Harm reduction products mentioned in cessation article

[Bill Godshall]

I was quoted citing a switch to smokefree tobacco/nicotine products as reducing health risks at the end of the following article on a North Carolina hospital based smoking cessation program
Hospitals will offer tobacco cessation

 

[Vocalek]

Bill: I'm not sure if it is clear to readers that what you meant is that only 5% of nicotine patch/gum/lozenge users manage to quit when they use the products as directed. A larger percent achieve smoking abstinence (I believe it is around 10%) when they use those products "off-label" as a permanent substitute for smoking instead of as a nicotine weaning method.

I think the message would have been more powerful if you mentioned that the best success rates for smoking abstinence are acheived by those who switch permanently to a smoke-free alternative. The survey results published in tobacco Harm Reduction 2010 showed that 79% of those who switched to an electronic cigarettes are completely smoking abstinent. According to one source I found, approximately 50% of the snus users today in Sweden are ex-smokers.

 

[Bill Godshall]

Per Elaine's comment, the many different studies I've read consistently found that fewer than 5% of NRT users have quit smoking, and the several studies I've read on long term NRT usage indicate that about 1-2% of NRT users who quit smoking have become long term NRT users.

There are many more NRT users who have become dual users of cigarettes and NRT (which isn't considered quitting smoking).

While I've long advocated NRT products for helping smokers quit and as temporary and long term harm reduction nicotine maintenance alternatives, I think its important to point out the limitations of NRT (which aren't mentioned by drug industry influenced smoking cessation programs) along with its benefits.

 

[Vocalek]

I have only seen one article on the benefits of smoking reduction. It took bupropion to reduce me from 2-1/2 packs to 1 pack a day. It took the addition of all the pieces of gum that my digestive track can handle (after they came out with a flavor that I find palatable) to reduce that to 1/2 pack. It took adding the e-cigarette to get rid of those last 10 cigarettes.

The Tobacco Control Crowd get all bent out of shape about "dual use" but it could very well be that "dual use" is an effective tool on the way to smoking abstinence.

I don't think my experience is unique. I think a lot of folks reduce the number they smoke on their way down to zero. My husband did, too.

One thing that is ignored is the dose-response relationship. There is one group of "experts" who claim that any cigarettes whatsoever are a major threat to health. In their book, one cigarette per day does just as much damage as five packs a day. Judge Judy says, "If it doesn't make sense, it isn't true."

If "the dose makes the poison," then higher doses of tar, CO, particles, and toxins would have to be more harmful than smaller doses.