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Correcting the misperceptions about nicotine and NRT Nicotine replacement therapy is one of the most accessible proven treatments for quitting smoking. But despite widespread marketing of these products, many smokers, and even healthcare providers, have misperceptions about them. Because of these unfounded fears, many smokers are reluctant to use nicotine replacement products to help them quit. Several studies have documented wide misconceptions about the safety and efficacy of NRT, especially among smokers with the least education (Cummings & Hyland, 2005). For example:
These misperceptions about nicotine negatively affect the demand for and use of NRTs. Correcting these misperceptions with smokers and health care providers may lead to more smokers confidently using these products and increasing their chances for quitting. Surprisingly, the way nicotine is discussed in many cessation materials may contribute to these misperceptions. For example, some cessation materials reviewed by NTCC did not clearly distinguish between the components of cigarettes and cigarette smoke that cause cancer, and the component that is addictive (nicotine). They way the information was presented on the "harms of smoking" left the reader with the impression that nicotine was one of the cancerous components. Considerable misinformation on nicotine and NRT can also be found on the internet. There are a number of websites that promote their non-evidence based cessation products and methods as more effective and even safer than products containing nicotine. For example:
How you can help To help a broad spectrum of health professionals and organizations communicate more effectively about the role of nicotine and NRT, NTCC has created a fact sheet that contains key points on nicotine and its role in quitting. There are many ways you can help in the effort to dispel the myths about nicotine and NRT:
By correcting misperceptions that may exist about nicotine and NRT, NTCC and its partners can help smokers make accurate and informed choices about which cessation aids to use and increase their chances of quitting. For more information on this fact sheet, or to obtain a copy, please contact Jessica Nadeau at jnadeau@aed.org or visit http://www.tobacco-cessation.org. Public Perceptions about the Effectiveness of Tobacco Cessation Products and Services In a survey conducted in the spring of 2006 by the
Harvard School of Public Health and RWJF, researchers polled a
sample of 1,076 adults to gauge the perceived effectiveness of
several tobacco cessation treatments and methods. The results
support existing evidence that there is a disconnect between the
perceived effectiveness and the actual effectiveness of tobacco
cessation treatments. Evidence-based smoking cessation methods
perceived as most effective by both smokers and nonsmokers included:
help from a doctor (77%), help from clinics or support groups
(73%) and using a nicotine patch (58%). Less than half of respondents
perceived that some evidence-based treatments were effective,
including nicotine tablets, lozenges or inhalers (37%), prescription
medication (47%), nicotine gum (45%) and telephone quit lines
(24%). In fact, methods without evidence like acupuncture, hypnosis,
self-aids and quit smoking programs offered by tobacco companies
were perceived as more effective than telephone quit lines. Many
consumers continue to underestimate the benefit of cessation treatments
that have evidence supporting their effectiveness. Therefore,
attitudes about cessation treatments remain a significant barrier
to utilization.
Drugs Help Smokers Quit, Even if Not First Time Smokers who use smoking cessation pharmaceuticals
to try to kick the habit should keep trying, even if the drugs
do not work at first. It can take several weeks for many people
to fully wean themselves off tobacco according to David Gonzales,
director of the Oregon Health & Science University smoking cessation
center. Researchers found that 24 percent of those taking Chantix
were able to quit right away, versus 18 percent taking Zyban and
just 10 percent given a placebo. But an additional 20 percent
of those taking Chantix and 11 percent taking Zyban were able
to quit if they kept trying through three months. "Our recent
analysis shows smokers and clinicians should not be discouraged
when total abstinence is not achieved in the first weeks of treatment
with smoking cessation medications," said Gonzales.
Smokers Who Switch to Oral Tobacco Still at Risk An American Cancer Society study of more than 116,000
men finds that cigarette smokers who switched to spit tobacco
products had a higher risk of dying prematurely from tobacco-related
diseases than former smokers who stopped using all forms of tobacco.
The study's principal finding was that the men who switched from
smoking cigarettes to using spit tobacco had higher death rates
from lung cancer, stroke, heart disease and all causes combined
than men who quit using tobacco entirely. Switchers also had more
than twice the death rate from cancers of the mouth and throat.
"Smokers who switched to snuff or chewing tobacco had considerably
worse health outcomes than those who quit entirely," said Michael
Thun, MD, vice president of Epidemiology and Surveillance Research,
American Cancer Society. "Any smoker who is trying to quit should
use proven methods such as nicotine replacement, antidepressants,
and behavioral counseling rather than other tobacco products if
they do not succeed in quitting without assistance. There is currently
no reliable evidence to support the promotion of alternative tobacco
products for smoking cessation."
