Although Jed Rose may live in tobacco country, that is where his affiliation with the industry ends.
While the University's roots are grounded in tobacco, Rose works to patent inventions that challenge the big businesses that get people hooked.
"The leading innovations in smoking cessation are coming from tobacco country," he said. "It is kind of ironic."
Having stumbled into the field of nicotine research in 1979 while at the University of California at Los Angeles, Rose eventually co-invented one of the most popular and standard forms of smoking cessation tactics-the nicotine skin patch. When he moved across the country years later, he brought his expertise and his patent savvy with him to Durham.
At Duke, Rose is a medical research professor in the Department of Psychological and Behavioral Sciences and director of the Nicotine Research Program. Nestled behind Mad Hatter's Bake Shop in Erwin Square, the Medical Center and Veterans' Affairs Hospital initiative has housed many innovations that help smokers kick the habit.
Rose became hooked on nicotine research at UCLA, where he tried to figure out how nicotine is so addictive while its immediate physical effects are so subtle.
Although Rose has never taken a drag, his research still has a personal side. "My father was a smoker and he was a physician," he said. "He died at a fairly young age, almost certainly due to smoking."
The reasons that smokers are stimulated by cigarettes is that nicotine stimulates the central nervous system, eventually activating the pathway that reinforces the behavior of smoking. Nicotine also binds to receptors that cause a discharge of adrenaline from the adrenal gland.
The idea of the nicotine skin patch was born in a car ride to a family reunion.
After discussions with his brother, a physician familiar with the use of skin patches for motion sickness, Rose began to wonder if the approach could be applicable to nicotine.
Although many experts snubbed the idea, pointing out that a skin patch would introduce nicotine at a much slower rate than smoking, Rose believed that the "seven-second hit from the lungs to the brain" was not as important as the effects of the nicotine itself.
He then began working with his mentor, Dr. Murray Jarvik, chief of the psychopharmacology unit at the West Los Angeles VA Hospital and then a professor of psychiatry at UCLA.
Rose's initial hunch proved correct, and they then turned themselves to the even more difficult proposition of patenting the treatment. "A person in New Mexico filed a patent at the same time," Rose said. "It turns out that we were first."
After the patent process, Rose and his associates at UCLA had to find a company willing to market the new product. It wasn't easy.
"We thought, 'Wow, the whole world will beat a path to our door.' But no companies were interested in working on it with us," he said.
Finally, in the late 1980s, Ciba-Geigy-now Novartis-became one of the sponsors of the nicotine skin patch, and the first patch was launched on the market in 1991.
Although the nicotine patch has only a 10 to 20 percent long-term success, Rose said, but other inventions have made the patch concept more effective.
Working with Edward Levin, an associate professor of psychology and behavioral science at Duke, Rose discovered the combination of nicotine and mecamylamine in a single skin patch would lead to a more effective treatment.
If combined in low doses, mecamylamine blocks some of the receptors in the brain, while the nicotine from the patch occupies other receptors.
Elan, a pharmaceutical company, has developed a nicotine-mecamylamine skin patch, and the combination leads to two to three times higher success rates than the nicotine patch alone.
In addition, Rose has invented several other innovative cessation strategies.
"[Rose is] really a gadgeteer," Jarvik said. "He's really fantastic at inventing equipment, putting it together, making it work."
Instead of the vapor form of nicotine that was originally used in a nicotine inhaler, Rose developed a powder, nicotine-salt form that makes the amount of nicotine inhaled more potent, and therefore more effective.
Duke owns the patent on the new nicotine inhaler that Rose developed, which ultimately delivers not only nicotine but the sensory feeling, Rose said, of the "grab in the throat" effect one receives from smoking.
The phrase "red hot chili pepper" takes on an entirely different meaning when applied to Rose's latest, and perhaps most creative, invention.
Inhaling the ingredient capsaicin, an ingredient that makes a chili pepper hot, stimulates nerve endings in the respiratory tract, makes a smoker strongly feel the effects of smoking a less harmful, low-tar cigarette. "If you put capsaicin into a low-tar cigarette," Rose said, "it feels like a real cigarette."
Low-tar cigarettes, if smoked no more intensively, have one-tenth of the dangerous tars and carcinogenic effects as regular ones.
Although this and other creative answers might help smokers kick the habit, Rose knows how the game is played.
"Each and every invention seems to be an inordinate amount of time to attract a sponsor," he said. But Rose knows that his work is worth the wait.
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