How And Why To Quit Smoking

Cigarette, cigar, and pipe-smoking are so debilitating that the immediate cessation of the habit is always
the first step of any program to improve one’s health – even more important than vitamins, diet, or exercise.
International studies of millions of people by government, industry, universities,
and private research institutions have determined that smoking can cause:
1. Stained teeth, fingers, and hair
2. Increased frequency of colds, particularly chest colds and bronchitis
3. Asthma
4. Neuralgia
5. Gastrointestinal difficulties, constipation, diarrhea, and colitis
6. Headaches
7. Nausea
8. Convulsions
9. Leukoflakia (smoker’s patch)
10. Insomnia
11. Heart murmur
12. Buerger’s disease (inflammation of blood vessel linings)
13. Shortness of breath
14. Arthritis
15. Smoker’s hack
16. Nervousness
17. Wrinkles and premature aging
18. Tension
19. Gastric, duodenal, and peptic ulcers
20. Lung cancer
21. Cancer of the lip, tongue, pharynx, larynx, and bladder
22.Emphysema
23.High blood pressure
24. Heart disease
25. Artherosclerosis & arteriosclerosis (thickening and loss of elasticity of the blood vessels with lessened blood flow)
26. Inflammation of the sinus passages
27. Tobacco angina (nicotine angina pectoris)
28. Pneumonia
29. Influenza
30. Pulmonary tuberculosis
31. Tobacco amblyopia
32. impared hearing
33. Decreased sexual activity
34. Mental depression
Blood flow to the extremities is decreased (cold hands and feet).One puff lowers the temperature in the fingertips 1ºF to 3ºF in 3 minutes.
Nicotine affects the nerve-muscle junctions, causing tremors and shaking. Nicotine causes narrowing and constriction of the arteries, adding to the heart’s load. Nicotine, through its ability to stimulate, causes excitement and anxiety. But the effect wears off, often a period of depression follows, whereupon another cigarette is taken. Nicotine, an insecticide, makes the blood more viscous and decreases the available oxygen. It also adversely affects the breathing, sweating, intestinal, and heart actions of our autonomic nervous system, probably due to hindering the blood flow to the nerve centers in the brain.
Two to four cigarettes in a row increase blood fats 200 to 400%. The average smoker (30 cigerettes per day) has 4 to 6 times the chance of having heart disease if he’s in the 45-54 year age group.
If the mother smoked during pregnancy, her baby will average 6 ounces less and its pulse will be 30% faster than a non-smoker’s baby, and there’ll be withdrawal symptoms in the baby after birth. Premature birth has been related to smoking by the mother. There is a direct link between parents’ smoking and children’s respiratory disease.
Smoking causes widespread permanent destruction of the tiny air sacs (alveoli) and narrowing of small blood vessels in the lungs, decreasing the oxygen supply, requiring a higher blood pressure, thus causing extensive circulatory problems and premature heart attacks. Smokers have difficulty running and exercising.
The cilia are tiny, delicate, hairlike coverings on the thin membrane of the surface of the lungs and trachea that, by means of their whipping, beating action, produce an upward current of foreign material and mucus from the lungs which is then swallowed or expectorated. This is the way the body cleans the lungs. This delicate lung-cleaning mechanism, in a cigarette smoker, at first paralyzes, then deteriorates, and is eventually made inoperative, through the complete destruction of the cilia. The smoker then must resort to coughing as a lung-cleaning method. This isn’t efficient, and more than a cupful of tars will have accumulated in his lungs by the time of his premature death.
Air pollution (auto exhausts, industry wastes, etc.) increases the lung cancer rate of the smoker, but not of the non-smoker. Apparently, the lung-cleaning cilia are alive and working for the non-smoker.
The time to recover from any specific ill, whether caused by smoking or not, is much longer for the smoker. Often, a non-smoker will survive a sickness from which he would have died had he smoked.
The non-smoker has no need to spend money to buy cigarettes, matches, lighters, holders, ashtrays, or to spend a dime a mile for that special trip to the store. Just the cigarettes alone amount to an average of $250 per year, after taxes – wasted. Add another $250 if the spouse smokes. This is hard-earned, after-tax, money of yours, used to pay for the above smoking paraphernalia – plus tax! (Please note: these are 1971 figures.)
By dying earlier, the smoker will lose many tens of thousands of dollars in social security and other benefits which will naturally end up in the pockets of the non-smoker. The cigarette tax is more money from the smoker to the non-smoker.
The smoker is sick more often, explaining why he misses an average of 7½ work days per year, usually with a loss of pay, while the non-smoker will miss only 4½ days.
The smoker must spend valuable time looking for ashtrays, cigarettes, matches, retail stores, vending machines, or change for these machines. He experiences displeasure if they aren’t immediately at hand. Just the process of deciding on “which brand” wastes vast amounts of mental, physical, and financial resources.
The overall bad health of the smoker results, on average, in a decrease of 8.3 years in his life expectancy, or about 12 to 14 minutes per cigarette. Just in lost social security income alone, this amounts to about a 5¢ a cigarette. The actual cost of each cigarette when you include extra medical expenses, lost pay, etc., is of the order of 25¢ per cigarette (1971 figures).
Just the extra medical expenses alone can be expected to eventually use up all of a smoker’s hard-earned savings, already depleted by the high cost of smoking. By the time non-smokers get sick, Medicare will foot their medical bills.
The smoker’s body requires more sleep every night. This extra sleep must come from his spare time. Besides needing more sleep, smokers don’t sleep as well.
Smoking destroys vitamins, particularly vitamin C and the B’s. If you smoke, it can be critical to supplement yourself with these vitamins. Click here to learn more about our C-Salts, sold exclusively by Wholesale Nutrition and considered to be the best form of vitamin C by Andrew Weil, MD. We also offer a wide variety of B vitamins, including our popular B Complex ’50’ Formula. You can also click here to view our B vitamins in full.
Smoking has induced cancer in dogs. Insurance rates can be higher for smokers. Some 100,000 doctors stop smoking every year.
Foods will taste much better to non-smokers. Many subtle flavors and aromas will be savored if your nasal and oral senses are freed of the effects of harsh chemicals, coal tars, and other combustion products. How long has it been since you’ve experienced the smell of fresh-cut grass or the delicate taste of lobster from Maine or Nova Scotia?
Other disadvantages of smoking: You must always carry cigarettes and matches; your pockets bulge – or there’s less space in your purse; smelly breath; smelly house; smelly clothes; messy rugs and furniture, often burned; cigarettes lying around for kids to smoke (and matches to light); you’re a bad influence on kids; you’re held in low esteem by your kids and your friends (even your smoking friends); the inside of your home and auto windows need cleaning more often; death or property loss due to smoking in bed.
Some 120 persons have died in two airline crashes that have been attributed to ashtray and lighter-fluid fires. Cigarette smoke collects with lint and is known to gum up delicate mechanisms such as aircraft controls.
Smokers get into more auto accidents due to being less alert, having slower reflexes, and also due to fussing around while driving (lighting up, etc.). In Czechoslovakia it’s illegal to smoke while driving. Accident-proneness has been related to smoking.
A non-smoker would have to put on an additional 150 pounds in order to increase his mortality rate to that of an average smoker.
The fact that the tobacco industry provides work, that wouldn’t exist without it, is a myth. The money now wasted on tobacco, if diverted elsewhere, would create a wealth of new job openings in industries producing goods and services more useful to the society than cigarettes.
