Talk:Smoking cessation/Archive 1

Withdrawal and reenforcing addiction
I tried to put the following into the nicotine patch article, but it was removed within minutes:

Nicotine is a relatively easy drug to quit. As far as I know, not one person has ever died from nicotine withdrawal. Moreover, nicotine dependency is short-lived. Nicotine is completely out of the body in 48 hours. At that point, physical cravings cease. Anyone who can go 48 hours without a cigarette stands a really good chance of quitting. Nicotine is highly addictive, however. Any small amount, even from second-hand smoke, will immediately reenforce nicotine addiction - resetting the clock back to 48 hours. The nicotine patch will guarantee that the addiction clock is reset back to 48 hours every time it is used. Logic might suggest that one cannot end nicotine addiction by taking nicotine. Unlike heroine or alcohol withdrawal, you cannot die from smoking cessation. Therefore, a step-down program would appear to be unnecessary, and fails as a quitting aid in a great many cases.

Perhaps the best method to fight cravings is exercise which causes the body to produce its own endorphins. These endorphins in turn negate many of the effects of withdrawal.

It seems likely that the cigarette industry would love to convince everyone that it is impossible to quit smoking. That way, people would not ever try to quit. Short of this, the next best thing would be to convince everyone that it is very difficult to quit smoking. Then people will give-up trying more easily.

How can this information be included in the article? Or is this article monitored by the advertising agencies and public relations firms for the patch sellers and the cigarette companies?

Nicotine Endorphin Link
Nicotine artificially stimulates endorphin production in the body. What smokers crave are the additional endorphins. Quitting smoking removes the artificial endorphin stimulant. After years of having this stimulant, upon quitting smoking, and only for a short time, the body will actually produce fewer endorphins without the stimulant than in a non-smoker. That's why it feels so terrible to quit. For a few days, the body will have much less endorphin production than is normal in a non-smoker. In other words, it is not that the body has fewer endorphins than is usual for a smoker, the body has fewer endorphins than for a non-smoker. In any case, if the goal is to increase the amount of endorphins to a normal long-term non-smoker's level, why have nicotine replacement therapies at all? Have endorphin replacement therapies. The easiest way to stimulate endorphin production is with exercise. One should take a long, fast walk or jog when withdrawal symptoms get bad. This will significantly increase endorphin production and lesson those withdrawal symptoms. This therapy is easy and absolutely free. Years ago I knew of a doctor who gave endorphin injections to help smokers quit. Either way, both of these endorphin based therapies do not entail using an addictive substance. My personal preference is for moderate exercise, as it has only beneficial effects.

Need to start again
This entry has become a mess and contains inaccurate information and what looks like promotion for commercial proprietory smoking cessation companies. I think we need to start again and propose the following text as the basis on which genuine experts can then build.

Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. Nicotine is a potentially addictive substance, especially when taken in by inhaling tobacco smoke, probably because of the rapid absorption through the lungs. Tobacco use is one of the major causes of death worldwide, according to the World Health Organization. .

Research in western countries has found that approximately 3-5% of quit attempts succeed using willpower alone (Hughes et al, 2004) and clinical trials have shown that Nicotine Replacement Therapy (NRT) (see below) can double this rate to approximately 6-10% (Silagy et al, 2004). This is a small effect but very worthwhile. Multi-session psychological support from a trained counsellor, either individually or in groups has been shown in clinical trials to have an effect similar to that for NRT. The best chances of success can be obtained by combining medication and psychyological support (see below) (USDHHS, 2000). Apart from NRT, medication that have been shown to be effective in clinical trials are: the tricylcic anti-depressant nortriptyline, bupropion (Zyban) and the nicotinic partial agonist, varenicline (Chantix in the US and Champix elsewhere). Thorough reviews of the evidence for all these methods of stopping are available via the Cochrane Library website Cochrane Library

There are many people and organisations touting what are claimed to be effective methods of helping smokers to stop. Any smoker thinking of paying money for such help would be well advised to ask whether the claims of success are backed up by indepedent comparative clinical trials, how the success rates have been calculated and what numbers of smokers have been included in the figures. It is very easy to make misleading claims of success rates which are not adequately supported by evidence.

