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Great American Smokeout ThursdayHere in the U.S. Thursday Nov. 17th's dawn will herald the 29th Great American Smokeout and yet another opportunity to quit smoking. But there's been a slight change since the American Cancer Society's first Smokeout in 1976. Over the past two decades the pharmaceutical industry was allowed to redefined the word "quitting."
Instead of the Smokeout being a day to discover that life without nicotine might actually be do-able -- and the days that follow as well -- over the next week millions in marketing will be spent encouraging smokers to spend the day toying with pharmaceutical grade nicotine, otherwise known as nicotine replacement therapy or NRT- the nicotine patch, gum, lozenge and inhaler.
The sales pitch is usually two-fold. First, it will be suggested that in the real-world use the patch, gum or lozenge will double a quitter's chances of quitting for good. Next it will likely suggest that quitting cold turkey is extremely difficult or that few cold turkey quitters succeed. Both assertions are false.
As for it being almost impossible to quit smoking cold turkey, nothing could be further from the truth. The American Cancer Society's Cancer Facts and Figures 2003 report indicates that over 90% of all long-term successful quitters quit smoking cold turkey. With 46 million ex-smokers, it means that more than 40 million Americans quit have successfully quit smoking cold turkey.
Contrary to it being almost impossible to quit cold turkey, a far more accurate and honest representation would be that it is the cessation method used by almost all successful quitters.
As for being twice as effective, only in formal clinical studies - not here in the real world. California, Minnesota, London, Quebec, Maryland, never once in any quitter survey have NRT users generated a higher six month quitting rate than those quitting entirely on their own. Never! But how can that be?
The pharmaceutical industry has known all along that nicotine is a psychoactive chemical which produces alert dopamine/adrenaline intoxication. It provides an extremely alert unearned "aaahhh" reward sensation. It makes the heart pounds faster, the fingers to grow cold and the senses perk.
In clinical studies quitters were told that they had a 50/50 chance of receiving weeks or months of free NRT products, or being assigned to a placebo group where the patch, gum or lozenge was normally nicotine free.
A June 2004 study published in Addictive Behaviors looked at blinding in clinical NRT studies and found that they were not blind as claimed, as 71% assessing blindness failed their own assessment as "subjects accurately judged treatment assignment at a rate significantly above chance."
Let's put it this way. If you were a smoker hoping to get weeks or months of free nicotine gum would you have stuck around and allowed yourself to be toyed with if your expectations were frustrated? The opposite is also true. If your expectations were fulfilled, would you have stayed around and attended the study's counseling sessions, accepted ongoing instruction and support (which each have their own independent quitting effectiveness), and have generally cooperated with those you knew were your ongoing source of free pharmaceutical grade nicotine?
What's it all mean? It means that NRT's clinical victories were not earned but by default. Contrary to marketing innuendo, never once in any clinical study did NRT quitters compete with quitters wanting to quit cold turkey - quitters with every expectation of abruptly ending all nicotine use.
There is no money to be made in on-your-own quitting and cold turkey quitting has few champions. But that isn't entirely accurate. It depends on your definition of champion, as here in the U.S. we're over 40 million strong.
John (Gold x6)
- No Nicotine Required thank you very much!
In the world of nicotine marketing, January 1, 2006 will likely mark extremes in two regards. It will in all probability be the day of the year when the fewest cigarettes are smoked and also the day when the most replacement nicotine is used.
If you successfully dodge the flood of NRT commercials this last week of the year you likely don't spend much time watching television. At least in that regard, not watching TV might be the healthiest thing a smoker contemplating a New Year's quit or an ex-smoker can do.
With more than 50% of all smokers having now tried replacement nicotine at least once, and over 95% having relapsed within a year, you'll likely notice a different tone to the commercials. They'll be bashing cold turkey quitting harder than ever but that's nothing new. What's new is that for the first time pharmaceutical companies are beginning to attack smoking.
Think about it. When have you ever heard an NRT commercial tell you that smoking was bad for you. Probably never. The tobacco industry and pharmaceutical industry have long had an agreement not to attack one and other. In fact, until last year the Philip Morris website was openly asserting that the key to successful quitting was to buy medicine (pharmaceutical grade nicotine) and use it.
