I wish it were true, that approved smoking cessation 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.
It wasn't just me. By any honest measure, over-the-counter nicotine replacement therapy (NRT) products (the nicotine gum, patch, and lozenge) undercut recovery and are a fraud upon smokers dying to quit.
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 despair, 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 deeper than wasted time, crashed confidence, obliterated opportunities, 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 Trojan Horse had not only defeated me, it obscured, interrupted, and delayed natural school-of-hard-quitting-knocks learning.
Even so, year after year, the toll of smoke's toxins was becoming more noticeable and impossible to deny. I had to keep trying.
Although not known by name, additional failed escape attempts would eventually force me to self-discover successful recovery's only rule, the Law of Addiction (Chapter 2).
Although free and cherishing it since May 15, 1999, I remain angry about 36 years of sham science displacing and suppressing truth for hundreds of millions of smokers.
Yes, it's massively bigger than my missing teeth, an inability to run more than a couple of hundred feet, or millions of lost memories.
Knowledge is power. It's my hope that the following insights aid you in seeing the light.
Open lies and hidden truths
Nearly four 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 history 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:
- Over-the-counter replacement nicotine has proven effective in real-world use;
- Most successful ex-smokers succeed by use of approved products;
- Few smokers are able to quit cold turkey;
- Clinical study findings are trustworthy, as participants were blind as to whether or not they were introducing nicotine into their body; and
- 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 selling NRT too.[2]
It also enhances appreciation of the very essence of our addiction, a recognition that dopamine pathway driven wanting, urges, and desires 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?
- 41%
- 28%
- 13%
- 6%
- 1%
Talk about fraud, the correct answer is number five, 1 percent.
Like an 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 reached for during 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.
Now, at long last, in 2020, even the U.S. Surgeon General has openly acknowledged that "most smokers who quit successfully do so without medications or any type of formal assistance." [4]
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 impulsiveness.
Smoking cessation is textbook if looking for a great example of how ethicless corporate greed and its quest for profits can purchase and manipulate clinical science, author government cessation policy, and control group-think.
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."[5]
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,[6] each year more nicotine addicts arrest their chemical dependence by going cold turkey than by all other methods combined.
How big an elephant? Up to three-quarters who arrest their chemical dependence are breaking free entirely on their own, without the use of any product or undergoing any procedure.[7]
According to the CDC, during 2014 the U.S. had 40 million adult smokers,[8] with roughly 6%[9] 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?[10]
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.
Again, in 2020, shockingly, the U.S. Surgeon General at long last acknowledged that numerous population surveys indicate "that cold-turkey quitters do as well or better than those who use over-the-counter NRTs." [4]
Despite the vast majority of successful ex-users 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 are heavily dependent on you not knowing the truth.
Since 1984, billions in marketing have been spent on 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 the coercive pressures upon smokers to stop smoking have never been more intense (higher cigarette prices, graphic pack warnings in most nations, the clean indoor air movement resulting in fewer places to smoke (or vape), 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).[11]
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 depressing 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, the decline in the U.S. adult smoking rate was only one percentage point, from 20 to 19 percent.[12]
And that's despite billions spent trying to convince smokers to purchase replacement nicotine, to risk popping Chantix or Champix pills,[13], to receive scopolamine 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"[14] or buy a power bracelet, or 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).[15]
Still, 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 a mountain of old urge satisfaction memories compel their prisoner to dream of a fast, surefire, 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.[16]
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 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 invent a new magic stop smoking product. Let's call it "Billy Bob's Lima Bean Butter."
Unless our product somehow undercuts natural cessation (as OTC NRT at 7% in fact does),[17] 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 success stories by creating a study in which our butter gets paired with other recovery interventions that 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.[18]
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, Zyban, and Chantix/Champix.
For example, Pfizer's five original Chantix 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 Chantix.[19]
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,[20] Massachusetts,[21] Minnesota,[22] Quebec,[23] London,[24] Western Maryland,[25] Nottingham,[26] Australia,[27] the National Cancer Institute,[28] England's Stop Smoking Services,[29], 2002-2003 TUS-CPS data,[30] English households,[31] the GfK’s U.S. KnowledgePanel,[32], U.S. 2013-2015 PATH data,[33], 2010-2011 TUS-CPS data,[34] and U.S. 2013-2016 PATH data,[35] after three decades of widespread use, real-world cessation surveys continue to show that, overall, those buying and using OTC approved products are wasting recovery opportunities, money, time, and life.
