Nicotine-Cessation Aids Questioned in Study

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Nicotine-Cessation Aids Questioned in Study

Something most of us here on ECF already knew

snip: A new study suggests cigarette smokers who quit after using over-the-counter medication such as nicotine patches are just as likely to relapse as smokers who go "cold turkey," casting fresh doubt on the effectiveness of such products.

 

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And the first rebuttal, get some popcorn

A Statement from GlaxoSmithKline Consumer Healthcare on Study Published in the Journal Tobacco Control - MarketWatch

 

[Vocalek]

From GSK's rebuttal:

GlaxoSmithKline Consumer Healthcare understands successfully quitting smoking requires breaking the body's addiction to nicotine

Strange. Can anyone explain how I have remained abstinent from smoking for 2 years and 9 months despite NOT having broken my body's addiction to nicotine? I must be unique.

 

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Strange. Can anyone explain how I have remained abstinent from smoking for 2 years and 9 months despite NOT having broken my body's addiction to nicotine? I must be unique.

I think they just said that NRT's are useless if you ask me ?

 

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Hundreds of clinical trials involving more than 35,000 participants and extensive consumer use for more than 20 years have proven both the efficacy and safety of NRT when used as directed.(1) NRT products have helped millions of smokers quit by gradually weaning them off of their tobacco addiction and is recommended as a first-line therapy for quitting.

i'm apalled. this is beyond misrepresentation. edit: as a intelligent adult, i must have been using NRT incorrectly all those times.

 

[EJH]

NY Times' take on this:

Nicotine Gum and Skin Patch Face New Doubt

 

[wfx]

NY Times' take on this:

Nicotine Gum and Skin Patch Face New Doubt

thank you. curious medical response to blame the patient.

 

[Tom09]

The Guardian (UK) also reports on this study:

Nicotine replacement has no long-term benefit when quitting smoking

 

[minigoat]

It's amazing how fast a story like this gets around…

 

[CES]

The study isn't surprising, but the cynical paranoid in me worries that it could be used by anti-nicotine zealots to limit the availability of any nicotine. the twist could go something like this: if approved NRTs don't work, then there's no reason to allow people to use nicotine when trying to quit smoking. Of course IMO, one of the reasons they don't work is that there isn't ENOUGH nicotine in NRTs.

 

[Bill Godshall]

The press release from Harvard is at:
Nicotine Replacement Therapies May Not Be Effective in Helping People Quit Smoking - January 09, 2012 -2011 Releases - Press Releases - Harvard School of Public Health

A newspaper reporter asked me to comment on this press release on Friday (when Harvard released it), but I told him that it would be unethical for me to respond to a study that I hadn't read (as the study wasn't published until yesterday, and I still haven't seen it). If anyone has the full text version, please send it to me at smokefree@compuserve.com

Please note that Greg Connolly (a coauthor of the study, and the most prominant anti tobacco activist at Harvard) is a tobacco/nicotine prohibitionist who has deceptively portrayed himself (and convinced many others to portray him) as a public health advocate.

Connolly doesn't receive drug industry funding (to my knowledge), but instead has received most of his funding from MA and US taxpayers. If nothing else, this new study helps to debunk the conspiracy theory (that has been promoted by many e-cigarette advocates) that the drug industry is driving all opposition to tobacco harm reduction and e-cigarettes. In fact, most of the opposition to e-cigarettes and harm reduction (here in the US and at the international level) has been coming from abstinence-only tobacco/nicotine prohibitionists, including some prohibitionist groups (e.g. CTFK, ACS, AHA, ALA, Legacy, WHO) that recieve funding from the drug industry.

Greg campaigned to ban snus sales in the EU, Australia, NZ and Hong Kong more than a decade ago, and for the past several years he's been advocating banning the sale of e-cigarettes, new dissolvable tobacco products and flavored tobacco products.

Ironically and hypocritically, Greg also aggressively campaigned (with Senator Ted Kennedy) to urge Congress to enact the FSPTCA, which contains a clause that prohibits the FDA from banning cigarettes. But most tobacco prohibitionists agreed to support that clause prohibiting the FDA from banning cigarettes, and then falsely claimed the bill would protect children from Big Tobacco and would save millions of lives because they were far more interested in banning all new smokefree tobacco products that are far less hazardous alternatives to cigarettes.

 

[Vocalek]

The study isn't surprising, but the cynical paranoid in me worries that it could be used by anti-nicotine zealots to limit the availability of any nicotine. the twist could go something like this: if approved NRTs don't work, then there's no reason to allow people to use nicotine when trying to quit smoking. Of course IMO, one of the reasons they don't work is that there isn't ENOUGH nicotine in NRTs.

I absolutely agree. When I was smoking 2-1/2 packs a day and they put me on a 21 mg. nicotine patch, it was a daily struggle with depression and problems concentrating. Each time the dose was reduced, the problems would get worse. They became unbearable when I came all the way off nicotine. I kept waiting for the promised "You will feel better than you have felt in years" to kick in, but it never did. Finally after 6 months of using intense will-power (and feeling as though I had lost 50 IQ points) I made a conscious decision to go back to smoking and to try to find a way to quit smoke without becoming dysfunctional.

But not enough nicotine is only half the problem. The rest of the problem is the requirement to stop using the products after a specified amount of time. Most other treatments use symptoms as a gauge. The goal is to get rid of the problems. If you are still sick when treatment ends, then you need more treatment. Some illnesses are chronic and require chronic treatment to keep symptoms under control.