Smoking makes a person irritable and argumentative, partially due to a subconscious knowledge of all of the above facts. Smoking has been related to brain damage and premature senility.
A smoker needs much more food and sleep since nicotine makes his body work harder and less efficiently and his heart beat faster, thus using more fuel and energy. This, together with the fact that a smoker loses much of his appetite and his taste for food, explains why smokers have less trouble keeping their weight down. When one quits smoking, it’s IMPERATIVE that the intake of food is drastically reduced in order to keep the body weight normal. Having to eat less is of course an additional saving of time and money.
Wouldn’t it be nice if everyone quit smoking? There’d be less general litter, no more butts, ashes, or wrappers in the streets, grass, urinals, etc.; no more smoke in restaurants, theaters, airplanes or buses; a more alert society, with more spare time to enjoy or improve their lot in life; fewer auto, plane, on-the-job, and household accidents; fewer forest fires; less air pollution; lower auto and life insurance rates; and fewer people coughing and spitting in public. By inflicting smoke on your non-smoking friends, it’s been shown that even THEIR health and life expectancy are adversely affected.
Notice how many of your friends have quit smoking in the last 5 years. They’re the smart ones (and you know it). Lower intelligence has been related to smoking. In fact, smoking is both a cause and an effect of lower intelligence, just as smoking is both a cause and effect of lower income. The (smoking)-(lower-intelligence)-(lower-income)-(more smoking) vicious circle can unknowingly spiral a brainwashed young person down and down into the depths of poverty and despair. He’ll not be as physically or mentally able to cope with life’s challenges. Our successful capitalistic system is based on competition, and the physically-mentally handicapped smoker inevitably ends up at the bottom of the heap. So get smart, today, now, and join the happy, healthy ranks of the non-smokers.
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Smoking Facts: The Facts About Smoking – How And Why To Quit
Smoking Facts: The Facts About Smoking – How And Why To Quit
Cigarette, cigar, and pipe-smoking are so debilitating that the immediate cessation of the habit is always
the first step of any program to improve one’s health – even more important than vitamins, diet, or exercise.
International studies of millions of people by government, industry, universities,
and private research institutions have determined that smoking can cause:
1. Stained teeth, fingers, and hair
2. Increased frequency of colds, particularly chest colds and bronchitis
3. Asthma
4. Neuralgia
5. Gastrointestinal difficulties, constipation, diarrhea, and colitis
6. Headaches
7. Nausea
8. Convulsions
9. Leukoflakia (smoker’s patch)
10. Insomnia
11. Heart murmur
12. Buerger’s disease (inflammation of blood vessel linings)
13. Shortness of breath
14. Arthritis
15. Smoker’s hack
16. Nervousness
17. Wrinkles and premature aging
18. Tension
19. Gastric, duodenal, and peptic ulcers
20. Lung cancer
21. Cancer of the lip, tongue, pharynx, larynx, and bladder
22.Emphysema
23.High blood pressure
24. Heart disease
25. Artherosclerosis & arteriosclerosis (thickening and loss of elasticity of the blood vessels with lessened blood flow)
26. Inflammation of the sinus passages
27. Tobacco angina (nicotine angina pectoris)
28. Pneumonia
29. Influenza
30. Pulmonary tuberculosis
31. Tobacco amblyopia
32. impared hearing
33. Decreased sexual activity
34. Mental depression
Blood flow to the extremities is decreased (cold hands and feet).One puff lowers the temperature in the fingertips 1ºF to 3ºF in 3 minutes.
Nicotine affects the nerve-muscle junctions, causing tremors and shaking. Nicotine causes narrowing and constriction of the arteries, adding to the heart’s load. Nicotine, through its ability to stimulate, causes excitement and anxiety. But the effect wears off, often a period of depression follows, whereupon another cigarette is taken. Nicotine, an insecticide, makes the blood more viscous and decreases the available oxygen. It also adversely affects the breathing, sweating, intestinal, and heart actions of our autonomic nervous system, probably due to hindering the blood flow to the nerve centers in the brain.
Two to four cigarettes in a row increase blood fats 200 to 400%. The average smoker (30 cigerettes per day) has 4 to 6 times the chance of having heart disease if he’s in the 45-54 year age group.
If the mother smoked during pregnancy, her baby will average 6 ounces less and its pulse will be 30% faster than a non-smoker’s baby, and there’ll be withdrawal symptoms in the baby after birth. Premature birth has been related to smoking by the mother. There is a direct link between parents’ smoking and children’s respiratory disease.
Smoking causes widespread permanent destruction of the tiny air sacs (alveoli) and narrowing of small blood vessels in the lungs, decreasing the oxygen supply, requiring a higher blood pressure, thus causing extensive circulatory problems and premature heart attacks. Smokers have difficulty running and exercising.
The cilia are tiny, delicate, hairlike coverings on the thin membrane of the surface of the lungs and trachea that, by means of their whipping, beating action, produce an upward current of foreign material and mucus from the lungs which is then swallowed or expectorated. This is the way the body cleans the lungs. This delicate lung-cleaning mechanism, in a cigarette smoker, at first paralyzes, then deteriorates, and is eventually made inoperative, through the complete destruction of the cilia. The smoker then must resort to coughing as a lung-cleaning method. This isn’t efficient, and more than a cupful of tars will have accumulated in his lungs by the time of his premature death.
Air pollution (auto exhausts, industry wastes, etc.) increases the lung cancer rate of the smoker, but not of the non-smoker. Apparently, the lung-cleaning cilia are alive and working for the non-smoker.
The time to recover from any specific ill, whether caused by smoking or not, is much longer for the smoker. Often, a non-smoker will survive a sickness from which he would have died had he smoked.
The non-smoker has no need to spend money to buy cigarettes, matches, lighters, holders, ashtrays, or to spend a dime a mile for that special trip to the store. Just the cigarettes alone amount to an average of $250 per year, after taxes – wasted. Add another $250 if the spouse smokes. This is hard-earned, after-tax, money of yours, used to pay for the above smoking paraphernalia – plus tax! (Please note: these are 1971 figures.)
By dying earlier, the smoker will lose many tens of thousands of dollars in social security and other benefits which will naturally end up in the pockets of the non-smoker. The cigarette tax is more money from the smoker to the non-smoker.
The smoker is sick more often, explaining why he misses an average of 7½ work days per year, usually with a loss of pay, while the non-smoker will miss only 4½ days.
The smoker must spend valuable time looking for ashtrays, cigarettes, matches, retail stores, vending machines, or change for these machines. He experiences displeasure if they aren’t immediately at hand. Just the process of deciding on “which brand” wastes vast amounts of mental, physical, and financial resources.
The overall bad health of the smoker results, on average, in a decrease of 8.3 years in his life expectancy, or about 12 to 14 minutes per cigarette. Just in lost social security income alone, this amounts to about a 5¢ a cigarette. The actual cost of each cigarette when you include extra medical expenses, lost pay, etc., is of the order of 25¢ per cigarette (1971 figures).
Just the extra medical expenses alone can be expected to eventually use up all of a smoker’s hard-earned savings, already depleted by the high cost of smoking. By the time non-smokers get sick, Medicare will foot their medical bills.
The smoker’s body requires more sleep every night. This extra sleep must come from his spare time. Besides needing more sleep, smokers don’t sleep as well.
