Part 3: Techniques, Troubleshooting, and Tips, Cont'd.
Last Updated: June 12, 2007
They don't get to smoke; they have to smoke.
- Dave Whiteis
Why so sad and woebegone? Will the world not heed you?
Courage! Even you have won friends you may rely upon when they really need
you.
-Piet Hein
30. What is the best method for quitting?
The best method to use for quitting is the method that works for you. If
one
method doesn't help, try another! Don't let external images get in the way
of your success (such as, it's weak to use the patch, or acupuncture is
too
New Age). Whatever works for you is a good method - with one big caution:
be
very wary of using unmedical miracle cures you may see advertised on the
WWW
or - gasp! - occasionally on AS3. They can be, at best, very overpriced,
and
at worst, dangerous. Please be cautioned that AS3 does not condone or
encourage the practice of advertising on Usenet, and it does not recommend
any product which may be advertised on the group.
Here is information on some conventional and not so conventional tools for
smoking cessation, along with some feedback from AS3 members. And
remember,
being prepared is key, no matter which method you try.
a. Rational Emotive Therapy (RET)
I put this one first because it can be - and IMHO, should be, - used in
conjunction with any of the other methods listed in this section. It also
seems to me to be closely related to the advice of Allen Carr, whose
method
is described below.
Don't shy away from what may sound like a technical discussion; RET
basically is no more than a way of changing your attitude.
b. Cold Turkey
This is certainly the cheapest, oldest, and simplest method: just stop
smoking. Aside from its economic and operational advantages, going Cold
Turkey means that the nicotine in your body will clear itself out as fast
as
possible - so your withdrawal period will be short, but it will also be
intense and, on occasion, a little frightening. You're removing the drug
addiction as well as behavioral and psychological addictions at the same
time.
c. The Patch
(Material for this FAQ was contributed from various sources, as credited.)
[Adapted from Brad Olin's contribution.]
The 'patch' is the common name for a nicotine replacement therapy (NRT)
which delivers varying dosages of nicotine to the bloodstream via a
plaster which adheres to the skin. There are several brands of the patch
available, manufactured by different drug companies in different dosages
and with slightly different properties, but all operate by weaning the
nicotine addict off the drug over a period of weeks or months. (Nicotine
gum is another form of NRT - see below.) Your body has become addicted
to nicotine, and nicotine addiction is a medical problem that can be
treated medically. However, NRT is not a sure-fire way to quit smoking.
Used properly, the patch can provide relative comfort from the physical
symptoms of withdrawal (e.g., irritability, frustration, anger, anxiety,
difficulty concentrating, restlessness), allowing those who feel
overwhelmed by the physical addiction some relief while dealing with the
behavioral habit. The discomfort felt when going from smoking to the
patch, or when reducing dosages, is not as sharp as that felt when going
cold turkey. But, some quitters contend that because the patch stretches
withdrawal out over a longer period of time, it isn't any easier than
quitting cold turkey.
Cravings may not be as intense when using the nicotine patch, but do not
expect them to disappear magically. For most smokers, nicotine addiction
is just one part of the habit. We develop behavioral and psychological
addictions as well. Certain feelings, times of the day, or activities
all become strong cues and make us crave a cigarette.
How many cigarettes does a patch equal? The nicotine released from the
21mg patch during a 24-hour period is roughly equivalent to that
ingested from a pack of 20 cigarettes, whether they be high or low tar
and nicotine. (Cigarettes are made 'light' by modifying the filter, not
the tobacco; but it has been shown that smokers of 'Lights' and 'Ultra
Lights' then modify the way they hold and inhale cigarettes, so that
they get the same amount of nicotine as with the stronger brands.) You
and your medical provider or pharmacist/chemist will determine, based
upon factors such as your weight, general health, and smoking habits,
the nicotine dosages you use and the length of time you will remain at
each
level.
Nicotine from the patch is not delivered to the bloodstream in the same
way as it is when you smoke. When you inhale, the nicotine in cigarette
smoke enters your bloodstream through your lungs. It is carried to your
brain very quickly (faster than an injection into your veins) and it
almost immediately satisfies your craving. At least for the moment. The
amount of nicotine in your blood is known as 'blood nicotine level.'
After a cigarette, the level of nicotine drops quickly. When it gets to
a low level, your body signals that it needs more and you experience a
craving. The desire is tem****arily satisfied when you inhale your next
cigarette. You may need a cigarette every 20 to 30 minutes. Throughout
the day your blood nicotine level is raised and lowered like a roller
coaster, and your system becomes a participant in a constant 'need-feed'
cycle of addiction.
The nicotine patch, on the other hand, delivers the drug at a controlled
rate into your bloodstream through your skin. The rate is intended to be
steady, but it's not perfect. When the patch is first applied, the blood
nicotine level quickly increases to its peak at about the two hour
period; it remains at peak delivery through about the sixth hour; then
it slowly tapers off through the remainder of the 24 hour cycle.
[Please note that nicotine remains in the blood for several hours even
once the patch is removed; therefore, it is crucial that once you begin
using the patch, you do not smoke. A nicotine overdose can result in
illness, heart failure, even death. Also, a significant amount of drug
remains in the patch itself even once it is discarded. See information
provided by Michiko Walraven further on in this section.]
While nicotine is nicotine regardless of its delivery system, using the
patch is not as harmful for you as continuing to smoke cigarettes.
First, you receive no more nicotine, and usually far less, through the
patch than you do from smoking. The patch does not contain tar or the
poisonous gases that are found in cigarettes. The patch does not
present health hazards, via second hand smoke, to those who share your
living space. And most im****tant, the patch is easier to stop using.
