Smoking retains it’s popularity in the United States despite all the Surgeon General’s warnings and tobacco company lawsuits. Roughly a quarter of all Americans are still smoking. In many parts of the United States, smoking is as part of the mainstream culture as baseball and apple pie. Why does this past-time enjoy such esteem in today’s day and age? That is a great question and one that has a pretty good, if not complicated answer.
Currently, there are many stop smoking aids, methods or products on the market. Everything from electric cigarettes to lasers. But when you get past the hype and look at the science of smoking cessation, you are left with a very stark reality. Let’s first look at what’s called the front line methods for smoking cessation.
The first category can be called non-pharmacologic means. This includes quitting cold turkey, behavior modification, and support groups/counseling. Quitting cold turkey, although the preferred method of quitting by most smokers, offers the lowest success rate at 3%. Group counseling and behavior modification has the highest success rate, right around 20%.
The second category would then be pharmacological interventions. Here is where you see nicotine replacement therapy, like nicotine gum, the patch, the nasal spray, etc. You’ll also find Zyban and Chantix in this category. The success rate found with nicotine replacement is about equal to what is found with Zyban. This rate is basically double that of quitting cold turkey. Chantix on the other hand, boasts a success rate above 20%. However, Chantix has been required by the FDA to place a warning label on each box dispensed. The label basically warns the consumer that some who take Chantix, have experienced erratic and bazaar behavior. Many who want to quit smoking may not be willing to take that chance, in spite of the potential upside in success. The last member of this group is the placebo medication. This is where someone takes a legitimate medication with a real medical use and offers it up as a stop smoking aid in an “off-label” manner. In other words, they may take some benign medication used to dry up secretions, and market it as a stop smoking shot. So it is no longer being used for the purpose stated on its label, but rather is now being used off-label. The consumer then receives this medication thinking they are getting some new smoking cure, and this idea is so powerful, it creates a very real placebo effect in their mind. The success rates for off-label or placebo medications is about equal to quitting cold turkey.
The final category is labeled alternative methods. This sort of catch-all group is where you find hypnosis, acupuncture, lasers and herbal or natural remedies. These methods might have a basis in non-traditional science and certainly have helped people to stop smoking. But there is sometimes no rhyme or reason as to whether it will or will not work; which, I suppose, doesn’t make them much different than any other method. There are no studied success rates with these methods and there are no clinical studies to quote statistics from. There is a segment of the population that will find success by using one of these methods, but most experts would agree it’s similar to or less than that of quitting cold turkey.
After looking at these success rates, it becomes easy to see why smoking is still so prevelent in our society. Many believe the success rates remain low because people are unwilling to make the necessary behavioral changes and/or are not really serious about quitting. Many are fed misinformation when they search for “easy ways to stop smoking” on the Internet. Too often people buy into a product or method because it offers them a “magic bullet” to stop smoking. However, they are not emotionally or mentally prepared for the grind that is about to take place in their brain.
How do we improve our results then? Many believe that quality information is what smokers need. Only then can they connect the dots between behavior, treatment and committment.
Smokers need to have realistic expectations that don’t fall flat after a couple of days without nicotine. They need to understand their nicotine addiction profile to know what methods might be the right for them. Would someone who smokes two packs a day and suffers from withdrawal symptoms be successful with nicotine gum? Probably not, although it’s not beyond the realm of possibility, but they might be better served using a combination approach under the direction of an expert. Simply put, knowledge has to be the driving force. The better informed someone becomes, the more sound their expectations will be and the more success they’ll have.