Smoking: Quitting is so hard

http://www.economist.com/news/leaders/21657391-everybody-now-knows-how-people-can-be-persuaded-stop-smoking-so-all-countries-should-be-doing

by paublyrne • 11 years ago

33 77 11 years ago

economist.com

snarfy3• 11 years ago

The most effective measure against smoking is taxation.

I hate this method of behavior control. It's always a disproportionate tax on the poor and yet another reason why if you are rich the rules don't apply to you.

toomuchtodo• 11 years ago

Do you have a better way to convince people not to smoke?

snarfy3• 11 years ago

It's an addiction. There is no convincing. That's not how addiction works. What does need to happen is people need to be convinced to never start smoking. Taxing the existing addicts does nothing for this.

amelius2• 11 years ago

I know one way: depict smokers as unlikeable beings in popular media, instead of the other way around.

tmvphil• 11 years ago

And yet it is empirically effective. What alternative would you suggest? It's true that rich people are not burdened by cigarette tax, but then again smoking rates are already much lower among the rich (at least in the US).

vezzy-fnord• 11 years ago

What alternative would you suggest?

Banning it.

I'm not even joking. If your only goal is to lower consumption rates, prohibition works. If you use cirrhosis deaths as a proxy, then alcohol consumption declined during the Prohibition era. [1]

The problem, of course, is everything else that happens in the wake of enforcing it.

An alternative option is to do nothing, because it's kind of a bikeshed issue, anyway.

[1] http://pubs.niaaa.nih.gov/publications/arh27-3/209-219.htm

rory0962• 11 years ago

Tax and dividend. Don't toss Pigovian tax money into the general fund, return it to the people by sending everyone a check for their share. Solves progressivity, forms the basis of a basic income, and ideally directly defrays some of the damages from externalities. (Last is somewhat less true with tobacco, where the biggest externality tends to be health problems that society ends up paying for.)

learnstats2• 11 years ago

I would note that the negatives from smoking generally fall disproportionately on the poor.

If you are unsuccessful at discouraging people from smoking, people are going to pay more through health outcomes later on.

Health problems will be particularly difficult for poor people to overcome, even if they have help from the state (which may be increasingly over-burdened).

dazc2• 11 years ago

I have a friend on a very low income - most of which he spends on alcohol and tobacco. When he runs out of money he borrows it to fund his bad habits.

High taxation hasn't help him. I'm not sure anything would?

cmdrfred4• 11 years ago

People often forget the hidden costs of what your friend does. The taxes exist to defer those costs to people who actually attempt to make a life for themselves.

jokoon4• 11 years ago

* smoking is recreational, its not a necessary expense

* the rich pay the tax too

* it has a cost and is a nuisance to others

* some countries fund the health programs caused by smoking thanks to those taxes

* you got to stop finding excuses about smoking, smokers are addicts, society must be intolerant towards regular smokers. I went through passive smoking as a kid, believe me, its awful.

perfTerm4• 11 years ago

Rich people are far less likely to smoke, and when they do they don't smoke enough to make up for the imbalance so this is by its very definition a regressive tax policy that affects lower class communities the hardest.

And I'm just not sure I can get down with your intolerance. Smokers are people too. I know a tremendous number of them having made friends with my working class neighborhood in Brooklyn as well as my father. Passive smoking sucks but shaming people who smoke isn't really the answer just like shaming people who are overweight is also a tremendously shitty thing to do.

Frozenlock2• 11 years ago

you got to stop finding excuses about smoking, smokers are addicts

So are coffee drinkers. Do you give them a hard time?

pessimizer7• 11 years ago

the rich pay the tax too

The rich don't pay the tax in proportion to their wealth, so it is by definition regressive. The rich will have a minuscule incentive to quit, while the poor will have a huge incentive to quit.

some countries fund the health programs caused by smoking thanks to those taxes

The poor shouldn't pay a higher rate to fund health programs than the wealthy.

willholloway5• 11 years ago

I've been able to get two people to quit smoking by giving them a superior option in every way, including the subjective effect and satisfaction that they feel: vaporizing a full spectrum extract of the tobacco plant.