It is not associated with qualities such as ***iness, rebelliousness, or
creativity; nor will you look to it to see you through tough times or to
join you in celebrations (though you may find yourself giving it a
little pat now and again)! And, as explained above, the relatively
constant nicotine level supplied by the patch, delivered passively and
regardless of whether you think you need it or not, ends the need-feed
cycle, allowing the body to disassociate itself from the expected
reactions to nicotine intake.
It is unfortunate that the cost of the nicotine patch sometimes presents
a barrier to its use, and although national governments and insurance
companies agree that smoking is a highly significant source of senseless
illness and premature death, few back up this belief by subsidizing the
cost of this treatment. But even if your health insurance won't pay for
the patch, remember that the cost of using the patch is usually no more
than continuing to smoke a pack a day. And patch use will usually end
within 10 to 16 weeks; cigarette buying never ends until the smoker
stops, one way or another.
Not everyone can use the nicotine patch, so be aware of potential
medical side effects associated with using the patch. It is possible,
and not uncommon, to have some mild itching, burning, or tingling when
the patch is first applied. This is normal and should go away after
about an hour. After you remove a patch, the skin underneath might be
somewhat red. Your skin should not stay red for more than a day. If you
get a skin rash after using the patch, or the skin under the patch
becomes swollen or very red, call your doctor. You might be allergic to
one of the components of that particular company's patch. You can try
switching brands, and see if you react more favourably. And, if you know
you have problems with adhesives plasters/bandages, then consult your
doctor before using the patch.
Most brands of the patch comes in different dosages, and using the wrong
one could result in side effects including headaches, dizziness, upset
stomach, diarrhea, blurred vision, weakness, and vivid dreams. Also, you
must inform your doctor that you are using the patch if he/she
prescribes other medication.
The happy side effect: Many people using the patch, especially one of
the brands designed to be worn round-the-clock, experience unusually
vivid dreams. One friend told me that the patch gave him extremely
*****c dreams every night! It seems that the patch's steady nicotine
delivery system keeps the brain relatively active even during sleep,
which in turns produces lively dreams.
If the patch is causing insomnia, however, or if the excessive dreaming
is disturbing, ask your doctor about switching to a 16 hour patch, or
removing the one you're using during the night.
[From The Journal of the American Medical Association. Distributed by:
JOIN TOGETHER: A National Resource for Communities Fighting Substance
Abuse.
Tel. 617/437-1500. Fax. 617/437-9394. 441 Stuart Street, Sixth Floor,
Boston, MA 02116. info@[EMAIL PROTECTED]
Effectiveness of the Nicotine Patch for Smoking Cessation: A
Meta-analysis_
- Michael C. Fiore, MD, MPH; Stevens S. Smith, Ph.D.; Douglas E.
Jorenby, Ph.D.; Timothy B. Baker Ph.D.
"Our objective was to estimate the overall efficacy and optimal use of
the nicotine patch for treating tobacco dependence. Our data sources
were from nicotine patch efficacy studies published through September
1993, identified through MEDLINE, Psychological Abstracts, and Food and
Drug Administration new drug applications. Our study selection was
double-blind, placebo-controlled nicotine patch studies of 4 weeks or
longer with random assignment of subjects, biochemical confirmation of
abstinence, and subjects not selected on the basis of specific diseases
(e.g., coronary artery disease). Pooled abstinence rates and combined
odds ratios (OR) at end of treatment and 6-month follow-up were examined
overall and in terms of patch type (16-hour vs 24-hour), patch treatment
duration, dosage reduction (weaning), counselling format (individual
vs group), and intensity of adjuvant behavioral counselling. Across 17
studies (n=3D5098 patients) meeting inclusion criteria, overall
abstinence rates for the active patch were 27% (vs 13% for placebo) at
the end of treatment and 22% (vs 9% for placebo) at 6 months. The
combined ORs for efficacy of active patch vs placebo patch were 2.6 at
the end of treatment and 3.0 at 6 months. The active patch was superior
to the placebo patch regardless of patch type (16-hours 24-hour), patch
treatment duration, weaning, counselling format, or counselling
intensity.
"The 16-hour and 24-hour patches appeared equally efficacious, and
extending treatment beyond 8 weeks did not appear to increase efficacy.
The pooled abstinence data showed that intensive behavioral counselling
had a reliable but modest positive impact on quit rates. Our conclusions
were that the nicotine patch is an effective aid to quitting smoking
across different patch-use strategies. Active patch subjects were more
than twice as likely to quit smoking as individuals wearing a placebo
patch, and this effect was present at both high and low intensities of
counselling. The nicotine patch is an effective smoking cessation aid
and has the potential to improve public health significantly.
"Abstract Source: Fiore M.C., Smith S.S., Jorenby D.E., Baker,
T.B.,(1994)
The Effectiveness of the Nicotine Patch for Smoking Cessation: A
Meta-analysis. The Journal of the American Medical Association, JAMA 271
(24) 1940 Article Source: Fiore M.C., Smith S.S., Jorenby D.E., Baker,
T.B., (1994) The Effectiveness of the Nicotine Patch for Smoking
Cessation: A Meta-analysis. The Journal of the American Medical
Association, JAMA 271 (24) 1940-1947. Date: 8/9/94"
[From Michiko Walraven, michiko@[EMAIL PROTECTED]
to Patch Users
This is a summary of an article I found yesterday morning in our local
newspaper. I hope this will help all the patch users who live with small
animals/children:
Excerpts from Victoria Times-Colonist, Jan 12, 1995, page B3.