Smoking destroys vitamins, particularly vitamin C and the B’s. If you smoke, it can be critical to supplement yourself with these vitamins. Click here to learn more about our C-Salts, sold exclusively by Wholesale Nutrition and considered to be the best form of vitamin C by Andrew Weil, MD. We also offer a wide variety of B vitamins, including our popular B Complex ’50’ Formula. You can also click here to view our B vitamins in full.
Smoking has induced cancer in dogs. Insurance rates can be higher for smokers. Some 100,000 doctors stop smoking every year.
Foods will taste much better to non-smokers. Many subtle flavors and aromas will be savored if your nasal and oral senses are freed of the effects of harsh chemicals, coal tars, and other combustion products. How long has it been since you’ve experienced the smell of fresh-cut grass or the delicate taste of lobster from Maine or Nova Scotia?
Other disadvantages of smoking: You must always carry cigarettes and matches; your pockets bulge – or there’s less space in your purse; smelly breath; smelly house; smelly clothes; messy rugs and furniture, often burned; cigarettes lying around for kids to smoke (and matches to light); you’re a bad influence on kids; you’re held in low esteem by your kids and your friends (even your smoking friends); the inside of your home and auto windows need cleaning more often; death or property loss due to smoking in bed.
Some 120 persons have died in two airline crashes that have been attributed to ashtray and lighter-fluid fires. Cigarette smoke collects with lint and is known to gum up delicate mechanisms such as aircraft controls.
Smokers get into more auto accidents due to being less alert, having slower reflexes, and also due to fussing around while driving (lighting up, etc.). In Czechoslovakia it’s illegal to smoke while driving. Accident-proneness has been related to smoking.
A non-smoker would have to put on an additional 150 pounds in order to increase his mortality rate to that of an average smoker.
The fact that the tobacco industry provides work, that wouldn’t exist without it, is a myth. The money now wasted on tobacco, if diverted elsewhere, would create a wealth of new job openings in industries producing goods and services more useful to the society than cigarettes.
Smoking makes a person irritable and argumentative, partially due to a subconscious knowledge of all of the above facts. Smoking has been related to brain damage and premature senility.
A smoker needs much more food and sleep since nicotine makes his body work harder and less efficiently and his heart beat faster, thus using more fuel and energy. This, together with the fact that a smoker loses much of his appetite and his taste for food, explains why smokers have less trouble keeping their weight down. When one quits smoking, it’s IMPERATIVE that the intake of food is drastically reduced in order to keep the body weight normal. Having to eat less is of course an additional saving of time and money.
Wouldn’t it be nice if everyone quit smoking? There’d be less general litter, no more butts, ashes, or wrappers in the streets, grass, urinals, etc.; no more smoke in restaurants, theaters, airplanes or buses; a more alert society, with more spare time to enjoy or improve their lot in life; fewer auto, plane, on-the-job, and household accidents; fewer forest fires; less air pollution; lower auto and life insurance rates; and fewer people coughing and spitting in public. By inflicting smoke on your non-smoking friends, it’s been shown that even THEIR health and life expectancy are adversely affected.
Notice how many of your friends have quit smoking in the last 5 years. They’re the smart ones (and you know it). Lower intelligence has been related to smoking. In fact, smoking is both a cause and an effect of lower intelligence, just as smoking is both a cause and effect of lower income. The (smoking)-(lower-intelligence)-(lower-income)-(more smoking) vicious circle can unknowingly spiral a brainwashed young person down and down into the depths of poverty and despair. He’ll not be as physically or mentally able to cope with life’s challenges. Our successful capitalistic system is based on competition, and the physically-mentally handicapped smoker inevitably ends up at the bottom of the heap. So get smart, today, now, and join the happy, healthy ranks of the non-smokers.
Quitting the Filthy Habit
The smoker’s body cells have become addicted to nicotine, and to quit smoking won’t be easy, since withdrawal symptoms can be expected. Here are some helpful tips that might ease the quitting process:
If you’re a light smoker, you should quit immediately, only moderately shocking your system.
The heavy smoker should allow two weeks for cutting down, then quit completely. An extended cutting-down period only prolongs the pain. Prepare for an agonizing month or two, though you might get off easily. The close family must give up, too, at least in your presence. It’d of course be best if the whole family quit at once. The pain and agony you’ll suffer can be relieved completely in most persons by taking vitamin C to bowel tolerance. That means to take as little as one gram or as many as fifty grams (50,000 milligrams) every day until you reach the point of liquid diarrhea, then decrease the amount until your stools are normal. But “normal”, for many smokers, means frequent constipation. Stools must always be soft, never, ever, necessitating any straining.
Wholesale Nutrition specializes in vitamin C powder products, many of which were invented by us and are sold exclusively by our company. Click here to view them in full.
If anti-smoking drugs help (Nikoban, Bantron, Pronicotyl), good, but be prepared to find they won’t. Vitamins C and B1 and tranquilizers often help to decrease irritability and other withdrawal symptoms.
After eating don’t sit down. Take a walk instead. Try to avoid situations that you associate with smoking, such as sitting in your favorite chair, particularly after dinner. Try to avoid situations that are conducive to smoking, such as bars, meetings, and boredom. Don’t invite smoking friends over during the critical first few months. Never, anytime, let them smoke in your soon-to-be smell-free home. In fact, after you’ve quit for a few months, you’ll notice how your clothes still have a strong residual smell of an ashtray. It may be necessary to clean or clear away every source of that smell, usually from carpets and clothes. Then get ready for a new life of clean lungs and great health. Your non-smoking friends won’t avoid you anymore now that you no longer smell like an ashtray.
When you get that urge to smoke (and you will), drink some water. If that doesn’t work, suck a prune and keep the pit in your mouth for an hour. Try the buddy system: phone a friend who’s also trying to quit. Think of the satisfaction of not having given in to that filthy urge. Think how bad you’ll feel if you do give in. Think about how your cigarette money helps support those hypocritical tobacco companies whose income is derived at the expense of the health, wealth, happiness, efficiency, and resources of the addicted smoker.
Keep this smoking facts sheet with you at all times, and re-read it when necessary, to refresh your memory of all the ugly disadvantages of smoking, and all the advantages of not smoking.
Try to avoid calories, but if you find that substituting food for cigarettes helps you give up smoking, then by all means have an apple, gum, beef jerky, or a prune. If at all possible, exercise a bit every day, especially when you get the urge to smoke. It’s a good substitute, and you’ll find that exercising comes much easier as a non-smoker.
After giving up, that filthy urge may remain for several years, so don’t start again. Some people are lucky in that after a few months the thought of smoking makes them sick. But don’t bank on being lucky.
Cigarette displays, cigarette ads, cigarette machines, anything having to do with smoking, must be looked upon in your mind as existing only for those poor unfortunates who are addicted to that filthy habit.
Life’s too good and too short to waste on that filthy habit.
nutri.com

