Who Should You Believe?

Who Should You Believe?

Joel
Joel

December 18th, 2003, 6:42 am #1

Joel's Reinforcement Library





Quitting Methods - Who to Believe?



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!



Last edited by Joel on April 1st, 2012, 12:37 pm, edited 2 times in total.
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Joel
Joel

December 18th, 2003, 6:47 am #2

We've edited the original post of this string. I am attaching the comments generated from that post below. There were some posts I am deleting for they where just thumbs up popping them to the top.

[/size]Reply Message 2 of 10 in Discussion From: JoelSent: 10/5/2003 7:23 AM


The three most common stories you will hear of how long-term quitters actually quit smoking:

  1. The woke up one day and realized they were sick and tired of smoking and never touched one since.
  2. They got sick. Not smoking sick, just sick--often just a cold or a flu. They felt miserable, didn't feel like eating or smoking. In a few days the infection subsided and they stated to get better. They realized that they had a few days under their belts without smoking and decided to keep the quit going and never went back.
  3. They left their doctor's office with an ultimatum--quit smoking or your going to drop dead--your choice!
You will be amazed at just how many people who are long-term ex-smokers fit into one of these three categories. The technique to quit for all three of these groups are the same, it is just that their initial motivations for quitting varied. It is the same technique being used by every member here, which is simply to have quit smoking and then sticking to the commitment they have made when joining up to never take another puff!

Joel

Reply - Message 4 of 10 in Discussion       From: Michelle72482      Sent: 11/21/2003 12:27 AM


Joel, I think what you do is an awesome and caring thing. To never have smoked yourself, but yet help those who do, quit is a remarkable and selfless thing.....Thank you.








Reply Message 5 of 10 in Discussion           From: ChristinenSam       Sent: 11/21/2003 1:04 AM
Joel, thanks for bringing up this post. And I agree with Michelle - you are wonderful for all the work you do for nicotine cessation.

The thing that really made me know that what you say is right, is that you totally and completely seem to be able to elaborate on how I felt, what I thought, etc even though you don't smoke and were not ever addicted to nicotine. How could you know? You are right .

Christine




Reply Message 8 of 10 in Discussion          From: John (Gold)           Sent: 11/26/2003 7:54 AM
Do your own survey. Trust your ears and eyes.



Psychological conditioning isn't just a by-product of an addictive chemical's half-life, it's also used in marketing to get us to believe and buy.





The tobacco industry wants you to believe that smoking nicotine is an adult choice issue while ignoring the fact that true chemical addiction means that the only choice the addict has is chemical withdrawal or that next mandatory smoke.





The pharmaceutical industry is spending a massive amount of money to condition smokers to believe that buying more nicotine is the answer to all our problems.





Athough I've tried hard to get nicotine addicts to actually read the latest NRT studies and reflect upon the disasterous relapse rates for themselves (numeric relapse rates in excess of 93% at six months that those pushing nicotine will continue to refuse to discuss), as Joel points out there is a much easier way to discover the truth.





The world's most brilliant marketing minds may be able to package relapse as victory but the proofs in the pudding. Trust in those you know or love to be a bit more honest with you than those trying to profit off of your addiciton.





Although the NRT industry has done an amazing job of successfully erasing almost all cold turkey quitting recommendations in cessation literature around the globe, they cannot erase the fact that all but a tiny sliver of those becoming free from all forms of nicotine are doing so by deciding to not put any more nicotine into their bodies.




Freedom should cost you nothing!


Breathe deep, hug hard, live long!  John


Reply - Message   9 of 10 in Discussion -         From jackrabit50GOLD           Sent: 11/26/2003 9:59 AM Joel,

Funny I was thinking about this yesterday. After I joined Freedom maybe about a week , my M.D said I might want to try a quit smoking class they had at thier clinic.

I went the next day thinking it might help. Wrong! I was the only one out of 20 people quitting cold turkey. All they did was sit around this table and whine about everything in general. I never went back. But I got to thinking of all my friends that quit. Only one out of 5 used N.R.T. and she started smoking again a month later. I can't imagine how miserable thats got to be. To be in constant withdrawls for months!

Thank for showing me my way to Freedom!