"A man in Duncan, BC has been on nicotine patch for the past 40 days
trying to quit smoking. He noticed that the patch sometimes gets loose
and falls off. So, he has been using duct tape on occasion. Last night
his patch fell off during his sleep, and his pet kitten (11-month)
accidentally swallowed it. The cat survived her nicotine blast and was
recovering fine at the time of newsprint. BC Drug and Poison Information
Centre representative says: 'With nicotine patches, when children get
them
stuck on them, we've had problems with nicotine toxicity where they get
very shaky, stomach cramping and if untreated sometimes there's always
the risk of seizures.' She recommends that users of patches consider
returning the used patches to their pharmacies for proper disposal
rather than just throwing them out with the normal trash. The spent
patches
could still contain traces of medicine."
d. Nicotine Gum
Another form of nicotine replacement therapy (NRT) is chewing gum laced
with
nicotine (sold under the brand name Nicorette in Canada, the U.S., and
Europe. Like the patch, it provides nicotine to the person quitting
smoking
via a less psychologically- attractive delivery system, and allows for a
more gradual (and theoretically more comfortable) departure of the drug
from
the bloodstream. Anoy using fewer pieces of the gum per day. Even if you
take months to go off the gum entirely, you will still be realizing many
health benefits from not smoking.
That the nicotine gum requires the user to take an active role in nicotine
dosing may make it an undesirable tool for some people. It may seem too
much
like smoking in that you are responding to the body's urges for nicotine
by
supplying it on an as-needed basis, only with gum rather than with a
cigarette. OTOH, you may prefer to have control rather than use the patch,
which sends nicotine to you whether you think you want it or not. If you
find the gum upsets your stomach, you may be using it incorrectly. The
package directions for Nicorette gum specify that you should chew a piece
with small chews every minute or so, and "park" it between your cheek and
gums when you're not chewing. The package also states most of the nicotine
will be released within the first thirty minutes. If you chew Nicorette
like
regular gum before the nicotine is released, this could and probably will
upset your stomach. Note that after the 30 minutes you can treat it as
regular gum and chew as often or as vigorously as you want.
e. Nicotine Nasal Spray
[Provided by Dixie, randixoe@[EMAIL PROTECTED]
"The spray is called Nicotrol NS and is manufactured in the U.S. by McNeil
Pharmaceutical. It was just approved by the FDA in July of 1996. It is a
prescription medicine. It is sold in a spray bottle containing 10 mg/ml
nicotine in an aqueous solution. Each time you spray the
Nicotrol NS into each nostril you receive about the same amount of
Nicotine
as smoking 1 cigarette.
"One spray in each nostril is considered 1 dose. Instructions are not to
use
more than 5 doses per hour or more than 40 doses in 24 hours. The
suggestion
is to use the spray no longer than 3 months. The cost is $38.30 for 1
bottle
that contains approximately 100 doses (200 sprays).
"Now for my experience with this nose spray. Although I had the
prescription
for Nicotrol NS, I wanted to see if I could quit 'cold turkey' first. Well
the first day, towards afternoon I was turning into a miserable bawling
mess. I decided to try the Nicotrol NS and to my amazement within 1 minute
I
was a new girl. I couldn't believe how well it worked, compared to the
patches I had tried years ago.
"That day I used the spray 6 times. Since then I have used the spray about
15-16 times a day. I really don't want to use any more than I have to
because in a couple of weeks I'll want to discontinue the use of the spray
also.
"The nose spray really did sting some when I first used it but doesn't
bother me much at all now. (They do give a warning for people who have
sinus
problems, etc. to check with their doctor before using.)
"From everything I've researched on this Nicotrol NS I think that someone
who isn't careful could have problems being addicted to and continuing the
spray longer than appropriate. My suggestion to anyone who decides to use
it
is to use as little as you can but don't let
yourself get to the panic stage before you use it. I was smoking 2 1/2
packs
a day when I quit and like I said I'm using about 15-16 doses a day. If I
did that for a whole month it would end up costing me about $190-$200 per
month."
f. Cutting down
Is there one among us who has not tried cutting down our tobacco intake at
one time or another? Perhaps you weren't even thinking of quitting smoking
as the ultimate goal, but of trying to reduce the damage or risk or save a
little money. I have personally notched many a cardboard matchbook cover
in
my day. What I got for my trouble was an obsession. How much time has
passed
since my last smoke? Can I have another yet? How do I make this <x> number
of cigarettes last me through <y> hours?
It would seem to be self-evident that gradually cutting down on smoking
would be a viable means to quitting altogether. After all, the less you
smoke, the less drug in your system, and this is the logic behind the
nicotine patch and Nicorette gum, right? But in fact, whether your goal is
to smoke less or to quit entirely, you're not doing yourself any favors by
cutting down, because each cigarette that you light sets you right back
down
in the middle of your addiction cycle. The further apart you stretch the
supply of drug, the longer you suffer the discomfort of withdrawal. The
only
way out of this cycle is to stop feeding the addiction altogether. That
way,
the body eventually gives up demanding the drug, and you're on the road to
freedom.
Switching to a lighter brand might seem sensible, and theoretically it is.
But keep in mind that what makes a cigarette's nicotine content less is
manipulation of the filter, not the tobacco, and smokers in reality manage
to compensate for that manipulation by holding the cigarette a certain way
and/or inhaling more deeply.
Having said this, there are some people who have quit by cutting down,
delaying smoking further and further into the day, limiting the places
where
they smoke, and/or switching brands. And if it works for you, great! If
not,
next time you can try another strategy. The im****tant thing is that you
keep
trying to quit.
g. Acupuncture/Acupressure
i. Before quitting
[Contributed by Grant N. Mazmanian <grantmaz@[EMAIL PROTECTED]
>]
"QUOTE I went to an M.D. specializing in anesthesiology at a local
hospital outside of Philadelphia at the recommendation of a friend. The
doctor gave me references and claimed a 75% success rate. I called
several doctors and nurses at the hospital and they all re****ted the
same results: they stopped smoking after one or two treatments, minimal
withdrawal symptoms, little or no weight gain and no apparent side
effects. They all had tried to quit several times and failed and were
very enthusiastic about the procedure.