Despite cessation method surveys being inexpensive, quick, and easy to conduct, in relation to hundreds of expensive clinical trials they're relatively rare.
Pharma's economic muscle is massive, penetrating, and corrupting. Ineffectiveness findings make NRT marketing claims laughable. It's why population-level effectiveness findings must be avoided, kept hidden, and attacked.
Still, with an unbroken string of cold turkey survey victories, the absence of favorable NRT real-world performance evidence was becoming glaring. Something had to be done.
So, how did pharma and its most trusted researchers respond? They started writing and conducting their own surveys.
In doing so, they wrote surveys that grossly overemphasize approved products via repeated questioning about them, while totally avoiding any mention of cold turkey. Instead, cold turkey quitters were either forced to pick "other" or "none," or have their method ignored [36] [37]
It also allowed financially conflicted researchers full control over raw survey data, the ability to exclude participants and "adjust" findings before publication,[38] and to keep damaging data and findings suppressed or ignored.
While successful ex-users have absolutely no reason to lie about how they finally achieved success, unless the quoted survey was generated by pharma's influence it's quickly dismissed as "unscientific."
It's true. Even the U.S. Surgeon General in his January 2020 "Smoking Cessation" report questions whether ex-smokers should be trusted to accurately recall what, for many, was their greatest accomplishment ever.[4]
Imagine asserting that ex-smokers can't be trusted to correctly recall the last quitting method they used, whether it involved approved products, or whether it brought them success (recall bias), unless pharma funded the survey.[36].
With straight faces, pharma and friends argue that the reason so many go cold turkey is because most lack insurance coverage and can't afford NRT.[4]
This when Walmart's cheapest pack of cigarettes is roughly $4.00, while the per unit price of a 21mg 24-hour Walmart nicotine patch is $1.85, and the per-unit cost of the maximum recommended number of pieces of 4mg. nicotine gum per day (10) costs $1.81.[39]
Pharma influence also suggests that the reason that cold turkey appears more effective in surveys than NRT is because of "selection bias," because "highly addicted smokers are those most likely to use NRT, but these smokers also have a lower likelihood of success."[4]
The argument ignores that super-selection bias that occurred when more than 200 NRT clinical trials dangled free NRT or "medication" as study recruiting bait. Imagine generalizing the findings from such studies as reflecting "your chances" when those dreaming of going cold weren't present.
Which is more deadly, hiding the big picture and truth about how most succeed, or lying to smokers about "their chances" when trusting their natural instincts? [30]
While true that heavy smokers tend to gravitate more toward NRT than light smokers, that tells us nothing about the outcome.
It ignores a 2012 population-level study which found that at 3 months into cessation, that cold turkey was 40 percent more effective than NRT among heavy smokers (more than 15 cigarettes per day), with nearly 3 times as many heavy smokers succeeding by going cold.[30]
Lastly, pharma and friends blame NRT's real-world ineffectiveness on improper use of NRT, that it's being used for "short periods of time or at lower-than-recommended doses," without "support available from tobacco cessation quitlines."[4]
So who is to blame for NRT being horribly ineffective? Let's see, blame memory, blame cost, blame real-world recovery for not mirroring clinical trials, and blame NRT users for improper use.
The real blame is greed that perverted science into labeling nicotine "medicine" and pushing it as "therapy" upon those addicted to it.
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 the use of placebo controls.
References:
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. U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General, January 2020, Atlanta, GA, https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf (see numbered page 15, PDF page 37).
5. SmokeFree.gov, Find a Quit Method That Works For You, https://smokefree.gov/explore-quit-methods, reviewed March 29, 2016.
6. 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").
7. Chapman S, MacKenzie R., The global research neglect of unassisted smoking cessation: causes and consequences, PLoS Med. 2010 Feb 9;7(2):e1000216; also see 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.
8. CDC, Smoking & Tobacco Use - Fast Facts, http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/ March 29, 2016.
9. 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%).
10. 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, https://whyquit.com/pr/021112.html
11. InsiderMonkey.com, 10 Most Expensive Countries to Buy Cigarettes in the World, July 24, 2015.
12. 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.
