Link: Copy link
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
I am attaching an article below from the January 19, 2004 issue of TIME magazine. It talks about the decline in smoking rates in America since the original release of the U.S. Surgeon General's report in January of 1964. The author was apparently led to believe that a whole lot more quitters would be successful if they would just stop trying to go cold turkey and use the many quitting aids available that can "double a person's chance of success."
One thing I want to comment on is how the article points out that smoking declined from 42% to 23% in the past 40 years, but how the drop-off stalled in 1990. The dates are interesting.
The article is saying is that there are a whole lot more effective ways to quit than by going cold turkey. It is basically talking about NRT products and Zyban. What is interesting is that almost all of these products came into widespread use in the 1990's--the years where the rapid decline in smoking cessation actually stopped.
Nicotine gum was first approved for use in America in 1984, by prescription only. In 1991 and 1992, four patches were approved for prescription use. In 1996 all controls broke loose--the gum and two of the four patches went over the counter and Zyban was just coming into the fray.
So now we have all of these miracle products available, many without prescription. If these products were so good at increasing success, and if they are being used by so many people you would think that smoking rates would be plummeting now when compared to when people just had to rely on their own resolve to quit.
Again, read the following line from the article below:
"The drop-off in smoking stalled in 1990 and has hardly budged since then."
Lets hope not too many miracle products for smoking cessation get introduced in the future as it may result in skyrocketing smoking rates.
The real way to once again increase the long-term success rate of people trying to quit is to help them to understand that they are fighting an addiction to nicotine and that to win that fight and to stay free forever is as simple as making and sticking to a commitment to Never Take Another Puff!
Joel© Joel Spitzer 2004
Page last updated by Joel Spitzer on October 15, 2004
Y O U R T I M E / H E A L T H
Stub Out That Butt!
But don't try to go it alone. Here are some tricks that make it easier to quit
By CHRISTINE GORMAN
Monday, Jan. 19, 2004
More than 42% of adult Americans smoked when the first Surgeon General's Report on Smoking and Health was published. Today, 40 years later, fewer than 23% do. That's good news, but it could be better; a lot better. The drop-off in smoking stalled in 1990 and has hardly budged since then. Surveys show that 70% of tobacco users want to quit, but kicking the nicotine habit isn't easy.
What a lot of smokers don't realize is that the most popular method of quitting; just stopping, a.k.a. going cold turkey; is the least effective. Studies show that getting intensive short-term counseling, taking drugs like Zyban (an antidepressant) or using one of the many nicotine aids (gum, patch, inhaler, nasal spray, lozenge) all double the chance of success. Preliminary results suggest that combining these methods will increase success rates even more.
The trick is to find out what works best for you. For counseling, you don't have to go into full-fledged psychoanalysis; you can pick up practical strategies from various quit-smoking telephone hotlines (for a list of numbers as well as tips, visit smokefree.gov). As for nicotine products, make sure you're using them the right way. You need to chew the gum slowly, for example, not swallowing the saliva until the nicotine can be absorbed through the cheek, says Dr. Elliot Wineburg, who has used everything from drugs to hypnosis at Mount Sinai Medical Center in New York City to help hard-core smokers quit. Many people try to make do with as little nicotine as possible, which is a mistake. "You don't want the brain to go into withdrawal," Wineburg says.
It's never too late to quit. As the years go by, an ex-smoker's risk of heart disease and stroke diminishes until it's essentially the same as that of a person who has never smoked, says Dr. Corinne Husten of the Centers for Disease Control's Office on Smoking and Health. Alas, the risk of lung cancer never quite gets down to what it would have been without smoking. "Even with cancer, people respond better to chemotherapy if they quit," Husten says. Best of all, of course, would be not to take up the habit in the first place.
Who should you believe on what is the most successful technique for quitting smoking - the government and most smoking cessation experts in the world and the professional health organizations of the world and the pharmacological industry and almost anyone whose career seems to be based in smoking cessation or me?
