Smokers
need more options
Without using the internet, the only
way New Zealand smokers can get
addictive nicotine today is to smoke. The nicotine gum patch and lozenges
at the pharmacy are useful for smokers wanting to quit smoking, but most
smokers are not ready to quit if that means giving up addictive nicotine.
Quitting smoking and nicotine at the same time means that most quitters
soon go back to smoking to get their addiction needs met.
Smokeless New Zealand a new charitable
trust has been formed to advocate for more choices for smokers, so
smokers don’t have to give up nicotine just to quit smoking.
Chair Dr Murray Laugesen says “The smoke is what kills people, but
the nicotine is what smokers want, and the two can be separated.”
Smokers smoke for nicotine, and 4000 smokers a year leave their
quitting too late. They often get no second chance, as by the time they
know they have lung cancer it has spread too far. The new warnings on
packets next year will increase the pressure on smokers to quit, but too
many will still find it very difficult. Is there some way for smokers to
quit smoking and still get their nicotine?
1. The first option
is to keep on smoking, but the risks from smoking are extreme -
cigarettes eventually kill half of those who continue to smoke past age
35. Almost anything else (including being a soldier in war for a few
years) is safer.
2. The second option is to quit smoking
and tobacco all at once
Smokers wanting to quit smoking and tobacco together should
contact their doctor or the QuitLine 0800 778 778, or if they are ready to do it and sure of
success, go cold turkey. This is the ideal, for those who have decided to
be drug-free. www.quit.org.nz
3. The third
option is to switch to addictive nicotine. Those who
don’t want to quit nicotine just yet,
should still quit smoking for their own safety. Several products that can
provide smokers with addictive nicotine:
3.1 Patches and gum First, many nicotine addicts find it
difficult to get enough nicotine from patches and gum. If they use
both together they find they do better.
A nicotine patch gives a steady background level of nicotine.
To take care of sudden urges to smoke, many quitters chew on 4mg
nicotine gum which they gives them a nicotine effect after say ten
minutes. Gum and patches are sold in supermarkets and pharmacies. If
people smoke at the same time as using these nicotine medications, they
may feel slightly sick, it means they are getting as much nicotine as
they need, and should now cut down on cigarettes until they rely on
the nicotine gum and patch only for their nicotine. www.smokeless.org.nz/nrt.htm
3.2 Nasal snuff. This traditional product will be going on sale in 2006. Regular users
obtain high levels of nicotine, equal to cigarettes. It gives a nicotine hit quickly,
within two minutes. It is legal to sell it, and specialist tobacconists
are likely to stock it. It is addictive, may cause disease, but is
much safer than cigarettes. Now that smoking is known to kill half of
continuing smokers, snuff could come back into fashion.
Because it has not been used it has not been studied, and little
is known about its effects. The safest nasal snuff with the lowest
nitrosamines is from Swedish Match. As the risks are likely to be similar
to oral snuff, (see below) nasal snuff, if it helps smokers to switch off
smoking, will avoid the high risks of smoking, and used for the first
year or so after stopping smoking, will reduce the risk of relapse to
smoking. Because of its fast action, it will be useful if kept handy as
an emergency source of nicotine, and used to satisfy and counter the urge
to smoke. Like glasses at parties it is best not shared between friends. www.smokeless.org.nz/nasalsnuff.htm
3.3 Oral snuff. This Swedish traditional
smokeless tobacco has to be ordered on the internet. It is barred
from sale in New Zealand. It costs about
two thirds as much as cigarettes. The only snuff worth using is made in Sweden, and is
very low in nitrosamines (under 5 parts per million) and is unlikely to
cause cancer. It is used by a million Swedes, mostly men, many times
daily. Some 200,000 Swedish women now dip snuff. It is spitless,
and used in the form of a small teabag under the upper lip. It is
kept there for half an hour and over the course of a day provides
nicotine levels higher than nicotine patches or gum. Dry snuff does not
have to be refrigerated before sale.
It is about 5% as dangerous as cigarette smoking, and the risk of
the uncommon mouth cancer, is one in five of the risk for smokers.
Smokers use it instead of going outside in the cold to smoke. As long as
people are satisfying their need for nicotine by not smoking, they are
95% better off health-wise. www.smokeless.org.nz/snusaidsquitting.htm
www.smokeless.org.nz/snus.htm
3.4. Fast nicotine
Fourthly, pure addictive
nicotine products are under research and development here in New Zealand. Nicotine
tea-bag-like pouches placed under the upper lip like Swedish snuff are to tested later this year in Auckland; also other oral
forms. In Wellington,
nicotine inhalers are being tested. These products are several
years away from commercial sale, but they have virtually zero risks,
and eventually if they are shown to be addictive for smokers, may be
able to do away with the need for smokeless tobacco snuff altogether. A
world wide market awaits the successful biotech companies which can make
this happen. www.smokeless.org.nz/fastnic.htm
To policy writers:
- Addiction to
tobacco varies greatly among smokers. Some give up smoking without
difficulty, others never, though they know the risks.
- Non smokers
may find it repugnant, but many smokers are nicotine addicts, and
this fact is accepted by health workers who deal with smokers, and
listen to their story.
- Seeing it
from the smokers’ point of view, perhaps nonsmokers will
concede that smokers have a right to be informed and to make their
own nicotine choices.
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