But recently I've noticed that Philip Morris has demoted NRT a notch or two and GlaxoSmithKline actually issued a press release on December 5th that, aside from blasting cold turkey (my rebuttal - GlaxoSmithKline Attacks Cold Turkey Quitting ), for the first time actually attacked smoking as unhealthy (see GSK's press release ).
When Joel titled this thread I doubt he foresaw just how messy these nicotine sales messages could get, but then again, knowing Joel, maybe not. I think we're about to hear some rather wild assertions. Keep your ears open and if you are quick enough to jot down the commercials assertions we'd fit well in this thread.
What we might want to keep in mind is that all nicotine comes from the exact same plant and that it probably isn't unusual for both the pharmaceutical and tobacco industry to be buying from the same farmers.
For visitors looking in, there have only been two published nicotine patch studies looking at success rates for second time patch users and in the first (Tonnesen 1993) 100% relapsed to smoking within 6 months and in the second (Gourlay 1995) 98.4% of study participants relapsed within 6 months.
Still just one rule guarantees success to all ... no nicotine just one day at a time, Never Take Another Puff, Chew, Patch, Pinch or Lozenge.
John (Gold x6)
| A few years back John came across a study done in Malta where they were evaluating the success of their smoking cessation programs done throughout the country so as to plan out the strategy for their future clinics. Here is the link John put up to that study: http://home.um.edu.mt/med-surg/mmj/15_01_7.pdf |
There are many that would be shocked by the conclusions drawn from the study. For what the study showed was that the six month cessation rate for the groups being examined was just about 10%. Of those who quit, eight of the ten went cold turkey. I don't know what the usage status was of the two using NRT, meaning, were they still using NRT at the six month mark or not? Giving them the benefit of the doubt that they had gotten off the NRT, it would still mean that 80% of the success stories were cold turkey quitters.
So what was the conclusions of the study investigators on how to improve their programs?
Well they thought that one of the problems with the approach being used was that participants were given a choice of going cold turkey or of using pharmacotherapies such as NRT. They concluded that the way to improve the program was to make NRT the cornerstone of future programs. As soon as I read that conclusion it made me think of this article:
"I Liked My Other Smoking Clinic More!"[/size]
Almost 20 years ago when I was conducting one of my first Stop Smoking Clinics, one of the successful participants, a lady named Barbara, told me that she had once attended another clinic and liked it more than ours. I asked her how long she had quit for in that program and she said, "Oh, I didn't quit at all." I then asked her how many of the other people quit. She replied, "I don't know if anybody quit." I then asked, if nobody quit, why did she like the program more? She answered, "When I completed the program, I didn't feel bad about smoking!"[/size]
The task of any smoking clinic should be to help the participant break free from the powerful grip of the nicotine addiction. To do this, each participant needs to have a thorough understanding of both why he or she smokes and the consequences associated with maintaining use of cigarettes. Cigarettes are addictive, expensive, socially unacceptable, and deadly. How in the world can any individual or clinic realize these effects and minimize the significance to the point where a smoker doesn't feel bad smoking?[/size]
The natural impulse of most smokers is to deny the health and social implications of smoking. When he picks up a newspaper and sees a headline with "Surgeon General", he will read no further. When he hears a broadcast on radio or television about the dangers, he either totally disregards the message or maintains the false belief that the problem doesn't apply to him. But eventually, even his own body complains. He may experience physical symptoms such as coughing, wheezing, pains in chest, numbness in extremities, headaches, stomach aches, hoarseness, and a variety of other complaints. He will generally pass the blame to the weather, his diet, to his stress, to a cold or flu, to allergies or any other excuse he can muster up to protect his cigarettes.[/size]
Our clinic was designed to permanently destroy all rationalizations of smoking by the smoker. He may make up lots of excuses for smoking, but he knows that they all are lies. Our clinic will accomplish one of two goals. Either the smoker will quit smoking, or the clinic will **** up his smoking for the rest of his life. No longer will he be able to sit back at the end of a day and think to himself in ignorant bliss how much he enjoyed his cigarettes. To the contrary, if any thought of smoking is allowed to creep into consciousness, it will be anger over how stupid it was to inhale 20, 40, 60 or even more cigarettes that day, and how sad it is that he is probably going to do the same again tomorrow.[/size]