A range of population level strategies such asadvertising campaigns, smoking restriction policies, and tobacco taxes have been used to promote smoking cessation. Of these, raising the cost of smoking is the one that has the strongest evidence (West, 2006).

Smoking cessation will almost always lead to a longer and healthier life. Stopping in early adulthood can add up to 10 years of healthy life and stopping in one's 60s can still add 3 years of healthy life (Doll et al, 2004). Stopping smoking is also associated with better mental health and spending less of one's life with diseases of old age.

The most common short-term effects of stopping smoking are: increased irritability, depression, anxiety, restlessness, difficulty concentrating, increased appetite, constipation, mouth ulcers and increased susceptibility to upper respiratory tract infections. These mostly last for up to 4 weeks, though increased appetite typically lasts for more than 3 months. The most obvious long-term effect is weight gain (Hughes, 2007).

Graceful216 17:22, 9 November 2007 (UTC)I agree that the organizations and structure of this page need to be made more user-friendly. I think what is posted above seems like a great start becuase you have cited the random statistics in the introduction. Graceful216 17:22, 9 November 2007 (UTC)

Graceful216 17:35, 9 November 2007 (UTC)It appears that many facts have been randomly placed in the Outline section due to the lack of structure of the article. I would say that the introduction proposed above would be a great replacement. What if we changed the section titles to: Information for smokers trying to quit, Information for healthcare professionals, and Political efforts (including information from the West 2006 article, smoking bans, etc.)? For a writing course I am supposed to restructure this document because I work for a smoking cessation medical research study. I will not change any information that people have posted, but I will eventually post a discussion with the reformat. Please let me know your opinions.Graceful216 17:35, 9 November 2007 (UTC)

Talk 1
What smoking cessation method has achieved the highest quit rate after six months? (Question added by an anonymous contributor a few months ago, still unanswered).  00:07, Nov 9, 2004 (UTC)

Compare each method with success rate

Quit by stop smooking immediately  about   7% Using non-pharmacologic method (behavior modification)  about   10-30% Using pharmacologic method about 10-20% Using combination therapy (behavior modification plus using medication) about 30-40%

But, first of all, smokers have to intend their quitting by themselves.

I will search references for this statistic as soon as possible. —Preceding unsigned comment added by Song in moonlight (talk • contribs) 05:51, 11 January 2008 (UTC)

No Smoking logo caption
"Get used to it..." !? Such a caption not only removes from the objectivity of this page but also is highly antagonistic to smokers - some who have come to this page to get a factual account of the benefits of quitting. 220.237.56.103 06:15, 26 August 2006 (UTC)


 * Agreed, it's hardly encyclopedic. I've changed the caption. Haddock420 14:47, 15 November 2006 (UTC)

Statistics
The claim that no method has ever achieved a success rate of greater than 25% really needs a citation. Even if it gets one, the statistic is misleading, as some methods may take longer than 6 months to work. For example, Allen Carr's EasyWay method claims a 90% success rate at their clinics because anyone who fails can go back for free until he is successful. Surely there are records of success rates of individual methods and aids that we could use in this section.Atripodi 11:59, 21 August 2006 (UTC)

Allan Carr - Easy way
Allan Carr “Easy way” is a private business enterprise in the field of tobacco cessation. This article smells of advertisement!

Smells of advertisement? There are two mentions of the book, one picture, and one as an example of a self-help book. Pretty sparse for what appears to have the highest success rate of any method. If not for that little picture of Carr's book in the corner, I never would have quite smoking, so I think we should have no qualms about pointing out which methods work better than others. This article has the potential to really help people make an informed choice about the smartest and easiest way to quit (and it can be easy). Or it could be a neutral, don't step on anyone's toes-type article that pretends AMA-approved sugar pills like the patch are as effective as other methods that happen to be provided by "private business". If we disallow ourselves to point out when private business is more effective than government alternatives, then we have a systemic bias that will keep people from quitting smoking. Carr's method works. The AMA and FDA fail. Let's point out the facts. Atripodi 06:30, 4 September 2006 (UTC)

The patch is far from a "sugar pill." It's a tool to help aid in quitting, not a cure.

