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Chapter 6: Common Hazards & Pitfalls

Topics:  Alcohol | Co-Dependency | Blood Sugar | Caffeine | Crutches | NRT | Placebo Fraud | Pharma Secrets | Chantix/Champix | E-cigs | Negative Support | Second-Hand Smoke | Bad Days & Disturbing Dreams | Weight Gain | Weight Control | Menstrual Concerns | Pregnancy



Nicotine gum, patch & lozenge
a fraud, sham and hoax

By any honest measure, over-the-counter nicotine replacement therapy (NRT) products (the nicotine gum, patch and lozenge) don't work and are a fraud upon smokers dying to quit.

I wish it were true, that approved stop smoking products were effective and "double your chances." I wish I'd broken free during my very first Nicorette nicotine gum attempt (about 1986). Instead, my spirit was left shattered.

I'd chewed my brains out. Still, when all the chewing and parking cycles ended, the wanting for more nicotine remained. And quickly, I was back to smoking as much as ever.

Was I somehow different? I'd just failed with the very best science had to offer. Was I hopeless?

Even in dispair, I wasn't finished trying. Thinking it was me, that I'd somehow misused it, I wasted three more valuable periods of cessation confidence attempting to wean myself off of nicotine by replacing it (once more with Nicorette gum and twice with the patch).

The cost was more serious than thrown away time, crashed confidence, obliterated opportunity, and missing money. Pharmaceutical industry marketing assurances that nicotine was "medicine" and its use "therapy" muddied and clouded critical natural learning.

I'd not only lost sight of the enemy, I'd purchased and used it: a performance diminishing drug, the very chemical my brain dopamine pathways were physically dependent upon.

Pharma's nicotine-filled Trogan Horse had not only defeated me, it obscured, interrupted and delayed natural school-of-hard-quitting-knocks lessons.

Smoking's internal damage gradually becoming more noticeable and painful, I refused to quit quitting. Although not known by name, additional on-the-job failures would eventually allow me to self-discover successful recovery's only rule, the Law of Addiction (Chapter 2).

Open lies and hidden truths

Three decades of trickery, deceit and outright lies, as I suggested in a 2012 letter published in the British Medical Journal, the most deadly health product consumer fraud in histroy involves the study, marketing and sale of over-the-counter replacement nicotine.[1]

The pharmaceutical industry and its army of henchmen have consistently misrepresented that: (1) over-the-counter replacement nicotine has proven effective in real-world use; (2) most successful ex-smokers succeed by use of approved products; (3) few smokers are able to quit cold turkey; (4) clinical study findings are trustworthy, as participants were blind as to whether or not they were introducing nicotine into their body; and (5) cold turkey quitters were soundly defeated by NRT users in clinical studies.

Understanding how the industry defrauds smokers helps make sense of the fact that cigarette companies are now beginning to sell NRT too.[2] It also enhances appreciation of the very essence of our addiction, recognition of dopamine pathway driven wanting, urges and desires that annually make the neo-nicotine industry billions.

Falsehood #1: Nicorette helps you "chew away your cravings"

Let's start with the most glaring consumer fraud, the underlying suggestion in every Nicorette nicotine gum advertisement we've ever seen, that nicotine gum has proven highly effective in helping smokers quit. Is it true?

Here in the U.S., Nicorette was first approved for sale by the Food & Drug Administration (FDA) on January 13, 1984. More than 30 years on the market, despite heavy Chantix advertising by Pfizer since 2008, nicotine gum remains the most marketed stop smoking product in history.

A July 2013 Gallup Poll asked U.S. ex-smokers how they succeeded in quitting.[3] Question: what percentage credited nicotine gum for their success?

  1. 41%
  2. 28%
  3. 13%
  4. 6%
  5. 1%

Talk about fraud, the correct answer is number five, 1 percent.