Cigarettes Are Enlisted to Test Ways of Quitting

When a truck recently delivered 45,000 cartons of cigarettes to a research company in North Carolina, it was a turning point in the government’s war on smoking.

These were no ordinary cigarettes, but experimental ones, made of genetically altered tobacco to lower the nicotine content by 97 percent while preserving all the other tastes and smells and rituals for smokers of conventional cigarettes.

Researchers had been seeking a new and bigger supply because shortages had limited previous studies to just dozens of people. The experimental cigarettes are produced by a Massachusetts company, the 22nd Century Group, which holds 98 patents for genetic manipulation of tobacco plants to reduce or increase the amount of nicotine in cigarettes.

The National Institutes of Health bought nine million of these cigarettes, marked “for research purposes only,” from the 22nd Century Group as part of a broadening scientific effort to find ways to regulate cigarettes so that they are nonaddictive. The Spectrum brand test cigarettes have eight different levels of nicotine for research, from a nicotine content of 3 percent to 100 percent of the nicotine in the  Marlboro Gold though a 97 percent reduction is the most common level.

Dr. Nora D. Volkow, director of the National Institute on Drug Abuse of the N.I.H., which oversees the work, called the delivery crucial for the new federal research projects. These include last month’s award of $2.5 million for the first year of a planned five-year series of studies into threshold levels of nicotine addiction and the possible impact of a sharp reduction in nicotine on smoking and public health.
One study of the test cigarettes will follow about 500 smokers over six months to determine whether they are more likely to quit if they switch to those cigarettes quickly or gradually. The research, led by Dorothy K. Hatsukami, a professor of psychiatry at the University of Minnesota, and Eric C. Donny, associate professor of psychology at the University of Pittsburgh, will use about 1.5 million of the recently acquired cigarettes.
For researchers, the availability of a new supply of test cigarettes is “a game changer,” said Mitch Zeller, co-chairman of the Tobacco Harm Reduction Network at the National Cancer Institute and a consultant on nicotine replacement products. “It’s still all about the nicotine. Only now we have the power to do something about it.”
At the same time, officials in the $80 billion tobacco industry have warned of unexpected side effects from addiction withdrawal and black market products, complex issues the Food and Drug Administration will have to study in considering regulation.
Under a 2009 law giving the F.D.A. authority over tobacco products, the agency cannot ban nicotine, but can require that it be reduced to extremely low levels if that is proved to benefit public health.
“We really need to have good science to determine whether this might be a product standard, and to have good science, we need reduced-nicotine cigarettes,” said Dr. Hatsukami, who is also a member of the F.D.A. Tobacco Products Scientific Advisory Committee. Her work stalled when companies stopped making very-low-nicotine cigarettes. “In the middle of a study, we don’t have the cigarettes,” she said.
Dr. Neal L. Benowitz, another researcher and member of the federal committee, had received specially manufactured low-nicotine cigarettes from Philip Morris, a division of the Altria Group, makers of Marlboro cigarettes. When he went back for more, Philip Morris had stopped making them. Dr. Benowitz is also relying on the new supply, which the government will give to researchers without charge.
The 22nd Century Group is also applying for F.D.A. approval of its own test cigarette, called “X-22,” as a prescription-only smoking cessation device.
“No one has ever sought F.D.A. approval of a cigarette as a medical device,” Joseph Pandolfino, the founder and chief executive of 22nd Century, said in an interview. Preliminary studies show smokers can have an easier time quitting if they taper off the nicotine while still being able to do all the other things they do with cigarettes, he said, but larger studies are needed.
Another cigarette in testing, called “Brand B,” has tobacco that was genetically modified to have high levels of nicotine. The company hopes it will be approved by the F.D.A. as a “modified risk” tobacco product — a safer cigarette because users would take fewer puffs to get the same amount of nicotine.
The growing industry of quit-smoking products — patches, gum, lozenges and pills — has not further dented the rather steady rate of smoking recently in the United States, which has stayed at about 20 percent since 2004 after years of notable decline. A new crop of electronic cigarettes and smokeless tobacco products seem aimed more at getting smokers through smoke-free times rather than quitting.
Earlier this month, the F.D.A. and N.I.H. also announced they were starting a $118 million study to track about 44,000 people over five years to assess usage trends, risk perception, quit-smoking attempts and the possible impact of new tobacco regulations. In 2006, a federal judge found that tobacco companies had designed cigarettes to precisely control the amount of nicotine and provide doses sufficient for addiction, while concealing much of their nicotine research. They marketed so-called light cigarettes, which delivered a lower dose to smoking machines because of holes in the filter, but the same dose or worse to smokers who compensated by covering the holes with their lips and drawing harder.
In two small studies by Dr. Hatsukami and Dr. Benowitz, the genetically altered cigarettes were found to defeat the phenomenon of smoker “compensation.” But researchers said they needed much more evidence.
Tests so far on the experimental cigarettes are encouraging enough that Dr. Hatsukami is going into a Phase 3 clinical trial. That means Phase 2 trials have proven effectiveness on humans. Phase 3 measures both effectiveness and safety. 22nd Century is also planning to start Phase 3 trials next year.
The studies are examining gradual or rapid reductions of nicotine. In a regulated marketplace, the government could set limits on nicotine and ratchet down. And teenagers could still experiment with cigarettes, as they are wont to do, without getting addicted.
“It’s a hot topic,” said Clifford E. Douglas, director of the University of Michigan Tobacco Research Network. “But as difficult as menthol has been, nicotine will be more difficult, because it’s not 15 million smokers, it’s every smoker in the United States.” The F.D.A., under its new authority, has focused on Congressional mandates over menthol-cigarettes-brands, dissolvable products and graphic warning labels on cigarette packages, each a contentious issue of its own with tobacco companies challenging science and policy.
The F.D.A.’s advisory panel has not put nicotine on its agenda yet, which is why Dr. Gregory N. Connolly, a Harvard professor of public health and antismoking advocate, said he resigned from the F.D.A. panel in December.
“After 50 years of knowing cigarettes cause cancer, it’s nice to know we have a supply we can investigate,” Dr. Connolly said. “But the real issue is the F.D.A. should have begun a process two years ago to see if we can eliminate nicotine in cigarettes, at least for children. If we can put a man on the moon, we can get rid of nicotine.”
By DUFF WILSON
Nytimes

What would happen if Americans stopped smoking?

