Be prepared to hear some confusing information

Rickrob53 Gold
Joined: 19 Dec 2008, 00:03

11 Nov 2005, 06:24 #41

I see by JoeJ's post above that one of the ingredients of the nicotine patch is High Density Polyethylene.
I wonder how many people realize that High Density Polyethylene is the same material that some sewage pipes are made of?

No one needs to stick any nicotine-laced sewage pipe material on your body to quit smoking! Cold Turkey works... Millions of people have done it... I've done it... you can do it!

21 months of freedom

Joined: 18 Dec 2008, 23:57

15 Nov 2005, 23:49 #42

With the Great American Smoke Out rapidly approaching I thought it might be a good idea to bring materials up to address much of the marketing that is going to be aimed at smokers wanting to quit over the next week. The increases in advertising and media kind of coverage that occurs over the next week may in fact result in more people starting to think about smoking cessation.

Unfortunately, many are going to get side tracked into the marketing blitz of products to buy to quit as opposed to getting any real education or help in understanding how to quit and how to stay off.

Being that we have the potential of having more people finding their way to Freedom this week I will be keeping many of our educational materials and information supporting cold turkey quitting near the top.

For the record, quitting smoking and staying smoke free is as simple as just stopping smoking and then making and sticking to a personal commitment to never take another puff!


John (Gold)
Joined: 18 Dec 2008, 23:57

26 Dec 2005, 11:22 #43

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)

Last edited by John (Gold) on 12 Apr 2009, 07:31, edited 1 time in total.

Joined: 18 Dec 2008, 23:57

04 Mar 2006, 06:02 #44

Next week the UK will once again be holding it's official "No Smoking Day." I thought it might be a good idea to bring materials up to address much of the marketing that is going to be aimed at smokers wanting to quit over the next week. I am starting to see an increase already in press releases trying to encourage potential quitters to stock up on their pharmaceutical supplies to quit smoking.

Unfortunately, many people who might actually be considering making a serious attempt to rid themselves of nicotine are going to get side tracked into the marketing blitz of products to buy to quit as opposed to getting any real education or help in understanding how to quit and how to stay off.

Being that we have the potential of having more people finding their way to Freedom I will be keeping many of our educational materials and information supporting cold turkey quitting near the top. For the record, quitting smoking and staying smoke free is as simple as just stopping smoking and then making and sticking to a personal commitment to never take another puff!


Joined: 18 Dec 2008, 23:57

05 Mar 2006, 19:59 #45

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:

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.

The closing paragraph there further illustrates just what kind of conclusions are drawn by the experts and reported to the general public.

Joined: 18 Dec 2008, 23:57

31 May 2006, 06:53 #46

For some of our members it is already World No Tobacco Day. Depending on where you may live you need to be prepared for an onslaught of misinformation in order to sell products and services to help you to quit smoking. The only thing people need to "buy" in order to quit is to buy into the idea that they smoke because they are nicotine addicts and to successfully break free and stay free from the nicotine addiction now is as simple and inexpensive as just knowing to never take another puff.


Joined: 18 Dec 2008, 23:57

12 Jul 2006, 18:52 #47

With the World Conference on Smoking starting today, we probably should be prepared for plenty of misinformation being released in order to boost the sales of NRT and other cessation drugs.
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]

Keenly aware of smoking's massive annual slaughter and in search of help, government health officials from around the globe will descend upon Washington DC from July 12-15 for the 13th World Conference on Tobacco or Health. What they'll find instead is that the conference's two corporate sponsors -- GlaxoSmithKline and Pfizer - have produced a well orchestrated commercial designed to convince them that government subsidized nicotine is the answer, replacement nicotine or NRT. What they won't hear is the truth, that replacement nicotine has never proven effective in any real-world setting and likely never will.