From the American Cancer Society's Guide to Quitting Smoking:

" There are some programs to watch out for as well. Not all programs are ethical. You should be concerned about programs that do the following:

* Promise instant, easy success with no effort on your part." http://www.cancer.org/docroot/PED/content/PED_10_13X_Guide_for_Quitting_Smoking.asp?sitearea=PED

The defense above "The AMA and FDA fail" was clearly written by someone with an financial interest in Carr's program. "The AMA and FDA fail"? How so? "AMA-approved sugar pills?" How biased is this language? Do you think anyone's going to be taken by it?

There should at least be some verification of the "appears to have the highest success rate of any method" claim. The citation provided in the article refers to a report on pharmacotherapy and makes no mention of Allan Carr. There is also a misleading footnote attached to the same claim in the wikipedia entry on Allan Carr. In that article, the citation leads only to an open letter to Tony Blair penned by Carr himself. If this is really intellectual honesty and not just flagrant sales pitching, someone should provide some authentic verification. 68.73.243.231 15:51, 26 October 2007 (UTC)

First, it is spelled Allen Carr, not Allan. Second, Carr's 12-month carbon monoxide exhalation confirmed success rate of 51.4% is from a study published in the journal Addictive Behaviours in Nov 2006 (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VC9-4MBC599-5&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=705d771d05e4d7806f598cad539587d5).

It should be noted that this success rate pertains to Carr's Easyway seminars and not to his books or webcasts. 72.39.251.33 (talk) 17:31, 23 April 2008 (UTC)

Alternative Techniques - Nicotine Half-life
It was stated in the text, "Nicotine has a half life of around two hours, so most smokers detox fairly effectively each night when they sleep. Hence the need to smoke so soon after waking that is seen in dependent smokers. Detoxification is probably an irrelevance in this field."

This is misleading, in its context, because the active metabolites of nicotine also have half-lives. Receptor downgrade from the presence of nicotine and upgrade after cessation also must be considered. The difficulty in quitting is from the lack of "toxin," so cessation based on removing the poison quicker than normal is of little help in the grander scheme.

I waited a month or so for a retort regarding this wrong supposition (wrong because it's based on a misunderstanding of what role the half-life of nicotine has in "detoxification") and then deleted it.

The whole "detoxification" thing is based on a pseudo-scientific premise anyways (i.e. the poison actually causes cravings). It completely disregards the neurochemical readjustment phase that is the most difficult part of cessation; a phase in which nicotine and its active metabolites are not present.

Zyban question
In the article it says: I checked the wiki article for it and nothing is listed. There is no reference on this page, and the drug companies website doesn't say anything about this. Should it stay or go? 64.216.197.18 04:53, 16 June 2007 (UTC)
 * (Zyban®, contraindicated in epilepsy, psychosis and diabetes)

I edited contraindication for Zyban now from Drug Information Handbook 12th edition, 2004. There are a few things should be concerned before take this medicines. Because it is antidepressant drug, action mechanisms are about many neurotransmitters in brain. So, if you have used some type of psychotic drugs, it will be enhanced their actions, very dangerous. Also, in patients with have eating disorders or epilepsy, they have some disorders in brains, using Bupropion in them may take disadvantage effects more than benefit. (Bupropion may cause seizure in mentioned patientsX About diabetes, there is no evidence for using-Bupropion prohibition.  —Preceding unsigned comment added by Song in moonlight (talk • contribs) 06:40, 11 January 2008 (UTC)

Images
The photo of the Nicoderm CQ patch clearly shows that it is on the left, not right arm. - Gilliam 00:33, 17 June 2007 (UTC)

Alternative techniques -- dosage miniaturization
"Reduced Smoking May Lead to Unexpected Quitting"-- Dr. John Hughes, U. of Vermont School of Medicine, www.cancer.gov. (Dec. 2006)

(Unfortunately this idea has not appeared yet in the article, so I wish to sketch it out here for the consideration of anyone who can help make it fit in.)