The number of New Yorkers who smoke dropped to an all-time low of 14 percent this year, Mayor Mike Bloomberg announced late last NY smoking banweek. That’s down from 22 percent in 2002 and translates into 450,000 fewer adult New Yorkers who smoke than did a decade ago.
The New York drop mirrors a nationwide decline, where smoking rates have fallen by over half since the 1950s. But that still leaves 46 million American smokers — what if they all kicked the habit, too? That’s the world “After Tobacco,” a new book from economic researchers Peter Bearman, Kathryn Neckerman and Leslie Wright, tries to imagine.
The authors estimate that if all smoking ceased in 2006, 2.8 million premature deaths would be avoided between then and 2025. Health spending would decrease by $211 billion, or 1.52 percent, in that same time period.
The economic effect on public programs, however, would be more of a mixed bag. States’ Medicaid costs would noticeably decrease: lower-income populations have higher rates of smoking and the negative health outcomes that follow. But states would also lose revenue from cigarette excise taxes, which amounted to $13.75 billion in 2006. If Americans stopped smoking altogether, states could see a 1.4 percent decrease in revenue, according to a chapter from Hunter College’s Howard Chernick.
A similar, spilt-effect would be true for Social Security. With Americans living longer, Social Security would bear the increased cost of supporting people for a longer time. But those costs are slightly offset from an increase in healthy workers, who “tend to earn more and retire later,” leading to higher contributions. On balance, “After Tobacco” estimates the end of smoking means a slight, 1.58 percent increase in Social Security outlays.
The end of smoking would even ripple as far as corporate philanthropy. Between 1997 and 2005, the tobacco industry made over $143 million in charitable donations, 42 percent of which went to public health and community development programs. Much, if not all, of that giving would presumably dry up with tobacco manufacturers making smaller profits. Nationally, the impact wouldn’t be giant, with tobacco only currently making up about 3 percent of corporate giving. But the authors speculate that in cities where tobacco giants are headquartered, like Winston-Salem or Richmond, nonprofits would notice the decline.
This is by no means to say that lost tax revenue or higher Social Security outlays is a reason to rethink anti-smoking campaigns; the end of tobacco use would be a huge public health victory, one that stands to prevent millions of premature deaths. Rather “After Tobacco” illustrates how entrenched tobacco has become, and remains, in the American economy. Despite huge reductions in smoking over the past 50 years or so, a complete halt to tobacco use would touch just about every public program and private sector in many, varied ways.
By Sarah Kliff

Quit Smoking to Enjoy Sex Life!

A new study suggests that for firmer, faster erections, men should quit smoking. The researchers found that men who successfully lifekicked cigarettes had thicker, more rigid erections and reached maximal arousal five times faster than smokers who relapsed.
The study involved 65 sexually active male smokers who wanted to quit and were willing to have their erections measured in the lab. The participants were enrolled in an eight-week quit program, which involved using nicotine patches (and no other drugs) and counseling, and were brought in for erectile testing three times: before the quit date, halfway through the program, then again one month after the program’s conclusion. To test men’s erections, the researchers used a device called a penile plethysmograph, which measures changes in circumference and hardness, while the men watched porn.
Thirty-one percent of the men had successfully stopped smoking by the end of the study. Compared with men who relapsed, those who remained nicotine-free had wider, firmer erections and reached maximum sexual arousal (but, importantly, not climax!) much more quickly. These improvements were not seen, however, until after the men had stopped using the nicotine patches.
Twenty percent of the participants reported having erectile dysfunction (ED) at the start of the study. By the end, 75% of these men who had quit smoking, no longer suffered erectile problems. But 61% of men with ED who had not stopped smoking also saw improvement in their condition. The difference between the two groups was not statistically significant, however, researchers said.
Despite the fact that the researchers’ objective measurements showed improvements in sexual health among the quitters, there was no change in men’s own ratings of their sexual functioning, including perceptions of arousal, orgasmic function and strength of erection.
“It might take longer for men to actually notice their level of difference subjectively outside of the lab, which is also dependent on their relationship with their sexual partner,” study co-author Christopher Harte, of the VA Boston Healthcare System, told Reuters.
The current study isn’t the first to connect smoking with sexual health. Smoking is known to damage blood vessels and hinder proper blood flow, which can also affect erectile function. Just this week, researchers from the Mayo Clinic found that men who made lifestyle changes to improve their cardiovascular health — by lowering cholesterol and blood pressure, losing weight and exercising — also improved their symptoms of ED.
The new findings, published in the British Journal of Urology International, suggest it’s not just smoking, but nicotine itself that causes erectile problems, since improvements in men’s erections weren’t seen until after use of the patch was stopped.
The good news is that doctors may now have a new strategy to help people quit smoking. For many people, the long-term fear of cancer or heart disease isn’t enough to motivate them to quit — or, worse, it can backfire by increasing stress and, in turn, the urge to smoke — but the promise of immediate and measurable improvements where it counts might be just the incentive male smokers need.
So, guys, the next time you have the urge to light up a post-coital Lucky, you might stop to think about whether it’ll keep you from your next chance to crave one.
By Maia Szalavitz
TIME.com

Graphic Labels May Not Discourage Smoking

Cigarette packages carrying images such as diseased lungs and oxygen masks may not discourage smoking, according to a report released by graphic cigarettes warningU.S. regulators.
Graphic labels tested in surveys for the Food and Drug Administration didn’t have a strong effect on whether smokers planned to quit or non-smokers intended to start, the study distributed today found. One exception was an image of a male corpse with a stapled chest that appeared to boost adult smokers’ intentions to quit.
Cigarette makers led by Altria Group Inc. and Reynolds American Inc. must put images on packages starting in 2012 under a law passed last year giving the FDA unprecedented regulatory power. The FDA proposed last month that each cigarette package carry one of nine images the agency will select from among 36 test graphics, including photos of dead bodies, rotting teeth and cancerous lungs.
“The graphic cigarette warning labels did not elicit strong responses in terms of intentions related to cessation or initiation,” according to the report. “One possibility is that the observation period is too short to see any change in these types of outcomes.”
More than 20 percent of U.S. adults, or 46 million people, smoke cigarettes, according to the Centers for Disease Control and Prevention in Atlanta. Smoking is the biggest cause of preventable death in the U.S., killing about 443,000 people a year, according to the CDC.
Expanded Labeling
The new labeling would cover 50 percent of the front and back of cigarette packages and 20 percent of print ads. The FDA is reviewing the “substantial amount of data” in today’s report, said Jeffrey Ventura, an agency spokesman.
“FDA will not only consider the results of this experimental study to select a set of nine final graphic health warnings, but also the public comments it receives on the proposed rule published on Nov. 12, 2010, and relevant scientific literature,” Ventura said in an e-mail. The agency plans to accept comments until Jan. 11.
The study, conducted in October, consisted of an initial survey and a follow-up taking 10 minutes each, administered about a week apart. The adult, young adult and youth study samples each included more than 4,500 people.
Canada, the U.K. and Brazil are among 38 countries that require graphic cigarette warnings, according to data compiled by the Campaign for Tobacco-Free Kids in Washington. One in five Canadian smokers reported reducing intake as a result of the labels, according to a 2004 study of more than 600 people.
U.S. cigarette packs and ads now carry one of four warnings under a federal law enacted in 1984. The messages include “Cigarette Smoke Contains Carbon Monoxide” and “Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.” The warning labels don’t include images.
By Molly Peterson
Bloomberg