The California tobacco survey, the Minnesota insurance survey, Quebec Quit and Win, the Tobacco in London survey, Western Maryland, UK NHS Smoking Cessation Services, Australia family practice survey, two decades after its 1984 introduction NRT does not have a single real-world performance victory, none. But that isn't stopping the pharmaceutical industry from encouraging health officials to waste precious resources purchasing a worthless remedy.

NRT Clinical Studies Were Not Blind and Are Not Trustworthy

The reason NRT will never be effective in head-to-head real-world competition is that the expectations of cold turkey quitters to abruptly end all nicotine use are beyond the ability of the pharmaceutical industry to exclude, redefine, tease, torment, play upon, frustrate, defeat or destroy.

The clinical lesson kept quiet by the pharmaceutical industry and its army of loyal research consultants is that clinical efficacy studies were an expectations nightmare. Study participants joined in hopes of receiving weeks or months of free replacement nicotine. Instead of NRT clinical odds ratio victories evidencing NRT efficacy they reflect the defeat and fulfillment of the nicotine addict's nicotine expectations.

Nicotine is a psychoactive chemical and a substantial percentage of participants knew what it felt like when their dopamine/adrenaline high was or was not replaced. This isn't news to a replacement nicotine industry that appears to be operating from the tobacco industry's nicotine play-book. Researchers found themselves resorting to the extreme of toying with small amounts of nicotine as a placebo device masking agent as early as a 1982 nicotine gum study. The practice is also noted in a number of nicotine patch studies.

Clinical efficacy and community effectiveness are two entirely different standards. According to an August 2004 article by Dr. Lois Biener, PhD, Senior Research Fellow, University of Massachusetts, "the effectiveness of NRT in the general population has not been established. In spite of the fact that NRT and other drugs are included in the Public Health Service guidelines, their efficacy has only been demonstrated in carefully controlled clinical trials. Evidence of their effectiveness in general population has been difficult to find."

Dr. Biener is one of two Conference presenters who have demonstrated the courage to speak truth to pharmaceutical industry muscle, money and influence. The other is Dr. John Pierce, PhD, Professor of Family and Preventive Medicine, University of California, San Diego.

Dr. Pierce analyzed seven years of data from the California Smoker's Survey, one of the world's largest. His study, published in the September 11, 2002 issue of the Journal of the American Medical Association, concluded that "NRT appears no longer effective in increasing long-term successful cessation in California smokers."

There is growing awareness that highly manipulated clinical studies cannot and should not be taken at face value. Equally important are performance evaluations, a step that both GlaxoSmithKline and Pfizer know they must avoid and belittle as unscientific if their golden nicotine goose is to continue laying golden eggs.

More than two years have passed since Mooney reviewed the blinding procedures associated with 73 "allegedly" double-blind NRT studies. Published in the June 2004 issue of Addictive Behaviors, he found that clinical NRT studies were not generally blind as claimed in that "subjects accurately judged treatment assignment at a rate significantly above chance."

Most placebo group members dropped out in the first few weeks of clinical studies. The NRT pharmaceutical industry has had two full years to conduct rather simple NRT blinding evaluations to prove that clinical NRT study results do not reflect the worst junk science and greatest smoker hoax the world has ever seen. The industry has had nearly four years since Dr. Pierce's ineffectiveness survey finding to produce its own survey showing effectiveness but it hasn't and won't. Why? Because it can't.

Instead, the 13th World Conference on Tobacco or Health will be used to introduce new excuses for NRT's dismal performance and to make implied promises of future performance that cannot and will not be kept. What health policymakers should be asking is how many priceless periods of cessation confidence have already been squandered? How many lives have needlessly been lost?

False Advertising

GlaxoSmithKline's site asserts, "In general, NRTs have been shown to double a smoker's chances of quitting versus 'cold turkey.'" Pfizer's Nicotrol website asserts, "Studies have shown that nicotine replacement therapy can double a smoker's chances of quitting versus cold turkey."