Everyone has seen electronic cigarettes in convenience stores everywhere, and they are billed as smoking cessation devices. The problem with them lies in that they only contain nicotine. The tobacco plant contains other psychoactive alkaloids like anabasine that smokers are used to and enjoy.

Whole tobacco alkaloid is a new type of juice for these devices. The two smokers I helped quit hated regular e-cigs because they are lacking. Very quickly they preferred vaping WTA juice to smoking. Smoking is dirty, smelly and socially discouraged.

Give them a better option and they will switch in droves.

I've examined all the tobacco extracts on the market, and the cleanest by far comes from a guy named Jeff at wholecig.com

He created his own process using only non-toxic solvents, it takes him 4 days to make one batch. He is an innovator and a nice guy.

In the future no one will burn raw tobacco, they will vape a full spectrum extract.

Update: I got an email saying this was the best written ad he's seen in a while, and I wanted to publicly say I have no ownership in wholecig and am not employed by them. I called Jeff about an order and got to talking to him and we swapped chemistry notes, I really like the guy and want his business to succeed because I think he's doing gods work, and saving lives through innovation.

igravious2• 11 years ago

I hope that day comes soon. Convenience is key. I'd switch in a heartbeat. Juul claim something similar, they use nicotine _salts_ which they say give vapers a similar hit to smoking which they don't get with regular e-cigs. I'd not heard about anabasine (what are psychoactive alkaloids?)...

willholloway5• 11 years ago

Alkaloids are chemicals in plants, like caffeine for example.

Psychoactive meaning having an effect on the users brain.

keeran• 11 years ago

I'm always preaching this sentiment - it is far superior, yet it seems like most governments want to stamp it out before the mass market innovation really kicks in.

heythrowaway• 11 years ago

Is there similar for giving up (or at least reducing) alcohol consumption? Giving up smoking is easy (no vaping required), alcohol less so IMHO.

willholloway5• 11 years ago

Ahhh, the holy grail! I think there are a lot of people who would prefer an alternative to alcohol as a social lubricant.

I myself really detest the way even moderate amounts of alcohol make me feel the next day, and the effect of alcohol on my sleep.

Its all well and good to go out to a bar and not drink but you are on a different wavelength than the rest of the crowd and it's just not the same.

So not drinking definitely puts a damper on my social life in this small coastal village I live in.

You can try phenibut, and it will work as well for your purposes as anything else on the market.

its my second favorite nootropic from behind the iron curtain. Phenibut, as the story goes, was created for cosmonauts who needed something to calm the nerves while stuck in tiny metal capsules risking their lives. The existing drugs all dulled the senses. So phenibut exists as a kind of smart benzodiazepine alternative.

It is habit forming though and you want to avoid a dependency.

Update because I can't reply:

Phenibut is not a benzo, and I don't use it in place of alcohol, but for the questioner, its probably the closest replacement to alcohol that I know of, but still very different. And for those who would otherwise drink to relax a far healthier choice IMHO.

narag2• 11 years ago

There are vaporizers that can be fed regular tobacco:

http://vaponic.com/

That one is more intended for mj and needs a torch lighter, so I guess it isn't as convenient as electronic ones, but it's much cheaper.

Disclaimer: I quit smoking before, so I can't really talk from long time experience, just tested it once.

tjohns• 11 years ago

When you say you got two people to quit, does that mean they eventually gave up the e-cigarettes, or just that they've switched from one form of smoking to another?

If you're vaporizing tobacco extract, is that any better than smoking from a health perspective?

(On a related note, since you mentioned toxicity... the lack of any sort of standards or certification for e-cig "juice" really makes me nervous about the whole field. It wouldn't surprise me if some of the brands out there could cause damage to your lungs in the long term... we just don't know yet.

