Category Archives: The Symonds Method

How to smoke without smoking – Part II

‘There’s such a craving for cessation!’

This cynical comment was made to me by Christopher Proctor, chief scientist of British American Tobacco, the company whose poisonous products, legally on sale everywhere, are responsible for about 9,600 deaths every year in the UK. (They have 10% of the cigarette market and 96,000 people die annually from smoking-related diseases in the UK – latest figures from ASH.)

There’s gold in them thar smoking cessation! Now every man and his dog are jumping onto the bandwagon.

Let me explain. The latest trick, would you believe it, is called Harmless Cigarette™. Just what we’ve been waiting for! It’s promoted as ‘A natural way to quit smoking’. (What’s an unnatural way then?)

The idea seems to be that whenever you have an urge to smoke you suck on one of these thingummies – they look like cigarettes – which are described as a ‘therapeutic quit smoking aid’ (the word ‘therapeutic’ is redundant) and that this helps ‘satisfy smoking behaviors and hand to mouth gestures associated with smoking.’ The key to how they allegedly work is given in the description of one variety, thus:

Harmless Cigarette™ Oxygen variant is both odorless and tasteless and does not contain any ingredients.

It does not contain any ingredients! And it’s only $19.95 a pack!

Though there may be a ‘hand to mouth’ muscle memory component of nicotine addiction, and it is possible these gadgets may satisfy that aspect, nonetheless mention of ‘smoking behaviours’ implies that smoking is a psychological problem. Indeed it is. I wrote a book with this title in 2016 – see under the ‘Buy now’ tab.

The psychological nature of smoking was recognised as long ago as 1964. The following is  from the US Surgeon General’s Report, Smoking and Health, published in that year.

The overwhelming evidence points to the conclusion that smoking – its beginning, habituation, and occasional discontinuation – is to a large extent psychologically and socially determined.

The psychological aspect of smoking is the key to successful quitting. This means that if smokers can be helped to understand why they smoke in spite of knowing the dangers, and why it seems so hard to stop – they can then stop smoking straightaway and with very little difficulty.

Text © Gabriel Symonds

How to solve the problem of smoking in pregnancy

In October 2015 in the UK a report was published called Smoking Cessation in Pregnancy: A Review of the Challenge. This endeavour was endorsed by no less than twenty-one worthy organisations such as Action on Smoking and Health, Bliss (‘for babies born too soon, too small, too sick’), the Community Practitioners’ and Health Visitors’ Association, and the like.

The report considers how to deal with the serious problem of pregnant women who smoke – an activity, as is well known, that is harmful to the unborn babies as well as to the mothers.

The unnamed authors start by congratulating themselves on their achievements against the Challenge Group’s 2013 recommendations, using a traffic-light rating system. There’s rather a lot of red and amber so there’s more work to be done, and they acknowledge the magnitude of the task: ‘In the region of 70,000 infants every year are born to mothers who smoke [in England].’

Rather than critiquing the whole paper, for this post I shall consider just the title: why is it merely Smoking Cessation in Pregnancy and not Smoking Prohibition in Pregnancy?

In the UK anyone aged over eighteen, pregnant or not, may go into any shop or supermarket where cigarettes are sold and buy – no questions asked – a packet containing twenty of these dangerous, addictive products.

Now let us suppose – just suppose – that smoking was banned for pregnant women. They would not be allowed to buy cigarettes in the shops or through the internet and other people would be forbidden on pain of instant excommunication knowingly to give cigarettes to a pregnant woman, and let us further suppose that this scheme worked perfectly so that there was no way a woman, once her pregnancy was confirmed, could legally smoke cigarettes or use any nicotine product. What would happen? Would there be an outcry? Would there be  marches in the streets with demonstrators carrying placards saying ‘We demand the right of pregnant women to smoke!’?

I suspect many women would be quite relieved that the dilemma of smoking in pregnancy had been taken away from them. They may well say to themselves, ‘Of course I know it’s bad for me and the baby, but now that I’m not allowed to smoke, well, I’ll just have to accept it.’

This is a fantasy, but at present, pregnant women as long as they are over eighteen, in spite of being strongly discouraged from doing so, may, if they wish, quite legally buy and smoke as many cigarettes as they choose.

Smoking in front of children is rightly discouraged and there are penalties for smoking in cars when children are present. But what about the developing baby in the womb of a smoker?

This absurd and unacceptable situation exists because in a democracy like Britain adults have the right to damage their health by smoking cigarettes. But should they have the right to damage other people’s health – including that of unborn babies – by smoking?

Before my critics start accusing me of being an agent of the Nanny State, let me make something quite clear. There is a big difference between smoking in pregnancy and other harmful behaviours and of course I am not proposing that laws  be enacted to try to save unborn babies from all possible dangers.

