Chew On This; Sticking With Nicotine Gum for the Long Haul

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Bill Godshall

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Recommendation for Long-Term Nicotine-Replacement Therapy May Be on the Way - WSJ.com

Looks like tobacco harm reduction is now being embraced by many of the same folks who have been advocating banning e-cigarettes and various smokeless tobacco products. Unfortunately, Kesmodel and Cummings failed to mention this hypocrisy in this article touting long term usage for NRT, as well as failing to mention that NRT is not an effective or desirable alternative for many smokers who prefer e-cigarettes and/or smokeless tobacco.
 
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Placebo Effect

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I just spoke to K. Michael Cummings to see what his opinion about the e-cigarette is in light of his comments to the WSJ that the harm from long-term use of nicotine is minimal. He was pretty reasonable, although I was very disappointed when he told me that he supported the NY ban despite the utter failure of those in tobacco control to show safety risks, and the fact that it's the FDA own fault that the product isn't regulated.
 

Vocalek

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Vocalek

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I just spoke to K. Michael Cummings to see what his opinion about the e-cigarette is in light of his comments to the WSJ that the harm from long-term use of nicotine is minimal. He was pretty reasonable, although I was very disappointed when he told me that he supported the NY ban despite the utter failure of those in tobacco control to show safety risks, and the fact that it's the FDA own fault that the product isn't regulated.

This is a quote from Molimard's article:

We cannot solve a problem if the messages are muddled. Undeniably, disturbing one’s sense of orientation and muddling communication hinders rational thought and behavior. Lies and manipulations are the weapons of choice for political and economic gains without regard for the well-being of people or the survival of the planet.

BTW: I was having the same dissonance when discussing the e-cigarette with Dr. Eissenberg. I finaly figured out that the crux of the problem was that he was looking at e-cigarettes as a treatment for nicotine addiction, while I was viewing it as a tobacco-like product to replace smoking without necessarily eliminating nicotine use. The difference between these two men is that Dr. E's view is that he cannot in good conscience recommend the product as a treatment until there is more proof it is safe, while Cummings would actively seek to remove the product as an option.

What neither man can seem to get through their heads is that some of us will never accept giving up nicotine. And if they take away the safer options we will choose the most hazardous option--smoking. Hello?

I think both men (and many members of the Tobacco Control Gang) hold on to the fantasy that some day every single smoker in the world will be able to use the beloved pharma products to become cured of "addiction" and live healthily ever after.
 
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rothenbj

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I responded to the NRT advocate in the comments section-

Louis, you make a good argument for the use of non-medical solutions for eliminating the smoker's habit. As decades of NRT usage have proven, long term, these products are ineffective 94-98% of the time. The medical recommendation is keep trying until you're successful. Whether any of that success rate relates to NRT is highly questionable. Perhaps eventually the successful quitter has finally gotten to the point that he/she was ready to quit.

Products like Electronic cigarettes provide the same tobacco ingredient, nicotine, but with the added advantage of providing the hand to mouth aspect and the visual of what appears to be smoke, but is only a vapor. These products not only attack the psychological aspects of smoking, but also enable the former smoker to wean off the nicotine level if that is their desire. As you and the article state, it's not the effects of nicotine that create the health risks. It is the byproducts created in burning and inhaling smoke that is the reason for 98% of the health risks.

Many of the other smokeless products on the market are vastly safer than smoking. As an example, Swedish snus has been around for centuries and has been refined and studied for decades. It is 98-99% safer than smoking, but these facts remain hidden from the general public with the claim that they are "not a safe alternative to smoking". NRT isn't either, it's just safer.

I took a 43 year, 2-3 pack a day habit and first used E cigs for seven months, then started using Swedish snus. Twenty months ago I started the jouney and have not had a puff on a cigarette for over a year with absolutely no desire for one. Four or five portions of snus a day satisfy my need for whatever is in tobacco that kept me on cigarettes for so many years.

Many have managed to quite smoking entirely, just with E cigs. If you were truly interested in helping people quit, you would be making those products a welcome avenue in the fight.
 

kristin

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I responded to the WSJ article. My comments seem to be getting a lot less "nice" these days. :(

Modern smokeless tobacco has been shown to have the same low health risks as gums, patches and lozenges, yet the public health groups (who receive millions in funding from the pharmacutical companies) want to ban smokeless tobacco in favor of pharmaceuticals. They call flavored tobacco "nicotine candy" and ignore that gums and lozenges they shill come in Fruit Chill, Cinnamon Surge, Fresh Mint, Cherry and Orange, too. Nicorette Minis look more like Tic Tacs than Camel orbs do, yet they say Big tobacco is the one making "nicotine candy" to target children.

Unfortunately, the pharmaceuticals only address (at too low levels) the nicotine addiction. They don't address the behavior, the taste, the feeling, the MAOIs or other tobacco alkaloids NOR do they address WHY the user was compelled to smoke in the first place. Smokers all smoke for different reasons and become dependent for different reasons. Anyone who says "I just quit, so should you" or ""you're just weak willed" is a sactimonious, ignorant jerk.

Nicotine and tobacco was vilified because it caused people to smoke. Smoke is where over 99% of the disease and death comes from, yet nicotine is still vilified even if the user is using smokeless tobacco. Nicotine is now NOT vilified if it comes in a pharmaceutical product?? Does anyone else see a double standard here??