I've got a friend who makes juice as a business, and it really is just something done in his kitchen, and faith that his ingredients aren't harmful when inhaled.)

Hopefully this doesn't come off as sounding too critical. Just questions I keep thinking of, especially since I've had several friends go from non-spokers straight to using e-cigs (rather than using them to quit smoking), since they're promoted as being safe.

willholloway5• 11 years ago

One of them has been switching to patches with the intention of quitting.

I believe that damage to the lungs is a real possibility, especially if the voltage is too high in the coils.

I can see no possibility that vaporizing tobacco extract is more harmful than smoking raw tobacco, either from a lung health or a cancer perspective.

I think vaping wta is a prudent harm reduction technique.

kriro• 11 years ago

From memory, I think the points made about (teen smoking) smoking in "Tipping Point" were pretty good without thinking it through deeply (on my part). Cliffnotes I remember is that teens keep smoking because "cool people" smoke not because "smoking is cool" etc. I don't know how to attack the demand side but I guess some sort of reverse "Don't Mess with Texas" campaign could be a start.

Then again one of the appeals of smoking is the fact that it's rebellion of sorts so not sure any campaigns work.

Keep on hammering the supply side is the best bet I'd guess. The demand side seems really tricky.

tomjen34• 11 years ago

Smoking is a rebellion, but getting around that is easy. You just make smoking lame, something only a loser would do. Then you introduce another behaviour that the can substitute as a (safe) way to signal tribal belonging (which is what a rebel really wants).

WBrentWilliams• 11 years ago

I think the whole problem with the smoking debate is that neither side (pro and anti) are willing to embrace harm reduction, even though the market has introduced many methods to use nicotine and/or tobacco that, to one degree or another, do in fact reduce the harm caused by the manufactured cigarette.

The anit-smoking side views harm reduction as a movement that is completely against their efforts. To the anti-smoking side, vaping is the same as {cigarettes, cigars, pipes, shisha, snus, ...}. The anti-smoking side's stated agenda is absolute eradication of tobacco use in any form, and they've hit all fronts just short of prohibition.

The pro-smoking side take a small-l liberal view: People should be able to use tobacco. Their problem with harm reduction is that harm reduction is also against their stated goals. While the pro-smoking side will happily embrace vaping, they view it as yet another way to enjoy tobacco.

In the meantime, people like their vices. As an exercise, re-write the Economist article, but substitute "alcohol" for "tobacco". As I recall, there was such an article posted to HN that showed how journalism colors the perception of drugs by writing about alcohol use as if alcohol was a new drug, not a very old one.

Back to my point on harm reduction, I believe that sooner or later a stasis should be reached. Harm reduction will be embraced by both sides. I believe that the only way to reduce the negative effects of any substance use to a society is to teach the risks and the safest way to use the substance. I think that the end result will be an open market where the suppliers of the substance will sell their product in any way they can and a corresponding social pressure that pushes users towards more acceptable (less harmful) practices while supporting programs that allow for self-selected cessation.

DanBC• 11 years ago

One of the problems with harm reduction is that the tobacco industry has produced and sold products under the guise of harm reduction where those products have had no harm reduction benefit.

You take a normal cigarette and test the tar and nicotine content. You then take the same cigarette and piece small holes in the filter. This new cigarette will test as lower tar and lower nicotine, but when real humans use it (blocking the holes) it's the same cigarette.

Chewing tobacco was sold as a harm reduction measure - and it caused a lot of mouth and throat and bowel cancer.

Tobacco companies are scum. It's a good thing that people are sceptical of tobacco companies.

blackhaz• 11 years ago

Quitting is actually very easy. I quit smoking with the help of four things: 1) genuine desire, 2) vaping, 3) Alan Carr's book and 4) bubblegums. These four were the critical ingredients for me.

I think nobody can quit without having a genuine desire. I had my first kid born and not wanting him to inhale all this shit is a good genuine desire. (Even when you smoke outside on the balcony surrounding people get it, there's no escape. Everything else is a dumb excuse.)