Like the alcoholic toying with gradual stepped-down weaning schemes, it's pretty much impossible for the brain to adjust to functioning without nicotine while it continues to arrive. Especially if used during many of the exact same situations where nicotine was smoked, vaped, dipped or chewed.

Falsehood #2: Most succeed by use of approved products

The same Gallup Poll also found that all approved stop smoking products combined, including Chantix, accounted for only a tiny fraction of successful quitting (just 8% or 1/12th).[3] The tail isn't just wagging the dog, it's killing it.

It's entirely normal for a craving addict who is able to satisfy their craving within 8-10 seconds of inhaling nicotine to want a quick-quitting-fix too.

What isn't normal is for the very government charged with protecting them to assist in presenting pharma fabricated mirages that play and prey upon their conditioned implusiveness.

If looking for a great example of how ethicless corporate greed and its quest for profits can buy and manipulate clinical science, author government policy, and control group-think, smoking cessation is textbook.

For example, the pharmaceutical industry effectively owns the Centers for Disease Control's (CDC) Office on Smoking and Health (OSH) and its SmokeFree.gov website, a storefront for GlaxoSmithKline and Pfizer quitting products.

SmokeFree.gov's "Find a Quit Method that Works for You" section devotes a topic tab to "Nicorette," another to "Nicoderm CQ", one to "Nicotrol," one to "Zyban" and another to "Chantix."[4] Guess which method isn't once mentioned? Yep, cold turkey, America's ex-smoker production champ year after year after year, a method that generates $0 profits.

Falsehood #3: Few are able to quit cold turkey

Truth is, there's a giant yet silent elephant in the room, one that never, ever advertises.

Reality is, as evidenced by the same Gallup Poll [3] and every long-term independent quit smoking method population level study,[5] each year more nicotine addicts arrest their chemical dependence by going cold turkey than by all other methods combined.

How big an elephant?

Today, up to three quarters of smokers continue to break free entirely on their own, without use of any product, procedure, website or book.[6]

According to the CDC, during 2014 the U.S. had 40 million adult smokers,[7], with roughly 6% [8] or 2.4 million successfully quitting each year. If 75% succeeded by going cold, that's 1.8 million success stories.

The billion dollar questions are, how is it possible that such a massive truth - how most quit - is kept hidden? And how do approved products prevail inside clinical trials, yet get clobbered in real-world competition?[9]

First, ask yourself, is it your dream to continue feeding your chemical dependence until the day you die, or to arrest it?

If less than 72 hours away from ridding your body of nicotine and moving beyond peak withdrawal, what sense does it make to pay money to extend nicotine withdrawal for weeks or months, or risk ending-up the cure's permanent slave?

Cold turkey is fast, free, effective and smart

You've been lied to by so many for so long that skepticism here and now is normal and warranted.

The flip-side of the industry lie that NRT is effective is that cold turkey isn't. Despite the vast majority of successful quitters having abruptly ended nicotine use without resort to products or procedures, industry influence continues to suggest that few succeed, that you'd need to be a super-hero to do so.

It's why quitting method surveys are relatively rare. The medicinization, nicotination and successful commercialization of cessation is heavily dependent on you not knowing the truth.

Since 1984, billions in marketing have been spent getting smokers to fear their natural recovery instincts. Reflect on diminished worldwide confidence in cold turkey fostered by decades of bombarding smokers with the lie that they're twice as likely to fail unless they buy and use the nicotine patch, gum, lozenge, spray, inhaler, spray, Zyban, Chantix or Champix.

Imagine being a cold turkey quitter and hit with that message while in the process of navigating early withdrawal. The "double your chances" fraud has eroded confidence, increased relapse, and contributed to costing millions of freedom seeking dreamers their lives.

Never in history has a greater array of approved products promised to double success. And never have the coercive pressures upon smokers to stop smoking been more intense (higher cigarette prices, graphic pack warnings in most nations, the clean indoor air movement resulting in fewer places to smoke, and a steady stream of studies, articles and victim television commercials on smoking's harms).