Rick

One year, six months, three weeks, one day, 2 hours, 43 minutes and 38 seconds. 45689 cigarettes not smoked, saving $11,400.25. Life saved: 22 weeks, 4 days, 15 hours, 25 minutes.
Last edited by Joel on April 26th, 2011, 11:29 am, edited 2 times in total.
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Joel
Joel

February 23rd, 2004, 11:17 pm #3

I saw a comment written somewhere today about a how a new member was following my approach to quitting. I think that it is important to note that cold turkey quitting is not my technique. Cold turkey quitting has been around as long as quitting has been around and is the way most people have quit smoking. The vast majority of people who have successfully quit in the world throughout history did so by going cold turkey and they had absolutely no knowledge of me.

I may be one of the more outspoken advocates of cold turkey quitting but cold turkey quitting is a technique that has been around for as long as quitting has been around. I guess I should point out that the relapse prevention strategy I advocate is not mine either. It too has been used by countless successful ex-smokers for many decades now--people who figured out or instinctively knew on their own that to stay smoke free they had to stay totally committed to never take another puff!

Joel
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DlunyGOLD
DlunyGOLD

February 24th, 2004, 3:26 pm #4

I was in the grocery store last night and heard an ad over the PA system for some NRT product. All I could think of was a line I have read somewhere here--"the biggest reason no one wants to jump on the cold turkey bandwagon is there is no money in it!"

After I said that to myself a couple of times I was able to go back to my shopping. John makes a good point about "The world's most brilliant marketing minds may be able to package relapse as victory but the proofs in the pudding." However, if they can repackage relapse can't they also repackage the pudding? Aren't they already trying to do so with all of their bogus claims of "double your chances" and other such claims?

Sounds like the best thing we can do for our sanity is to just remember to never take another puff one day at a time, spread the word about this site as much as possible, and welcome those people who do ultimately come here for help! We can make a difference!

yqb, David Three months, two weeks, two days, 17 hours, 25 minutes and 47 seconds. 1957 cigarettes not smoked, saving $146.78. Life saved: 6 days, 19 hours, 5 minutes.
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Joel
Joel

October 24th, 2005, 5:44 am #5

There are many people at other sites who feel that if their members come our direction and accept our views that they are going to be at greater risk of losing their quits. There are many at other sites who are infuriated when members of their sites come to www.whyquit.com or Freedom, read our views of the limitations of NRT and then decide to quit their NRT.

The members of these other sites often write on how they know many people who lost their quits because they read at our site and then decided to come off NRT too soon--no matter how long the person may have been on it. These people seem to be working with the impression that stopping the intake of nicotine caused these people to relapse. We see it quite differently.

Those people who relapsed did not do so because they stopped taking nicotine--they relapsed because they took in nicotine one more time after they stopped their use of NRT--or in other words they took a puff on a cigarette. No one relapses back on smoking without taking a puff and that is an act that each and every individual is responsible for. People who succeed forever do so because they didn't take a puff--people who relapse do so because they did. This is a universal truth that applies to all people no matter how they quit and no matter what groups they do or don't belong to.

From the string Reading at other quit smoking sites
Last edited by Joel on February 16th, 2010, 11:57 am, edited 1 time in total.
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Joel
Joel

November 4th, 2005, 6:15 pm #6

I am starting to see where cold turkey quitting is starting to get bashed pretty heavily in the media. One of the techniques that is being used is having smoking experts come out and say that while everyone seems to know one person who has quit cold turkey, that most people just cannot quit this way. They are trying now to undercut the real world examples that people are inevitably exposed to since since this is the way that most people have successfully quit smoking. I would agree that if a person just seemed to know only one person who had successfully quit smoking by a certain technique, it would be a clear sign that maybe the technique was not very successful. The issue is that if people go through the trouble of finding out what technique was used by ALL of the people they know who had quit smoking, they would most likely find that most if not all of them were in fact cold turkey quitters.



Here is the standard commentary I use when addressing the issue of talking to ex-smokers: I really do encourage all people to take this survey, talking to long-term ex-smokers in their real world. People who you knew when they were smokers, who you knew when they were quitting and who you still know as being successful long-term ex-smokers. The more people you talk to the more obvious it will become how people quit smoking and how people stay off of smoking. Again, people quit smoking by simply quitting smoking and people stay off of smoking by simply knowing that to stay smoke free that they must never take another puff!

