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Miscellaneous thoughts and ramblings
Monday, January 09, 2006
NRT Followup from Joel Spitzer, Cessation Expert
I post these threads at this time of year, because so many attempt to quit around the beginning of the year, and I think it's important that they hear the other side of the nicotine replacement "therapy" story; the one they don't give you during the commercials. Here's one from last year:

Truth About Nicotine Gum, Patches and other Nicotine Replacement "Therapy"

We keep a link to Joel Spitzer's cold-turkey support and education website (free, no B.S., volunteer-driven) in our list of links on this site. Joel is a smoking cessation expert, who has been running highly successful clinics (roughly 50% of patients are still completely nicotine-free after 1 year) in and for the city of Chicago for about 30 years. Here is the link again:


If you're trying to quit, or thinking about it, consider looking at the information there. Here is Joel's commentary on the "New York Times" piece I just posted:

So what's the harm of just using nicotine for the rest of your life. After all, it is not totally clear if nicotine itself is a carcinogen, and so many medical professionals think that it is relatively harmless when compared to the well established dangers of smoking.

The real danger is an issue that most people asking this question are not taking into consideration. The products are keeping the users in a mild to moderate form of chronic withdrawal. These people are never getting free of nicotine and thus free of the demands that their bodies are going to put on them.

When I first met Jeanne who was talked about in this story it was at a Chamber of Commerce meeting in the city where I live. Jeanne, knowing that I was the person who ran the clinics for the city, came up to introduce herself to me and to tell me that she had been off smoking for 12 years. Jeanne was proud of that fact. She was not looking for help or advice at the time. My guess was that she didn't feel she needed it considering she was off smoking for 12 years.

Her next comment to me though is what triggered our longer term association. She told me that she has still struggles every day and still constantly thinks of smoking. This raised a flag to me. You see, whenever I meet a person who has been off anywhere close to Jeanne's time off, they will generally say that they hardly think of smoking anymore. Or sometimes, they will say that the still think about smoking, and when I pursue the conversation it turns out that they think about it once a month or once every six months, and that it is nothing major or difficult to contend with.

Jeanne's story was different though, she was clearly saying that she was still struggling daily and has been for the past 12 years.

This is when I asked Jeanne how she quit and when she told me that she had used nicotine gum. When I asked her how long she used the gum she said that she was still using it. I think I let out a little laugh and proceeded to ask her if she ever tried to get off the gum. To that she responded that she had at one time tried to get off the gum by using the patch. That one elicited a bigger laugh from me.

Actually, when Jeanne first quit she used the gum as prescribed and pulled off the quit and got off the gum. I talk about this kind of person in the post Is cold turkey the only way to quit? She was off for a number of months, but one day under stress felt that she needed something and took a piece of her left over gum to help her through the moment. That piece of gum is what resulted in a 12 year, $15,000 addiction that kept her in a constant state of relative discomfort.

So is long-term use of NRT going to have the potential of killing a specific individual? No one knows the answer to this for sure at this point in time. But long-term use of NRT is going to have the full potential of making a person suffer years or decades longer and spend a small fortune compared to any person who simply makes and stick to the commitment to never take another puff!


Disclaimer: I ain't a doctor, and neither is Joel. Don't let that stop you from quitting smoking. Joel's forgotten more about smoking cessation than most doctors ever learn. :)
I quit cold turkey three times. The last time was the LAST time. I have had an occasional cigar, but no cigarrettes for damned near five years now. Cold turkey is the only way.
In my medical practice I have never met a smoker who successfully quit using NRT. Several patients have used Wellbutrin/Zyban/buproprion as adjuncts, and I believe it has especially helped those who are prone to depression. In general though, I tell my patients that cold turkey is the way to do it.
I quit cold turkey twice, but the second time stuck. It's been at least 17-18 years.
Cold turkey delicious! And crunchy.
Joel Spitzer is my Elvis, my buddha. I quit cold turkey in the middle of a wretched flu in November, and THEN looked around for some support on the Web.

Joel's videos and articles on WhyQuit.com got me through the withdrawls and miseries in fine style. I am forever grateful.
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