Do you really think that you'll stop once the price goes up a few more dollars, euros or pounds? So did millions of Australian nicotine addicts who in July 2015 found themselves paying an average of $16.11 per pack (New Zealand $14.67, Norway $14.48 and the UK $12.25 per pack).[10]

Reflect on the millions of addicts here in the U.S. since 2006 who repeatedly listened to commercials sharing a long and frightening list of Chantix side effects, who were thereafter willing to risk their lives in giving it a try.

What's sad is that the #2 quitting method behind cold turkey isn't Chantix/Champix or the nicotine patch or nicotine gum. It's smoking yourself to death.

Here in the U.S. we experienced 2.5 million U.S. smoking related deaths from 2004 to 2010. Still, during those same six years, decline in the U.S. adult smoking rate was only one percentage point, from 20 to 19 percent.[11]

And that's despite billions spent trying to convince smokers to purchase replacement nicotine, to risk popping Chantix or Champix pills,[12], to receive scapolomine injections that make you too sick to smoke (a "cure" invented by a quack who went to prison for a weight loss fraud scheme), to purchase magic herbs such as "Smoke Remedy" [13] or buy a power bracelet, or to undergo hypnosis, acupuncture or laser therapy.

A 2006 Australian study analyzed the smoking patients of 1,000 family practice physicians. It found that 88% of all successful ex-smokers succeeded by going cold turkey, and that those going cold were twice as likely to succeed as those using the patch, gum, inhaler or Zyban (bupropion).[14]

Still, we nicotine addicts make extremely easy prey. Why? Because thousands of daily urges for more were satisfied within seconds of use. Because the bars formed by that mountain of urge satisfaction memories compel their prisioner to dream of a fast, sure fire and painless escape.

And we dream in an arena where the most ridiculous or even fraudulent scheme imaginable "should," statistically, generate success testimonials by 10-11% of users at six months.[15]

That rate reflects the per attempt 6 month odds of successful smoking cessation by those stopping entirely "on-their-own," without education, counseling or support. Don't fret. It's why this book exists, to shine light on darkness, to emphasize the fact that it's IMPOSSIBLE to fail so long as all nicotine remains on the outside.

To aid in understanding cessation fraud, pretend that together we concoct a new magic stop smoking product. Let's call it "Billy Bob's Lima Bean Butter." Unless our product somehow undercuts natural cessation (as NRT at 7% in fact does), 10-11 percent who use our butter should succeed and still be smoke-free at 6 months.

The sad part about cessation fraud is that nearly all who succeed while using Billy Bob's Lima Bean Butter will deeply believe that our butter was responsible for their success. In fact, even after telling them the truth, we probably won't be able to convince them otherwise.

And we can improve upon our sham even more. We can substantially inflate the number of successful quitters by creating a study in which our butter gets used in conjunction with other recovery interventions which have their own proven effectiveness.

For example, we could combine butter use with coping skills development, behavioral therapy, or individual or group counseling, all of which have been proven to at least double success rates.[16]

While our study would generate headlines, we'd have to downplay or even hide the secret to our butter's success. Unfortunately, it's a success rate inflation formula used in nearly all clinical studies of NRT, bupropion (Zyban) and varenicline (Chantix/Champix).

For example, Pfizer's five original varenicline studies broke records for the number of participant counseling sessions (up to 25). And to this day, Pfizer marketing continues to award full credit to varenicline.[17]

While approved products defeat the expectations of placebo users inside clinical trials rich in support and counseling, real-world performance has been a disaster.

California,[18] Massachusetts,[19] Minnesota,[20] Quebec,[21] London,[22] Western Maryland,[23] Nottingham,[24] Australia,[25] the United States,[26] and England,[27] after three decades of widespread use, real-world cessation surveys continue to show that, overall, those buying and using approved products are wasting recovery opportunities, money, time and life.