GlaxoSmithKline and Pfizer should be compelled to identify any study which invited cold turkey quitters to compete against those wanting and seeking replacement nicotine, in which the NRT rates doubled the rates of cold turkey quitters. Given that NRT has never once prevailed over "cold turkey" quitters in any head-to-head real-world survey and that those wanting to quit "cold turkey" were never invited to challenge NRT in any clinical trial, aren't both GlaxoSmithKline and Pfizer, the pharmaceutical industry sponsors of the World Conference, engaged in intentional smoker deception?

Nicotine Being Painted as Helpful, Enjoyable and Safe

Look what curious youth and smokers are reading about smoking nicotine at GlaxoSmithKline's Nicorette website. "Smoking stimulates chemicals in your brain that appear to enhance awareness and concentration. It increases dopamine levels, which improves your mood. It even increases the levels of some hormones, including adrenaline. This is why cold-turkey attempts seldom work. But Nicorette helps you control cravings, while gradually weaning your body from nicotine."

ImageMomentarily overlook the fact that today almost all successful quitters around the globe are quitting cold turkey (80 to 90%). Instead, focus on the nicotine benefits suggested. What visitors are not told is that GlaxoSmithKline has determined that at least 36.6% of all current nicotine gum users are chronic long-term users of greater than 6 months ( Tobacco Control, Nov. 2003).

What is not shared are recent studies evidencing that nicotine is a major player in the harms caused by smoking. It has now been linked to chronic depression, hardening of the arteries, accelerated tumor grow rates, to rendering chemotherapy substantially less effective, memory impairment and early dementia.

United Kingdom NRT industry consultants are expected to boast to the World Conference that their nation has approved NRT for both child smokers above age 12 and pregnant smokers. According to Professor Theodore Slotkin with the Department of Pharmacology and Cancer Biology at Duke University Medical Center it's a recipe for disaster.

"There is abundant evidence that the major problem for fetal development is exposure to nicotine rather than other components of cigarette smoke." "NRT, especially by transdermal patch, delivers more nicotine to the fetus than smoking does."

A March 2003 study published in Reproductive Toxicology found that the nicotine concentration in the brains of fetal mice were 2.5 times greater than the nicotine concentration found in the mother's bloodstream when nicotine was continuously administrated, as would be the case with the nicotine patch. A pregnant smoker need only imagine what it would be like if her mind were trapped and forced to constantly endure 2.5% more nicotine than normal.

"The patch is the 'easiest' NRT approach, and it turns out that this is the absolute worst form of nicotine administration for the fetus. Essentially, achieving a continuous steady-state plasma level of nicotine in the mother removes the protective effect of the placenta (delay of entry to fetus, partial catabolism of nicotine) because all water spaces become saturated with nicotine," explains Slotkin.

Tobacco Industry/Pharmaceutical Industry Agreements

Imagine spending billions on advertising which boasts that your product can double a smoker's chances of quitting yet never once mentioning the horrors that await smokers if they fail to purchase it. Is it coincidence that those selling replacement nicotine continue to fail to mention smoking related diseases or is there an oral or written non-compete agreement between the tobacco and pharmaceutical industries?

Is it coincidence that Philip Morris' website has touted replacement nicotine as a key to successful quitting? Is it coincidence that the per use cost of over-the-counter replacement nicotine remains at or near the cost of cigarettes when NRT products are not subject to tobacco excise taxes? What are NRT production costs?

Failure to Disclose NRT's Actual Quitting Rates

Youth and young adults listening to NRT marketing are being led to believe that quitting with NRT is relatively easy and the NRT products are generating high success rates. This marketing message plays directly into the tobacco industry's hand in actually inviting experimentation, knowing that quitting is easy. Worse yet the message is false.

Professors Saul Shiffman and John Hughes are both admitted GlaxoSmithKline consultants. In March 2003 they combined and averaged seven over-the-counter (OTC) nicotine patch and gum studies - that manner in which almost all U.S. NRT is sold and used today - and found that 93% of study participants had relapsed to smoking within six months. Those attending should ask the Conference's sponsors why they have kept OTC NRT's dismal 7% six-month quitting rate a secret these past three years.

