet of cigarettes," he added.

smoker and planning to get pregnant

If you're a smoker and planning to get pregnant, there's good news and bad news.

First the good news: Australian researchers say women who stop smoking before 15 weeks of pregnancy cut their risk of giving birth prematurely and having small babies to the same level as non-smokers.

Now the bad: Women who don't quit by 15 weeks are three times as likely to give birth prematurely and twice as likely to have small babies, compared to women who stopped smoking.

The lesson, says lead author Dr. Lesley McCowan from the University of Auckland, is that that maternity care providers need to emphasize the importance of mothers-to-be giving up smoking as early as possible.

The findings are based on a study of 2,500 healthy women, 80 per cent of whom were non-smokers and 10 per cent of whom had stopped smoking before 15 weeks. The remaining 10 per cent smoked past 15 weeks.

Timing critical to reduce risk

Doctors already know that when pregnant women stop smoking their likelihood of premature births and delivering low-birth weight babies decreases, but this is one of the few studies to examine whether there is a critical time by which smoking must stop to reduce such risks.

Another important finding was that women in the study who stopped smoking reported they were not more stressed than women who continued to smoke.

In conclusion, the authors write that their "results are of considerable public health importance.

"The data suggest that the adverse effects of smoking on these late pregnancy outcomes may be largely reversible if smoking is ceased early in pregnancy, offering an important incentive for pregnant women who smoke to become smoke-free early in pregnancy."