E-cigarettes help to solve the aesthetic part of the equation - they take all the joy out. When you vape, you have the same doping effect except you realize what a pathetic f^H addict you are with all those batteries, cartridges, bottles of liquid and stuff. Bye-bye smoking with class.

The Alan Carr's book is a great help with the psychological aspect. From the perspective of hopeless addict (three packs a day) he tells you that quitting is very easy and it turns out to be indeed so. Carr also tells you to stop instantly instead of easing off. I got from smoking pack a day to vaping then chain-vaping and then I just quit right away. Carr also addressed one very important aspect for me as an IT guy: concentration. When I tried to quit smoking before I lost focus due to cravings and was afraid I could no longer work. Bullshit. Without cigarettes I am even more focused now. In the end you get more health, more focus, more stamina - more everything.

Finally, the bubble gum helped me to deal with the mechanical addiction. I wanted to smoke when I got into the car, when I got out of the car, after the lunch, and so on, so instead of smoking, I chewed spearmint bubblegum. Now I do without gum.

Good luck to everybody. It is indeed worth it.

cmdrfred4• 11 years ago

The most important point you have made is number one. Addiction isn't a magic spell that forces you to behave in a particular matter. Complicated behaviors require thought, thought can be reigned in with logic and introspection. People simply don't want to deal with the temporary discomfort of withdraw and prefer to continue what they are doing. "I'm addicted" makes for a nice excuse to tell yourself.

Remember the emotions that you feel were generated via random permutations of your genetic code. Logic was developed by Grecian scholars and continually improved by the best of us. Don't "Trust your gut", trust your mind.

pessimizer7• 11 years ago

"Genuine desire" stinks of the genuine belief that is supposed to make magic and prayer work. How do you know the desire wasn't genuine? Because the smoker failed to quit; Q.E.D..

conwaytwitty• 11 years ago

I stopped smoking by getting a prescription drug called Champix (apparently Chantix in the us).

The instructions tell you to pick a day to stop like 5 days after starting the drug, I think on day 7 I just didn't feel like smoking anymore. After the prescription ran out I started to crave cigarettes again but no where nearly as badly as going cold turkey so I just didn't smoke any more.

contingencies• 11 years ago

A broader spectrum of legally available, socially acceptable drugs would certainly negatively impact both smoking and alcohol consumption.

Really, both nicotine and caffeine are terrible stimulants, despite the fact that most people, especially city people and young people, seem to love stimulants. For example, chewing coca leaves or consuming coca-leaf derived teas is probably better for you than smoking (and certainly better for you than snorting cocaine). Coca Cola famously used to include coca leaves: why not re-legalize? Ephedrine is also a great natural stimulant, still consumed traditionally in China, Central and South Asia.

Alcohol is awesome socially at a certain range of intoxication, beyond that it gets progressively more terrible. However, many people who have tried low doses of empathogens such as MDMA believe they are better socially than alcohol. Many highly ranked medical professionals also believe that occasional use of these substances is less dangerous than alcohol.

But intelligent drug policy is unlikely to happen on a wide scale any time soon: like many major facets of our current international capitalist dystopia, there's far too many cashed up, cross-border, back-scratching mutual support networks with an interest in the status quo to easily facilitate change: for example existing cartels with near-monopolies on supply (and everyone they pay off), big pharma, the prison industry, and conservative politics.

PS. To quit smoking, have a child... you get free backup from hormone changes, and naturally wind up spending more time around non-smoking young parent types.

Thriptic2• 11 years ago

Really, both nicotine and caffeine are terrible stimulants, despite the fact that most people, especially city people and young people, seem to love stimulants. Ephedrine is also a great natural stimulant, still consumed traditionally in China, Central and South Asia.