"My visit lasted about an hour. Sterile, disposable acupuncture needles
were inserted along my arms, hands, ears and head. There was little to
no pain. A final needle was placed on the top of my head and an
electrode was connected to a mild electric current. I rested in a chair
during the procedure.
"At the end of treatment, I was given an herb to mix with hot water to
make a tea. I was instructed not to smoke and if I had any cravings, to
drink the tea. If the tea didn't work, the doctor gave me his beeper
number.
"For the first few days I felt a craving but I didn't know what I
wanted; it wasn't for a cigarette but I was at a loss to describe what
the craving was for. I called the doctor about it and he told me that it
was a normal response. I went for a second session because I wanted to
reinforce the first treatment but I honestly didn't think I needed it.
After a week, the craving subsided. The usual cigarette 'triggers were
gone after two weeks."
[N.B. - Grant does not know the herb he was given - ed.]
ii. After quitting
[Contributed by Tina <tivity@[EMAIL PROTECTED]
>]
"I was getting discouraged that after sooooo many days without nicotine,
I was still longing to smoke all the time. It didn't seem to make sense
to reintroduce nicotine into my system via gum or patches (though if I'd
planned my quit, I would have used one of them). I went to an
acupuncturist instead, and thought I'd post a re****t. ...
"After swabbing my ears with alcohol, she used long tweezers to poke a
little ring into the upper arch of my left ear, and another one at the
nest-like hollow in the lower part of my right ear. These rings are less
than 1/8 inch diameter, and though they seem to be laying flat on the
skin, they must have a pointy part facing into the skin because a) I
could feel them being placed as if they were poking my skin (although
this might have been the tweezers) and b) I was instructed to tap the
rings to activate the pressure points in question. Using small pieces of
clear surgical tape, Dr. Lee secured the rings to my ears. She issued
the following instructions: lightly tap the points 20 times each morning
upon awakening; tap them 5-7 times any time I feel the urge for a
cigarette. I could swim, shower, sleep, etc without fear of disturbing the
rings,
but I shouldn't scratch at them. They would help me be free of urges to
smoke, and even if I did have a cigarette, it would taste bad and I
wouldn't want to smoke it. (Junkie thinking ALERT: It did cross my mind
to test this theory....) Because I had already quit for 2 weeks, she
thought a week would do me, and I should drop by (no appointment needed,
because it's so fast) to have the rings removed. The visit cost $50.
"So, how is it, you're asking. From the first, I noticed that tapping
the rings did seem to help get over cravings. The first day, I did this
many many many times. Fewer the second day, and, you guessed it, fewer
each day than the last. Also, I could feel a little soreness, especially
in the left, at the beginning, and this too diminished.
"The experience, especially noticeable with the 20 a.m.-taps, is
sorta... Eastern. That is, the cravings don't feel like they're being
wiped out, as if with a drug, but rather that you are becoming slightly
better balanced, and therefore your need for something to fix you, like
a cigarette, is less. I can't imagine that this subtle effect would be
enough to have made me quit had I still been smoking. And I have not
tried what it would taste like to smoke a cigarette."
h. Hypnosis
[Contributed by Michiko Walraven <michiko@[EMAIL PROTECTED]
>:
"I had decided to use hypnosis simply because: (1) I knew I did not have
strong willpower; (2) I honestly believed that I would go under very
easily.
Also, the initial session was covered by our medical insurance, since it
was
a referral from my physician. My appointment with the doctor (a General
Practitioner with a certificate for hypnotherapy) was
9 a.m. on my birthday (sheer coincidence, which turned out to be a great
motivator later). I had my last smoke in the car in the parking lot at
8:59
a.m. The doctor asked me at the beginning of the session to describe to
him
why I was going to quit. It was, I told him, because I knew I had to quit
eventually, and that it was as good as any other time (rather laid-back
attitude). One thing I really emphasized was that I didn't want to turn
into
an ex-smoker who would become a strong anti-smoker, poking his/her nose
into
everybody else's (i.e. smoker's) business.
"My session began. He asked me to look back for the first happy moment I
could remember as a non-smoker. That took a lot of going back... I had
been
a smoker since 16 or so. I was about 12 years old or so in that image. The
doctor then told me that I no longer needed to smoke, and asked me if I
could visualize myself being a non-smoker in that image, only at the
current
age. After some time I would see myself being a non-smoker. He then asked
me
if I could see myself being a non-smoker one week from that day, one
month,
3 months, etc. etc. finally down to one year from that day. Fortunately I
could really see it.
"That was basically it. I did not become violently ill at the smell or
sight
of smoke, I did not turn into a radical anti smoker. I am just a happy and
proud non-smoker for over two years now. Of course this newsgroup helped a
LOT, particular at the beginning, and when I was
going through some legal/family trauma. Sure, the thought comes to me
'Boy,
a smoke would really hit the spot' once in awhile. But if necessary, I can
always go back for a follow-up session. Actually I was told to have an
follow-up after 2 weeks/months, but never bothered because (1) I did not
need it all thatmuch, and (2) it would cost me $80.00 CDN. (First session
was covered by the medical insurance, lucky!)
"If you are interested, ask your family doctor. That is exactly what I
did,
and he recommended doctors who could do hypnotherapy (1 hr) for my
purpose.
It was strictly a private session. I don't know how a group session would
have worked for me, since I wasn't interested."
Here is more on hypnotherapy, from a licensed practitioner.