Again, go talk to as many long-term successful ex-smokers (people off all forms of nicotine for at least a year or longer) in your real world that you can find and find out how they quit. I don't believe that there is a single professional smoking cessation NRT advocate who will suggest to their patients that they take a similar survey. For if they did their credibility would be called into question almost immediately when the patient starting seeing the results of their real life survey.
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Joined: January 16th, 2003, 8:00 am

February 5th, 2006, 10:11 am #7

From: Joel Sent: 10/5/2003 7:23 AM
The three most common stories you will hear of how long-term quitters actually quit smoking:
  1. The woke up one day and realized they were sick and tired of smoking and never touched one since.
  2. They got sick. Not smoking sick, just sick--often just a cold or a flu. They felt miserable, didn't feel like eating or smoking. In a few days the infection subsided and they stated to get better. They realized that they had a few days under their belts without smoking and decided to keep the quit going and never went back.
  3. They left their doctor's office with an ultimatum--quit smoking or your going to drop dead--your choice!
You will be amazed at just how many people who are long-term ex-smokers fit into one of these three categories. The technique to quit for all three of these groups are the same, it is just that their initial motivations for quitting varied. It is the same technique being used by every member here, which is simply to have quit smoking and then sticking to the commitment they have made when joining up to never take another puff!

Joel
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LeoEx Smoker
LeoEx Smoker

February 5th, 2006, 3:07 pm #8

Hiya,

I've been really revved up about this NRT issue. Today I got on radio (well, kinda snuck on really ) - the ABC in one state of Australia. It was talkback on New Year's Resolutions. So I called in and said that I'd quit cold turkey, it was easier than I thought, and (talking very quickly) that despite the marketing saying that NRT doubled my chances, in reality it more than halves it.

Every week I'm going to do something like this. I'm going to write or email someone, some government body, some newspaper, some TV show, some research organisation, and just ask questions. One day, someone is going to listen, and if lots of ex-smokers do it, then change can happen. I know that sounds a bit naff and idealistic but I genuinely believe that. Public health issues like this - like smoking and the tobacco companies, and asbestos - it's the little guys who end up shouting so loud that someone in power, one day, goes 'HARK! I HEAR THE RESOUNDING WHISPER OF A CLASS ACTION! and bingo, suddenly people with money start to take notice and change what their companies are doing.

Also I think it's vital that we give back. Joel and you managers and John and oldbies - you are all in here giving to us newbies 24/7. You are Quit Angels. I don't know that I'll ever be that good at encouraging other individuals along their quits. But I know that I can help out by getting the word out in general about NRT. I 'll just start with Australia, this year.

hehehehehe

Leonie

Leo - Free and Healing for One Month, Three Days, 7 Hours and 43 Minutes, while extending my life expectancy 4 Days and 4 Hours, by avoiding the use of 1201 nicotine delivery devices that would have cost me $529.30.
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nicoGerm
nicoGerm

February 6th, 2006, 5:00 pm #9

I gotta admit that cold turkey is the only way to go... BUT...

I'm a rookie. I'm 25 days into my quit and I know I'm strong. Tonight, I drank myself silly surrounded by smokers and never once thought to take a puff. I couldn't be happier. I still can't help but think that someday, I may be able to balance nicotine the way I do everything else in my life...

I drink once a week, why is it impossible to think that I couldn't smoke once a week too?

I'm an addict. I know that. Now, next year, the year after, I can't smoke. I won't smoke, that I promise myself. Never? I can't answer that question right now. Scratch that... I won't answer that right now.

-NG

nicoGerm - Free and Healing for Twenty Five Days, 3 Hours and 28 Minutes
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Starshinegrl Gold
Starshinegrl Gold

February 6th, 2006, 6:35 pm #10

Last edited by Starshinegrl Gold on February 16th, 2010, 1:04 pm, edited 1 time in total.
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Jonesdance1
Jonesdance1

September 20th, 2006, 10:49 pm #11

Question......

This was posted above:

From: Michelle72482 Sent: 11/21/2003 12:27 AM Joel, I think what you do is an awesome and caring thing. To never have smoked yourself, but yet help those who do, quit is a remarkable and selfless thing.....Thank you



[/size][/font]



Just wondering if this was true? Joel, you never smoked?