Imagine GlaxoSmithKline's consultants establishing that only 7% of OTC patch and gum quitters were still not smoking at six months, while a page at its Nicorette website carries a title which reads, "According to one study, 90 percent of 'cold turkey' quitters start smoking again within six months." Is that not admitting defeat?

Failure to Disclose Second-Time NRT Use Rates

Unlike abrupt nicotine cessation, where the odds of success actually increase with each subsequent attempt (as quitters eventually discover the amazing power of one puff of nicotine to shatter and destroy a quitting attempt) NRT's already dismal odds of success dramatically decline with repeat NRT use.

All Internet websites advocating the use of NRT keep quiet about the only two nicotine patch studies that have ever examined success rates for second-time patch users. Not knowing the results carry potential of being a life or death issue for true believers of NRT marketing hype as one study found a 100% six-month failure rate (Tonnesen 1993) and in the other 98.4% relapsed (Gourlay 1995).

A February 2004 study by Shiffman in Addiction boldly concludes "Smokers with a history of past failure of pharmacological treatment have lower success rates without pharmacological treatment, but equally good outcomes with active lozenge treatment."

What the 2004 study abstract fails to reveal is that unlike the 1993 and 1995 studies examining second-time nicotine patch use, Shiffman declared repeat NRT use "effective" after only 6 weeks instead of 6 months. Even worse, nicotine lozenge users in Shiffman's study were given up to 20 free lozenges per day for a period of six full months. Imagine giving alcoholics alcohol via IV bags for 6 months while declaring those still wearing the bags successful quitters at 6 weeks.

But that has not stopped GlaxoSmithKline from using what is primarily abrupt nicotine cessation historical quitting data in an attempt to sell replacement nicotine to those who have already repeatedly tried it and failed. For example, GlaxoSmithKline's website asserts, "It is quite common for smokers to make anywhere from three to six quit attempts before achieving success."

With each passing year of NRT use, NRT use recycling becomes more critical as in some nations almost 50% of all smokers have already tried quitting with NRT at least once and failed. Instead of doubling national cessation rates as promised, here in the U.S. cessation has almost ground to a halt.

Not only are health policymakers allowing a completely ineffective line of quitting products to remain on center-stage, they have remained silent for more than two decades as the NRT industry has bashed, trashed and attempted to claim a larger share of the market by all but destroying confidence in the planet's most productive quitting method - abrupt nicotine cessation.

A May 2006 study in Addictive Behaviors analyzed 2002 and 2003 patient quitting method data collected by 1,000 Australian family practice physicians. Our most recent quitting method performance evidence, it found that cold turkey success rates were twice as high as among those relying upon the nicotine patch, gum, inhaler or bupropion (Zyban and Wellbutrin). Not only was cold turkey quitting the most effective method, it was by far the most productive method accounting for 1,942 of 2,207 former smokers, a whopping 88% of all success stories.

Time to Abandon NRT Group Think

If GlaxoSmithKline's 10% at six-month cold turkey figure is correct, even the most ridiculous quitting product imaginable should generate testimonials from 10% of users at six months, so long as it does not somehow undermine the quitter's own natural recovery odds - as does NRT at 7%. It's why no area is more ripe for consumer fraud than smoking cessation.

If current NRT clinical efficacy and real-world effectiveness standards are the benchmark for evaluating a new wave of now arriving pharmaceutical cessation products then the best hope for earth's one billion nicotine dependent humans may well be prayer, and lots of it. We should not trust forward movement while traveling a road built on known and intentionally ignored blinding failures.

Actual drug performance must be elevated above clinical findings, especially when the clinical studies themselves attract a self-seeking population in search of weeks or months of free replacement nicotine, not a population wanting to abruptly end all nicotine use.