13. Polito, JR, "Will Chantix really help me quit smoking?" WhyQuit.com, August 25, 2006.
14. Polito, JR, Smoke Remedy" infomercial: a fraud, hoax and scam? WhyQuit.com, January 10, 2011.
15. 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.
16. Polito, JR, Does the Over-the-counter Nicotine Patch Really Double Your Chances of Quitting? WhyQuit.com, April 8, 2002.
17. Hughes, JR, Shiffman, S, et al., A meta-analysis of the efficacy of over-the-counter nicotine replacement, Tobacco Control, March 2003, Volume 12, Pages 21-27. 21-27.
18. Polito, JR, FDA Chantix Handling Betrayed Public Health, WhyQuit.com, February 29, 2008.
19. 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 https://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.
20. 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.
21. 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.
22. 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.
23. 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.
24. SmokeFree London, Tobacco In London, Facts and Issues, [see Figure 14], November 26, 2003.
25. Alberg AJ, et al, Nicotine replacement therapy use among a cohort of smokers, Journal of Addictive Diseases, 2005, Volume 24(1), Pages 101-113.
26. 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].
27. Doran CM, et al, Smoking status of Australian general practice patients and their attempts to quit, Addictive Behaviors, May 2006.
28. 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 https://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).
29. UK NHS, Statistics on NHS Stop Smoking Services in England, April to December 2007 [see Table 6], April 16, 2008.
30. 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: https://whyquit.com/studies/2012_Pierce_Table_1.jpg ).
31. Kotz D et al, Prospective Cohort Study of the Effectiveness of Smoking Cessation Treatments Used in the "Real World," Mayo Clinic Proceedings, October 1, 2014, Volume 89, Issue 10, Pages 1360-1367.
32. Weaver SR et al, Are electronic nicotine delivery systems helping cigarette smokers quit? Evidence from a prospective cohort study of U.S. adult smokers, 2015–2016. PLoS ONE, 2018, 13(7): e0198047. https://doi.org/10.1371/journal.pone.0198047 (see no ENDS use data in Table 7).
33. Benmarhnia T et al, Can E-Cigarettes and Pharmaceutical Aids Increase Smoking Cessation and Reduce Cigarette Consumption? Findings From a Nationally Representative Cohort of American Smokers, American Journal of Epidemiology, Nov. 2018, Volume 187(11), Pages 2397-2404. doi: 10.1093/aje/kwy129 (see "no tobacco use" data in Table 2).
34. Leas EC et al, Effectiveness of pharmaceutical smoking cessation aids in a nationally representative cohort of American smokers, Journal of the National Cancer Institute, 2018 Volume 110(6) Paes 581–587.
35. Pierce JP et al, Role of e-cigarettes and pharmacotherapy during attempts to quit cigarette smoking: The PATH Study 2013-16, PLOS One, Published: September 2, 2020 https://doi.org/10.1371/journal.pone.0237938
36. USDHHS, ICPSR 36231, Population Assessment of Tobacco and Health (PATH) Study [United States] Restricted-Use Files, Wave 3: Adult Questionnaire Data (English Version), Updated: April 19, 2018, https://whyquit.com/studies/PATH-survey-2018.pdf
37. West R, Smokers Toolkit February 2010 Wave 40 - FINAL QUESTIONNAIRE, Smoking in England, 2010, http://www.smokinginengland.info/ Available at: https://whyquit.com/studies/2010_West_STS015_Questionnaire_Used_to_Destroy_Cold_Turkey.doc
38. Polito JR, Pharma bias destroys ITC quit smoking medication study, August 20, 2012, https://whyquit.com/pr/082012.html sharing Professor Michael Siegel's August 20, 2012 study review entitled "New Study Reports Effectiveness of Smoking Cessation Medication But is Biased Towards Finding an Effect; Financial Conflict of Interest Present," http://tobaccoanalysis.blogspot.com/2012/08/new-study-reports-effectiveness-of.html a critical review of Kasza KA, Effectiveness of stop‐smokingmedications: findings from the International Tobacco Control (ITC) Four Country Survey, Addiction, August 14, 2012, published January 2013, Volume 108, Issue1, Pages 193-202.
39. Walmart.com, search Nicotine Replacement Therapy, used per unit prices for Equate NRT product line. Date searched August 23, 2020.
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