Waylon
Last edited by Jonesdance1 on April 26th, 2011, 11:31 am, edited 1 time in total.
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JoeJFree Gold
JoeJFree Gold

September 20th, 2006, 11:14 pm #12

 

1. Yes, Joel is a never smoker. He explains why this has proved to be an advantage both in the video he has recently produced ( http://www.joelspitzer.com/misc/firstclinic.mov) and in this article - Freedom - the forum's early history

2. I have found that the management team and longer-term members who contribute are quite concientious about making sure what is contained in this site is 100% true and factual.


JoeJ Free - NicotineFree and Living as I was meant to be for One Year, Eight Months, Ten Days and 58 Minutes, while reclaiming 53 Days and 15 Hours,
by choosing not to use 15451 nicotine delivery devices that would have cost me $3,130.41.
Last edited by JoeJFree Gold on February 16th, 2010, 1:06 pm, edited 1 time in total.
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Joined: November 11th, 2008, 7:22 pm

April 26th, 2011, 11:35 am #13

We received the below email last night.  A message from another new believer!
From: Joe
To: [url=mailto:john@whyquit.com]john@whyquit.com[/url]
Sent: Monday, April 25, 2011 10:40 PM
Subject: I did it!


I smoked for about 27 years. I am at three months. I have tried to quit too many times to count. Tried the patch and almost EVERY other "method" available. I have spent an enormous amount of money over the last 5 years trying to quit. I found for myself they were useless.

I hated smoking for so long. Every day I tortured myself by continuing to smoke. Every day I would beat myself up for the fact that, even as strong willed a person that I am, I could not quit. I was so angry that I was paying big tobacco big money to cripple and or kill myself. Where is the logic in this. I saw none. Yet I could not quit.

One evening about three months ago I was down in my garage having my cigarette as I watched the heavy smoke roll out the garage door. I have watched this many times before but this time it was different. To this day I am not sure why but it was different.

Out of nowhere I decided to quit..........again. I have never went more than one day.

I went upstairs to my living room and opened my IPad and did a search on quiting smoking. I came across your site. I only read for about 15 minutes and I went back to my garage, grabbed my open pack of cigarettes, gave them a bath and threw them in the trash, went upstairs and told my wife I quit. She is always supportive but I knew in the back of my mind she was thinking "yeah.....ok, here he goes again. She quit 2 years ago and I swore I would be right behind her and quit too. That never happened. But in my mind it didn't matter because i knew I would have to just show her instead of running my mouth. I definately had my doubts. I have always failed before.

Now for the reason for this e-mail. It was your site that made me push forward and get where I am at now. I read through all of the links and then some for a week straight. Every time The cravings got really bad I would read more. I bombarded myself with knowledge, encouragement, and maybe a little fear. I occasionally come back and read some more just to not forget.

My wife and I are still amazed that I did it. I am not sure who is amazed the most.

Besides the obvious reasons to be happy for quiting such as health and money, winning against the tobacco companies is right up at the top of my list.

 Before I ever read anything on your site, I came to this conclusion from experience, cold turkey IS the only way. There are a few reasons for this.
As was stated, using nicotine replacement or cutting back is just torturing yourself with eternal withdrawal.
Also, you have to REALLY want to quit. To continue to use nicotine of any form does not show a person of enough resolve to succeed in quitting. It is actualy, the perceived "easy way" that does not work.

In closing I just want to thank you all.

Trust me, If I can do it........ANYBODY can! If you can't, you don't want to enough. It's that simple. Never thought I would be able to say that.

Joe
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Joined: November 11th, 2008, 7:22 pm

February 27th, 2012, 5:01 pm #14

Yet Another Study Shows that Nicotine Replacement Therapy Has Not Improved Population Cessation Rates by Michael Siegel, MD, MPH  Professor  -  February 27, 2012

A new study published in the journal Tobacco Control concludes that the proliferation of smoking quit lines and the greatly increased use of nicotine replacement therapy over the past two decades have not led to improvements in the rate of smoking cessation on a population level.