The third half of the problem (OK, you can chuckle now) is that some of the NRTs are not designed very well for long term use. People get tired of walking around with black circles all over their upper arms because the adhesive from the patch refuses to wash off. I developed a nasty skin reaction to the patch. The large Commit lozenges take a year and a day to melt, and I kept ending up with a whitish ring around my mouth (less than attractive). Some people have problems with gum chewing either due to dental work (sticking to crowns, bridges, or getting into braces), or due to getting sore jaws. I tried the nasal prescription spray and it felt as if I stuck a lit match up my nose. I only got to try the prescription oral inhaler because of friend of mine participated in a clinical trial. I found it a problem to need to take puffs continually for 20 minutes instead of being able to put it down, like I would a real cigarette. It also wasn't very satisfying. I still wanted a real cigarette. The biggest obstacle for the latter two products being suitable for long-term use is that both still require a prescription (duh!).

 

[CES]

I agree with you about all 3 halves. I've slowly (over two years) decreased my nic level - but only when my body told me it was time, not on the basis of some external timeline.

I tried the nasal spray once. OMG! it hurt. then i read the package insert- the placebo they tried it against in clinical trials was a dilute pepper spray. Certainly not designed for long term use.

 

[Vocalek]

I agree with you about all 3 halves. I've slowly (over two years) decreased my nic level - but only when my body told me it was time, not on the basis of some external timeline.

I tried the nasal spray once. OMG! it hurt. then i read the package insert- the placebo they tried it against in clinical trials was a dilute pepper spray. Certainly not designed for long term use.

OMG. I just realized something. Maybe they designed the nasal spray that way on purpose, hoping to guard against "abuse." I wouldn't put it past them.

 

[DC2]

I have to wonder if a study like this is intended to pave the way for approval of long-term NRT use.
Maybe we'll start seeing studies showing people using NRTs for longer periods of time have higher success rates?

 

[ByStander1]

curious medical response to blame the patient.

Seems to be Standard Operating Procedure these days...

"If you'd come in sooner..."

"If you'd change ____ in your daily routine/lifestyle..."

"If you..."

"Here's what I recommend, but it's still not guaranteed," "Everybody's different," "There are possible side-effects," "The problem in cases like yours."


What a racket! When all's better, the doc's the hero. If, however, all goes down the tank, the patient is responsible for the failure.

At least ancient healers looked to something greater than themselves and gave credit accordingly.

 

[Bill Godshall]

DC2 wrote

I have to wonder if a study like this is intended to pave the way for approval of long-term NRT use.

I'd be shocked if that were the case, since Harvard's press release included the following:

“What this study shows is the need for the Food and Drug Administration, which oversees regulation of both medications to help smokers quit and tobacco products, to approve only medications that have been proven to be effective in helping smokers quit in the long-term and to lower nicotine in order to reduce the addictiveness of cigarettes,” said co-author Gregory N. Connolly, director of the Center for Global Tobacco Control at HSPH.

Here are three more news stories on this study.
Nicotine Gum and Patch Don't Help Smokers Quit Long Term | Healthland | TIME.com
Nicotine Patches, Gums Fail to Help Smokers Quit for Good - Businessweek
Nicotine patches, gum won't help smokers quit for good: Study - HealthPop - CBS News

 

[DC2]

What this study shows is the need for the Food and Drug Administration, which oversees regulation of both medications to help smokers quit and tobacco products, to approve only medications that have been proven to be effective in helping smokers quit in the long-term...

Well, I do expect studies of long-term nicotine use to show much greater effectiveness.
And I do expect such studies, as the pharmaceutical industry is surely wanting the FDA to approve long term use.

...and to lower nicotine in order to reduce the addictiveness of cigarettes,” said co-author Gregory N. Connolly, director of the Center for Global Tobacco Control at HSPH.

Well, if the longer term usage does include instructions for a more gradual reduction in nicotine use...

Honestly, it sounds like there is a potential for a "longer term usage" gold mine for Big Pharma here.
And it sounds like going to higher nicotine dosages to start may fit right in with a longer term lowering plan.

Or maybe I've just gotten way too skeptical and jaded?



Either way, the description of a product...
--That helps smokers quit in the long term
--And can facilitate lowering nicotine dependence over time

Sounds just like what the doctor ordered, which would be.... wait for it....
ELECTRONIC CIGARETTES!!

 

[fumarole]

One thing this study did do is raise Mr G. Connolly in my estimation - temporarily.

He had previously been linked, in my mind, due to various accusations that seemed to have merit, with the pharmaceutical industry's gang of paid liars. But since he very clearly points out in this study and his personal commentary on it that NRTs don't work, the previous accusations seemd to have been invalidated. Perhaps, it seemed, he is indeed an independent.

On the other hand, one reading of this work and his commentary is that if NRTs don't work, then we should be using quit-smoking drugs that do work. According to the tobacco control industry's definition, there are indeed several drugs that 'work'. Or at least they work better than NRTs, which are showm by innumerable studies to have a success rate of 7% at 6 months and 2% at 20 months (and by the present study to be absolutely worthless and an expensive placebo). Chantix etc show better results although the 20-month figure is not available. It may be as high as 10% at 18 months, which is quite good for these things. Useless compared to e-cigs and Snus of course, but that goes without saying - not to mention that no sensible doctor who reads a newspaper would put a member of his own family on Chantix.

So all things taken into account, perhaps Mr Connolly may not have any association with NRT manufacturers, but have more than a passing acquaintance with other drug manufacturers. The jury's still out on that.

 

[ThreePutt]

Just saw this story on Yahoo, and was disappointed they didn't include PVs as part of their story. The message boards were awash in recommendations on taking Chantix as the miracle cure. Really?

I took liberty to praise what today's PVs are doing for me and this community, and invited smokers reading the thread to visit us here at ECF. This has been the biggest support group and EVIDENCE that vaping provides tremendous strides in quitting the analogs. Hope some of them come visit.