The Addiction That Defies Reason

Step away from the cigarettes: November is lung cancer awareness month, and there are myriad local resources for quitting.

A knot of people standing in a parking lot smoking is an unremarkable sight. But the specifics about the group are jarring—their relative is in the hospital, dying of lung cancer.  

This scenario isn’t uncommon, said Richard Fischel, M.D., a thoracic surgeon and Orange County leadership board member for the American Lung Association in California. He sees families of cancer patients who smoke and has taken care of patients whose lung cancer was caught early, treated with surgery, chemotherapy, and radiation and whose prognosis could be positive, but who continue to smoke.

In spite of increasing limitations on where people can smoke, higher cigarette taxes, more vivid warnings on cigarette packages, and multiple campaigns graphically illustrating the hazards of smoking, 50 million Americans continue to light up. Each year, 443,000 people die prematurely from smoking or exposure to secondhand smoke, according to the Centers for Disease Control and Prevention.

“The addiction is very powerful,” Fischel said. “You can show people the scary blue guy in a wheelchair with oxygen, or put a skull and crossbones on cigarette packages with a warning that says, ‘This will absolutely, positively shorten your life and give you a terrible disease from which you will suffer,’ and smokers will read that while lighting up. It’s not a rational thing,” he said.

Can the Habit Be Taxed to Extinction?

According to the U.S. Department of Health and Human Services, 3,400 young people start smoking every day.

“They don’t know that they’re on a 40- to 50-year track of smoking,” Fischel said.

To curb this trend, he favors continuing to educate kids about the harm of smoking and raising cigarette taxes to the point where smoking is “so unaffordable, inconvenient, and uncomfortable that it goes away.”   

In June 2012, Californians will vote on the California Cancer Research Act, which will increase cigarette taxes by an additional $1 per pack if passed. Fischel sounded exasperated when he described the wrangling that goes on among interest groups about how cigarette tax money should be allocated.

“The answer to that is, ‘Who cares where the money goes?’” he said. “Throw it in a big hole and bury it if it will keep kids from starting to smoke.”

Get Help Quitting

Parents who don’t smoke or who quit smoking model positive behavior that can help keep kids from developing the habit. If you or a family member is thinking about giving up smoking, you don’t need to go it alone—there is plenty of help. The Great American Smokeout is Nov. 17, the day when the American Cancer Society urges people to quit or make a plan to quit, and the entire month of November is Lung Cancer Awareness Month. You can also call 1-800-NOBUTTS (1-800-662-8887) for information and telephone support from the California Smoker’s Helpline.

Hoag Hospital offers an eight-week smoking-cessation program that meets Monday and Thursday from 7 to 9 p.m. Call 949-764-5511 for more information. There are no classes in December, but the program starts again in January for those who resolve to give up cigarettes in 2012.

The Memorial Care Todd Cancer Institute also provides stop-smoking programs at Long Beach Memorial Medical Center and Saddleback Memorial Medical Center. Call 562-933-0961 to find out more for more details.

E-Cigarette Controversy

Electronic cigarettes, or e-cigarettes, deliver a puff of vapor formed from liquid nicotine and aerosol mist, but no tar, formaldehyde, carbon monoxide, or other harmful chemicals in cigarettes. Some smokers rely on e-cigarettes, or “vaping,” to cut down on or quit smoking.  

E-cigarette detractors argue that vaping actually diminishes people’s motivation to quit smoking, and that only nicotine gum and patches should be used as stop-smoking aids. The Food and Drug Administration’s attempt to have e-cigarettes labeled as drug-delivery devices failed last year, but the agency continues to warn that their safely has not been verified, and that they may entice young people to smoke.

E-cigarette proponents maintain that these devices may in some cases accomplish what no amount of hectoring, taxing, frightening images of people smoking through a tracheotomy, or banishing from public places can do: help people quit.