Despite cessation method surveys being inexpensive, quick and easy to conduct, they're amazingly rare. Pharma's economic muscle is massive, penetrating and corrupting. Ineffectiveness findings make its marketing claims laugable. It's why population level effectiveness findings must be avoided, kept hidden and attacked.

Still, recently, pharma funded researchers have started framing and conducting their own surveys. In doing so, surveys are being written so as to grossly overemphasize approved products via repeated questioning about them, while totally avoiding any mention whatsoever of cold turkey.

It also affords financially conflicted researchers full control over raw survey data, the ability to "adjust" findings prior to publication, and to keep damaging data and findings suppressed, ignored or hidden.

While successful ex-users have absolutely no reason to lie about how they finally achieved success, unless the findings were generated by pharma's paid pals, NRT stakeholders quickly dismiss surveys as "unscientific." They argue that smokers and ex-smokers cannot be trusted to correctly remember the last quitting method they used, or whether or not it brought them success.

Frankly, what can't be trusted and should be dismissed as junk and unscientific is every smoking cessation clinical trial efficacy finding whose validity is rooted in use of placebo controls.



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References:

1. Polito, JR, Are those who quit smoking paying with their lives because of NRT's failure? British Medical Journal, February 7, 2012, Page 344, e866.
2. Michael Feldberbaum, Tobacco Giant Reynolds Wants To Be A Major Nicotine Gum Company, AP, September 4, 2014 (story relates how U.S. sales of RJ Reynolds Zonnic brand nicotine gum are going nationwide).
3. Gallup. Most U.S. smokers want to quit, have tried multiple times. July 31, 2013: "http://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspx
4. SmokeFree.gov, Find a Quit Method That Works For You, http://smokefree.gov/explore-quit-methods, reviewed March 29, 2016.
5. Cancer Council Australia, Most Australians still quit smoking unassisted, Oct. 8, 2010 ("survey found that 69% of Australians quit smoking cold turkey"); also see Chapman S, MacKenzie R (2010) The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences. PLoS Med 7(2): e1000216. doi:10.1371/journal.pmed.1000216 ("Research shows that two-thirds to three-quarters of ex-smokers stop unaided").
6. Chapman S, MacKenzie R., The global research neglect of unassisted smoking cessation: causes and consequences, PLoS Med. 2010 Feb 9;7(2):e1000216.
7. CDC, Smoking & Tobacco Use - Fast Facts, http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/ March 29, 2016.
8. CDC, Morbidity and Mortality Weekly Report (MMWR), Quitting Smoking Among Adults - United States, 2001-2010 (see Table 1: annual average adult cessation rate 6.2%).
9. Doran CM, et al, Smoking status of Australian general practice patients and their attempts to quit, Addictive Behaviors, May 2006, Volume 31(5), Pages 758-766 (88% of successful family practice patients stopped smoking cold turkey with cold turkey doubling success rates for NRT and Zyban); also see Polito, JR, Replacement Nicotine's Killing Fields, WhyQuit.com, February 11, 2012, http://whyquit.com/pr/021112.html
10. InsiderMonkey.com, 10 Most Expensive Countries to Buy Cigarettes in the World, July 24, 2015.
11. Compare: CDC, Cigarette Smoking Among Adults - United States, 2007, November 28, 2008, MMWR Vol57, No. 45 with CDC, Vital Signs: Current Cigarette Smoking Among Adults Aged 18 Years - United States, 2005-2010.
12. Polito, JR, "Will Chantix really help me quit smoking?" WhyQuit.com, August 25, 2006.
13. Polito, JR, Smoke Remedy" infomercial: a fraud, hoax and scam? WhyQuit.com, January 10, 2011.