Bob Christofferson asked a hypnotist who posted to AS3:
"Do you have any advice for how to select a hypnotherapist? Is one session
enough, or are results better with more sessions? Are group sessions any
good? Is there a way for a person to tell if he or she would be a good
candidate for hypnotherapy? Is that enough questions for now? :) "
Edward Hutchison, a practicing hypnotist, responded:
"First, I don't know any sure guide to picking a lawyer, a good school, a
wife ... or ahypnotherapist. There really aren't any goodaccrediting
agencies with universal recognition for hypnotists or psychotherapists so
about all I can suggest would be to ask friends or perhaps your family
doctor. But, to be honest, although hypnosis is taught at some medical
and
dental schools it is not a part of the typical MD's training.
Consequently,
not enough of them are aware of its full potential and some patient might
ask a question about it and, as you probably know, MD's are bred to never
say 'I don't know.'
"As to the number of sessions: it depends. I prefer to see people once,
and
for about 70%, that one visit is enough to quit smoking. Crassilneck and
Hall have published a study with an 82% success rate but it is predicated
upon four sessions and the only subjects seen were males with a medical
referral.
"I have conducted numerous group sessions - usually where some employer
undertakes the expense of the program. The success rate is only about
50%.
But in terms of cost-effectiveness these programs, especially in the
absence
of other options, can be very worthwhile. They last three hours (with two
brief breaks) as opposed to about 70 minutes for the individual sessions.
"The last question is the easiest. Virtually everyone with the
intelligence
to ask the question is a good candidate for hypnosis. That is to say,
about
the only people who have any difficulty in obtaining the light trance
necessary for stop-smoking suggestions are those who
are very dull and those who are actively psychotic. In a long private
practice I have only about one percent who were, in my opinion, refractory
to hypnosis. Of course, the goal is not hypnosis, but change, and
unfortunately no good way exists to measure the motivation
so essential to all change."
i. Herbs
Herbal Teas. Excerpt from: Using Herbs To Quit Smoking by Elizabeth
Phillips, "The Herb Quarterly"(ISSN 0163-9900), Winter 1993.
A regimen of teas to take for a few weeks:
* First thing in the morning to relax: 1/2 teaspoon valerian root; 1/2
teaspoon chamomile
* 11 AM to aid in withdrawal: 1/2 teaspoon licorice root; 1/2 teaspoon
comfrey
* Noon to cleanse blood: 1/2 teaspoon black cohosh; 1/2 teaspoon burdock
root
* 2:30 PM to clear lungs: 1/2 teaspoon slippery elm; 1/2 teaspoon
fenugreek.
NOTE: if after two days you are not coughing or bringing up mucous, you
can
discontinue this tea)
* 4:00 PM to aid in quitting: 1/2 teaspoon magnolia; 1/2 teaspoon
peppermint
* 6:00 PM to boost immune system: 1 teaspoon of Echinacea in a cup of
boiling water
These teas are brewed for ten minutes in four ounce teacups. Of course
there
are always words of caution: check with your doctor before trying any
herbal
remedy. Do not mix herbal remedies with over-the-counter prescription
medication. If you have allergies to ragweed or hay fever to not take
chamomile. You can substitute skullcap. If you have heart problems do not
take licorice root or goldenseal tabs. If you have high blood pressure do
not take vitamin E capsules. I would further recommend that you get a copy
of this article ... this tea regimen is for 3 WEEKS ONLY.
Thanks to the original poster, Barbara R.
j. Cream of Tartar
A few of us (myself included) saw this remedy presented on some breakfast
television-type show, and one poster shared his experience:
Mark <river1824@[EMAIL PROTECTED]
> wrote:
"Well, I am getting ready to quit ... I have been using the cream of
tartar
for a few days now. What you do is take 1/2 teaspoon in a glass of orange
juice, and it pulls the nicotine out of your system. You might sweat it
out
at night or urinate more. You can buy cream of tartar at
the grocery store at the cooking spices. Cream of tartar is used to make
meringues have more holding power and also is a component of baking powder
(if I remember correctly). It is natural, as it is the dried powder of the
remnants left in wine vats, from grapes. The idea is to smoke only when
you
actually crave ... not habit but craving. As you do this each day, you
crave
less and less as more and more nicotine has left your body. The eventual
idea is to work your nicotine level to a tolerable and controllable level,
that you can then quit completely. Without the terrible full strength
withdrawal. I recommend it. It is an inexpensive way that might work for
some. I would be interested in hearing from those that try it. My
neighbors
tried it with some success, however, they did not want to quit smoking at
the time. They did, however, notice a difference."
k. Zyban a/k/a Wellbutrin and Other Antidepressants, w/ or w/o NRT
Wellbutrin (generic name, bupropion) was recently released under the name
Zyban for marketing as a smoking cessation aid. They are the same drug,
made by the same company, Glaxo-Wellcome.
During testing of the antidepressant Wellbutrin, it was realized that the
test group experienced a reduced desire for nicotine. Studies have since
been done using Wellbutrin as an aid in smoking cessation, both in
conjunction with nicotine replacement therapy (in the form of the patch),
and without. No conclusive results have yet been published. The
following information was written and contributed by Scott Leischow
<leischow@[EMAIL PROTECTED]
>.
"Greetings! Wellbutrin is one of several medications being tested for
smoking cessation. Keep in mind that no medication has been found to be
efficacious for a large percentage of people, and that different
approaches
work differently for each person. There are data to suggest that
Wellbutrin
(bupropion) increases the chances of quitting - see studies by Linda Ferry
at Loma Linda Medical Center. Note that other medications being tested
include Inversine (mecamylamine) in combination with nicotine, lobeline,
cotinine (a metabolite of nicotine) - and new nicotine replacement options
will eventually be available as well, such as nicotine nasal spray,
nicotine
inhaler ,nicotine lozenge.
