Help may not be a patch on willpower when giving up smoking
But what if nicotine replacement therapy was really a perfidious ally, capable of understanding and support, but also apt to undermine?
Simon Chapman believes scientists, governments, and smokers themselves have fallen too hard for the nicotine replacement doctrine.
The professor in public health at the University of Sydney, who is a long-time anti-smoking advocate, says the pharmaceutical industry’s line that gums and patches improve the likelihood of a successful attempt to quit may be true in the rarefied world of clinical trials, where smokers receive their products free and have their progress painstakingly monitored by researchers.
But it ignores the evidence that up to three-quarters of former smokers have quit without formal assistance, Chapman says, and in most cases without much difficulty.
The Nicabate and Nicorette franchises of GlaxoSmithKline and Pharmacia & Upjohn are highly visible juggernauts. . . .
But a trawl this week through health campaign websites reveals some messages that would surely delight sponsors of nicotine replacement therapy.
NSW’s Quitline, for example, urges smokers to “Plan ahead to deal with temptation. Keep a record of every cigarette so that you can identify certain situations where you feel tempted … You should also speak to your doctor to discuss the different medications that are available that can help you stop smoking.”
Chapman says the idea that giving up needs to be approached as a precision exercise, complete with diary, does not stack up. He says smokers should be told that many people who quit unassisted do so on a whim, without planning, and most find it less traumatic than they expect. . . .
Chapman believes it is therefore not unreasonable to recommend multiple approaches, including nicotine replacement for those well suited to it.
But that is an argument that fits Australia and other rich developed nations much better than it does poorer countries