Intensive Smoking Cessation Intervention Reduces Mortality in High-Risk Smokers with Cardiovascular Disease Hospitalized patients who undergo structured treatment
to quit smoking are significantly more likely to remain smoke-free,
according to a new study. New research published in the February
issue of Chest suggests that high-risk smokers with acute
cardiovascular disease are three to four times more likely to
quit smoking when treated with an intensive smoking cessation
program. All patients received 30 minutes of counseling prior
to hospital discharge, plus self-help materials. Those in the
intensive therapy group received a minimum of 12 weeks behavior
modification counseling, plus individualized anti-smoking medication.
The smoking cessation therapy was continued on discharge from
hospital. After two years of follow up, 39% of those in the intensive
smoking cessation therapy group were still abstaining from tobacco,
compared to only 9% in the usual care group. Their risk of hospitalization
was also cut by half. Those in the usual care group had four times
the death rate compared to those in the intensive smoking cessation
therapy group.
Study Finds Exercise Helps Curb Nicotine Cravings In a review that appears in the journal Addiction,
reviewers examined 12 different studies on cigarette cravings
and exercise that each required different amounts and types of
exercise. Most included smokers who don't exercise regularly.
In most studies, the smokers were asked not to smoke for a certain
amount of time, ranging from half an hour to about 17 hours, on
average. In some studies, they were put in tempting situations,
such as being in a room with a lit cigarette. Overall, the studies
show that exercise reduces smokers' cigarette cravings and prolongs
the amount of time before smokers light up a cigarette. The reduction
in smokers' cigarette cravings after exercise was described as
"encouraging." The review doesn't show exactly how exercise cut
cigarette cravings, but the reviewers argue that exercise does
more than merely distract people from the urge to smoke. Further
studies are needed, but the researchers point out that exercise
curbs stress, improves mood, and spurs the release of brain chemicals
that may override nicotine cravings.
Long-term Smoking Cessation May Reverse Artery Stiffness Ex-smokers achieved non-smokers' level of arterial
stiffness after a decade of smoking cessation, in a cross-sectional
study reported in Hypertension: Journal of the American Heart
Association. The researchers studied 554 people who had high
blood pressure but had never been treated for it. Researchers
divided the subjects into: current smokers, ex-smokers and never-smokers.
Researchers found that current and ex-smokers of only one year
had significantly higher stiffness measurements compared with
non-smokers. In ex-smokers, duration of smoking cessation was
directly related to improvement in arterial stiffness. They found
some improvement after one to 10 years, but arterial stiffness
parameters only reached normal levels after more than a decade
of smoking cessation.
California Anti-Smoking Laws Save Thousands of Lives, New Study Finds According to a new study, more than 50,000 lives
will have been saved by the year 2010 in California because of
statewide tobacco control policies. The study also estimates smoking
rates among Californians dropped by 25 percent due to higher cigarette
prices, ramped up media campaigns, clean air laws and reducing
youth access to cigarettes. "As the first state to successfully
initiate a comprehensive plan to 'denormalize' tobacco, California
serves as a benchmark for other states" said study author David
Levy, Ph.D., a senior research scientist at PIRE Public Services
Research Institute. The study estimates the change in adult smoking
rates and smoking-related deaths with these new policies in place
individually and as a group after controlling for other trends.
The research is based on SimSmoke, a computer simulation of tobacco
control policy effects developed by Dr. Levy that can be programmed
for use in countries and states. SimSmoke projects smoking trends
over time, and traces the impact of tobacco control policies and
smoking habits on death rates.
Black Children Especially Vulnerable to Second-Hand Tobacco Smoke Black children may be far more susceptible to secondhand tobacco smoke than white kids according to researchers. In a study published in the March issue of the journal Chest, 220 children with asthma, black children exposed to at least five cigarettes a day had significantly higher toxin levels in their hair and blood than white children exposed to the same amount of smoke. The study may shed light on why black children are more susceptible to tobacco-related disorders, like asthma, sudden-infant death syndrome and low birth weight. For more information, see web link: New Online Tobacco Treatment Training Program Announced The American Society of Addiction Medicine (ASAM)
and Clinical Tools, Inc., recently launched a new Internet-based
training program to educate healthcare providers about tobacco
prevention and cessation. The training program prepares physicians
and other health professionals to provide clinical tobacco interventions
for prevention and cessation. The Tobacco Treatment Training Program
is available on the Internet 24 hours a day, 7 days a week and
can be completed at the convenience of the learner. No special
software is needed with this browser-based program. The new Tobacco
Treatment Training Program is available online at http://www.TobaccoTreatmentTraining.com.