Caffeine use has nearly the same low health risks as smokeless nicotine use (whether in a gum or smokeless tobacco), yet smokless nicotine use is considered bad and caffeine use is accepted. Nicotine users are expected to quit and suffer for the rest of their lives, while caffeine users continue to happily get their fix from a Starbucks on every corner, a Big Gulp of Mountain Dew or their 5 Hour Energy drink.

Yes, smoking is bad, but quit trying to eliminate ALL tobacco based on the evils of smoking. If caffeine users smoked ground coffee, they'd probably be at risk for a lot of the same diseases and illnesses. It's the method of delivery, NOT the tobacco itself. There is plenty of science to back this up, which the public health groups ignore in their prohibitionist zeal to abolish all tobacco from the face of the earth.

People are learning the truth about smokeless tobacco and electronic cigarettes and it's freaking out the pharmaceutical companies who depend upon the quit-relapse cycle of smokers, who falsely think that nicotine is evil (and thereby they are somehow sinners) and the public health groups who rely on drug company funding. They are doing everything to ensure they get the biggest market share.

Open your eyes and follow the money America. You've been taken for a ride.

For transparency, I receive no money from the tobacco industry and I am a former smoker. I am on the board of directors for the Consumer Advocates for Smoke-free Alternatives Association (CASAA.org), which is a 100% volunteer, non-profit organization that receives no funding from tobacco companies. CASAA's mission is to get the truth out about smokeless alternatives and expose the lies and myths perpetuated by the anti-tobacco groups. Anti-tobacco started with the right idea - to help people stop smoking - but it has been twisted into a campaingn to demonize all tobacco and smokers in order to reach their unattainable goal of complete tobacco prohibition. It doesn't matter who gets hurt along the way - for them, the means justify the imaginary end.

For the record - CASAA would support the long-term use of pharmaceutical nicotine products if it works to keep people off of smoking. I'm not arguing the long-term use, just the hypocrisy when it comes to other smokeless alternatives.
 

Bill Godshall

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I've known and have been friends with Mike Cummings for more than 20 years, and we've collaborated on many things.

Ironically, he was an outspoken advocate of smokefree tobacco harm reduction products and policies more than a decade ago, and his presentation at the 2000 National Conference on Tobacco OR Health (which was entitled something like "Let the free market reduce smoking") convinced me that tobacco harm reduction products and policies were best for public health and informed consumer choice.

But during the past five years, as Cummings has received more funding from drug companies and from being an expert witness in many lawsuits against cigarette companies, he's backed off of his harm reduction advocacy.

In 2004/05, Cummings convinced Rosswell Park to oppose the FSPTCA because it made it more difficult for tobacco companies to market smokefree alternatives to cigarettes (which has been my position since 2004), but in 2006/07 Cummings and Rosswell Park jumped on the bandwagon urging Congress to enact the FSPTCA.

And after Cummings urged FDA to ban e-cigarettes, he got upset at me because I referred to him as an e-cigarette prohibitionist, claiming that he wasn't advocating prohibition, but rather FDA regulation of e-cigarettes.

But when the DC Court of Appeals recently ruled against the FDA (in the NJOY case), Cummings sent me an e-mail congratulating our victory. So I'm surprised to read that he supports NY legislaiton to ban e-cig sales.
 

Placebo Effect

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But when the DC Court of Appeals recently ruled against the FDA (in the NJOY case), Cummings sent me an e-mail congratulating our victory. So I'm surprised to read that he supports NY legislaiton to ban e-cig sales.

I believe he called the decision a "huge mistake" or at least said that it was wrong.

He also asked me something to the extent of, "When did the cigarette companies finally admit smoking is harmful?" after I brought up no how banning something that hasn't been proven harmful until it is regulated does not make sense. When the FDA's own tests don't show dangerous levels of anything (to the point where, as I recall but I may be incorrect, the FDA's own lawyers didn't try to claim the chemicals found were harmful in their briefs), I hardly see why the opinion of the e-cigarette companies themselves are relevant.

He also seemed to be strongly against indoor malls having e-cigarette kiosks, but most of that seemed to be the claims of smoking cessation that they're making. Thankfully he didn't appear too keen to argue that the vapor could be dangerous.

And when I brought up Linda Rosenthal's inane comment about she was able to quit with the nicotine patch (so everyone should), he laughed, but declined to say anything negative about her.

He was pleasant and talked to me longer than he needed to, so +1 for that. And unlike my phone call to the Utah PTA individual yesterday, she didn't hang up on me.
 

ChipCurtis

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What neither man can seem to get through their heads is that some of us will never accept giving up nicotine.

One of the more pernicious aspects to this group-think mindset among the anti-nicotine elite is the idea that they are to conduct this 'grand experiment' to see just how desperate human beings will get when undergoing nicotine withdrawal. I think many of them are simply curious to see just how psychologically powerful nicotine as an addicting drug can be, and are curious to see how many hoops people will jump through in order to get their next cigarette. It's like they're saying, "Look, we just want to take this freedom away from you in order to use you as a human guinea pig to see if you'll want to keep your freedom to do this particular thing". It doesn't even occur to them that just the idea of taking away a person's freedom to do a particular thing in the name of propaganda and utopian thinking wouldn't lead to "the next thing we can try to take away from them".

I really think that most of former middle-class America is nothing more than a huge pool of guinea pigs that the wealthy elite are performing a kind of Doctor Mengela type experiment on, trying to see how much crap people will put up with in having their money, possessions and way of life stripped away from them one small piece at a time.
 
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