Up in smoke: Which smoking-cessation products really help smokers quit?
Forty-four-year-old Joan Leigh has been smoking cigarettes most of her adult life and has been trying to quit recently. For years, she saw smoking as “cool,” emblematic of her engraved tin box where she stored her smokes. But middle age has crept up on her, and between coughing fits and her teenager’s constant entreaties, the idea of quitting is starting to gain sway.
Cigarettes are used by nearly 38 million Americans, and smoking claims nearly half a million American lives each year — 1,300 a day — making tobacco use the leading cause of preventable disease and death in the United States.
[Read more: Kroger pharmacies add smoking cessation services in 2 states]
Not interested in becoming a statistic, Leigh turned to patches. This discreet transdermal solution delivers the addictive nicotine into her body while it prevents the assault on her lungs. She has also looked at CBD — a study in England gave smokers a CBD vaporizer to use when the urge struck to smoke tobacco cigarettes; those dozen smokers who used CBD smoked 40% fewer cigarettes compared to the placebo group over the course of a week.
Do e-cigs work?
Other studies have investigated whether electronic cigarettes can help cigarette smokers quit. These e-cigs contain nicotine only (plus carrier oils, typically propylene glycol and glycerol).
Researchers from Harvard and the U.K. conducted a meta-analysis of 50 studies representing more than 12,000 smokers. They focused on four studies with “moderate-certainty evidence” showing nicotine vapes led to an additional four per 100 smokers to quit, with effects lasting at least six months.
Four out of 100 may not sound like a lot, but only 7.5 out of 100 smokers successfully quit every year, according to the Centers for Disease Control and Prevention. This is important work because healthcare providers and regulators remain uncertain if e-cigs can truly help smokers quit, and if they can do so safely.
The FDA took aim at e-cig market leader Juul, which had 50% market share, and then on July 6 suspended its order to stop the company from selling its vaping products pending a review. Juul would like to define its wares as a “switch” product — i.e., it helps switch consumers away from smoking tobacco with arguably a healthier alternative. The FDA and others, meanwhile, blame it for appealing to chil-dren — despite a ban on all smoking and vaping products for those under age 21.
Other nicotine replacement therapy, or NRT, approaches include using nicotine gums and reducing tobacco use.
A group of British researchers scanned the evidence base and found NRT reduced by half the number of cigarettes smoked daily. Adding talk therapy to the mix also significantly reduced the number of cigarettes smoked but had no effect on absolute cessation. Overall, however, the researchers concluded that the medical literature remains “inadequate” to make firm conclusions.
FDA considers low-nic cigs
Reducing the amount of tobacco in cigarettes is a new approach. On June 21, the FDA proposed a rule that would require tobacco companies to make cigarettes less addictive by cutting the amount of nicotine in them.
The new standard could take many years to come to fruition, and it could be scrapped altogether as not all big tobacco companies are exactly on board.
Yet one tobacco company, 22nd Century Group, is already test marketing in Chicago-area Circle K stores modified-release tobacco products, or MRTP, that contain 95% less nicotine.
[Read more: Dr. Reddy’s adds store-brand Nicorette lozenges]
“VLN from 22nd Century offers a new approach in this fight,” said John Miller, president of 22nd Century’s tobacco programs, “a tobacco cigarette that actually helps adult smokers reduce their nicotine consumption and smoke less.”
For Leigh, the quest to quit continues. The health statistics are too hard to ignore. Yet so is the pull of nicotine. Patches remain her go-to solution for now. If nothing else, it helps her lungs, her breath smells better and there are fewer butts in the world. It helps her live on to fight another day.
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22nd Century Group VLN -
Juul Device -
GSK Nicorette Gum -
Habitrol Nicotine Transdermal System Patch
Product Picks
22nd Century Group VLN, SRP: $9 to $12, depending on tax
These normal-looking cigarettes contain tobacco bred to have only 5% of the nicotine in traditional cigarettes. VLN had to go through clinical trials and testing by regulators to receive a “reduced-risk” tobacco product designation by the FDA. A national rollout is expected by the end of 2022.
Juul Device, SRP: $9.99
It kind of looks like a computer memory stick, and in fact it comes with a USB charging dock to keep the vaporizer going. It’s so popular it had 50% market share of e-cigs — until the FDA began its aggressive crackdown on vapes, starting with flavors seen as appealing to children, and potentially the entire category. For now, though, the products are still available; evidence suggests e-cigs may be healthier and may help adults quit.
GSK Nicorette Gum, SRP: $55/110 count
Nicotine gum comes in two strengths, 2 mg and 4 mg. For those who like to wake and smoke, the larger dose is better. Gums are also sometimes used in conjunction with patches, with gum employed during cravings. It is also recommended to not eat or drink for 15 minutes before or during chewing. For best results, counsel customers to do the “chew and park” — bite down slowly, then hold it in between the cheek and gums for a good minute.
Habitrol Nicotine Transdermal System Patch, SRP: $119.99/56 patches (eight-week kit)
For serious smokers, who inhale more than 10 cigarettes a day, this three-step patch system also includes a behavior support program self-help guide. The first step is a high dose of nicotine, used for four weeks. Step two lowers the dose for two weeks, and the third weans users to mild doses for an additional two weeks.