While I agree that caffeine is less potent / enjoyable than ephedrine, it is far safer. I would certainly not advocate for widespread consumption of ephedrine, as overdose is far easier and more dangerous, especially if mixed with caffeine.

collyw• 11 years ago

I am not sure.

I have an electronic cig at the moment, as it's when I am drunk that I crave cigarettes the most.

wanting to give up smoking is a terrible reason to have a child, though I am sure that's not quite the way you intended that last part to come out.)

nitrogen2• 11 years ago

...that last part...

Deliberately inverting motivations or reversing cause and effect is a common form of humor. Another example: "If you want to wear your seatbelt, get into a car crash."

pessimizer7• 11 years ago

Ephedrine is also a great natural stimulant, still consumed traditionally in China, Central and South Asia.

It is also a stimulant that we used to use in high school; stay up for days tweaking, thinking that spiders were in our hair. It also makes a great precursor for crystal meth, which is why it is a controlled substance.

tombrossman• 11 years ago

I'd been smoking about a pack a day for 15 years when I started seeing electronic cigarettes. They were a bit expensive at first, but once the prices started to come down I couldn't resist trying one. I like electronic gadgets and the idea of trying these (and being able to smoke in even more places) was appealing. I had no intention of quitting when I bought my first one, it hadn't even occurred to me.

Gradually the convenience of the electronic cigarettes shifted my habit away from regular cigarettes, and I found myself rarely lighting up a normal one. I also would take fewer puffs, I might do one or two drags and put it down absentmindedly, not thinking about smoking for a while after. It was 100% on-demand, no urgency to finish something lit.

I tell people I 'accidentally quit' now, since I just gradually weaned myself off tobacco and nicotine. I haven't smoked or used electronic cigarettes in about eight years, and the cravings are gone. I liked smoking and I might consider going back to it if the health risks disappeared due to advances in medicine.

I wonder why the medical community hasn't done more to embrace electronic cigarettes as a 'safer' alternative or method of quitting. Addicts of other drugs are treated using the same model. I don't expect them to embrace it as a safe alternative, but I think they could help others quit or reduce their traditional cigarette smoking habits.

tomjen34• 11 years ago

The only reasons I can come up with is lobbying by stop smoking groups and stupid politicians.

dragonwriter• 11 years ago

The medical community hasn't embraced e-cigarettes as a safer stop-smoking aid because there is only intuitive speculation and some preliminary research, but not substantial clinical research, that they are useful in that role, while other smoking cessation approaches, including those using more established alternative nicotine delivery methods, are more proven.

woah3• 11 years ago

Anecdotal evidence from many people, myself included, suggests that they are far more effective.

perfTerm4• 11 years ago

Is the medical community allowed to embrace something for which we as a society don't really know any of the long term consequences?

Will these candy flavored vaporizers get more kids addicted to nicotine?

Do people consume more nicotine with these vaporizers than if they had continued smoking cigarettes?

Is long term nicotine vapor inhalation harmful?

narag2• 11 years ago

1 - Embrace? What about just not being overly hostile?

2 - Are kids allowed to smoke? Should we ban sweet wine?

3 - No. Actually less.

4 - Most likely. But the question is if it's more or less harmful than burning packaged cigarrettes.

It shouldn't matter, but I don't smoke or vaporize tobacco.

perfTerm4• 11 years ago

For anyone who would like to quit smoking, "The Easy Way to Quit Smoking" read in one sitting is what did it for me. I went from a pack every three days or so for a few years to nothing in four hours. No patches. No smokes. No vaporizing.

Sounds like magic but it's just a damn good book.

tomjen34• 11 years ago

No it is easy. All you gotta do is want it.

Most addicts don't want to, probably because they enjoy it.

So try to convince them to start vaping instead - much the same hit, much less cancer.

d-equivalence• 11 years ago

Allen Carr's Easy Way to Quit Smoking. Be careful cause it works like magic only the first time.

curiousjorge• 11 years ago

In my experience, being broke forced me to quit smoking. It narrows your choices down to one possible outcome. You simply can't afford $15 for 20 cigarettes.

pessimizer7• 11 years ago

I recommend using Swedish snus to quit; it worked for me, and when I was using it, I had to bulk import it from Sweden rather than it being available at every 7-11.