Clinical studies have no trouble randomizing quitters with similar expectations. What they cannot do is hide the presence or absence of the dopamine/adrenaline high produced by a powerful psychoactive chemical such as nicotine. What they cannot do is hide the fact that those wanting to abruptly end all nicotine use did not participate in any NRT studies. What they cannot hide is that it is impossible to randomize opposing expectations regarding receipt of a psychoactive substance.

No Copyright - This Article is Public Domain

Last updated July 10, 2006

John (Gold)
Joined: 18 Dec 2008, 23:57

01 Jan 2007, 14:11 #48

90% of Ex-smokers Quit Smoking Cold Turkey
WhyQuit - Sunday, December 31, 2006[/size]

ImageIn that New Year's is by far the biggest quitting time of the year, smokers are being bombarded with ads attempting to convince them to betray their natural instincts. What pharmaceutical companies dare not reveal is that during 2006 almost all long-term successful quitters again succeeded by ending all nicotine use, not by replacing it by use of the nicotine gum, nicotine patch or new "cherry flavored" nicotine lozenge (NRT or Nicotine Replacement Therapy), or by using designer drugs that attempt to imitate it (Chantix or Zyban).

In 1992 the Centers for Disease Control (CDC) claimed that "approximately 90% of successful quitters have used a self-help quitting strategy, most by quitting abruptly." In 2000 the Surgeon General stated "historically, the great majority of smokers (more than 90 percent) who successfully quit smoking did so 'on their own.'" In 2006 an Australian study following smoking patients of family practice physicians found that cold turkey quitters accounted for 1,942 of 2,207 former smokers, a whopping 88% of all success stories.

Even more disturbing, the Australian study, published in the May 2006 edition of Addictive Behaviors, found that the success rate for cold turkey quitters was twice as high as the rates for those using the nicotine patch, nicotine gum, nicotine inhaler or Zyban (bupropion).
After more than two decades of wide-spread NRT use the pharmaceutical industry cannot point to a single real-world performance evaluation in which those quitting with NRT performed better than those quitting without it.

A September 2002 Journal of the American Medical Association study concluded that "NRT appears no longer effective in increasing long-term successful cessation in California smokers." The California finding is backed by quitting surveys from Minnesota, Quebec, London and Western Maryland.

It is also backed by a study published in the April 2005 edition of Addiction that surveyed quitting rates from England's National Health Service quit smoking program. There, 25.5% of cold turkey quitters were still not smoking at one year, compared to only 15.2% of NRT quitters, 14.4% of Zyban users, and 7.4% of those using both NRT and Zyban at the same time.

How can this possibly be correct? In both Australia and England the cost of NRT and Zyban is government subsidized making them available to all? For years we've heard pharmaceutical company marketing claim that these products double your chances. Who is telling the truth? What's going on?

The answer rests in the difference between "efficacy" and "effectiveness." When pressed, most marketing NRT, Zyban and Chantix will openly admit that their marketing assertions are based upon clinical efficacy findings not effectiveness.

"Efficacy" findings are a product of highly manipulated randomized double-blind clinical trials conducted under what researchers hope are ideal conditions. They are big on internal controls but at the expense of being unable to generalize findings as applying to quitting populations not studied or quitters quitting under different conditions.

"Effectiveness" evaluations, on the other hand, evaluate how quitting methods perform in real-world populations under real-world conditions. While high in external validity they lack controls. Effectiveness evaluations can be quick, simple and inexpensive. When you ask 1,000 former smokers if they tried quitting last year, and if so what method they used and whether or not they succeeded, it's a little hard to make a mistake or manipulate outcome. What you see is what you get.

Although clinical trial researchers and pharmaceutical influence have condemned quitting method surveys as "unscientific" the scientific integrity of their own work has now been completely undermined. A June 2004 study found that NRT clinical trials were generally not blind as claimed in that "subjects accurately judged treatment assignment at a rate significantly above chance."

