Imagine that you're a longtime smoker who is well aware of the health risks of smoking, not only in terms of lung cancer but also other cancers, heart disease, and other illnesses. You want to quit smoking, and perhaps you've tried several times, even trying Chantix, the nicotine patch, and other techniques. But in the end, it's been hard to kick the pleasurable sensation of cigarettes. What if you could just remove that?

In fact, there's a company called Nabi BioPharmaceuticals that is trying to harness the immune system to neutralize the reinforcing effect of nicotine. Anyone interested can see a few summary videos of their "NicVax" (Nicotine Conjugated Vaccine) concept , but the brief summary is that they've created a vaccine made of a nicotine derivative bound to a special carrier protein that, when injected, can teach the immune system to generate antibodies that recognize nicotine, bid to it in the bloodstream, and therefore block the ability of nicotine to cross through the blood brain barrier and stimulate receptors on brain neurons that release neurotransmitters signalling reward/pleasure. It's injected a total of six times over six months.

Over the past few years, the company has done research that is highlighted in a company summary document that clearly demonstrates that many, but not all, patients who receive the NicVax vaccine generate an antibody response to nicotine. Suggesting a cause/effect relationship was the fact that there was a good correlation of high levels of anti-nicotine antibodies and success at quitting, measured by reported behavior and also blood tests to confirm it. When the company looked at differences between those who quit and those who continued to smoke, the people who quit had significantly higher antibody levels than those who didn't quit. Also, when they looked at the top 30% in terms of antibody levels (a group that I must presume that they arrived at because they kept looking at the data from every angle and focused on the one that made their work look most promising through the "retrospectoscope"), that group achieved a nearly 25% sustained quit rate, vs. only 13% for the recipients of placebo vaccine injections.

Among the leading questions, then, are:

1) Why don't all vaccinated patients achieve a good antibody response?

2) Why don't all patients who achieve an antibody response lose the desire to smoke?

3) If this is a sustained immune response, why do some of the people who quit smoking for a few months begin smoking again several months later?

This research is moving forward with some large clinical trials to test effectiveness. One randomized phase III trial that is just getting started in the US, by Nabi in collaboration with the National Institute of Drug Abuse, is comparing NicVax to placebo in 1000 actively smoking patients. Another randomized phase III trial of 600 active smokers is based on the Netherlands and giving the Chantix pill in combination with either the NicVax vaccine or placebo. So while there is still more work to be done, this approach may lead to more people being able to quit smoking forever, a very good thing even if it isn't the answer for everyone.