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Shaking, sweating, confusion, disorientation and the depths of despair: the withdrawal symptoms peaked 24 hours after I came off nicotine. Not that I'd smoked for five years, you understand. Instead, I went cold turkey last month when I abandoned the nicotine lozenges that had become my crutch - and an even harder addiction to break. I'd been hooked on the cure for at least the past two-and-a-half years, and the withdrawal was worse than anything I'd experienced coming off cigarettes.
Nicotine replacement therapy (NRT) and cigarettes have been compared to the difference between heroin and its substitute, methadone, which is said to be far harder to be weaned off. Yet I was embarrassed that the debilitating withdrawal symptoms that left me a basket case for three days and jittery for almost a week were not the result of a class-A drug but a sweet flavoured lozenge or gum available in every supermarket.
A month on, I still have the empty, insecure feeling associated with nicotine withdrawal that every former smoker will understand - except I have no interest in cigarettes and only miss the tablet substitutes.
But in the wake of Scotland's smoking ban, sales of NRT products have increased: indeed, according to Asda's figures, they have trebled. Some even display nicotine gums next to ordinary chewing gum.
Allen Carr, the most famous anti-smoking guru of our times and author of the bestselling book, The Easyway to Stop Smoking, believes my experience is just the tip of the iceberg. He fears it is only a matter of time before NRT makes the leap from drug to confectionery. Nicotine-replacement toffee, coffee and chocolate are said to be in testing. "I wonder if these flavours are designed to help smokers quit or are being created for the next mass market of NRT users: our children," says Carr.
As an adult who got hooked on NRT, I dread what it would be like if a child were given the sweet shots of a highly addictive drug. Yet NRT can legally be given to children as young as 12; in an initiative in County Durham, pupils at six secondary schools are being offered nicotine patches as part of an initiative to stop them smoking.
Somehow I didn't stop to consider that by ditching cigarettes for lozenges or gum I was moving on to something equally addictive. But, unlike cigarettes, there are no prominent warnings on these packets.
"The problem facing us today," says Carr, "is not just the tobacco industry but the nicotine industry, which is made up of two major players - the tobacco industry and the pharmaceutical industry. Both have a vested interest in perpetuating addiction to nicotine, not curing it. We have more and more people attending our clinics to get NRT, which does not cure addiction to nicotine - it perpetuates it."
He insists that those who stop smoking by using it do so despite it, not because of it.
I quit my 20-a-day habit easily enough when I fell pregnant for the first time, but after a blip when I smoked for a few days after the birth of my second son, I was desperate not to start again and turned to NRT.
Microtabs, designed to be placed under the tongue, gave me a persistent sore throat. Then I chewed gum until my jaws ached, before moving on to lozenges.
They were a revelation. Suddenly, I was able to get the nicotine buzz of a cigarette with no unpleasant side-effects such as the smoke, or the smell or the tar. Popping them like sweeties, I could get the pleasure of nicotine at times when I'd never have been able to smoke, like bathing the kids or in the cinema. They were discreet: no-one knew the sweet I was sucking was giving me a head-rushing buzz and I was congratulated for not succumbing to cigarettes again.
But within the three months that it's recommended you take NRT such as gum, lozenges, microtabs or patches, I was hopelessly hooked.
Little wonder, considering the tablets, available in 4mg or 2mg of nicotine strengths, were far stronger than the packets of Silk Cut I used to puff, at 0.1mg of nicotine. Even the lowest strength is stronger than "heavy" cigarettes such as Camel, which measure 0.9mg nicotine per cigarette.
But, of course, I wasn't smoking - which means I wasn't inhaling tar or toxins from a cigarette. So, was I in any danger? Could I have stayed sucking the lozenges happily forever?
The pharmaceutical company GlaxoSmithKline, which manufactures lozenges, said in a statement that "long-term use of NRT does not seem to be associated with any significant harmful effects".
It added: "Nicotine from smoking cigarettes is addictive in large part because smoking delivers high doses of nicotine to the brain very quickly - within seconds of taking each puff. In contrast, NRT provides nicotine more slowly and doesn't give the same 'hit'."
The statement added that the prevalence of abuse (use for reasons other than smoking cessation) and of dependence (that is, difficulty stopping) with currently available nicotine medications, was nil for the nicotine patch or very low (less than 10% of users) for nicotine gum, nasal spray and inhaler.
It added: "Even if dependence on nicotine medications develops, there is likely to be an overall health benefit if the individual is no longer smoking cigarettes."
It said that NRT "typically" provided less nicotine than cigarettes. Questioned about why levels of nicotine are so high in NRT, more than the strongest cigarettes at 0.9mg of nicotine, the company's explanation was that "cigarettes actually contain much more nicotine than this - about 10 times more - but the 0.9mg figure is what the tobacco companies say the smoker will inhale. This is based on measurements from a smoking machine. Unfortunately, real smokers do not behave in the same way as the machine". Smokers take more or deeper puffs, and consciously or subconsciously block ventilation holes in the filter.
The company's licence allows for adults to use it unsupervised for up to nine months - after which, it says, they should seek more help and support from the healthcare professionals.
But when I asked pharmacists and doctors for advice, I was told to vary my tablets with normal sweets or gum, which left me as irritable as a smoker denied a cigarette and only compounded my fear that I would never be able to beat the secondary addiction.
Aware that my dependence was far from waning and under increasing pressure from my family to ditch the tablets, I also began to fret about possible side-effects. I had worsening insomnia, not helped by the powerful stimulant I was sucking from dawn to just before bedtime; then I heard about someone with stomach ulcers exacerbated by nicotine gum, and I began to worry about the future risks of mouth cancer.
But I was far from alone and I continually met people at the counter of my usual chemist who said they'd been taking lozenges for months or years. I was even told of one woman on nicotine gum for 23 years.
