4th quarter 2004

Vaccination against smoking

The US biotech company Nabi Biopharmaceuticals recently reported that in a Phase II clinical trial, 33% of the smokers who had been administered the NicVax nicotine vaccine succeeded in stopping smoking for at least 30 days. In the placebo group, on the other hand, only 9% succeeded in stopping for that length of time.

In a press release, Nabi Biopharmaceuticals announced that the smokers who had received the highest dosage of the vaccine reduced their average cigarette consump¬tion considerably compared to those who had received lower dosages or placebos. Confirmation that individual test participants had in fact ceased to smoke was obtained by examining biochemical markers for smoking (cotinin and carbon monoxide).

The vaccine, which was administered to the participants in a series of four injections over a six-month period, consists of a bacterial protein to which nicotine has been bonded. This construction is necessary in order to make the immune system aware of nicotine, as individual nicotine molecules are normally not perceived as foreign or dangerous.

Bonding nicotine to the protein, on the other hand, stimulates the immune system of vaccinated persons to form antibodies against nicotine. If vaccinated persons smoke, their antibodies intercept the nicotine in the bloodstream and prevent it from reaching the brain, thus interrupting the addiction mechanism that is located there.

In the initial hours following publication of the data, Nabi Biopharmaceuticals' stock price rose by 18%. However, there are also other companies working on anti-nicotine vaccination (Xenova Group plc and Cytos Biotechnology AG), as well as pharma¬ceutical companies testing anti-smoking medications that utilise other mechanisms.

Effects

The availability of a potent therapy against smoking could — in combination with conventional measures — largely eliminate this health-impairing behaviour. Since smoking is responsible for a large share of morbidity and mortality, the advent of such a therapy would have a substantial impact on health and life insurance. (A study conducted in Louisiana in 1994 attributed one quarter of all deaths to smoking, asserting that smoking had shortened the lives of smokers by an average of 13 years.) Breaking the addiction to smoking would decrease the frequency of lung cancer, chronic obstructive lung disease, ischaemic heart disease, myocardial infarction, stroke and smokers' leg, among others. Morbidity and mortality would shift to a higher age, which would be economically advantageous, since smokers often fall ill while still of working age. This would apply analogously to disability income and TPD insurance.