If clinical trial participants could tell whether or not their nicotine gum or lozenge was delivering nicotine or was instead an empty placebo it would explain why NRT efficacy is so high in clinical trials yet falls flat on its face the moment it exits the trial clinic's doors.

Are NRT, Zyban and Chantix clinical study results grounded in science or do they instead reflect fulfilled or frustrated expectations associated with a quitter either sensing or not sensing some degree of reduction in their own personal withdrawal syndrome, a syndrome that those with any prior quitting history might find difficult to forget?

Imagine the cornerstone of an entire nation's quitting policy resting upon studies that were not blind, upon efficacy conclusions reflecting junk or pseudo science. Is it possible that scores of cessation pharmacology "experts" have built research careers and academic reputations upon the biggest sham ever perpetrated upon smokers?

If cessation pharmacology eventually proves to have been a complete sham upon smokers it does not follow that all involved were charlatans, or necessarily motivated by financial conflicts of interest, or knew it was a sham. I'm convinced that most are good, decent and well intentioned folks who were caught up in "group think." Their greatest fault was in accepting rather than challenging what to them seemed like well-established foundations.

ImageWhat it would mean is that researchers were horribly wrong in convincing millions upon millions to believe their conclusions about over-the-counter NRT products, products we now know produce a 93% failure rate among first time users and nearly a 100% failure rate among those making a second try.

It would be refreshing if during 2007 health agencies and researchers at last started being open and honest with smokers about how almost all long-term successful quitters quit during 2006. Smokers are entitled to the truth. They can handle it. It would also be great to hear them admit that, out here in the real-world, cold turkey has yet to be defeated in any head-to-head competition to date.

In October the CDC reported that for the first time since 1997 the U.S. smoking rate failed to decline. In June 2000, U.S. cessation policy not only turned its back on cold turkey quitters, quitting lessons shared by the CDC and all other government agencies started interfering with natural school of hard-quitting-knocks lessons. Through repeated attempts most smokers were eventually able to discover that putting any nicotine back into their bloodstream, even one puff, meant that they had to go back to square one and start all over again.

Instead of teaching the "Law of Addiction" and the need to end all nicotine use the CDC muddies the mind and confuses all prior relapse lessons by teaching every smoker and quitter visiting its website that nicotine is "medicine" and "key to quitting" is to "get medication and use it correctly."

If granted one wish during 2007 it would be for U.S. government to immediately repeal U.S. Cessation Guideline Recommendation 7 which currently reads, "Numerous effective pharmacotherapies for smoking cessation now exist. Except in the presence of contraindications, these should be used with all patients attempting tobacco cessation." Not with "some" patients but "all."

Repeal would be based upon one simple premise. After 22 years, cessation pharmacology cannot produce a single shred of real-world proof of effectiveness in going head-to-head with those quitting without it. To continue to teach smokers that nicotine cessation is wrong, that instead they need to replace it, is an insane policy that's costing lives.

Breathe deep, hug hard, live long,

John (Gold x7)

John (Gold)
Joined: 18 Dec 2008, 23:57

30 May 2007, 18:34 #49

Chantix and Champix
This 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 of
Chantix / Champix Adverse Events
But 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 Adverse
Chantix / Champix Events
If you know someone using Chantix or Champix who experiences significant side effects encourage them to ...
immediately call their physician
Also, encourage them to report the adverse reaction to their national health officials. Here's a few links:
U.S. Food & Drug Administration -
U.K. Medicines and Healthcare Products Regulatory Agency
Australian Therapeutic Goods Administration
Canadian Adverse Drug Reaction Monitoring Program

Joined: 18 Dec 2008, 23:57

31 May 2007, 21:04 #50


Today is World No Tobacco Day. Depending on where you may live you need to be prepared for an onslaught of misinformation in order to sell products and services to help you to quit smoking. The only thing people need to "buy" in order to quit is to buy into the idea that they smoke because they are nicotine addicts and to successfully break free and stay free from the nicotine addiction now is as simple and inexpensive as just knowing to never take another puff.