E-cigarettes worked for Darrin Gold, 41, a southern California real estate agent who happened upon an electronic cigarette kit at 7-11 almost a year ago when he stopped in to replenish his cigarette supply as had been his intractable habit for 27 years.

“The kit cost about 20 bucks, and I was spending 60 bucks on a carton of cigarettes, so I figured I’d try it,” he said.

Next month will mark one year since he has had a cigarette.

Like many smokers, Gold had tried to quit multiple times without success, using the nicotine patch and gum, and going cold turkey. Nicotine gum gave him headaches from chewing it too rapidly, which delivers too much nicotine too quickly. He said the nicotine patch produced a rash.

Gold still uses an electronic cigarette that delivers a small amount of nicotine, but said he will eventually dial the e-cigarette down until it delivers no nicotine. “I’ll continue to enjoy vaping for the flavor and the habit,” he said. Including e-cigarettes in stop-smoking ammunition is OK with Richard Fischel.

“Anything that can make people quit is a good thing,” he said. “Whether it’s gum, medication, hypnosis, or a support group so that you don’t feel alone. If that’s what you need to help you break the addiction to nicotine, fantastic. The more things there are to help people quit, the better.”

Have you quit smoking using the nicotine patch or gum, cold turkey, or e-cigarettes? What helped you the most? If you’re still a smoker but would like to quit, tell us what gets in your way.