I guess using this standard it would be best not to believe me. But before jumping ship there is one other important group of people that you may find that will back me up and who are already quite credible to you. It's the people in your family and your friends in your real world who have successfully quit smoking and been off all nicotine products for at least one year or longer.
Find out how the people you know who are long-term ex-smokers actually stopped smoking. By long-term I mean people who are currently off all nicotine for at least a year or longer. You'll likely find that few if any of them have ever heard of me. You will see that many of them had previous quits and relapsed, using all sorts of methods that are endorsed by professionals and maybe even a few of them had professional help with previous attempts. You will find that almost all of them did not follow what is considered the standard recommended advice on how to quit yet they did quit and are still going strong. You'll find that they most likely quit by simply stopping smoking one day for one reason or another and then have been able to stay off by sticking to a commitment that they made to themselves to not take a puff.
Talk to every long-term ex-smoker you know. Do your own surveys. While you are at it, talk to the current smokers you know too. See how many of them have used products and followed the advice of the professionals. Keep in mind, most professional literature will advise people to use pharmacologic aids like nicotine replacement products. Try to see how many long-term successful quitters in your real world encounters actually followed this advice.
Another piece of advice written in most literature produced by smoking cessation experts is something to the effect that temporary slips are common and that you should not let a slip put you back to smoking. People who write advice like this do not understand addiction. A person needs to understand that taking a puff is likely going to kill a quit.
Try to find one smoker who once had quit but are now smokers again who didn't one day take a puff. Finding one such person who fits this criteria is going to take you forever. On the other hand finding current smokers you know who had once had quits that actually lasted for months, years or decades who lost their quits by taking that first puff are quite easy to find. Understand, some of these people had heard comments like, "don't let a slip make you go back to smoking," but sadly, found out from experience that they had little control of the matter once they took that puff.
Our advice if to successfully quit smoking is to simply stop smoking. Our advice for staying off cigarettes is simply to stick to a commitment to never take another puff. So talk to long-term ex-smokers and find out how they quit and hear how they have managed to stay off. Pretty soon you will see it is not a matter of pitting all of the world professionals against me. It becomes a matter of pitting every long-term ex-smoker you know who has successfully quit against the world's professionals. Do the surveys and then I will just become another voice in the crowd of real people who have proven to you that they way to quit smoking and to stay smoke free is to never take another puff!
If you look around the Internet or even request information from professional health organizations on how to quit smoking you are likely to find that the standard advice given is to use a pharmacological approach, i.e., nicotine replacement products and or Zyban. Each time you see this advice you will also be told that these approaches double your chances of quitting. Some sites and groups come out and almost say, point-blank, do not go cold turkey--basically leaving the reader with the impression that nobody could possibly quit this way.The American Cancer Society's Cancer Facts & Figures 2003 report contains the chart to the right which shows the percentage of current smokers who have tried different routes at quitting smoking and also indicates the percentage of current ex-smokers who quit by different techniques.The numbers that are highly telling are the percentages that indicate how former smokers had actually quit. Keep in mind that this chart is limited. It does not tell us how long they had quit or other key pieces of information, such as, did the people who used quitting aids such as NRT ever actually get off the NRT. But I am not concerned about that at this moment.According to the American Cancer Society report, how did former smokers actually quit? Those using drug therapies and counseling had a 6.8% quitting rate while those using other methods 2.1%. The remainder quit cold-turkey or cut down. In that it is generally accepted that cutting down techniques do not work, we can safely assume that they had an extremely limited impact upon the overall number. So, approximately 90% of the people who are successfully classified as former smokers quit cold turkey. On the same page as Table 3 is located you will find the following recommendation:"All patients attempting to quit should be encouraged to use effective pharmacotherapies except in the presence of specific contraindications."You have to ask yourself how many of the successful ex-smokers in the world today would have actually succeeded if they sought out and listened to "professional" advice such as this.If you are trying to determine what is the best way to quit, you have a choice. You can go with the "experts" or you can go with what 90% of successful quitters have done.Take Your Own SurveySo how do most people really quit smoking? Don't take our word for it, or the American Cancer Society's, but instead talk to every long-term ex-smoker you personally know. See how many of them fall into one of the following three categories:[center]1. People who woke up one day and were suddenly sick and tired of smoking. They tossed them that day and never looked back;[center] [center]2. People who get sick. Not smoking sick, meaning some kind of catastrophic smoking induced illness. Just people who get a cold or a flu and feel miserable. The feel too sick to smoke, they may feel too sick to eat. They are down with the infection for two or three days, start to get better and then realize that they have a few days down without smoking and decide to try to keep it going. Again, they never look back and stuck with their new commitment; or[center] [center]3. People who leave a doctors office given an ultimatum. Quit smoking or drop dead--it's your choice. These are people who some sort of problem has been identified by their doctors who lays out in no uncertain terms that the person's life is at risk now if they do not quit smoking.