14. Doran CM, et al, Smoking status of Australian general practice patients and their attempts to quit, Addictive Behaviors, May 2006, Volume 31(5), Pages 758-766; also see Polito, JR, Cold Turkey Twice as Effective as NRT or Zyban, WhyQuit.com, May 19, 2006.
15. Polito, JR, Does the Over-the-counter Nicotine Patch Really Double Your Chances of Quitting? WhyQuit.com, April 8, 2002.
16. Polito, JR, FDA Chantix Handling Betrayed Public Health, WhyQuit.com, February 29, 2008.
17. Chantix Lisa commercial - You Tube http://youtu.be/Suwx2d0H7XM "In studies, 44% of Chantix users were quit during weeks 9 to 12 of treatment compared to 18% on sugar pill;" also see www.Chantix.com where the site's hompage stated on August 5, 2012, "Proven to Work 44%" "In studies, 44% of CHANTIX users were quit during weeks 9 to 12 of treatment (compared to 18% on sugar pill)." Contrast Polito, JR, Is a 14% Chantix success rate worth risking death? June 14, 2011 WhyQuit.com Press Release at http://whyquit.com/pr/061411.html reviewing the 2011 Hughes Chantix study. Also see the five original Pfizer Chantix studies which include Gonzales D et al, Varenicline, an a4b2 Nicotinic Acetylcholine Receptor Partial Agonist, vs Sustained-Release Bupropion and Placebo for Smoking Cessation: A Randomized Controlled Trial. JAMA. 2006, Volume 296(1) Pages 47-55, during which participants received up to 14 counseling/support sessions lasting up to 10 minutes each by week 12 of varenicline use, with up to an additional 11 counseling/support sessions between weeks 13 and 52 of follow-up.
18. Pierce JP, et al, Impact of Over-the-Counter Sales on Effectiveness of Pharmaceutical Aids for Smoking Cessation, Journal of the American Medical Association, September 11, 2002, Volume 288, Pages 1260-1264.
19. Alpert, HR, Connolly GN, Biener, L, A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation, Tobacco Control, Online First, January 10, 2012.
20. Boyle RG, et al, Does insurance coverage for drug therapy affect smoking cessation? Health Affairs (Millwood), Nov-Dec 2002 Volume 21(6), Pages 162-168.
21. Gomez-Zamudio, M, et al, Role of pharmacological aids and social supports in smoking cessation associated with Quebec's 2000 Quit and Win campaign, Preventive Medicine, May 2004, Volume 38(5), Pages 662-667.
22. SmokeFree London, Tobacco In London, Facts and Issues, [see Figure 14], November 26, 2003.
23. Alberg AJ, et al, Nicotine replacement therapy use among a cohort of smokers, Journal of Addictive Diseases, 2005, Volume 24(1), Pages 101-113.
24. Ferguson J, et al, The English smoking treatment services: one-year outcomes, Addiction, April 2005, Volume 100 Suppl 2, Pages 59-69 [see Table 6 where consistent with Doran 2006, 25.5% of those stopping without medication were still not smoking at 1 year versus 15.5% of NRT and 14.4% of bupropion users].
25. Doran CM, et al, Smoking status of Australian general practice patients and their attempts to quit, Addictive Behaviors, May 2006.
26. Hartman AM. What does US national population survey data reveal about effectiveness of nicotine replacement therapy on smoking cessation? Paper presented at World Conference on Tobacco or Health, 12-15 July 2006, Washington, DC. Full Text available http://whyquit.com/NRT/studies/Hartman_NCI_NRT.pdf (see PDF pages 33 to 38); also see Pierce JP, et al, Quitlines and nicotine replacement for smoking cessation: do we need to change policy? Annual Review of Public Health, April 2012, Volume 33, Pages 341-356 (see Table 1 indicating that among light smokers of less than 15 cigarettes per day that 26% who stopped unassisted succeeded at 3 months versus only 19% who used NRT or prescription medication, and also that among heavy smokers of greater than 15 cigarettes that 15% of unassisted succeeded versus 9% who used NRT or prescription products).
27. UK NHS, Statistics on NHS Stop Smoking Services in England, April to December 2007 [see Table 6], April 16, 2008.



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Page created August 11, 2015 and last updated January 22, 2017 by John R. Polito