“The Truth about Addiction and Recovery,” pgs. 95-99
Addicts themselves said crack cocaine was easier to quit than smoking cigarettes. This information was based on a number of surveys of addicts and alcoholics in treatment. In a study published in the Journal of American Medical Association, for example, 1000 people who sought treatment for alcohol or drug dependence at the Addiction Research Foundation in Toronto we're questioned. Although these patients usually rated cigarettes as being less pleasurable than alcohol or drugs, 57% said that cigarettes would be harder to give up than the substance for which they were seeking treatment.
When we speak at addiction conferences, we ask the audiences – consisting largely of counselors and members of A.A. and similar programs – what drug they think is the hardest drug to quit. Nearly all shout out, "cigarettes!" We then ask how many of them have quit smoking. Usually from 1/3 to 1/2 of those presents have done so. Finally, we ask how many used a treatment program to quit. At most, a few hands go up. In audiences where more than a 100 people have quit smoking, we sometimes find no one who relied on a formal program to do it. Thus, an audience of people committed to the disease – treatment model have just told us that a very large number of them have given up an addiction tougher than drugs or alcohol without treatment.
The ex-smokers in these audiences are representative of smokers in United States as a whole. The Office on Smoking and Health reports that 45% of all Americans (and 60% of college graduates) who have ever smoked no longer do so. By now, 30% of adult Americans – more than 40 million – or former smokers. What's more, 90% of those who have stopped smoking have done it on their own.
The 1987 Surgeon General's report, Nicotine Addiction, announce that cigarette smoking is as addictive as heroin, cocaine, and alcohol. We have seen this is true. Former Surgeon General C. Everett Koop had the admirable goal of informing the public that addiction is not associated only with illegal substances and tobacco companies are purveying a highly addictive substance. Unfortunately, another message many derived from this report is that cigarettes must be awfully hard – perhaps impossible – for smokers to quit on their own.
This is certainly a point that various medical treatments and smoke ending programs try to drive home in the advertisements. For example, Merrell Dow Pharmaceuticals has for a number of years taking out full-page ad's proclaiming that "physical dependence on nicotine" is the major factor in people’s smoking habits, and that because the unpleasant sensations of nicotine withdrawal "can defeat even a strong willpower, your chances of quitting successfully are greater with a program that provides an alternative source of nicotine…" This ad is meant to encourage people to have their doctor put them on Nicorette, a nicotine gum marketed by Merrell Dow.
A research team studied the effectiveness of Nicorette therapy published the results in the Journal of American Medical Association. In the study, 10% of those receiving the nicotine gum and 7% of those receiving a gum that didn't contain nicotine we're still not smoking after year. The researchers concluded that the value of Nicorette in helping people quit smoking permanently is "either small or nonexistence." This conclusion was criticized by a Dow spokesperson, who said the calling the gum ineffective because people were smoking year after using it was “like blaming an anti-depressant [drug] if a person gets depressed again a year after discontinuing the drug." Must people continue taking Nicorette in order to stay off cigarettes? Is this the purpose of the treatment not to free people from nicotine addiction, but simply to have them chew it rather than smoke it?
Many people have ignored the importuning’s of Merrell Dow ads: "if you want to quit smoking for good, see your doctor." Schacheter, a Columbia University psychologist, found that more than 60% of the people he polled in two communities who had tried to quit smoking had succeeded. These people, on the average, had not smoked for more than seven years. Heavier smokers (three or more packs a day) were just as likely to have quit as lighter smokers – thus disproving Schacheter own previously stated view that heavy smokers are permanently "hooked" on nicotine.
The most comprehensive survey of American smoking, conducted by the Office on Smoking and Health at the Centers for Disease Control, strongly supported Schacheter results. Writing in the Journal of American Medical Association, the researchers summarize their investigation of the methods used by 40 million Americans who have quit smoking:
Daily cigarette consumption [that is, how heavily people smoked] did not predict whether persons would succeed or fail during their attempts to quit smoking. Rather, the cessation method used was the strongest predictor of success among smokers who attempted cessation within previous 10 years, 47.5% of persons who tried to quit on their own were successful whereas only 23.6% of persons who used cessation program succeeded.7
This does not mean that those who quit on their own find it easy to do. It does mean, however, that the amount of assistance a formal program can give on such a perilous journey is limited, and even counterproductive. For example, far from being helpful, Nicorette therapy produced results in the clinical trial in which 10% of smokers quit that are worse than those of other therapies, or of peoples efforts to quit on their own. In the Centers for Disease Control study that found people are twice as likely to succeed when they quit on their own as when they seek treatment, nicotine gum therapy was at least successful treatment of all.
The problem is that many people believe the ad for Nicorette programs that the treatment will get them off cigarettes without any effort on their part. Imagine the difference between two people who want to quit. The first says, “I must quit smoking now or I’m going to kill myself.” The other person says, “I’m afraid I won’t be able to stand the discomfort o quitting. I hear they have ways of making withdrawal painless.” As a result, the second person signs up for a medical program that promises to minimize withdrawal discomfort. Who do you think is more likely to succeed? By holding out the prospect of some magical, medical way of getting off cigarettes, the treatment program actually undercuts the key to quitting: that is, the realization that you yourself much confront and overcome the discomfort of being without cigarettes.
How do smokers actually quit on their own? In Schachter’s study:
Roughly two-thirds reported that their only technique was Deciding to stop. 8
No techniques can substitute for the inner personal reorientation that is the key to quitting.
If one smokes 1 pack a day, here is the breakdown of their repetition of the behavior:
20 drags to finish a cigarette x 20 cigarettes per pack = 400 drags per pack per day
400 drags per day x 7 days = 2,800 drags per week
2,800 drags per week x 52 weeks (1 year) = 145,600 drags per year
145,600 drags per year x 10 years of smoking = 1,456,000
Repetition Deepens the Impression or Strengthens the Behavior. Imagine if you told yourself you are brilliant 400 times a day or that you are good person 400 times a day or that that you can do the task you’re dealing with 400 times a day? It would be life changing!
Those who smoke Vapes said they hit them around 700 times in a day. *Wasatch Recovery