Tag Archives: nicotine replacement products

Tobacco Harm Reduction Catches On

Yesterday I mentioned the controversy over legislation that would give the FDA authority to regulate tobacco products, authority the FDA itself (or at least its current head) does not want.

One reason for the agency’s leeriness is the possibility that FDA regulation could actually increase the harm associated with tobacco use.

One way that could happen, as I’ve noted before, is through censorship of truthful comparative risk claims – in particular, efforts to promote smokeless tobacco as a harm-reducing alternative to cigarettes.

Last week there were a couple of positive developments in this area. Britain’s Royal College of Physicians endorsed the concept of tobacco harm reduction, saying snus (Swedish-style oral snuff) and other nicotine-delivering products should be available to smokers who want to cut their risks but are not prepared to give up their drug habit.

In a commentary published by The Lancet (which has long supported “less harmful nicotine delivery systems”), two doctors who worked on the RCP report, John Britton and Richard Edwards, note that the health risks associated with snus are roughly 90 percent lower than the health risks associated with cigarettes.

They question the E.U.’s ban on smokeless tobacco (which does not apply in Sweden) and the policy of treating nicotine replacement products as quitting aids instead of long-term replacements for cigarettes:

snus.jpgWe believe that the absence of effective harm reduction options for smokers is perverse, unjust, and acts against the rights and best interests of smokers and the public health.

Addicted smokers have a right to choose from a range of safer nicotine products, as well as accurate and unbiased information to guide that choice.

Britton told The Independent:

Smokers smoke because they are addicted to nicotine, but it isn’t nicotine in cigarette smoke that kills….We need to liberalise the medicinal market and introduce a decent cigarette substitute. We may end up with millions of people addicted to nicotine inhalers, but so what? Millions are addicted to caffeine.

Although there is more to the cigarette habit than nicotine (one reason the success rates for “nicotine replacement therapies” are so low), smokers certainly should be free to switch to other, less dangerous sources of nicotine if that’s what they want.

The distinction that Britton draws between addiction and the harm associated with it is a vitally important one that discussions of drug policy tend to overlook. There is no rational reason we need to pretend that nicotine gum, patches, and inhalers are medicines that treat the disease of nicotine addiction, as opposed to safer ways of getting the same drug.

Another encouraging sign regarding snus: Last week The New York Times ran a story about snus products in the U.S. that clearly reported the truth: Although not 100 percent risk-free, snus is indisputably less dangerous than cigarettes.

The Times quoted Thomas Glynn, director of cancer science and trends at the American Cancer Society, who questioned the evidence that “smokers are able to switch to smokeless tobacco and remain switched.” But even Glynn conceded that “if every smoker in the United States were to switch to smokeless tobacco, ‘in the next decade we would see fewer cancers and less heart disease.'”

That acknowledgment is significant, since American anti-smoking groups (like American public health agencies) generally have been hostile toward harm reduction via smokeless tobacco, muddying or denying the product’s clear health advantages. By contrast, Britain’s Action on Smoking and Health has supported tobacco harm reduction for years.

Why was last week’s story more scientifically accurate that the usual Times take on smokeless tobacco? Probably because it ran in the business section instead of the health section.

Source: Jacob Sullum, Reason Magazine

[Thanks to Brad Rodu and Bill Piper for the tip about the RCP report.]

Dealing With Nicotine Withdrawl

Everybody knows that nicotine withdrawal comes with the territory of quitting smoking but that doesn’t make it any easier.

It can be hard and even frustrating for the person quitting to deal with withdrawal and for those around the person.

But understanding what’s going on, physically and psychologically, can help and can assist you in helping a friend quit.

When smokers quit, they begin to go through some changes, some physical, some emotional. The physical symptoms, while annoying and difficult, are not life threatening.

Nicotine replacement products such as the patch or gum can help reduce many of these physical symptoms. For most smokers, the bigger challenge is the psychological part of quitting.

This psychological part of smoking is really hard to beat because smoking becomes linked to so many things – things like waking up in the morning, eating, reading, watching TV, drinking coffee, etc. It’s like a ritual.

Your body becomes used to having a cigarette with certain activities and will miss this link when you first become smoke-free.
Woman Yanking HairIt will take time to “un-link” smoking from these activities.

Unfortunately, the patch or gum can’t relieve the psychological need to smoke. That’s why it’s so important for the smoker to create a plan to deal with situations that trigger their urge to smoke. Smokers can also ask friends and family for support with simple things like walking around the building before class instead of having a cigarette.

Stop Smoking Withdrawal Symptoms

If and when a smoker goes through withdrawal, they need to keep this in mind. Even though they may not act like themselves, and they may feel rotten, these feelings will pass. After 30 days or so, and after they’ve quit smoking, all this will be behind them. In the meantime, here are some of the withdrawal symptoms smokers may experience and what they can do about them.

Craving – This is the body’s physical addiction saying, “I need nicotine now!” Each craving will last for only a couple of minutes and will eventually stop happening altogether in about seven days. Smokers should use nicotine replacement products to help reduce cravings.If the smoker still feels the urge, they can admit out loud to themselves or someone else that they are having a craving. Then they should count to one hundred and let the feeling pass – and it will, usually within a couple minutes.

Difficulty Concentrating –  “Help, I quit smoking and I can’t concentrate!” Some people say nicotine helps focus their attention. When they quit smoking, the increased blood flow and oxygen can lead to a feeling of mental fogginess.If this happens, they should try making lists and daily schedules to keep organized, then set aside some total relaxation time when they don’t have to concentrate on anything!

Fatigue/Sleeping Problems –  Trouble sleeping and fatigue are common symptoms of withdrawal. Because nicotine increases one’s metabolism to an abnormally high rate, when people stop smoking their metabolism drops back to normal, making them feel like their energy level has dropped.So what can they do? They need to get their body used to the new metabolic rate by getting plenty of sleep, whenever possible. Although sleep patterns may be interrupted at first, this is normal and temporary.

Irritability –  If you have snapped at someone or had a new non-smoker snap at you, you know what we are talking about. Irritability is caused by the body trying to adjust to the sudden disappearance of all those chemicals it’s been used to. The best way to handle this is for smokers to simply be honest with those around them that they are trying to quit and they do not feel like themselves.

Source: American Cancer Society