
Smoking: Quitting is so hard - paublyrne
http://www.economist.com/news/leaders/21657391-everybody-now-knows-how-people-can-be-persuaded-stop-smoking-so-all-countries-should-be-doing
======
tombrossman
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.

~~~
dragonwriter
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.

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

------
willholloway
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.

~~~
tjohns
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.

~~~
willholloway
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.

------
kazinator
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
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.

------
blackhaz
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.

~~~
cmdrfred
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.

~~~
pessimizer
"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..

~~~
cmdrfred
No, genuine desire is the willingness to complete something despite the
discomfort. I have a desire for 6 pack abs, not a genuine desire.

------
snarfy
> 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.

~~~
jokoon
* 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.

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

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

~~~
pessimizer
I'm addicted to board games, too.

------
WBrentWilliams
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
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.

------
pessimizer
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...](https://scholar.google.com/scholar?q=swedish%20snus&btnG=Search&as_sdt=800000000001&as_sdtp=on)

~~~
woah
Why is it so much healthier than chewing tobacco?

------
contingencies
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.

~~~
collyw
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.)

~~~
nitrogen
_...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."

------
anotherevan
> 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...](http://freakonomics.com/2014/04/03/how-to-make-people-quit-smoking-
a-new-freakonomics-radio-podcast/)

[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

------
kriro
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.

~~~
tomjen3
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).

------
conwaytwitty
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.

------
perfTerm
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.

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

------
tomjen3
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.

------
curiousjorge
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.

