Category Archives: Quit smoking

The perfect ‘product’ for nicotine addiction

The US Food and Drug Administration (FDA) recently announced it has awakened to the interesting idea that the way to help people quit smoking is for them to have a wider range of ‘products’ available in addition to so-called nicotine replacement therapy (NRT).

The FDA recognises that NRT (nicotine-containing gum, patches and lozenges) is of limited effectiveness and so it now wants the smoking public to have access to more options, in particular, e-cigarettes. Further, it wants to have NRT and e-cigarettes approved as medical products and possibly even have them covered by health insurance.

Let’s pause for a moment to consider this curious situation. In the US cigarettes are freely and legally available for sale to anyone over 18 (21 in some states). As a result many people become addicted to smoking and because of this there are about 480,000 deaths from smoking-related diseases in the US every year. And the way the government is trying to deal with this is that when people are already addicted to the nicotine in cigarettes and find it difficult to stop smoking, they should be offered nicotine in some other form as a ‘therapy’ to help them. But because NRT doesn’t work very well they need to have other products or options available as quit smoking aids.

Isn’t there something a bit odd about this? Either nicotine-containing consumer products (especially cigarettes) should cease to be available, in which case the problem wouldn’t arise for those who don’t yet smoke, or we need a radical new approach to treating nicotine addiction for those already in this unfortunate position.

It gets worse. The FDA is contemplating new measures that would enable cigarette companies to get non-cigarette nicotine-containing products approved as medicines to treat the nicotine addiction that their primary product, cigarettes, caused in the first place.

Big Tobacco must love this. They can present themselves as part of the solution to the smoking problem – a win-win situation for them because they can anticipate their income will be protected as sales of cigarettes fall while sales of alternative nicotine products rise. This might just about be acceptable if they were to announce, for example, that at the stroke of midnight on 31st December 2020 all cigarette production in the US will cease. Of course they won’t commit themselves – any suggestion of phasing out combustible tobacco products is projected to some vague time in the fairly distant future.

Tobacco companies should be seen for what they are: the whole of the problem. And the only role they can have solving it – and it would be a very big role which would virtually eliminate the problem – would be to stop making cigarettes.

Instead of pushing for this obvious measure, or even mentioning it, the FDA Commissioner, Dr Scott Gottlieb, verbosely talks about ‘what we can do to create additional pathways to bring additional nicotine replacement therapies to the market’.

By the time smokers are addicted to nicotine it’s too late. Dr Gottlieb is pursuing a non-existent goal. You have to remove the cause of nicotine addiction, not treat it when it’s happened. Why aren’t smokers clamouring for relief, for a ‘product’ or even for a range of options to help them escape their thraldom to nicotine?

Because the tragedy of nicotine addiction is that many sufferers don’t want to escape.

Text © Gabriel Symonds

How to quit smoking the hard way

I have written before about the American Cancer Society’s efforts to scare people into quitting smoking (29 April 2016 http://nicotinemonkey.com/?p=293). This august organisation appears again in connection with the so-called Great American Smokeout, an annual event in November. It’s worth looking at the current offering in a little more detail.

There’s a film titled: ‘Smoking Cessation – 3 Steps to Quitting’. (The word ‘Cessation’ would be better omitted.)

The object seems to be to get smokers to quit through fear: the word ‘cancer’ occurs in spoken or written form in this short film (it’s just over three minutes) no less than nine times.

Everything about this film is a demonstration of how to quit smoking the hard way. It starts by mentioning what smokers already know: that if they quit they’ll feel and look better and their risk of cancer will be less.

Here’s a brief excerpt of the script with my comments:

It’s hard to quit smoking

It isn’t, if you go about it in the right way

It can take several tries to stay quit

The concept of trying to quit is meaningless – you either smoke or you don’t.

What is important is that you learn from each attempt so that you can plan better for the next.

Even if we accept the idea of a ‘quit attempt’, what is there to learn? All this means is you have merely failed to quit, so now what do you do?

There’s no one right way to quit.

But there is. You just stop!

There are three steps that lead to quitting for good. First, make the decision to quit and set a quit date.

This is counter-productive and I explained why in my post of 10 May 2016 (http://nicotinemonkey.com/?p=377). In any case, there’s only one step that leads to quitting for good. You make the decision to quit and – that’s it! You never smoke again. If you make a decision to quit but put it off for, say, the next three weeks, you haven’t ‘made a decision to quit’ – you’ve decided to carry on  smoking. And what’s going to be different in three weeks’ time?

Second, make a plan to manage your day without smoking. Smoking is likely a big part of your daily life and activities, so your next step should include a plan for how to manage your day without smoking.

Why do you need such a plan? If you stop smoking you just carry on with all your normal activities without smoking.

Think of the different things you can do instead of smoking that can help you manage cravings.

Here we go again: you’ll have ‘cravings’ that will need to be ‘managed’. As already mentioned, you don’t need to do different thing instead of smoking: you just carry on with your normal activities.

Some of these might include exercising, getting out the house for a walk or visiting a local park, chewing gum or hard candy, relaxing with deep breathing or meditation…

It would be rather uncomfortable chewing on hard candy. And do you really have to go the trouble of learning meditation in order to stop smoking?

Finally, talk to your doctor or pharmacist about your decision to quit. They can provide counselling and discuss other options like medications to help you quit. Studies show that you have a much greater chance of quitting when you get support.

Now we come to the point. Why would you talk to your doctor or pharmacist unless you were seeking a prescription drug or an over-the-counter medicine, respectively? You don’t need medications to help you quit – you just need to quit!

You may also want to talk to your doctor about a screening test that can detect lung cancer early – a low-dose CT scan. It is a fast and painless test that can find early stage lung cancer when it is more easily treated.

Apart from being scary, this is controversial: there’s no proof that such screening saves lives even in heavy smokers. One of the problems is that if the screening shows the all-clear, the next day a cancer might start to develop.

Curious that in all this there’s nary a word about why people smoke: nicotine addiction.

Text © Gabriel Symonds

The painting is ‘Morning Coffee’ is by Atanas Matsoureff