The training program was developed with funding from the National
Cancer Institute and the National Heart, Lung, and Blood Institute.
Health professionals can complete the program all at once or over
multiple sessions. Healthcare providers who complete the training
program will earn continuing medical education credits. Training
in smoking cessation has been shown to increase the rate of tobacco
interventions that are conducted by health professionals. Furthermore,
comprehensive training, such as what the Tobacco Treatment Training
Program offers, results in increased cessation rates among patients.
Fight Against Tobacco Addiction Reached Tipping Point In The US Last year marked the tipping point in the fight against tobacco addiction according to Free & Clear®, a national leader in coaching-based tobacco dependence treatment. The United States now has more former smokers than current smokers. Further, over half of Americans now live in a city or state that is smoke-free. In 2006, seven states and 116 cities, including Washington, DC, enacted local smoke-free laws, bringing the total up to 22 states and 577 municipalities. With these new policies in place, employers and health plans have begun joining state agencies in assisting tobacco users to quit. Free & Clear has helped these agencies and organizations implement their programs and services. In 2006, Free & Clear signed contracts with over 40 large employers, health plans, and government organizations and is now the official tobacco cessation program for sixteen states and over 100 employers and health plans. "Over 10% of the Fortune 100 has partnered with Free & Clear to lower health care costs and increase employee productivity by helping their people quit using tobacco," said Tim Kilgallon, chief executive officer and president. "In 2006, we registered over 115,000 people into Free & Clear tobacco cessation programs and completed nearly 700,000 intervention calls." For more information, see external PDF:
Campaign Launches Online Component to Target Teenage Chewing Tobacco Users To combat chewing tobacco use among teens, the Pennsylvania
Department of Health has launched an aggressive media and online
campaign -- including a MySpace profile and Youtube videos. The
campaign's target age group is teenagers ages 14 to 17 and began
last fall with television and radio advertisements. Expanding
the campaign to the Internet will help reach more teens, said
Yasmin Coleman, Pennsylvania Department of Health director of
marketing. "The motivation is to reach teens where they live and
play today, which is online," said Coleman. The campaign will
have an account on MySpace.com and launch videos on the popular
video-sharing site, Youtube.com. It also hosts its own independent
Web site, whereispete.org, which targets teens with photos and
interactive games. Coleman said the campaign's primary purpose
is to raise awareness throughout Pennsylvania, but to motivate
people to visit the Web site, whereispete.org, and to call the
free quit line, 1-800-QUIT-NOW.
Battle Heats Up Over Nicotine Therapy-Anti-Smoking Experts Plan Push to Ease Warnings on Use Some critics claim that nicotine replacement products
are producing only limited gains in smoking cessation. But some
high-profile public-health experts say the problem isn't the effectiveness
of the product, but may be over-regulation. They say that federal
law requires nicotine gums, patches, lozenges and other products
to carry so many warnings that smokers are reluctant to use them.
So tobacco researchers and policy makers are starting to argue
that the federal Food and Drug Administration should tone down
the warnings on pharmaceutical nicotine. At a day-long summit
in February in Austin, Texas, entitled "The Case for More Flexible
Regulatory Policy," public-health experts discussed a number of
changes they may seek to current regulations. Among other possibilities,
they say they may recommend relaxing the health cautions for pregnant
women and eliminating the requirement that teenagers refrain from
using over-the-counter nicotine products without the approval
of a physician.
Where Tobacco Ruled, Smoking Ban Gains Ground Smoking in most workplaces could soon be banned
in Tennessee, a state with a long history of producing tobacco,
the New York Times reported on March 12. Tennessee Gov. Phil Bredesen
has proposed the indoor-smoking ban as well as tripling the current
cigarette tax to help pay for smoking-prevention programs. The
smoking ban has won support from the Tennessee House speaker and
the Senate president, as well as the Tennessee Chamber of Commerce.
Mr. Bredesen said he proposed the ban because he felt the time
was right. The harmful effects of smoking are well documented,
he said, and tobacco's declining clout in the state has now made
it possible. "What's exciting here is that we're seeing more activity
in what is traditionally tobacco country," said Annie Tegen of
Americans for Nonsmokers' Rights. "Times are definitely changing,
and just because they grow tobacco there does not mean that they're
not going to take public health seriously."
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