(See: Shu-Hong Zhu, Madeleine Lee, Yue-Lin Zhuang, Anthony Gamst, Tanya Wolfson. Interventions to increase smoking cessation at the population level: how much progress has been made in the last two decades? Tobacco Control 2012;21:110e118. doi:10.1136/tobaccocontrol-2011-050371)

The study used data from the National Health Interview Survey to examine trends in the population rates of smoking cessation during the period 1991-2010. The findings were as follows: "Cessation rates vary from year to year, but there is no significant upward trend for the whole period. Attempts to fit a linear trend for these two panels of data (weighted by the sample size for each survey year) found the slopes are slightly negative but not statistically significantly different from zero (r=-0.02, p=0.94, all smokers, and r=-0.17, p=0.50 for white smokers)."

The study concludes: "Most importantly, there is no consistent upward trend, which
would be expected given the various interventions that have been implemented in the USA over the last two decades. This is a perplexing result."

The article offers several possible explanations for the study findings. Two of the most critical are: (1) "the true effects of interventions are much smaller than reported"; and (2) "an overemphasis on the power of medications to help smokers quit may lead them to think they cannot quit without the medications, lowering self-efficacy and reducing the base rate of quitting."

The Rest of the Story

The paper correctly notes that: "Pharmacotherapies such as nicotine patches are recommended as first-line quit-smoking aids in clinical practice guidelines." Despite the explosive increase in the promotion of these products for smoking cessation over the past two decades, there has been no improvement in population smoking cessation rates.

This research reinforces the findings of a previous study by Pierce et al., which came to the same conclusion (see: Pierce JP, Cummins SE, White MM, Humphrey A, Messer K. Quitlines and nicotine replacement for smoking cessation: Do we need to change policy? Annu Rev Public Health 2012; 33:12.1-12.16).

This research highlights a major problem in the anti-smoking movement: Because of the strong pharmaceutical company ties of the leading anti-smoking researchers and organizations, there has not been an objective assessment of the effectiveness of smoking cessation policy, and this has led to an over-emphasis on nicotine replacement therapy and an exaggeration of its benefits.

Not only has the obsession with nicotine replacement therapy and other smoking cessation drugs harmed the public's health by diverting attention away from more effective national approaches, but it has also harmed public health because, as the authors of the present study correctly note: "an overemphasis on the power of medications to help smokers quit may lead them to think they cannot quit without the medications, lowering self-efficacy and reducing the base rate of quitting."

It would be one thing if the flawed advice being given by the NIH expert panel on smoking cessation (i.e., every smoker should be treated with pharmaceutical agents unless specifically contraindicated) were due simply to an innocent mistake, such as lack of complete knowledge of the effectiveness of various smoking cessation strategies. However, I believe that this is not an innocent mistake. Instead, it is the direct result of financial conflicts of interest which have clouded the judgment of those making national recommendations, including the NIH expert panel on smoking cessation, whose recommendations have heavily influenced the anti-smoking movement and helped to produce today's overemphasis on the power of medications to help smokers quit.

Far from being an objective review and assessment of the best possible strategy to enhance smoking cessation among smokers in the United States, the smoking cessation clinical practice guideline is a heavily biased analysis that is plagued by the presence of severe financial conflicts of interests among the panel's chair and at least 8 of its other members.

These 9 panel members have received, or are currently receiving, funding from pharmaceutical companies. Most of the involved companies stand to gain from the clinical practice guideline's recommendations, because these companies manufacture drugs recommended by the panel.

Here is the long list of financial conflicts of interest among this supposedly objective panel of expert scientists:

Michael C. Fiore (panel chair): "reported that he served as an investigator on research studies at the University of Wisconsin (UW) that were supported wholly or in part by four pharmaceutical companies, and in 2005 received compensation from one pharmaceutical company. In addition, he reported that, in 1998, the UW appointed him to a named Chair, which was made possible by an unrestricted gift to the UW from GlaxoWellcome."

William C. Bailey: "reported significant financial interests in the form of compensation from three different pharmaceutical companies in 2006 and two in 2007 for speaking engagements."

Timothy B. Baker: "reported that he has served as a co-investigator on research studies at the University of Wisconsin that were sponsored by four pharmaceutical companies."

Neal L. Benowitz: "reported significant financial interest in the form of compensation from one pharmaceutical company for each of the years 2005-2007, as well as stock ownership in one pharmaceutical company."