Fruit and vegetables do not reduce overall cancer risk

Eating lots of fruit and vegetables will do little to reduce your risk of developing cancer, according to a review of a decade of fruit marketresearch involving more than a million people. It concluded that maintaining a healthy weight and cutting down on smoking and drinking are far better ways to ward off the disease.
Vegetables and fruit are important for a healthy diet but the review says that eating increased amounts does not seem to offer much protection against cancer.
“There’s strong scientific evidence to show that, after smoking, being overweight and alcohol are two of the biggest cancer risks,” said Tim Key, an epidemiologist from Oxford University, who wrote the review.
In an article published today in the British Journal of Cancer, Key summarised the epidemiological evidence from more than a million people taking part in several dozen long-term research projects looking at the amount of fruit and vegetables people eat and their overall cancer risk. He also studied specific cancers of the gastrointestinal tract, lung and breast.
Key found little, if any, connection between eating lots of fruits and vegetables and the likelihood of developing cancer. “The conclusion implies that, at least in relatively well-nourished westernised populations, a general increase in total fruit and vegetable intake will not have a large impact on cancer rates,” he wrote. “A certain level of intake is necessary to prevent nutrient deficiencies, but intakes above that level do not make the relavant tissues ‘super healthy’.”
The studies included data from the European Prospective Investigation into Cancer and Nutrition, the Pooling Project based at Harvard University, and the National Institutes of Health and American Association of Retired Persons Diet and Health Study.
The idea that fruit and veg might help reduce cancer rates was first postulated in the 1970s, when the results of a small-scale study showed that, after controlling for smoking, people with reduced intakes of vitamin A were at increased risk of lung cancer. By the 1990s, scientists were concluding that “for most cancer sites, persons with low fruit and vegetable intake experience about twice the risk of cancer compared to those with a high intake, even after control for potentially confounding factors.”
But these “case-control” studies – where people with a disease are matched with controls who do not have the disease – still suffered from confounding factors. “While a lot of those [earlier] case-control studies do try and adjust for how much people smoke and how much people drink, there’s always a worry that you haven’t completely adjusted for that because smoking and drinking have such a massive impact on the risk of those cancers,” said Ed Yong, head of health evidence and information at Cancer Research UK.
Key said case-control studies can suffer from two main types of bias. “One is that people with cancer may be under treatment so it may affect how they remember what they used to eat in the years before they developed cancer. They may be feeling ill or under strong medical treatment.”
A bigger problem is with the selection of the control group, which might not be entirely random. “People who come forward are those interested in health and related behaviours,” said Key. “The controls may well appear to have a healthy diet because the potential controls with an unhealthy diet may have stayed in the pub eating chips and beans and not volunteered to be studied.”
A better way to analyse the relationship between diet and cancer is to conduct “prospective studies”, which ideally follow hundreds of thousands of people who don’t have cancer. “They tell you what they eat and you follow them until, inevitably, some of them do develop cancer,” said Key. “But you made the measurements when they’re healthy, so the biases don’t apply. Those types of studies have been coming out in the last 10-15 years and have not supported the original findings [from case-control groups].”
Key’s review supports work published in April in the Journal of the National Cancer Institute. Paolo Boffetta from the Tisch Cancer Institute at Mount Sinai School of Medicine in New York found that eating a lot of fruit and vegetables has only “a very modest” protective effect against cancer. That conclusion was based on a decade of research on almost 500,000 people in 10 European countries.
Despite the results of the studies, Yong said it was still a good idea for people get their minimum daily five portions of fruits and vegetables. “It’s not a bad message because it could help people to lose weight, which is a massive cause of cancer, and it could displace other [unhealthier] things in their diet,” he said. “There’s no harm to eating lots of fruits and vegetables and there are benefits for other diseases as well, such as heart disease.”
By Alok Jha
The Guardian

NYC tapes illegal cig sales on reservation

NEW YORK – New York City investigators secretly videotaped cigarette dealers on a Long Island Indian reservation illegally selling untaxed smokes for re-sale at city bodegas, officials said Thursday.
The sting operation – during which one seller says on tape “the less I know, the better” – is part of Mayor Michael Bloomberg ongoing fight to stop reservations from selling untaxed cigarettes that end up in New York City. He has long complained the practice cheats the city out of tax revenues.
Native Americans are allowed to buy untaxed cigarettes on reservations, but only for personal use and not for resale.
In an effort to prove shops are flouting the law, Bloomberg’s administration sent undercover investigators to the Poospatuck reservation last week.
The investigators, who wore hidden cameras, told two separate sellers they were buying cigarettes to sell in New York City, and were able to purchase 60 cartons of untaxed smokes.
“I have to do a re-sale, you know, in Brooklyn,” said one investigator who bought 30 cartons of Newports.
“I don’t want to know any information that you’re talking about because our cigarettes are for personal use,” the saleswoman told him. “Should I know that you’re going to resell them, I can get in trouble. So the less I know the better.”
In the other videotaped sale, the investigator told the saleswoman: “I have to resale, I have to make, basically, you know some money on it.”
Unkechaug Nation Chief Harry Wallace suggested in a statement that the tape was edited and said the tribe does not support breaking the law.
“Our goal is to protect the lawful retail trade of tobacco for personal use,” he said.
Wallace, along with the Oneida Nation on Thursday, also blasted Bloomberg for his remark last month that the governor should get “a cowboy hat and a shotgun” and enforce the state tax law.
“Now the mayor is retaliating instead of apologizing for his indefensible statements,” Wallace said.
Some of the largest shops on the Mastic, N.Y., reservation have been effectively shut down by a federal judge who ordered them to stop selling tax-free cigarettes to customers who weren’t members of the tribe.
Those stores, however, have been replaced by new shops not covered by the court order.
State records show that cigarette sales on the reservation have dropped, but business continues to be robust. The city has accused several merchants who were covered by the court order of secretly reorganizing and continuing to do business through relatives or front companies.
“We will keep the heat up on smoke shops who make illegal deals with traffickers,” Bloomberg said. “Let this be a warning to anyone selling bootleg cigarettes – it is time to clean up your act. We are not going to stand around and do nothing.”
New York’s Indian tribes say treaty rights exempt them from having to pay the state’s $4.35-per-pack sales tax on cigarette purchases from wholesalers.
For decades, state authorities have hesitated to enforce it out of deference to their sovereignty claims.
Gov. David Paterson announced the state would begin collecting the tax, but the effort was delayed after some tribes sued in federal court in Buffalo.
An appeals court this week declined to block the enforcement of the new law, giving the go-ahead to the state to begin collecting the tax.
By Sara Kugler Frazier