Ricardo Torres November 14, 2011 at 05:26 PM
I quit smoking the day I got my E-cigg in the mail, it's been almost three months now. I can't imagine going back to tobacco ever!
Matt Zukowski November 14, 2011 at 05:52 PM
Took me about a month to transition over to e-cigs. But in Feb2011 I went from a pack/day to a pack that month. So I can't honestly say I quit the day I got my starter kit in the mail. But after 30 years of smoking, and the patch, gum, Zyban, e-cigarettes were full of win.
Mike Craig November 14, 2011 at 08:23 PM
Nicotine Anonymous is a twelve-step recovery program adapted from Alcoholics Anonymous. The only requirement for membership is a desire to stop using nicotine. Our fellowship defines "abstinence" as a state that begins when all use of nicotine ceases. There are no dues or fees, but we are self-supporting through our own contributions. Our program of recovery consists of the Twelve Steps and Twelve Traditions and five "tools" - meetings, sponsorship, literature, the phone list, and service. There are two meetings weekly in South Orange County: Sundays 5:00 pm at St. Georges church, 23802 Avenida De La Carlota, Laguna Hills, CA 92653 Wednesdays 7:30 pm at Wells Fargo Building (upstairs conference room), 32222 Camino Capistrano, San Juan Capistrano, CA 92675
Paige Austin November 14, 2011 at 09:55 PM
It's really that good? I know people who have been smoking for decades, and I would love to get them the E-Cigg if it works. How long have you been off tobacco?
Rodger Higgins November 14, 2011 at 10:10 PM
I believe if they tax the hell out of people who smoke they better damn well do the same to alcohol and perfume. Cigarette smoke is obnoxious but so are people who drown themselves in perfumes and colognes. The drinkers that cause accidents should be made to pay $11.00 per bottle of beer and $15.00 per shot of alcohol minimum.
Michael Long November 14, 2011 at 10:33 PM
Mike Craig.... You do realize that nicotine is not the actual problem here. Caffiene is as addictive and can be as deadly. Nicotine is found in naturally growing vegetables that we eat. One of which is the tomato, another is eggplant. So, I would figure that your program, since it does call for all nicotine abstinence, to deny yourself those foods made with select vegatables that happen to contain nicotine? The smoker is not only addicted to the nicotine in the tobacco, but also to other compounds that are made when the tobacco is combusted and inhaled. But I would figure that research into things are not what you do there. Also research this also, uses of nicotine in Alzheimers patients. That probably puts a nice thorn in your side. Thinking, wow.... we are trying to get people off of nicotine and the health officials are making it in pill form. Oh, but who am I anyways.... I am a user of the Electronic Cigarette. I smoked for 20 years, watched my mom die of cancer from smoking. Tried numerous times to quit, patch, gum, everything else.... except for a program like yours where I would probably just feel like an idiot. The first day I recieved my starter kit I stopped smoking. First DAY. Yes I did start at a higher level of nicotine, but have bumped it down to a nominal level. AND I can go to ZERO nicotine. Thats all fine and dandy, but you'll never get me off of eating tomatoes or caffine. See, We all get our nicotine from somewhere.
met00 November 15, 2011 at 06:47 AM
"443,000 people die prematurely from smoking or exposure to secondhand smoke" May I call BS on this? The WHO first and most comprehensive study on ETS: http://www.ncbi.nlm.nih.gov/pubmed/9776409?dopt=Abstract - The study found no Dose/Response relationship for spousal ETS exposure - The RR for workplace ETS was 1.17 with a CI of .94 - 1.45, well below the preferred 2.0 - 3.0, and with another CI that straddled 1.0. - the RR for exposure from both a smoking spouse and a smoky workplace was 1.14, with a CI of .88 - 1.47. On March 8, 1998, the British newspaper The Telegraph reported "The world's leading health organization has withheld from publication a study which shows that not only might there be no link between passive smoking and lung cancer but that it could have even a protective effect." ETS (second hand smoke) may stink, may be annoying, but the WHO study shows that it ain't gonna hurt ya (and may actually help kids). As for smoking tobacco hurting you... see next post...
met00 November 15, 2011 at 07:13 AM
Tobacco product are not all the same. The Federal Cigarette Labeling and Advertising Act of 1965 and the Public Health Cigarette Smoking Act of 1969. created a new class of tobacco products. Manufactured tobacco. That uses synthetic nicotine (nicotine in natural tobacco varies in rates, and the labeling act required known amounts of nicotine within each manufactured cigarette) Natural tobacco contains nicotine, a natural substance that occurs in nature. Manufactured tobacco contains a man made chemical compound in the nicotine family. In other words, the chemical bonds between the two are very different, and therefore react differently at the cellular level. The difference between synthetic and natural nicotine can be seen in studies that show that natural tobacco users cancer remains a steady percentage of the users over time, while over time those that use synthetic nicotine have an increasing percentage of cancer rates among users. Much as there is "good" and "bad" cholesterol, there is a difference between the natural and synthetic nicotine. While I won't say that nicotine is "good", I will say that synthetic nicotine is very, very bad. As for the greatest "problem" with natural nicotine, it is that it makes blood platelets stick together. Much in the same way that sugar does. In fact, of the two, sugar is far worse. So, if you are going to smoke, grab a pipe or cigar. Cigarettes will kill you. A good cigar is no worse than a cup of coffee, sweet and light.