Mint nicotine gum is now available in Canada, Mexico, and several European
countries, and an even more flavorful gum is or will be available in the
UK
(made by Ciba-Geigy). Meds, of course, are not the answer - they can work
to
enhance personal motivation. All of these
changes will definitely increase uncertainty about what to use (if
anything), and whether we should be concerned about people using pure
nicotine for long periods of time. There seems to be a growing consensus
in
the scientific community that we should not be too concerned about long
term
use of nicotine - if the alternative is returning to smoking.
Just as with methadone versus heroin, the lesser 'evil' is the pure
nicotine. I am not suggesting we should not be concerned about long term
use, just that we put it in perspective. Note that I have no financial
interest in any treatment approach - I do research on smoking cessation
treatments at the University of Arizona (including on several of the
methods I mentioned above). Send me a note if you have questions
/comments/flames."
But before you run out and demand a prescription from your doctor, please
consider this information, written and posted by Bob Christofferson
<rechris1@[EMAIL PROTECTED]
>:
"Prozac (generically, fluoxetine) is a selective s*****onin reuptake
inhibitor (SSRI) and Wellbutrin (bupropion) is a heterocyclic
antidepressant
which affects reuptake of dopamine as well as s*****onin. (Because of the
affect on dopamine, by the way, Wellbutrin has been
tried for alleviating symptoms of cocaine withdrawal, with inconclusive
results.)
"Effexor (venlafaxine) affects reuptake of s*****onin and norepinephrine
and
only very weakly affects dopamine.
"This will be on the exam, so take notes. :)
"Seriously, most of us have no reason to try to remember this stuff, but
it's worth mentioning, I thought, partly as an example of the
individuality
of brain biochemistry. All of the drugs mentioned, and a lot more, are
useful for some people who have symptoms of clinical depression. But the
response to any particular drug by any individual patient is
unpredictable -- it may have no effect, or even make the depression worse.
But in someone else, with the same clinical symptoms, the drug will work a
miracle.
"The same sort of individual difference applies, I think, with regard to
smoking cessation -- how hard it is, how long it's hard, what helps --
these
are widely different and unpredictable. So, it's worth keeping in mind
that
even with all the things we have in common, the experiences of any one of
us
may not be very predictive about anyone else. In other words, I need to
keep
in mind that even if you do exactly what I did, you may not have the same
results.
"It's also worth comparing to smoking cessation, I think, because in cases
where one antidepressant doesn't work, another one very well might -- just
like one method of smoking cessation may not do it for an individual, but
there are a lot of other choices to try. And (to tie this into a bow) one
method that may be the key to smoking cessation for some people is to take
antidepressant medication. It certainly wouldn't be the first suggestion
I'd
make for anyone, but for those who have not succeeded with other methods,
and especially for anyone who thinks they may be using nicotine to
self-medicate depressive symptoms, I would recommend talking to a medical
professional about the possibilities."
l. Mecamylamine and the Patch
Another drug being tested in conjunction with the nicotine replacement
patch
for use in smoking cessation is mecamylamine, a prescription drug
frequently
prescribed for high blood pressure. A detailed summary of the original
controlled study, see Clin. Pharmacol. Ther. Vol. 56 no. 1 pp. 86-99; also
available on the Internet from the Medline page. Here's the short,
layman's
version: Source: The Mirkin Re****t #6455 (online)
"Jed Rose of Duke University has discovered that 6 weeks of taking a
nicotine skin patch with mecamylamine pills, a drug that blocks the
effects of nicotine, helped more than one third of smokers to stop
smoking one year later. In high doses, both nicotine and mecamylamine
have horrible side effects. High doses of nicotine cause high blood
pressure, a fast thumping heart beat and shakiness. High doses of
mecamylamine cause shakiness, dizziness, fainting, constipation and
even convulsions. However, when the two drugs are combined in low
doses, people trying to stop smoking seldom suffered side effects and
many were not smoking one year later. The recommended doses were
standard nicotine skin patches daily and 2.5 mg of mecamylamine twice
a day."
m. Chantix
[Contributed by FlatIronMike <flatironmikenyc@[EMAIL PROTECTED]
>]
Chantix [varenicline] is a new stop-smoking prescription drug developed by
Pfizer. Their website states "In studies, the most common side effects for
people who took CHANTIX were nausea, changes in dreaming, constipation,
gas
and/or vomiting. In studies, nausea was the most common side effect in
about
30% of patients. Generally it was mild to moderate and for most people,
but
not all, it went away. Most people were not bothered enough to stop taking
CHANTIX. "
Well, my own personal experience was that it worked for me. I had heard
about it from my sister a few months ago and finally talked with my doctor
about it when I was getting my yearly physical. He was very enthusiastic
about it and said other of his patients who had used it had good results.
So, I got the prescription filled and read up on it that evening.
According
to the website, http://www.chantix.com,
it states you need to set a quit
date about a week before you stop.
Pfizer has set up a website, http://www.getquit.com
that I signed up for
the
day I started the meds as it is a sort of sup****t system. I got a daily
e-mail from them and logged into their site daily. They had a lot of
articles about the effects we generally go through as we detox from
tobacco
as well as a lot of positive thinking that was good re-enforcement. Still,
I
do not believe for a minute that I could be smober today had I not been
reading and posting in AS3. There is NO substitution for the encouragement
we all give to each other.
In the week leading up to the quit, you start taking the Chantix. The
first
three days, you only take the morning pill, but from day 4 onward you take
one pill in the morning and one in the evening. I realized by about Day 4
that smoking did not seem to feel the same as it had for the nearly 40
years
I've smoked. This feeling of just 'going through the motions' as I smoked
increased each day and by the end of Day 7, I had smoked my last
sickerette
and I knew that this was the end of my smoking life.