Why do we want to make the smoker miserable about smoking? Because maybe if he gets mad enough about smoking he will stop it. Sooner or later logic may motivate him to stop. Maybe he will do it on his own, or maybe he will come back to us for help. How he does it is not important; what is important is that he does quit. For, while the concepts we instill in him may make him miserable, not understanding them can cause more significant long term suffering.[/size]
If our clinic did what Barbara's first clinic accomplished--alleviating negative feelings toward smoking--it could result in the ammunition necessary to maintain smoking. Since cigarettes are responsible for over 400,000 premature deaths per year and the crippling of literally millions of others, alleviating the anxiety of smoking is not in the best interest of the smoker. Consider the physical, psychological, social, economical and any other personal consequences of smoking. Consider them all and NEVER TAKE ANOTHER PUFF![/size]
The original subject of this letter, Barbara was in a clinic I ran back in 1977. Again, she was in a group of people most of whom had successfully quit smoking. She did not. She was in another group at one time where she also had not quit smoking--but then again, neither did any of the people in her group. So where would she turn if she ever somehow decided that maybe she should quit again? I suspect she would have gone back to her other program.
Its amazing what kind of conclusions people can draw from different situations. Everyone here should know that there are other schools of thoughts and options out there for how to attempt to quit smoking. But always try to use the simplest level of logic when analyzing the problem at hand here. The problem is everyone here is addicted to a drug--nicotine. The way most people here got addicted to nicotine is by inhaling burning tobacco, usually via cigarettes. Inhaling burning tobacco is dangerous and basically downright deadly. The only way to eradicate the risks of inhaling burning tobacco is to not inhale burning tobacco. Once a person becomes nicotine free the physical need to inhale burning tobacco or to take in nicotine via any route of administration to stave off nicotine withdrawal will be permanently over. Your body will never need nicotine again as long as you never take nicotine from any NRT source and as long as you always remember when it comes to burning tobacco products that to stay smoke free you must never take another puff.
|From: John (Gold)||Sent: 7/10/2006 6:23 PM|
13th World Conference on Tobacco
or Health Drenched in Nicotine
WhyQuit - Monday, July 10, 2006[/size]
Chantix and ChampixThis year varenicline (Chantix and Champix) is the new kid on the block. Pfizer boasts that it aided 1 in 5 clinical trial users in quitting for a year. But aside from Chantix/Champix use, a number of study design factors may have heavily influenced outcome. More alarming, there's mounting user concerns that Pfizer has failed to adequately warn smokers about adverse events, including "frequent" risk of significant muscle and joint pain (what Pfizer lists as "arthralgia, back pain, muscle cramp, musculoskeletal pain, myalgia" - see page 14), without telling users how frequently, or that symptoms may persist long after varenicline use has ended.Link to Pfizer's complete list ofChantix / Champix Adverse EventsBut if the Chantix / Champix user makes it past the side-effects, they truly will experience up to 60% of the dopamine output that nicotine would have generated if sitting on the exact same acetylcholine receptors. The trick with Chantix / Champix isn't in feeling comfortble while using it but adjusting to living without it, as more than half of clinical trial users who quit smoking for 3 months while using varenicline relapsed within a year.If you have a friend or loved one using Chantix or Champix there's absolutely no reason, whether they continue using it or not, that they cannot go the distance and succeed, so long as zero nicotine finds its way back into their bloodstream. Key is relapse prevention. You may want to send them the link to downloading Joel's free PDF book "Never Take Another Puff" which can be downloaded at:Reporting AdverseChantix / Champix EventsIf you know someone using Chantix or Champix who experiences significant side effects encourage them to ...immediately call their physicianAlso, encourage them to report the adverse reaction to their national health officials. Here's a few links:U.S. Food & Drug Administration - http://www.fda.gov/medwatch/U.K. Medicines and Healthcare Products Regulatory AgencyAustralian Therapeutic Goods AdministrationCanadian Adverse Drug Reaction Monitoring Program
|FOR IMMEDIATE RELEASE |
Saturday, November 11, 2006
Charleston, South Carolina