met00 November 15, 2011 at 07:22 AM
Taxing tobacco products is not going to get people as upset as taxing alcohol. In fact,if the taxes on alcohol were increased at the same rate as tobacco over the last 50 years, a can of beer would cost over $10,00, wine would cost over $20 more for an average bottle and spirits would be over six times their current cost. But the spirits, wine and beer industries have very powerful lobbying groups. So all tobacco products have been taxed through the roof, while spirits, wine and beer have not. and since I have a mild allergic reaction to most perfumes don't get me started on that thread...
met00 November 15, 2011 at 07:32 AM
Oh heck, one story won't kill me... I was at a very nice resturant in the Seal Beach / Los Alamitos area seated after a 20 minute wait. We had ordered our meal and just started our appetizers when another party was seated at the table next to us. The lady apparently had bathed in ode-de-stink and my allergic reaction started to kick in. I called over our waitress and asked if they could reseat the other guest. The owner came over and said that they would be glad to reseat my table, but I would have to wait another 10 minutes or so. I pointed out that I was in mid-meal, and that they had best reseat the other table. The owner said that the other guests were regulars and had waited for that specific table and asked if I would rather stay at my current table, or be reseated. I told them to cancel the balance of my meal, give me the check. I paid and then I wrote reviews of the experience on a number of on-line sites. I still wonder what they would have done had I just decided to light up and smoke my cigar.
Treacy Colbert November 15, 2011 at 03:25 PM
Hi, all. Thanks for taking the time to read and respond. The data on secondhand smoke is the latest from the CDC. Best of luck to all who try to give up smoking on Great American Smokeout day, or any day for that matter. Having witnessed someone dear to me die of lung cancer, I'm all for anything that helps people quit.
Mike Proctor November 15, 2011 at 06:05 PM
You're like the peanut alergie people....everyone has to change, or conform because of a small percentage of the population. You have to be kidding, you expected a restaurant manager to ask a table to move because you are alergic to the persons perfume. You have some serious gaul. The manager handled it perfectly, and you as a patron, did what you should have done if you were not happy, pay the bill and take your business elsewhere. Sorry you have allergies, but thats your problem, not the the publics problem.
Tonto November 16, 2011 at 05:57 AM
I think they drink to much worrying about taxes already. Reduce taxes and they won't be driven to drink by the government :)
met00 November 16, 2011 at 06:12 AM
Why bother reading the World Health Organization report that they buried when it wasn't politically correct. No study to date comes close to the WHO report quoted above in terms of the quality of the work. But since it defies the conventional wisdom, and the political correctness, there is no good reason to consider it. You're a reporter, aren't you even a little bit curious as to why the report that disagrees with all the politically correct data was buried?
Tonto November 16, 2011 at 03:11 PM
Its time to outlaw fat people under the same concepts. Enough is enough !!!
Treacy Colbert November 17, 2011 at 01:33 AM
Hi, met00, Here's the current WHO statement on secondhand smoke: Second-hand smoke accounts for one in 10 tobacco-related deaths. Creating 100% smoke-free environments is the only way to protect people from the harmful effects of second-hand tobacco smoke.
met00 November 17, 2011 at 04:06 AM
Right. And that is based on completely ignoring their own research and adopting the US method (EPA 1993 study). The 1993 EPA Study was a Meta Analysis, an analysis of existing studies. The term "Meta Study" is often used to describe this type of report, but the word "study" is inaccurate. The EPA has never conducted nor financed a single ETS study. They have only analyzed the studies of others. On page 23 of the study, paragraph 3, the Congressional Research Service noted that out of 30 studies, only five found a statistically significant risk at the 95% confidence level, and one showed a statistically significant negative risk (a protective effect). The remaining 24 studies showed no statistically significant increase or decrease in risk. So how did the 93 EPA get to be the gold standard? The EPA ignored nearly two-thirds of the data. The EPA doubled their margin of error to come up with their desired results (moving the CI to 90% rather than the standard 95%). Even after manipulating the meta-analysis the 93 EPA came up with an RR (Relative Risk) of ETS causing lung cancer 1.19. A RR of less than 2.0 is usually written off as an unimportant result. An RR of 3.0 or higher is considered desirable. In 1998 Judge William Osteen vacated the study - declaring it null and void after extensively commentating on the shoddy way it was conducted. His decision was 92 pages long. Yet the 93 EPA is still the gold standard and used to support all the ETS lies.
Nancy Wride (Editor) November 20, 2011 at 11:29 PM
I wish I knew what the secret to my quitting was, because I tried for years. But a key thing that altered things for me was that I got tired of having to go outside my workplace to huddle and felt like an outcast. So I do think reducing the number of public places on can smoke is effective. It has been more than a decade and the public warnings did wear me down, but in the end none of that knowledge helps once you start. I was idiotic to start smoking as a teen when my mother was suffering from cancer. I try to impress on my child that this is one where there is no safety net. In our gene pool, you start, that's it.


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