Sunday, March 28, 2010

Quitting smoking

  • Research shows that two-thirds to three-quarters of ex-smokers stop unaided. In contrast, the increasing medicalisation of smoking cessation implies that cessation need be pharmacologically or professionally mediated.

  • Most published papers of smoking cessation interventions are studies or reviews of assisted cessation; very few describe the cessation impact of policies or campaigns in which cessation is not assisted at the individual level.

  • Many assisted cessation studies, but few if any unassisted cessation studies, are funded by pharmaceutical companies manufacturing cessation products.

  • Health authorities should emphasise the positive message that the most successful method used by most ex-smokers is unassisted cessation.

    Oh my goodness! So let me get this straight. Most people who quit smoking, do it without using ANY pharmaceutical products or "professional" help.

    So when folks want to quit smoking, we should tell them the best thing for it is for them to just do it. We can charge you some money but it is your efforts that will determine success.

    Change all the ads for Chantix to ads stating "most ex-smokers quit without paying a dime to the medical system"

    I guess that'd be bad for business.

1 comment:

  1. In an article, "Smoking, The Missing Drug Interaction in Clinical Trials: Ignoring the Obvious," Dr. Carolyn Dresler and her colleagues concluded that we can no longer ignore the obvious: smoking is a critical variable that affects cancer treatment and outcome and has been shown to vitiate or interact with the effects of some therapeutic agents and chemopreventive agents. Measurement of smoking history and status in clinical trials of cancer therapy will increase our knowledge of the adverse effects of the constituents of tobacco smoke, including nicotine, and of drug interactions.

    She makes the point that since ongoing smoking may significantly affect the outcome of subsequent surgery or therapy and negatively impact long-term survival, it is now the specialists' turn to provide the urgent smoking cessation treatment.

    No pharmaceutical trial ever followed whether patients smoked during their clinical trials, despite dosing themselves daily with cigarettes with hundreds chemicals in them. Dr. Dresler stated that "the addition of nicotine inhibits the ability of a chemo drug (like etoposide) to induce apoptosis by 61%." If a drug like nicotine, which occurs in the highest concentration of any drug in a cigarette, inhibits the ability of a major chemotherapy drug by 61%, a medical oncologist should care if it was being ingested during treatment.

    There are guidelines regarding smoking cessation techniques that have resulted from reviews of the world's literature and are very well accepted throughout the medical and psychological fields. However, "the biggest problem remains in having healthcare providers implement them routinely," Dr. Dresler says, "Most have emphasized the role of the primary healthcare provider in providing smoking cessaton advice to patients, whereas the specialists, such as medical oncologists, radiation oncologists, thoracic surgeons or pulmonary care specialists should be dealing with the health problems resulting from the smoking as the patient faces imminent interventions such as radiation therapy, chemotherapy or surgery."

    Oncology health professionals have called for increased advocacy for tobacco control. Furthermore, the routine inclusion of smoking status and cessation need to become a standard of care for all patients. The inclusion of smoking data in oncology clinical trials will also provide clinicians with improved means of delivering individualized advice to patients with cancer that may be critical in motivating their cessation efforts and sustained abstinence.

    Scientific, financial, and clinical support is critical to this goal. The failure to date to assess, analyze, and report smoking status has limited our ability to investigate the effect of smoking on treatment efficacy and outcome. The time has come to integrate data about the single most important lifestyle risk factor in cancer prevention into cancer treatment and survivorship trials.