The next morning I awoke, took my Chantix, and simply went about my day.
I
did not have any of the side effects that were mentioned, but I did notice
that I seemed to be in a brain-fog. The fog slowly lifted as the days wore
on and by the time I had two months of smobriety, the fog was nearly
lifted.
When I finished the 90 days of the Chantix, I knew that I was over the
need
for it, although I did have a few extra pills as I had missed more than
one
evening dose over the days. I kept them as 'insurance' for about a week
and
then passed them on to a buddy who wanted to start down the road to
smobriety.
Yes, Chantix is expensive. Luckily for me, my insurance covered it, but
from
what I have read and heard, the cost is about $120US a month if you have
to
pay outright for them. That is steep, but for most of us smokers, no more
than what we spend on sickerettes. The beauty is that now that I have
finished the prescription, I have been saving the money I would have spent
on smoking.
I have quit several times over the past 10 years. I have gone cold turkey
as
well as using the patch, but I found this quit to be the easiest I have
ever
accomplished. I strongly recommend Chantix as an option to consider as you
decide that smobriety is the road you want to travel.? FlatironMike
n. Allen Carr
Alan Carr's books and quitting philosophy have benefited numerous people.
Since Carr's philosophy, or quitting method is widely discussed, a summary
will be included in the FAQ. This does not mean that AS3 endorses,
sup****ts, or solicites Carr's publications. If Carr's philosophy
intrigues
you, then feel free to investigate further on your own.
The following synopsis of Carr's Method was written and contributed by
David
Moss <moss@[EMAIL PROTECTED]
> and originally posted to AS3:
"First, Allen Carr's qualifications: he's not a doctor or a psychologist,
he's a guy who smoked five packs per day (I didn't even know that was
possible!) and who quit one day with no difficulty whatsoever. He was so
astounded by this that he subsequently devoted his
time to finding out why quitting had been so easy for him, and then wrote
a
book about it.
"He understands how smokers' minds work, so he doesn't fill his book with
a
load of horror stories on why you shouldn't smoke. We all know that
already,
and it doesn't help. Allen Carr turns it around and asks, why smoke? Our
bodies tell us 'have a cigarette' and we give way, or we fight it with
huge
amounts of willpower. Instead, we should ask our bodies 'what for?'. He
takes all the stock answers - it tastes good, it helps me relax, it helps
me
concentrate, it relieves stress, it relieves boredom - and disproves them
one by one. In fact, we smoke to relieve the withdrawal symptoms that we
all
suffer between cigarettes, because
nicotine is a fast acting, fast decaying drug. All the other
justifications
are rationalizations which don't stand up to scrutiny. The logical
conclusion is that you shouldn't even think in terms of 'giving up'
cigarettes, because you're not giving up anything - you're just stopping
smoking because you simply don't need cigarettes.
"His next point is that quitting is actually very easy. Most smokers make
the mistake of confusing the physical withdrawal symptoms with the
psychological "crawling up the walls" cravings and panic that you get when
you want to smoke and can't. The actual physical withdrawal symptoms are a
mild, empty, hunger-like feeling, which doesn't hurt and
which is easy to ignore. The psychological cravings, because they're
psychological, will simply cease to exist if you can develop the right
mental attitude. For this reason, Carr is very insistent that the reader
continue to smoke until he's got his attitude right (i.e. until he's
finished the book), so as to avoid the negative experience of a failed
attempt to quit. Think about the question given above - what
positivebenefits do you get from smoking - until you're completely
convinced
that smoking gives you nothing. You don't need huge feats of willpower,
because you're not giving up anything. Making quitting into a test of
willpower only makes it harder. You don't need replacements like sweets
or
gum, because you're not giving up anything that needs replacing. You don't
need nicotine patches or nicotine gum, because you don't need nicotine.
Enjoy the withdrawal symptoms, because that's how it feels when you defeat
your addiction.
"We all know that it takes about three weeks for the body to be cleared of
nicotine. But don't think in terms of 'making it' three weeks without a
cigarette, which would lead you to expect something wonderful to happen
after three weeks. Nothing happens, because the physical
withdrawal symptoms are so mild that you don't even notice they've gone.
That wonderful thing happens in the moment you stub out your last
cigarette
and become a non smoker. Don't get melancholy and depressed about life
without cigarettes, because you're not giving up anything. Enjoy life as a
non-smoker, it's better in every way. Don't even try to avoid thinking
about
cigarettes - every time you think of them, think about how wonderful it is
that you don't need them.
"Allen Carr gives five point that need to be internalized before you
begin:
"1. Be quite clear in your mind, you're going to quit. Not hoping to
quit
or trying to quit, just going to quit. It's easy.
"2. You're not giving up anything, but you're gaining a hell of a lot.
"3. There's no such thing as 'just one cigarette'. Your choices are to
quit, or to smoke for the rest of your life.
"4. Don't think of smoking as an unpleasant habit. It's an addiction,
and
it's getting worse every day. The right time to quit is now.
"5. Understand the difference between the chemical addiction and the
'junkie' mentality. As soon as you stub out your last cigarette, you're a
non-smoker. Non-smokers are people who don't use cigarettes.
"If you've really taken these points on board, quitting will be simple and
absolutely painless. You don't believe it? That's not surprising, we've
all
been brainwashed by advertising, by films, by society's generally tolerant
attitude to smoking, and by our own addiction. You need to open your mind
and think about what Carr is saying in order to ditch this conditioning
and
realize that Carr is right.
"Finally, a disclaimer - the above is my personal summary of Allen Carr's
book, and I may have left out or misunderstood something im****tant.