Cancer and the Environment

The President’s Cancer Panel is the Mount Everest of the medical mainstream, so it is astonishing to learn that it is poised to join Cancer and the Environmentranks with the organic food movement and declare: chemicals threaten our bodies.
The cancer panel is releasing a landmark 200-page report on Thursday, warning that our lackadaisical approach to regulation may have far-reaching consequences for our health.
I’ve read an advance copy of the report, and it’s an extraordinary document. It calls on America to rethink the way we confront cancer, including much more rigorous regulation of chemicals.
Traditionally, we reduce cancer risks through regular doctor visits, self-examinations and screenings such as mammograms. The President’s Cancer Panel suggests other eye-opening steps as well, such as giving preference to organic food, checking radon levels in the home and microwaving food in glass containers rather than plastic.
In particular, the report warns about exposures to chemicals during pregnancy, when risk of damage seems to be greatest. Noting that 300 contaminants have been detected in umbilical cord blood of newborn babies, the study warns that: “to a disturbing extent, babies are born ‘pre-polluted.’ ”
It’s striking that this report emerges not from the fringe but from the mission control of mainstream scientific and medical thinking, the President’s Cancer Panel. Established in 1971, this is a group of three distinguished experts who review America’s cancer program and report directly to the president.
One of the seats is now vacant, but the panel members who joined in this report are Dr. LaSalle Leffall Jr., an oncologist and professor of surgery at Howard University, and Dr. Margaret Kripke, an immunologist at the M.D. Anderson Cancer Center in Houston. Both were originally appointed to the panel by former President George W. Bush.
“We wanted to let people know that we’re concerned, and that they should be concerned,” Professor Leffall told me.
The report blames weak laws, lax enforcement and fragmented authority, as well as the existing regulatory presumption that chemicals are safe unless strong evidence emerges to the contrary.
“Only a few hundred of the more than 80,000 chemicals in use in the United States have been tested for safety,” the report says. It adds: “Many known or suspected carcinogens are completely unregulated.”
Industry may howl. The food industry has already been fighting legislation in the Senate backed by Dianne Feinstein of California that would ban bisphenol-A, commonly found in plastics and better known as BPA, from food and beverage containers.
Studies of BPA have raised alarm bells for decades, and the evidence is still complex and open to debate. That’s life: In the real world, regulatory decisions usually must be made with ambiguous and conflicting data. The panel’s point is that we should be prudent in such situations, rather than recklessly approving chemicals of uncertain effect.
The President’s Cancer Panel report will give a boost to Senator Feinstein’s efforts. It may also help the prospects of the Safe Chemicals Act, backed by Senator Frank Lautenberg and several colleagues, to improve the safety of chemicals on the market.
Some 41 percent of Americans will be diagnosed with cancer at some point in their lives, and they include Democrats and Republicans alike. Protecting ourselves and our children from toxins should be an effort that both parties can get behind — if enough members of Congress are willing to put the public interest ahead of corporate interests.
One reason for concern is that some cancers are becoming more common, particularly in children. We don’t know why that is, but the proliferation of chemicals in water, foods, air and household products is widely suspected as a factor. I’m hoping the President’s Cancer Panel report will shine a stronger spotlight on environmental causes of health problems — not only cancer, but perhaps also diabetes, obesity and autism.
This is not to say that chemicals are evil, and in many cases the evidence against a particular substance is balanced by other studies that are exonerating. To help people manage the uncertainty prudently, the report has a section of recommendations for individuals:

  • Particularly when pregnant and when children are small, choose foods, toys and garden products with fewer endocrine disruptors or other toxins.
  • For those whose jobs may expose them to chemicals, remove shoes when entering the house and wash work clothes separately from the rest of the laundry.
  • Filter drinking water.
  • Store water in glass or stainless steel containers, or in plastics that don’t contain BPA or phthalates (chemicals used to soften plastics). Microwave food in ceramic or glass containers.
  • Give preference to food grown without pesticides, chemical fertilizers and growth hormones. Avoid meats that are cooked well-done.
  • Check radon levels in your home. Radon is a natural source of radiation linked to cancer
  • Quit smoking

By NICHOLAS D. KRISTOF, Nytimes

What it takes to quit smoking

Higher cigarette taxes, smoke-free policies, exposure to aggressive media campaigns and access to cessation programs that include counseling are among the biggest factors that help smokers kick the habit, according to recent studies from the Centers for Disease Control and the North American Quitline Consortium, a nonprofit that promotes quit-smoking hotlines.
The states that enacted tobacco taxes, instigated smoke-free policies, and put the most money into smoking-cessation programs generally have shown the biggest success in lowering smoking rates, according to a comprehensive CDC report on all 50 states’ prevention strategies released in April.
On the one hand, smoking reduction is one of the country’s biggest public-health victories. The portion of Americans 18 and older who smoke has dropped substantially from 42.4% in 1965, the first year the CDC tracked that data, to 20.6% in 2008, said Thomas Glynn, director of cancer science and trends for the American Cancer Society.
But declines plateaued with virtually no change from 2004 to 2008, and many public-health advocates worry that state budget cutbacks will make it even harder for the 70% of smokers who say they want to quit.
If all states spent between $9 and $18 per resident on comprehensive tobacco-control programs, which the CDC recommends, 5 million fewer people would smoke five years from now, it says. Just one state, North Dakota, meets that funding level, and 31 states and the District of Columbia allocate less than a quarter of it.
Twenty years of research show that smoking rates decline after policy changes that make it less accessible, less attractive and less affordable to light up, said Terry Pechacek, associate director for science for CDC’s Office on Smoking and Health.
For example, in California, which has the nation’s oldest statewide tobacco-control program, only 14% of adults and 6.9% of youth smoke, and lung-cancer rates have decreased four times as rapidly in the state as in the U.S. overall. The state saved $86 billion in tobacco-related health-care costs between 1989 and 2004, according to the CDC.
New York has some of the highest state cigarette taxes at $2.75 a pack, stringent indoor smoke-free-air laws, and the nation’s second-most intensive tobacco counter-marketing campaign. The Empire State has reduced its percentage of adult smokers to 16.7% in 2008 from 22.3% in 2002, according to the state health department.
Compare that to South Carolina, which spends only 5.4% of the CDC’s recommended investment and has no indoor smoke-free-air laws. About 20% of South Carolina adults and 11.8% of youth smoked in 2008, but the Palmetto state appears to be changing its approach.
On Thursday, South Carolina lawmakers voted to override Gov. Mark Sanford’s veto of a bill that would raise the cigarette tax to 57 cents a pack from 7 cents. The new tax rate hike would take effect July 1.
Overall, state per-pack taxes average $1.36, but 23 states had tobacco taxes of less than $1 as of May 1, according to the American Lung Association. While 24 states and the District of Columbia have comprehensive smoke-free-air state laws for almost all public spaces including work sites, restaurants and bars, 15 have weak or no smoke-free laws.
Insurance coverage matters, too. Only 39% of employers provided smoking-cessation programs as a benefit in their insurance plans, according to a 2009 survey from the Society for Human Resource Management. Seven states have laws or insurance regulations that require cessation coverage in some or all private insurance plans in the state.
Help on the line
Ted Williams of Tucson, Ariz., was a pack-a-day smoker for 45 years. He tried to quit multiple times, unsuccessfully using nicotine patches and other medications. Per-pack prices in his area hit $7 after federal cigarette taxes increased a year ago, and the recession slowed his home-building and design business, but still all he could do was adapt by buying less-expensive loose tobacco and rolling papers and purchasing cheaper packs at a nearby Indian reservation.
“I started at age 15 with peer pressure because everybody that was cool smoked,” said Williams, who is now 60. “I would sit at the computer and smoke nonstop.”
A massive heart attack in January finally convinced Williams his life depended on quitting now. But he still might not have succeeded if hospital staff hadn’t arranged a call with a counselor at his state’s free “quitline,” he said. Williams said he received not only encouragement to quit but also help in developing a plan to combat his urges.
“I don’t think the cravings will ever go away, but what I’ve done is change my habits,” he said. “I used to get up in the morning and have a cup of coffee and four cigarettes, but now I have a glass of tomato juice or brush my teeth — things that make a cigarette taste bad.”
Tobacco use is the No. 1 preventable cause of disease, disability and death worldwide. About 443,000 Americans die from either smoking or secondhand exposure to it annually, according to the CDC.
Another 8.6 million Americans have a serious illness caused by smoking, and smoking costs the nation $96 billion in medical costs and $97 billion in lost productivity annually.
Williams’ case illustrates the importance of state funding for quitline programs in that it is not unusual for smokers to attempt quitting at least three times, and usually many more, before they succeed, Glynn said.
Studies show that quit-success rates rise to 30% when smokers combine one of seven FDA-approved medications to stem cravings, including nicotine patches, gum or lozenges and prescription non-nicotine medications such as bupropion, or Zyban, with some form of counseling, such as a quitline.
Typically the smoker or a health-care provider will make the initial call into a quitline, then the quitline will schedule follow-up calls to walk though the individual’s history of smoking, review habits associated with smoking and develop a customized quit plan, said Linda A. Bailey, president of the North American Quitline Consortium. Smokers can call into the quitline themselves as many times as needed for support or advice.
But because of limited marketing budgets, many smokers don’t know about quitlines, Bailey said. And it may be harder for them to find out and receive help, because state funding for such services nationwide is down 7% this fiscal year compared with last year.
“It really is sad because when you don’t have the budget, you cannot advertise services,” Bailey said. Many states also have had to cut back on other services and now, for example, are making only one to two, rather than five, scheduled follow-up calls to smokers.
Last year, a record 515,000 people, or 1.2% of smokers nationally, used quitlines, which now are available in every state, as well as the District of Columbia, Puerto Rico and Guam. That’s up 129% over the past five years since the program’s nationwide launch, Bailey said.
The cutbacks couldn’t come at a worse time because quitlines reported up to four times their usual caller volume last spring around the time of the federal tax hike, she said.
Raising cigarette prices through higher federal and state excise taxes is another powerful incentive. Studies have shown that a 10% price increase translates into a 4% reduction in adults who smoke and 7% fewer children taking a puff, Glynn said.
Becoming an ex-smoker
If you want to quit and are having trouble, start out by acknowledging that the number of Americans who are ex-smokers, 47 million, now exceeds the number of smokers — 46 million, Glynn said.
“Someone considering quitting knows it’s hard, but also knows that there are 47 million people out there who have successfully done it,” Glynn said.
Also, keep in mind there is no age too old to quit, and you will likely add years to your life. Improved breathing is an immediate benefit, and elevated risks for heart disease, stroke and peripheral vascular disease go away within just a year or two. Lung-cancer risk reduction takes longer, but is down by about one third after a decade of being smoke-free.
Check with your insurer to see what they do and don’t cover. Also, 38 states pay for patches, gum and even drugs if you enroll in a quitline program. However, many states have cut back on such benefits and may restrict that support to certain groups such as Medicaid recipients, pregnant women or the uninsured.
If you do have to pay, keep in mind that although patches, gum and medications may seem to cost a lot up front, they are typically priced not to exceed the amount you would have paid for cigarettes, Glynn said.
Want to compare costs? The American Cancer Society has a tool on Cancer.org where you can calculate how much you’re spending on cigarettes now.
Glynn recommends talking to your doctor, then joining a support group, enrolling in a smoking-cessation program sponsored by your insurer or workplace or calling your state quitline (all are accessible through one national number, 1-800-QUITNOW).
The American Lung Association also has an information and counseling helpline at 1-800-LUNGUSA and information on how to quit on its site, LungUSA.org, including its own web-based cessation program.
The ALA’s web-based program offers a free basic membership where users access information about quitting and use tools and activities on their own. A premium membership costs $15 a month or $40 a year and includes support and tips from others in the program, plus a personal blog and other interactive tools.
By Anya Martin
Marketwatch, May 13, 2010

