Talk:Smoking cessation

Deleted "Unsuccessful methods" section

I just deleted the Unsuccessful methods section header and moved its contents to the Cessation Methods (or whatever it was called) section. "Unsuccessful" is quite the value judgement to apply to alternative medicinal methods of quitting smoking including herbal cigarettes; if Big Pharma gets represented in the "legitimate" section of the article while others are excluded, that creates bias within the article. 99.245.254.91 (talk) 01:27, 27 June 2010 (UTC)

Better version of this section

This shorter version goes directly to the health effects in explaining why people try to quit. The current article focuses on market products containing nicotine, even though they have a poor record of curing nicotine addiction. For instance in confounding studies where nicotine was combined with much more effective means, such as antidepressants and/or counseling the larger effect is attributed to the nicotine, not the antidepressant. The overall article markets nicotine products in text and image selection.

A 'No Smoking' sign

Smoking cessation is the effort to stop smoking tobacco products. Nicotine is an addictive substance, especially when taken in by inhaling tobacco because of the rapid absorption through the lungs. Tobacco use is one of the major causes of death worldwide, according to the World Health Organization.

Description

Research in Western countries has found that approximately 3-5% of quit attempts succeed using willpower alone (Hughes et al, 2004). The British Medical Journal and others have reviewed the evidence regarding which methods are most effective for smokers interested in breaking free of the smoking habit, and concluded that

Nicotine dependence is most effectively treated with a combination of drugs and specialist behavioural support ...

(Managing smoking cessation | Paul Aveyard, National Institute of Health research career scientist, Robert West, professor of health psychology and director of tobacco studies | Clinical Review | BMJ 2007; 335:37-41 (7 July) | doi:10.1136/bmj.39252.591806.47 | http://bmj.bmjjournals.com/cgi/content/full/335/7609/37?fmr )

As detailed in the Statistics section below, multi-session psychological support from a trained counselor, either individually or in groups has been shown in clinical trials to provide the greatest benefit.

An even better chance of success can be obtained by combining medication and psychological support (see below) (USDHHS, 2000). Medication or pharmacological quitting-aids that have shown evidence of effectiveness in clinical trials include medical nicotine replacement patches or gum, the tricyclic anti-depressant nortriptyline, bupropion (Zyban, or Quomem in some countries), and the nicotinic partial agonist, varenicline (Chantix in the US and Champix elsewhere).

There are many people and organizations touting what are claimed to be effective methods of helping smokers to stop. Any smoker thinking of paying money for such help would be well advised to ask whether the claims of success are backed up by independent comparative clinical trials, how the success rates have been calculated and what numbers of smokers have been included in the figures. It is very easy to make misleading claims of success rates which are not adequately supported by evidence. A separate thorough review of the evidence for each of several methods and aids for stopping smoking is available via the Cochrane Library website, Cochrane Library.[3] ( Cochrane Topic Review Group: Tobacco Addiction http://www.cochrane.org/reviews/en/topics/94.html )

A range of population level strategies such as Anti-smoking advertising (http://en.wikipedia.org/wiki/Tobacco_advertising#Anti-smoking_advertising), smoking restriction policies, and tobacco taxes have been used to promote smoking cessation. Of these, raising the cost of smoking is the one that has the strongest evidence (West, 2006).

Smoking cessation will almost always lead to a longer and healthier life. Stopping in early adulthood can add up to 10 years of healthy life and stopping in one's 60s can still add 3 years of healthy life (Doll et al, 2004). Stopping smoking is also associated with better mental health and spending less of one's life with diseases of old age.

The most effective programs for stopping smoking include strategies for dealing with common short-term side effects such as transient increased irritability, depression, anxiety, restlessness, difficulty concentrating, increased appetite, constipation, mouth ulcers or increased susceptibility to upper respiratory tract infections. The side effects are mostly gone within four weeks, though increased appetite typically lasts for more than 3 months. The most obvious adverse longer-term effect is weight gain (Hughes, 2007). Overcoming these temporary challenges is rewarded by the immediate enjoyment of lasting benefits including freedom from smoking and tobacco addiction, savings, health, and improving quality of life.

Statistics

A U.S Surgeon General's report includes tables setting forth success rates for various methods, some of which are listed below, ranked by success rate and identified by the Surgeon General's table number.

• Quitting programs combining counseling or support elements with a prescription for Bupropion SR (Zyban/Wellbutrin) found success rates were increased to 30.5 percent, (Surgeon General's Table 25, page 72).

• Quitting programs involving 91 to 300 minutes of contact time increased six month success rates to 28 percent, regardless of other quitting method included Surgeon General's Report Table 13, page 59]

• Quitting programs involving 8 or more treatment sessions increased six month success rates to 24.7 percent (Surgeon General's Table 14, page 60)

• High intensity counseling of greater than 10 minutes increased six month success rates to 22 percent whether added to any other quitting method, nicotine replacement, or cold turkey Surgeon General's Report Table 12, page 58]

• A physician's advice to quit can increase quitting odds by 30 percent to ten percent at six months Surgeon General's Report Table 11, page 57]

• Just Seven percent of over-the-counter nicotine patch and gum quitters quit for at least six months

This article doesn't seem very good to me

This article seems to me to contain far too many of what I can only term "lists of ideas" with no judgment or evidence.

I just removed a link from the article not because it is necessarily a bad link (it might be, though) but because it seemed more or less placed randomly and might be spam. (Please put it back if there's a good reason for it...)

I wonder what we can do to improve this article.--Jimbo Wales (talk) 02:44, 15 May 2010 (UTC)

To give an example of what I mean by "lists of ideas" check out the Intervention and Prevention section. It just lists a bunch of possibilities with no information at all. Most of the other sections are similar.--Jimbo Wales (talk) 02:47, 15 May 2010 (UTC)

I agree with you. This article needs work. One problem is that it uses public domain information from the U.S. Surgeon General, but that information "did not examine evidence regarding unaided quit attempts". The PLoS study, which is Creative Commons text and also usable, is named "The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences" (which points in my mind to the U.S. government file as being sadly lacking). -SusanLesch (talk) 01:40, 21 May 2010 (UTC)

Removed "Programs" section

Pfizer and its drug was already mentioned throughout the article, appropriately so. There is no reason for a separate section for it. —Preceding unsigned comment added by 189.27.252.197 (talk) 21:48, 6 June 2010 (UTC)