Most medical professionals believe that the way to quit smoking is to use pharmacological aids. They think that pharmacological aids are an effective tool for smoking cessation. Why do they believe this? They believe it because almost all of the smoking professionals of the world tell them that they work. Even the Surgeon General of the United States says that they work. If almost all world experts believe that they work, and the Surgeon General says that they work, well then they must really work. Right?
Well, I look at it like this. Lets say I see a published story come out that says a specific pill prevents colds in 100% of the cases in human trials. Then another study verifies it. In fact, every expert in the world comes out and says colds no longer exist -- the pill has eradicated them.
But most people I knew who took this miracle pill still got colds. Worse than that, I took the pill myself and all of my friends who were on the pill kept giving the cold to me. Pretty soon I would dismiss those studies and no matter how many times I see it I would not believe it. Sooner or later I would have to believe my own eyes and ears, basically my own instincts, more than expert opinion.
I have seen people use the argument of who should they believe, the Surgeon General of the United States or me. I somehow get the idea that people think that the Surgeon General is a person who has spent years and decades working with nicotine addicts. That somehow being an expert in smoking cessation is a prerequisite for being the Surgeon General.
I have been running stop smoking clinics since 1976. Back in 1976 I told my second group that they were nicotine addicts. If the people in my 1976 clinics were skeptical and wrote the Surgeon General and asked him if it were true that nicotine was a drug addiction he would have answered no it was not.
It was clearly spelled out in the 1964 Surgeon General's Report that cigarette smoking was not an addiction. In the report of the Surgeon General back in 1979 the Surgeon General was starting to say that maybe it was an addiction, but still had put the emphasis on the habit of smoking being the primary problem. In 1988 the Surgeon General finally issued a report stating once and for all that nicotine was an addictive substance.
In all of the programs I did from 1976 through 1987 I was constantly criticized and attacked for saying that cigarette smokers were drug addicts but I had too much first hand contact with smokers trying to quit that was making it abundantly clear that the Surgeon General was wrong. So I accepted the fact that the Surgeon General and most of the experts of the world were not going to agree with me. For eleven years I was wrong that smoking was an addiciton because the Surgeon General said I was wrong yet today I am no longer wrong on this fact.
The same thing is happening now when it comes to issues like the effectiveness of all of the quitting aids available today. The Surgeon General and most of the world experts say that these products increase success and that people should not quit cold turkey. Again, I have still have too much first hand contact with people who are trying to quit using these products as well as too much contact with people who are actually quitting and succeeding without their use. It is still all too obvious that in real world settings these products do not increase success and that people have a much greater chance of success by disregarding the experts advice.
So I think I am going to just take a wait and see attitude on what the Surgeon General will say ten years or twenty years from now on what is the most effective way to quit smoking. Maybe he or she will have come around by then, maybe not. But I know one thing for sure. That all of the people who decided to follow my advice on how to quit, and then stay committed in the interim to the advice that I gave them on how to remain smoke free, that all of these people will still be successful ex-smokers.