First tried it out of curiosity when I was at a tobacco shop and saw the strange cans in a tiny refrigerator behind the counter, and before finishing the can, noticed I had been completely forgetting to smoke (20 year 1 pack a day habit.) I had accidentally quit within 2 months.

2 years later I quit snus entirely also, and I've been 3 years without a tobacco product of any sort. Snus is far easier to quit than smoking because you lose the hand thing, and the inhaling thing, and the exhaling thing, and basically everything that is fun about cigarettes, and are simply left with a pure addiction. That can't be said about electronic cigarettes, which are pretty much an drop-in replacement for cigarettes.

In that, just the switch to snus is like half-quitting in itself. Snus is also well-studied, with no known negative health effects other than an assumed link to higher rates of a few rare pancreatic cancers - based on the fact that it contains a chemical that has been linked in cigarettes to higher rates of those pancreatic cancers, but snus contains that chemical in about a tenth of the concentration.

And by well studied, I mean really well studied: https://scholar.google.com/scholar?q=swedish%20snus&btnG=Sea...

woah3• 11 years ago

Why is it so much healthier than chewing tobacco?

kazinator• 11 years ago

I don't care whether you quit smoking. Just quit throwing cigarette butts on the ground. Quit smoking in and around buildings where non-smokers live and work. Quit smoking in waiting areas. Quit walking and smoking in busy urban pedestrian corridors; others are walking in the same direction. Quit smoking upwind from the picnic table where I'm having lunch. Quit smoking on park trails, at least when the risk of forest fire is high, for crying out loud.

Other than that, knock yourself out.

jrs235• 11 years ago

And stop throwing your butts out your car windows!

They (use to, don't know if they still do) make ashtrays in cars. Most people I knew who had them and smoked didn't use them. They a) couldn't be bothered to clean it out regularly and/or b) didn't want the butts to stink up their car. But b) was pointless, they and their car already stunk like cigarettes. Their noses just could detect it anymore.

nitrogen2• 11 years ago

Also please remember that vaping is very nearly as annoying as smoking to nonparticipants. It still hazes up the room, it still has a smell, etc. So be courteous when vaping, and don't just start vaping in any old place, least of all an office, train, or a non-vaper's private residence.

chmaynard• 11 years ago

I wonder if habitual smoking always turns people into anti-social slobs, especially when they are outdoors? Social scientists, please get to work on this problem.

anotherevan• 11 years ago

The most effective measure against smoking is taxation.

That is certainly one of the levers used in Australia. It has also promoted a thriving black market for cigarettes. There’s a balancing act there.[4]

Other measures such as plain packaging, graphic warnings on packaging and banning in many public places are also in use here.

A while ago I listened to a Freakonomics podcast[1] about how to make people quit smoking. There were two related points that stuck with me.

1. Nicotine can have a lot of positive benefits. As one of their experts stated, “Good drug, bad delivery system.” [2]

2. One of those benefits is a possible anti-depressant effect. So smoking may inadvertently be treating a person’s undiagnosed mental health issue[3], an additional difficulty when trying to quit smoking.

This second point has made me a little more compassionate towards smokers, and to the difficulty of quitting. (As least in theory, still get annoyed when I can smell cigarette smoke on myself after a trip down to the shops because of some smoker on the sidewalk.)

[1] http://freakonomics.com/2014/04/03/how-to-make-people-quit-s...

[2] I don’t think smoking, and trying to quit smoking, it just about the nicotine. That’s just one aspect of the issue.

[3] NOT advocating this as an excuse to continue smoking. There are better treatments.

[4] “The art of taxation consists in so plucking the goose as to get the most feathers with the least hissing.” — Jean Baptiste Colbert

Smoking: Quitting is so hard

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