Michael G. Goldstein: "reported that his employer received support from Bayer Pharmaceutical prior to 2005 and that he was employed by Bayer Pharmaceutical Corporation prior to January 1, 2005. His organization received payments for his professional services from two pharmaceutical companies and one commercial Internet smoking cessation site during the period 2005-2007."

Harry A. Lando: "reported serving on an advisory panel for a new tobacco use cessation medication and attending 2-day meetings in 2005 and 2006 as a member of this panel."

C. Tracy Orleans: "reported significant financial interests in the form of a dependent child who owns pharmaceutical stock... ."

Maxine L. Stitzer: "reported participation on a pharmaceutical scientific advisory panel for a new tobacco use cessation medication."

Sally Faith Dorfman: "reported her employment by Ferring Pharmaceuticals, Inc., a company whose business does not relate to treating tobacco dependence."

GlaxoWellcome, which apparently endowed the Chair position that the chair of the panel enjoys, is the manufacturer of Wellbutrin, Commit lozenge, Committed Quitters, NiQuitin/Nicoderm, Nicabate, and Nicorette. The use of all of these drugs is recommended by the panel.

What this means is that we basically have a group of experts who are largely financially linked with pharmaceutical companies, and who stand to gain personally if they recommend the use of pharmaceuticals as part of their smoking cessation guidelines. The more use of pharmaceuticals they recommend, the more they stand to gain.

This is a conflict of interest in the ugliest way that I can imagine. It is precisely the type of thing that needs to be stopped.

Ironically, it is the Department of Health and Human Services, the Public Health Service, and NIH itself which are regulating conflicts of interest among America's medical researchers. To have such a huge conflict of interest in its own supported work is unconscionable.

While I find it objectionable that these agencies would allow experts with these type of financial conflicts of interest to serve on the panel, I find it equally troubling that such individuals would agree to serve. I believe that based on these conflicts, these experts should have recused themselves from service on the panel.

The conflict in this case is not just a hypothetical one. It reveals itself in the extreme bias of the guideline. The analysis over-estimates the benefit of drugs in smoking cessation and overlooks population-based evidence showing that most people who quit smoking do so without pharmaceutical aids.

As my colleague Dr. Lois Biener of the University of Massachusetts Boston argued in an Associated Press article about the guideline, there is little if any "real-world evidence" that when used outside the context of clinical trials, drugs produce any long-term enhancement of smoking cessation, and certainly not the magnitude of benefit as suggested by those who are touting the importance of these drugs.

One national expert on smoking cessation who was not on the panel - John Polito - has suggested that the guideline is basically a "sales pitch" for the pharmaceutical industry, that the benefits of pharmaceuticals are overstated, that the value of quitting cold turkey is not considered, and that the recommendation to promote Chantix use is misguided and could cause harm.

Polito has really stated it better than I could and he is right on the mark. The guideline is basically a sales pitch for the pharmaceutical industry, and it demonstrates what corporations can buy through their payments to scientific experts.



What's most disturbing to me is that while the medical field continues to move to decrease the influence of pharmaceutical companies on physicians by restricting financial benefits for doctors, the tobacco control field seems to be increasingly plagued by this pharmaceutical influence. The problem is being ameliorated in medicine, but in tobacco control, it continues to get worse.



The ultimate irony of all of this is that we in tobacco control have been so vehement in decrying the tobacco industry's influence on science. We have attacked and berated scientists for having financial ties to tobacco companies. We have discredited scientific conclusions based solely on the financial connections of the authors to Big Tobacco. But now, our national policies are being set by individuals who have equally strong connections to Big Pharma.



It may come as a surprise to many in tobacco control, but this type of science is just as bad. Bad science is bad science. Conflicts of interest are conflicts of interest. Believe me, the science doesn't get any stronger just because it is a less detestable industry. As a field which has literally helped to ruin the careers of scientists with tobacco industry connections, we should be beyond reproach in not allowing similar conflicts of interest to degrade and poison our science.

 

Michael Siegel, MD, MPH  Professor
Department of Community Health Sciences
Boston University School of Public Health
801 Massachusetts Avenue, 3rd Floor
Boston, MA 02118



Disclaimer: The opinions expressed in this communication are my own personal views and do not necessarily represent the opinions of Boston University or the Boston University School of Public Health.

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