Heavy drinking in pregnancy is harmful to the baby: it can produce a serious condition called the foetal-alcohol syndrome. But the occasional glass of wine or beer is probably all right. Nonetheless, where to draw the line is unclear, and I would not advise drinking any alcohol in pregnancy.

But whereas the occasional alcoholic drink in pregnancy is probably safe, pregnant women who smoke do not do it occasionally; they do it every day, repeatedly. There is no question whatsoever that smoking can directly damage the developing baby and that is why is it strongly discouraged and help is offered to pregnant smokers to quit.

The reason that some women smoke when pregnant is the same reason they smoke when they’re not pregnant: nicotine addiction. They may claim they do it for pleasure or relaxation or to relieve stress but such claims are illusory – as any smoker can easily demonstrate to himself or herself.

The question, then, comes down to this: because of the high risk of serious harm to the unborn child, should smoking in pregnancy be banned?

Text © Gabriel Symonds

Danger! Never Smoke While Using Oxygen!

Here is some good news for those unfortunate patients suffering from a serious condition  known as chronic obstructive pulmonary disease, or COPD. It’s a complex disorder but the main features are shortness of breath with cough, phlegm and chest tightness as the lungs are progressively damaged; the result may be fatal. The biggest risk factor for getting COPD is cigarette smoking so it’s obvious what a smoker should do if he or she has been given this  diagnosis.

Easier said than done! Or so it may appear. Here we have the absurd situation where smoking is literally killing these patients and they may say they can’t stop. Well, unless someone has a death wish – and respiratory failure is not a pleasant way to die – I don’t believe someone can’t stop smoking. I have had a number of patients with the COPD under my care and when they  realised the state they were in, even if they didn’t want to avail themselves of my method of smoking cessation, they just stopped. It’s similar to the situation of a smoker who gets a heart attack: they usually quit forthwith.

Now there has been a new study, reported in the journal Thorax in May 2017, undertaken by six researchers from the UK, Germany, The Netherlands and the USA, that shows, apparently, that giving the drugs varenicline or bupropion to smokers with COPD – those who by implication are unable to quit on their own in spite on of this serious diagnosis – is safe, in that these drugs ‘do not appear to be associated with an increased risk of cardiovascular events (heart attacks and strokes), depression or self-harm (suicide attempts) in comparison with (so-called) nicotine replacement therapy.’

Smoking is a voluntary activity. Yet the orthodox approach of medical workers involved in the care of these patients is that they can only offer nicotine products or drugs to help them stop killing themselves. But even if they use these drugs or nicotine products they still have to stop smoking!

It’s not generally realised that offering drugs or nicotine products as smoking cessation ‘aids’ is inherently discouraging and may make quitting more difficult. This is because these treatments imply that it’s too difficult to quit on your own. Even if you’re suffering from COPD, and obviously the smoke is going into the very place where the trouble is, namely, the lungs, there’s an unspoken collusion that these poor people can’t stop without medical intervention.

Psychologically this is a disaster: it gives the patient an in-built excuse for failure. Like all smokers, even though dying from this smoking-induced disease is a real possibility, they still don’t really want to stop. They can say, therefore, that they tried the drugs or nicotine products and they didn’t work, so in a sense they have permission to carry on smoking!

What, then, should be done?

First of all, it is a ludicrous situation, is it not, that people with a potentially life-threatening illness largely caused by smoking, are able to go into any corner shop or supermarket and buy a pack of cigarettes, no questions asked. Pictures of diseased lungs and patients with breathing holes in their throats (tracheostomies) do nothing to put off those COPD patients who continue to smoke. It is, therefore, not lack of information about the harmful effects of smoking that is the reason many people start or continue smoking.

Why, then do they do it?

Children and teenagers start smoking because they see other people smoking, either older people whom they wish to emulate, or their peers whom they wish to impress. Horrible pictures on the packs make very little impression. ‘Lung cancer happens to older people – it doesn’t apply to me.’ Or they think of themselves as invulnerable – which is understandable and even normal at that age. The ‘graphic health warnings’ may even act as an incentive to  smoke, as a dare. What is absurd is that cigarettes are on sale at all.

There’s a glaring inconsistency in that cigarettes, in packs emblazoned with warnings not to smoke, are nonetheless freely available. I have even had young people say to me, ‘If cigarettes were really so dangerous they wouldn’t be allowed!’ This is a good point, but how do you respond to it? By saying that government is either lying or being irresponsible?

And why do older smokers continue to smoke in spite of knowing the dangers? Because they are addicted to the nicotine in cigarettes. This statement, however, is not an adequate answer to the question. We can put it succinctly like this: the only reason smokers smoke is because they believe they are unable to quit.

Text © Gabriel Symonds