Anne Penman, a laser therapist whose acupuncture-based treatment eased my withdrawal symptoms, treats people addicted to NRT. "Some people are using both, like wearing patches at work and removing them for a cigarette at breaks and at the end of the day," she says. "Women seem more prone to NRT addiction, partly because of the weight gain associated with stopping smoking.
"What we have now are people who feel too foolish to come forward for help. They feel guilty because family and friends think they are nicotine-free when, of course, they are simply a new type of addict."
I replaced a 20-a-day cigarette habit with a 10-a-day nicotine lozenge habit that cost about £7.50 for a pack of 36, so it was cheaper and without nasty side effects such as the risk of lung cancer or heart disease. But if I ran out, I panicked.
It was a hollow victory over cigarettes and could have been avoided by three days of cold turkey at the very beginning. Instead, many people will now be substituting that with a lifetime of nicotine addiction.
Copyright © 2006 Newsquest (Herald & Times) Limited.All Rights ReservedSource Link:
Thanks Joel for sharing this find!
Thanks for the email and ebook. I would be a good "example" in regards to how the nicotine replacement products can actually be more harmful than helpful. I have been messing with the gum and patches for over 10 years now. Again, I became addicted to nicotine while chewing tobacco over a period of about 5 years. After 5 years of chewing tobacco, I wanted to quit, so I turned to what was then a new product, the nicotine gum.
I started out with the 4mg and chewed it like regular gum. I had to in order to keep the level of nicotine in my body that I was accustomed to. I have been chewing the gum now for a period of over 10 years! I can assure you that it's every bit as addictive, if not more so, than chewing tobacco was. When I would drink alcohol, I would need to increase the number of pieces of gum or even smoke a cigarette to keep the nicotine at a level that didn't make my body feel uncomfortable. Having never been a smoker, I began using cigarettes when I would drink alcohol. When I attempted to quit the gum, I went from the 4 mg to the 2mg thinking that would be a step in the right direction - I just chewed more pieces. I have attempted to get off the gum several times and have actually had to use a nicotine patch to try to calm my withdrawal from the gum. Isn't that ridiculous - having to use the patch to get off the gum?
Right now I am in my 2nd day of quitting. I am experiencing severe nicotine withdrawal including headaches, irritability, trouble with concentrating & sleeplessness. Please feel free to use this information but just use my first name of "Frank" and not my last name. Again, I would be a great case study for you if would like to check on my progress. I know that there are quite a few people addicted to the NRT products. Nicotine, no matter what form it is ingested, is simply bad news. In my case, the gum or patch is just as addictive as chewing tobacco or smoking cigarettes,
Obama's New Addiction?November 2, 2007, 1:15 pm New York TimesSenator Barack Obama is using nicotine gum to help him quit smoking. Now the question is, can he quit the gum?Mr. Obama has said he started using the nicotine gum Nicorette about nine months ago. That's six months longer than the three months recommended on the gum package label. And Mr. Obama is not the only quitter who is still seeking a nicotine fix months after giving up cigarettes. A small percentage of the people who use nicotine replacement products like gums or lozenges end up hooked on a new habit, say doctors who specialize in smoking cessation. A colleague tells me her husband still chews the gum although he quit smoking several years ago.Smoking cessation experts say they hope Mr. Obama's use of nicotine gum will encourage smokers to try a nicotine replacement product to help them quit. Although nicotine therapy doubles a smoker's chance of successfully kicking the habit, use of the products remains relatively low. "The problem is not that people use it too much,'' noted Lynn T. Kozlowski, interim dean of the school of public health and health professions at the University at Buffalo. "The greater problem is that they use it too little. People use it for a week, and then they are back smoking cigarettes."People often don't stick with nicotine gums and lozenges because they dislike the taste. Another concern is that many people think nicotine is what makes cigarettes harmful. But nicotine is what makes cigarettes addictive. The harm comes from the combustion and release of 40 known carcinogens and other toxic chemicals into your body every time you take a puff.Last month, a study in the medical journal Addictive Behaviors noted that part of the problem is that nicotine gums and lozenges have stricter labeling requirements than cigarettes themselves. Cigarette packages usually contain one simple boxed warning about the health risks of cigarettes. But package labels on smoking cessation products come with detailed warnings about use and side effects. The language leaves the impression that products to stop smoking are as risky or riskier than cigarettes themselves, said lead author Dr. Kozlowski. The study was aimed at developing a consensus statement for consumers about the safety and benefits of nicotine replacement products.Doctors say their goal is to get more people to try nicotine replacement products as an aid to help them kick the smoking habit. Most people won't get hooked on the nicotine products, but a few people will. Susan Zafarlotfi, clinical director of the Breath and Lung Institute at Hackensack University Medical Center in New Jersey, said one of her patients quit smoking a year and a half ago but still uses nicotine gum. "Especially when he smells someone else's smoke, he goes for the gum,'' she said.Long-term use of nicotine gum is discouraged in part because it can be expensive and the gum can potentially stick to and damage dental work. Pregnant and nursing women and people taking certain medications may also be advised against using nicotine products. Some people get side effects from nicotine products, including headaches, hiccups, sore jaw and hives.Dr. Zafarlotfi says that once someone has stopped smoking, she tries to encourage patients hooked on nicotine gum to start substituting real gum from time to time. "You may get a placebo effect," she noted.Dr. Scott Sherman, associate professor at the New York University School of Medicine, says he encourages people to wean themselves off nicotine gum once they've quit smoking. "But if I had a choice between them being on Nicorette gum or going back to smoking, there's absolutely no question the gum is better," he said.Source Link:Note: the bottom of the above link allows readers to submit commentsCopyright New York Times 2007
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