Revised popular stop smoking book at odds with national cessation policy

Ironically, the National Cancer Institute (NCI) is rolling-out its retooled SmokeFree.gov website at the exact same time that its #1 competitor, WhyQuit.com, is announcing release of the 4th edition of the popular quitting book "Freedom from Nicotine - The Journey Home" (FFN-TJH).

Medication versus smart turkey, the two couldn't be more at odds.

While SmokeFree.gov (a/k/a BuyMeds.now), has a rich history of either ignoring or bashing cold turkey, WhyQuit and FFN-TJH promote, teach, support, defend and celebrate it.

The revised SmokeFree.gov site declares that "Most people who quit don't quit cold turkey on their own" and that "medications can double your chances of quitting for good."

Chapter 6 of FFN-TJH presents evidence that "while approved cessation products clobber placebo inside clinical trials, that they get clobbered just as badly by cold turkey in real-world use." It asserts that "clinical smoking cessation studies reflect the worst junk-science ever perpetrated upon humans."

So who's right? Who's wrong?

Four decades and billions spent promoting Nicorette, yet according to a July 31, 2013 Gallup Poll, nearly 50 times as many ex-smokers credit their success to cold turkey than to nicotine gum. According to the poll, all approved quitting products combined accounted for only 8 percent of success stories, while almost half (48%) attribute success to cold turkey, with at least another 25 percent indicating cessation under conditions historically and normally defined as cold turkey (abrupt nicotine cessation without use of a quitting product or procedure).

Have you ever wondered why we've never seen a Nicorette commercial claim that it has helped more than a million smokers quit? The answer is, it simply isn't true. And what percentage of the 1% crediting nicotine gum are dependent upon and slaves to it?

Gallup's cold turkey production finding clearly does not square with SmokeFree.gov's assertion that medication is more "effective" than "self help." It also strongly supports the existing population level effectiveness evidence-base in suggesting that toying with NRT or replacement nicotine, especially nicotine gum, is a weapon of mass destruction that has likely cost millions of U.S. smokers their lives.

Whether reviewing long-term population level effectiveness studies that distinguished light from heavy smokers (Pierce 2012), that interview patients of 1,000 family practice physicians (Doran 2006), or that were conducted by the NCI's own staff (see NCI, Hartman 2006, Pgs. 34-37), the results are the same: cold turkey prevails.

Written by John R. Polito, WhyQuit's 1999 founder, FFN-TJH is unique in taking direct aim at the root cause of all tobacco use: nicotine dependence. Whether the user is addicted to smoking, chewing, sucking or vaping nicotine, the book walks all brave enough to take that first step, through withdrawal and recovery, to the amazing sense of quiet and calm that arrives once their addiction's chatter goes silent.

The 4^th edition of FFN-TJH is free and can be downloaded at WhyQuit in PDF format as an ebook or as individual chapters. A paperback version is also available through Amazon.com.

FFN-TJH provides users with both an easy to follow road-map home and packing tips. It explains how nicotine enslaved them, quitting's only rule and the inherent conflict between quitting and recovery. It debunks common use rationalizations while alerting readers to common pitfalls.

The meat of the book provides tips on moving beyond peak withdrawal (within 72 hours) and then launches into recovery's four overlapping layers: recognizing normal physical healing, extinguishing subconscious conditioning, navigating the emotional sense of loss, and overcoming conscious use fixation. It concludes with homecoming and the keys to relapse prevention.

It should be noted that neither the PDF version nor paperback versions contain the color photos seen in the individual PDF chapter downloads. Most of the color chapter photos were last minute additions yesterday, paid for by U.S. taxpayers, and borrowed from the revised SmokeFree.gov website.

While SmokeFree.gov's medicine, set a quit date, "slips," and how to handle withdrawal lessons each undercut successful cessation and will most certainly cost lives, the new photos are outstanding. Regarding setting quit dates see West 2006 and Ferguson 2009, and in regard to teaching the false lesson that slips are "a small setback" that "doesn't make you a smoker again" see Garvey 1992.

The NCI and its TCRB cessation leadership are strongly encouraged to immediatley end the deceptive and highly misleading practice of suggesting to SmokeFree.gov visitors that clinical efficacy victories over participants seeking medication but instead randomized to placebo look-a-likes bear any relationship to population level "effectiveness" or "your chances. The AHRQ knows the difference and so should you!"

More than 400,000 annual deaths, decades spent toying with replacement nicotine while calling it "medicine" has interrupted natural relapse lesson learning ("I am a nicotine addict and for me one equals all") and ground nicotine cessation to a standstill. Year after year, defeat after defeat, it's difficult to imagine what could possibly motivate any rational government health official to continue to intentionally discourage our nation's most productive and effective method.