The 700-mg. format
Over the last century the tobacco companies have been allowed an absolute dictatorship over the choice of serving method for their drug, i.e. the sledgehammer overdose 700-mg. hotburning cigaret. While some 92% of tobacco worldwide is made into cigarets, some say nearly 99% of the advertising budget -- now nearly $10 bil./yr.USA alone-- is used to glamorize the cigarette format from whence cometh their profit margin.

With their monstrous tax "subsidy" to the government and campaign donations to politicians they have also induced lawmakers to act in their favor by banning alternative, i.e. "conservative" smoking methods, anything safer than a cigaret, on such pretexts as that the latter are "drug paraphernalia" usable for cannabis, etc.

(Perhaps everyone need not "quit" smoking! George Burns with his cigars made it to 100.  Bertrand Russell with his pipe made it to 98.  Users of those products often say, "We don't inhale."  They receive moderate nicotine dosages through their mucus membranes and it gets to the brain sure enough.)

Miniature utensil
However, it may be possible to go on inhaling nicotine the rest of your life and still avoid the cigaret health damages. The trick is to devise a miniature utensil which serves 25-mg. tokes-- of which you can get 28 from the tobacco in one typical commercial cigaret.

The best way is to use a 1/4" i.d. socket wrench, into the hex end of which you press a 1/40-inch mesh wire screen about 3/16" of the way in, and into the other (square, or driver) end, a 1/4" o.d. flexible plastic tube, as long as possible to give the "smoke" i.e. hot gas plenty of distance to go, cooling down before it gets to your trachea. (Tape around the crack to seal air leak.)

Kiseru, Midwakh
If you want to look more "legitimate" and spend money, look at the Wikipedia article, Kiseru, where you can see an illustration of an elegant Japanese product (made in the Republic of Toke-yo). It has a small crater with a long straight tube, in fact it looks like something out of a 19th century illustration for "Huckleberry Finn". (You can add a tight fitting screen.) An Arabian counterpart is the Midwakh.

From 700 mg. to 25 mg. in one "cigaret break"
Now tear off a tiny bit from the cigaret ("This cigaret "break" will save your life!"), stuff it in the screened crater, light with a butane maxifer (don't call those things cigaret lighters), and suck as slow as possible, getting all the smoke and burning the weed at absolute minimum temperature. If one such toke doesn't replace an entire cigaret, have two! (The poor damn corporation is still getting only 1/14 as much of your money.)

Even yours looks better with an air bonnet on it
Then if you aren't ashamed (because it sure ain't dangerous), breathe in and out of a plastic or paper sack several times. You will get a maximum amount of nicotine and a minimum amount of carbon monoxide (the worst toxin).

Cognitive behavior therapy-- Cttttin' down
Now to borrow a page from Marks' Cognitive Behavior Therapy (see above), keep a simple diary in which you indicate every toke, such as described here, with a "t" and every hotburning overdose you backslid into with a capital "C". Today's entry might consist of a single line:


 * Wednesday, September 12: tttttCttttCttttttttt etc.

Such a "liberal" approach permits you to light a capital C overdose now and then when you are especially tense, or that certain person is looking, etc., but your aim is to eliminate them altogether! The Big C and little t's showing up in your diary will help remind you that you are Ctttttin' down!

It seems that this kind of "therapy" would make smoking more important over time. In other words, by putting more attention into the act of smoking and increasing the ritual nature, the smoker would develop an even larger psychological addiction. —Preceding unsigned comment added by 66.94.176.22 (talk) 22:37, 31 August 2008 (UTC)

Smoother
This method feeds you nicotine on demand any time you want it, but without getting the drastic sudden upsurge in bloodsugar ("pleasure") level followed by an equally drastic drop within the hour leading to the next overdose, which is the secret sacred (cigaret) dynamic that keeps the "habit" going. This smooths out your mood swings, mitigates "glucose bipolarity".