Help may not be a patch on willpower when giving up smoking

Like a caring friend they are always there for the would-be former smoker: patches, gums, inhalers, lozenges and under-the-tongue give up smoking tabs to prop up the fragile willpower when it starts to fall apart.
But what if nicotine replacement therapy was really a perfidious ally, capable of understanding and support, but also apt to undermine?
Simon Chapman believes scientists, governments, and smokers themselves have fallen too hard for the nicotine replacement doctrine.
The professor in public health at the University of Sydney, who is a long-time anti-smoking advocate, says the pharmaceutical industry’s line that gums and patches improve the likelihood of a successful attempt to quit may be true in the rarefied world of clinical trials, where smokers receive their products free and have their progress painstakingly monitored by researchers.
But it ignores the evidence that up to three-quarters of former smokers have quit without formal assistance, Chapman says, and in most cases without much difficulty.
The Nicabate and Nicorette franchises of GlaxoSmithKline and Pharmacia & Upjohn are highly visible juggernauts. They are advertised prominently in pharmacy point-of-sale displays and on TV. Chapman argues that they impart a subtle message: “serious” quitting requires external support, and unaided attempts to give up are doomed to fail. “Smoking cessation is becoming increasingly pathologised, a development that risks distortion of public awareness of how most smokers quit – to the obvious benefit of pharmaceutical companies,” writes Chapman in an analysis in the online journal PLoS Medicine yesterday. “The persistent message that … stopping unaided will be futile” undermined people’s “confidence in their own ability to change”.
The global market for nicotine replacement in 2006 was estimated at $US1.7 billion ($1.9 billion). If it is to be expected that the products’ own manufacturers will talk them up, then Chapman says a more critical approach should be the province of government and health researchers.
But a trawl this week through health campaign websites reveals some messages that would surely delight sponsors of nicotine replacement therapy.
NSW’s Quitline, for example, urges smokers to “Plan ahead to deal with temptation. Keep a record of every cigarette so that you can identify certain situations where you feel tempted … You should also speak to your doctor to discuss the different medications that are available that can help you stop smoking.”
Chapman says the idea that giving up needs to be approached as a precision exercise, complete with diary, does not stack up. He says smokers should be told that many people who quit unassisted do so on a whim, without planning, and most find it less traumatic than they expect. That could galvanise people to act on a sudden desire to throw away their cigarettes, instead of deferring that impulse until they can get to a pharmacy, by which time it may have passed.
Chapman says public health messages should focus on the fact that relapses after quitting are widespread and are not failures, but augur well for the future as “rehearsals for eventual success”.
The federal government emphasises unsupported quitting. Its Quitline website says: “Going cold turkey means stopping suddenly and completely. For most people this is the most successful method.”
But the bulk of research into quitting involves medication, psychotherapy or counselling. In part, Chapman says, this is for a familiar reason: industry sponsorship.
Just as important, though, is the culture of science, which favours research into such interventions because they can be more readily incorporated into experiments that will yield a definitive result. More naturalistic studies of how real-world smokers actually quit have neither obvious potential sponsors nor tidy design.
Fewer than 20 per cent of Australians now smoke, an all-time low. But tobacco still accounts for 20 per cent of all cancer and 10 per cent of all heart disease, according to Australian Institute of Health and Welfare statistics. It remains by far the biggest preventable cause of illness.
Chapman believes it is therefore not unreasonable to recommend multiple approaches, including nicotine replacement for those well suited to it.
But that is an argument that fits Australia and other rich developed nations much better than it does poorer countries, where smoking rates are higher and cigarettes are cheaper. “In Indonesia, for example, three months of [nicotine replacement] costs as much as seven years’ supply of cigarettes, placing NRT totally out of the reach of all but the wealthy,” he writes.
The head of the Cancer Council NSW, Dr Andrew Penman, agrees that nicotine replacement has been oversold. “There has been a disproportionate focus on the use of pharmaceuticals as a means to quit.”
Instead of getting people off cigarettes, Penman says, the emphasis needs to shift to keeping them off – and the most effective strategies towards that goal are taxes, smoke-free environment legislation, and anything else that makes tobacco less ubiquitous, accessible or desirable.
JULIE ROBOTHAM, smh.com.au
February 11, 2010