My advice to them, that is so controversial today, is simply that to quit smoking and to stay smoke free is no more complicated than just knowing to Never Take Another Puff!
|Addiction - the Surgeon General says ...||4.42mb||13.2mb||1.77mb||5.49mb||12:00||10/09/06|
|How did the people you know quit smoking?||1.90mb||18.8mb||0.77mb||2.34mb||05:10||09/27/06|
|My first encounter with NRT||3.99mb||16.1mb||2.13mb||6.66mb||14:37||11/16/06|
|WhyQuit's candid views about Chantix (and Champix)||17.8mb||53.3mb||7.11mb||22.0mb||48:16||10/19/07|
I have seen it written that we have said that the ONLY way to quit smoking is to quit cold turkey. This is not a totally accurate statement. It is not that cold turkey is the only way to quit,; it is just that cold turkey is the method which gives people the best chance of success. It is the method that all but a small percentage of long-term ex-smokers in the world used to successfully quit smoking.
There are people who have quit using alternative approaches. There are some who cut down gradually and actually succeeded at quitting. For every person who did it like this and succeeded, there are many many many many others who tried it and failed. The individual who used the method will think it is great because it worked for him or her, but since it works for so few people it will generally be recognized as a pretty ineffective technique by most people who do "real world" research into how to quit.
By "real world" research I mean by going to long-term ex-nicotine users who you know personally and finding out how they all got off nicotine. Again, you will very rarely find any who did it by gradual withdrawal. If you find a person like this who is now off years, you should never minimize the person's success. He or she quit smoking, likely doing it in a way that made it much more difficult than it needed to be, but still he or she did pull off the quit. The only advice that I would encourage that you share with the person is that now to stay off he or she must understand the bottom line method of sustaining his or her quit. That message is staying cognizant of the addiction and that the only true guaranteed method to stay off now is knowing never to administer nicotine again.
The same principle here applies to people who use NRT products. There are people who have quit this way. Again, it is a small percentage of the long-term ex-users out there, but they do exist. An individual who pulled it off this way will also feel that it is a great method for quitting. But again, this method works for a small percentage of people who try it and if you look into real world long-term quits you will have a very hard time finding many people who actually successfully got off nicotine this way.
I feel it necessary to use that phrase, "got off nicotine," as opposed to saying, "got off smoking." There are some major experts coming out and advocating that people should be given nicotine supplements forever to stay off of smoking. Can this work? Of course it can. If you can give people enough nicotine via supplements it will satisfy their need for nicotine. After all, this is the primary reason they were smoking at the end--to feed a nicotine addiction. If the smoker can just get nicotine for the rest of his or her life via another route, he or she will avoid going through the three days of nicotine withdrawal.
The question needs to be, why should anyone have to pay what is likely to be tens of thousands of dollars to avoid a few days of withdrawal.? On top of this, these people will never be totally free of the moderate withdrawals that such usage is likely to keep going. These people will in fact tout the use of the product as a great aid, but when compared to what people who are totally nicotine free are experiencing, this victory over cigarettes is just a bit hollow.
There are a few people though whom you may encounter over your lifetime that did quit using NRT's as intended, weaning down for week after week and eventually quitting. If the person is now off for years, he or she is pretty much in the same state as a person who had quit cold turkey. He or she is nicotine free, and he or she should be thrilled by that fact. In some ways I look at people like this with a bit of awe, for they in all likelihood stuck with a process that was pretty much a gradual and prolonged withdrawal and yet they succeeded.
Again, debating the merits of their method with them is pretty much a moot point. It worked for them and you are going to have a pretty hard time convincing them that it is an ineffective method. But you do have a message that you can share with them that they do need to know. That message is that even though they are off nicotine for years, they still need to recognize that they are not cured of nicotine addiction and never will be. No matter how they had stopped, they must still understand the bottom line message, that the only way to stay free now is staying totally committed to never administer nicotine again via any nicotine replacement source and to never administer nicotine again from the original source that likely started the whole process by knowing to never take another puff!