Screen maintenance utensil etc.
It remains to mention that you might want to wire a large safety pin onto your utensil to use for clearing the screen periodically, and have Q-tips, pipe cleaners and a little bottle of rubbing alcohol handy for occasional further cleaning.

Herb choices
The shredded tobacco in any cigaret is ready to use in this manner. For cigar tobacco, coarse pipe tobacco, cannabis and other herbs-- consider trying basil, marjoram, oregano, rosemary, sage, savory, thyme, peppermint, spearmint, pennyroyal, hops flowers, camomile flowers, rosebud and many others available at any health food store--always use a 1/16" wire screen strainer to grind your herb down to a fine, consistent particle size so that it will burn smoothly and reliably when you suck slowly through the long extension tube.

Thanking every editor for your patience and hoping you will contribute to promoting this approach which might have a chance to save 5.3 million lives a year (WHO estimate 2003), else what's a 'pedia for. Tokerdesigner 19:20, 20 September 2007 (UTC)


 * Dude an encyclopedia isn't meant to promote anything at all... Zedmaster375 July 4 2008  —Preceding comment was added at 23:25, 4 July 2008 (UTC)

Robertjwest/Buginblue's contribution
Buginblue (AKA Robertjwest) has created an article that he thinks should replace the current one. Buginblue replaced the current article with his own, and I reverted the changes and placed the new article into his user space. A quick glance shows that the new article is not that bad, but it probably needs some fixups.-- Mumia-w-18 12:17, 7 November 2007 (UTC)


 * Ideally, discussions about the new Smoking cessation article would take place on its talk page. Ideally, Buginblue/Robertjwest would refrain from additional sock puppetry.-- Mumia-w-18 12:17, 7 November 2007 (UTC)

Citations Needed
In the outline, a citation is needed for: "A serious commitment to arresting dependency upon nicotine is essential. Medication, such as a nicotine replacement therapy product or Wellbutrin (aka Zyban) have been clinically proven to double a quitter's chances of stopping successfully versus placebo."

Does anyone have a source that validates this?

Secondly, in the outline, Ginzel is cited for a 2007 article, but the reference is not cited in the bibliography.

Does anyone have this article's information? Graceful216 04:51, 13 November 2007 (UTC)

HELP! EVIL COMPUTER JUNK CODE CAN'T BE ERADICATED
The text string "Proxy-Connection: keep-alive Cache-Control: max-age=0" appears again and again, despite repeated attempts to eradicate it. It was there when I came to the article and each time I remove it, it reappears, and takes out about three letters of characters of text. The below is an example of its current incarnation:


 * Smoking cessation will almost always lead to a longer and healthier life. Overcoming tobacco addictionProxy-Connection: keep-alive Cache-Control: max-age=0


 * n early adulthood can add up to 10 years of healthy life and stopping in one's 60s can still add 3 years of healthy life (Doll et al, 2004). Stopping smoking is also associated with better mental health and spending less of one's life with diseases of old age.

It's beyond me to fix it. Could it relate to the strange things that have been happening lately when I hit "save page" or "Show preview"? I am sent to an error page, but when I return to the article, my edits have been laid in. I fear Wikipedia has been hacked or has become terminally buggy. But maybe it's just me. In any case, will someone with more tech savvy than I please pitch in and delete the code and advise the powers that be of the problem?

Lancet
- Lancet review provocatively titled "Tobacco addiction". JFW | T@lk  21:32, 27 August 2008 (UTC)

Comments
I support Graceful2i6s offer. It would be very help think. --Robertjwest 08:10, 11 November 2007 (UTC) Graceful216 04:47, 13 November 2007 (UTC)If this is your work below, make the change. I do not want to take what you wrote and paste it in the article, but I think it is a good start to changing this article, and if anyone wants to make changes to the new article, they can feel free.Graceful216 04:47, 13 November 2007 (UTC)

I've learned not to waste my time. The tobacco company and pharma trolls will just delete what I write in the article within hours. Then they will stick in some industry funded study drivel about why quitters need the patch. It's a lost cause. —Preceding unsigned comment added by 206.109.195.126 (talk • contribs) 2008-11-12