"I very much hope that this information will make quitting as easy for
someone out there as it was for me, and I'd be happy to deal with any
follow-up questions. David<moss@[EMAIL PROTECTED]
>"
o. Programs
This information was supplied by Carolina Johnson. It is of use mostly to
those in the U.S. and Canada; I would welcome receiving information on
similar organizations from our members in other parts of the world.
American Lung Association, 1740 Broadway New York, NY 10019. (212)
315-8700
The American Lung Assoc. sponsors stop-smoking groups in most cities. It
also publishes an excellent guide to quitting, Freedom from Smoking forYou
and Your Family. This book guides readers through a step-by-step 20 day
program that leads to quitting and provides guidelines for remaining a
non-smoker. The book is available from your local chapter of the
American Lung Assoc. (consult your telephone directory for the address and
phone number) or from their national headquarters at the addressabove.
American Cancer Society, 4 West 35th Street New York NY 10001. (212)
736-3030.
Local affiliates of the ACS sponsor a four-session stop smoking program
called "Fresh-Start." Sessions last one hour each and extend over two-week
period. Sessions focus on behavior modification, goal setting, mastering
obstacles, and social sup****t. The ACS also publishes a free handbook for
potential quitters, the "I QUIT KIT", which is available from your local
chapter (consult your telephone directory for the address and phone
number)
or from their national headquarters at the address listed above.
The Breathe-Free Plan to Stop Smoking Narcotics Education Inc., 6830
Laurel
Street, N.W., Wa****ngton DC 20012. Many local affiliates of the
Seventh-Day
Adventist Church run a highly recommended program that is usually led by a
pastor physician team. The Breathe-Free Plan to Stop Smoking is based on
motivation, lifestyle, modification, values clarification, modelling,
visualization, affirmation, positive thinking, and self-rewards. There is
also an optional nondenominational spiritual component. The plan consists
of
8 sessions that take place over three weeks, with periodic phone contacts
for one year thereafter. Prospective group members are invited to attend
the
first two sessions before making a decision as to whether to register for
the remainder of the course. During the 3rd week a
graduation ceremony is held. Successful quitters receive a BNS (Bachelor
of
Nonsmoking degree) during the 3rd week. MNS (Master of Non-Smoking)
degrees
are awarded at six months, and DNS (Doctor of Nonsmoking) degrees at 12
months.
Smokers Anonymous, PO Box 25335, West Los Angeles CA 90025. This group
provides information on starting your own sup****t group. They will also
let
you know if there is a Smokers Anon group in your area. Write to them at
the
above address enclosing a self-addressed stamped envelope. [N.B.: This is
not the same organization as Nicotine Anonymous, a 12-steprecovery
program. - ed.]
p. Alternative Healing
Here are summaries of tools and techniques described in New Choices in
Natural Healing (a Prevention magazine book), ed. by Bill Gottlieb
(Pennsylvania: Rodale Press, 1995), pp. 505-507. I haven't tried any
ofthem
except imagery, and make no restitute in Albuquerque, New Mexico.He says
to
use this remedy whenever you desire a cigarette.
Food Therapy
No, not eating everything in sight! :) According to Dr. John Pinto of
Cornell University Medical College and a nutrition researcher at
Sloan-Kettering Cancer Center, load up on Vitamin C well beyond the
Recommended Dietary Allowance; its antioxidant qualities will help repair
damage done by smoking. Thomas Cooper, D.D.S. concurs but note, he says to
avoid orange juice if you're using the patch: "By making your urine more
acidic, the juice will clear your body of nicotine faster. But the purpose
of the patch is to keep some nicotine in your body as you try to wean
yourself off the weed.
Hydrotherapy
The body wrap, or wet sheet pack, can help detoxify your system if you're
trying to quit, according to Charles Thomas, Ph.D. This treatment can be
done at home but will probably require help from a partner. After warming
up
with a hot shower, lie down on a bed with your
entire body wrapped in a sheet wrung out in cold water. Then wrap yourself
in one or more wool blankets. While the pack feels cool at first, your
body
heat will gradually dry the sheet, and you will begin to sweat. Leave the
wrap in place up to two hours after you start perspiring. Dr. Thomas
suggests using this treatment once a day until you no longer feel as
intense
a craving for cigarettes.
Imagery
See yourself smoking. While you're doing it, do you perceive yourself as a
smoker? In your mind, continue to see yourself smoking, but say to
yourself
'At this time, I have the habit of smoking, but I am not a smoker,' says
Dennis Gersten, M.D., a San Diego psychiatrist .... Now picture something
that is good for you that you desire tremendously. It could be health,
better looks or more control of your life. Focus on your desire. See
yourself as an incredibly healthy, beautiful or self-reliant nonsmoker.
Let
that image overpower any desire that you
have to smoke. Dr. Gersten recommends using this imagery for 10 to 20
minutes twice a day.
Relaxation and Meditation
'Studies have shown that many smokers use tobacco to help them reduce
anxiety and tension. If you meditate, your mind learns another way to
counteract that anxiety, so you may become less reliant on cigarettes,'
says
Dr. [Sundar] Ramaswami [a clinical psychologist]. ... Meditate for 20
minutes twice a day or for a few minutes whenever you feel the urge to
smoke, suggests Dr. Ramaswami.
Thoughts to close the Alt.Sup****t.Stop-Smoking FAQ, Part 3:
"The Willpower Method is based on giving up something you want to do and
thus
have to resist the desire to continue doing it. The Easy Way is to change
your
thinking so that you are not giving up anything, but becoming free of
something
that you don't want to do. That way you can enjoy it. - gecko@[EMAIL PROTECTED]
"
"Once you get to the point where your mind is made up once and for all, it
is very difficult to fail."
- Cindi Smith
Please go on to Part 4.
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