A new study has recently gained substantial media attention, with the authors claiming that nicotine replacement may not help smokers to quit smoking. The study recruited 4991 smokers and recent ex-smokers via telephone survey in 2001 and 2002, and then again 2003-4 when 2805 (56%) were reached, and again in 2005-6 when 1916 were reached (38% of original sample). The study focused on those who at one of the first two interviews claimed they had quit smoking in the previous 2 years, and then were later interviewed again (728). The main finding was that the chances of relapsing were not significantly different between those who had previously used NRT to quit, either with or without professional counseling. The authors concluded that these results "raise serious questions regarding the population-level effectiveness of widely popular smoking cessation medications used with or without behavioral counseling." They then suggest that increases in insurance "coverage for individual treatment must not be at the expense of public health programs and policy interventions that have proven effective in promoting cessation." There are many serious problems with this study (such as the low 38% overall follow-up rate), but the main problems lie with the misunderstanding of the purpose of tobacco dependence treatment and the misinterpretation of the data presented. Nicotine replacement therapy is currently marketed for short term use as an aid to smoking cessation. Counseling is similarly primarily conducted to help current smokers to successfully quit. Both of these interventions have been shown to increase the chances that smokers will successfully quit, but there is no evidence, from randomized controlled trials or population studies suggesting that after the medication or counseling has stopped that the relapse rate is dramatically different than from smokers who quit without treatment. So the benefit of treatment is of increasing the initial quit rates, meaning that even with similar relapse rates, there are more long term quitters. So for this study to ignore the first part, the "getting quit" and then focus on the second part, the "staying quit" and to find no difference is really unsurprising . There are other surprising weaknesses in this report, including a failure to cite other population studies that fail to support the claimed findings of this study. For example, a population-based study published by West and colleagues in 2007 concluded that NRT use by smokers making self-initiated quit attempts without behavioral support is associated with improved long term abstinence rates. Amazingly the authors failed to cite recent population-based studies from their own state finding that use of a comprehensive tobacco cessation pharmacotherapy Medicaid benefit was associated with a significant decrease in smoking prevalence and claims for hospitalizations for acute myocardial infarction and acute coronary heart disease . So does this recent study show that NRT doesn't help smokers to quit? No. Despite the headlines, this wasn't even a study of whether NRT use helps smokers to quit. Rather it was a rather weak study of whether people who quit smoking a long time ago have a tendency to relapse long after. The sad reality is that relapse continues. But of course this is a long recognized characteristic of an addiction, not a new finding. So this study has little bearing on the solid evidence that nicotine replacement therapy helps smokers to quit, and that tobacco treatment remains one of the most cost effective healthcare interventions available.View Thread
Some people using the nicotine patch report an unusual taste in their mouth (more often described as "metalic"). Hard to say what the other symptoms are. Note that when you quit smoking your metabolism of some drugs slows down. Caffeine is one of them. So if you consume caffeine you may get caffeine levels 50% higher than you previously did....which can cause a fluttery feeling in the chest. Let us know how it progresses, and keep going with your quit attempt...you are off to a great start.View Thread
You mentioned that you have an Rx "on hand". If your doctor prescribed it recently for the symptoms you described, then that makes sense. But if not, then check with your doctor again first. Sometimes it can be harder for the doctor to figure out what is causing what if the patient has made numerous changes,View Thread
Are you planning to quit at the New Year? This is one of the most popular times to make a serious quit attempt. As the excesses of the holiday season come to a close, and people look to healthy self-improvement in 2012, New Year is one of the most popular times of the year for smokers to quit. So I'm just putting out a reminder today that January 2012 is only 5 days away, and there are some steps you may want to take now to get ready.
Firstly, you may want to make a firm decision when you are going to quit. January 1st is traditional but it is okay to plan it for whatever day suits your schedule, so long as you stick to the plan.
Once you have chosen your Quit Date, then you should decide if you plan to use a smoking cessation aid. There are three nicotine replacement products (gum, patch and lozenge) that are available over the counter from your pharmacy, and four prescription-only medications: varenicline (Chantix), bupropion, nicotine nasal spray and nicotine inhaler. All of the nicotine replacement products are started on your quit day, but varenicline and bupropion should be started prior to the quit day (ideally at least a week before). So if you were planning to use one of those, you should go and see your doctor now.
Then there are a range of other tips, websites and resources that may be helpful. You could try the Smoking Cessation Health Center on WebMD (linked above), or another free smoking cessation site such as www.becomeanex.com . It would be good to hear what some of you are doing to prepare for quitting, and to hear tips from those of you who have already quit successfully. View Thread
When someone has concurrent medical problems and stress and then quits smoking it can be difficult to tell which symptoms are caused by stopping smoking and which symptoms are caused by the other issues. Insomnia and feelings of stress can increase during the few weeks after quitting smoking and are due to nicotine withdrawal. The good news is that the part of these symptoms due to nicotine withdrawal usually gets better within 2-4 weeks or sooner. This article gives a bit more detail. This article provides some tips on managing nicotine withdrawal sumptoms. I hope this is helpful.View Thread
Continuing smokers are about 20 times more likely than never smokers to get lung cancer, about 16 times more likely to suffer chronic respiratory disease and about 3 times more likely to have a heart attack. It harms virtually every organ in the body. Most of the health effects are in middle-old age but some are at a younger age (e.g. effects on pregnancy, cervical cancer, impotnece etc). You may find much more info here.View Thread
Generally it is better to avoid alcohol during the first month of quitting smoking at least, regardless of whether you are using a med or not. Many people associate smoking with alcohol and so alcohol triggers cravings. Also the alcohol clouds our judgement. Not a great mix when trying to quit smoking. You can find a bit more info. here .View Thread
I would suggest getting some additional help and support for your quit. Some of the websites already discussed on the forum are very helpful: www.smokefree.gov and www.becomeanex.org for example. Also get some extra encouragement from the quitline on 1-800 QUITNOW.View Thread
Hi, As I am sure you understand, I cannot say anything about you personally, but I can answer your question by commenting on what the research evidence suggests about the risks of smoking and for people with your general history. So, the vast majority of smokers who quit at age 36 and never smoke again will avoid most of the serious long term health risks from smoking. Clearly your family history and comments from your doctors imply you are not the average 36 year-old smoker. However, within a few years of quitting, cardiovascular risks will have almost returned to those of a never smoker and within 15 years half of the excess lung cancer risks due to smoking will have gone. By quitting at age 36 a smoker will likely avoid the excess risk of COPD due to smoking. Every single additional cigarette smoked causes the lungs to be coated with over 50 carcinogens. So your doctors are correct. Quitting smoking now is the single best thing you can do for your health.View Thread