Tomorrow is the thirtieth Great American Smokeout. For the past twenty-nine years, the American Cancer Society has used this day to encourage millions of American smokers to quit. Unfortunately, while millions may quit for this twenty-four-hour period, the likelihood of their abstaining from cigarettes much longer is very low. The addiction to cigarettes and their nicotine is very powerful. In fact, only 4-5% of smokers who try to quit each year succeed in doing so. What's more disturbing is a recent report from the Centers for Disease Control (CDC) showing that the promising eight-year decline in smoking rates may have stalled. The percentage of Americans who smoke (20.9%) was the same in 2005 as in 2004.
The Great American Smokeout has inspired many to quit smoking, and some may have even quit for good. However, the majority of smokers need to use a combination of smoking cessation techniques to succeed in becoming lifelong quitters. (Please see our publication, Kicking Butts in the 21st Century: What Modern Science Has Learned About Smoking Cessation.)
Cessation methods include behavioral counseling, hotlines, nicotine replacement therapy (patches and sprays, etc.), pharmaceuticals, and physicians' advice -- though it appears not all physicians are giving their assistance, since almost half of all smokers had a routine medical checkup in 2003, but only 63.6% of those were counseled by a physician to stop smoking! Advice from doctors is an easy and inexpensive method to promote smoking cessation, and it is irresponsible of physicians to deny their patients this counseling.
The most recent drug marketed to help smoking smokers quit is Chantix (varenicline tartrate). Chantix is a non-nicotine drug that may help smokers quit by stimulating the release of the chemical dopamine in the brain to reduce craving and withdrawal while also blocking the effects of nicotine from cigarettes. However, in clinical trials the majority of smokers taking Chantix did not succeed in quitting. At best, only 23% were still abstinent at one year. As with other techniques, Chantix may help some but not many.
Another method that could help some smokers quit is the use of smokeless tobacco. Using smokeless tobacco causes significantly fewer adverse health effects than smoking cigarettes. While using smokeless tobacco is not risk-free, it can be a helpful form of harm reduction for smokers for whom complete tobacco and nicotine abstinence is unrealistic. Others may want to quit tobacco completely, and while it takes most smokers more than one attempt to quit, switching to smokeless tobacco in the meantime can reduce the harmful effects of smoking.
Since 1977, the Great American Smokeout has inspired many to quit smoking. Until recently, smoking rates were in a steady decline. The recent stall should be a wakeup call to everyone who thinks quitting is easy and requires only a little willpower. Quitting smoking is incredibly difficult, and it's much easier not to start. Perhaps the Great American Smokeout should have two purposes: a day when smokers across the nation attempt to quit and a day for adults, smokers and non-smokers alike, to remind children and teens how hard it is to quit and how important it is not to start.
Molly Lee is the Earhart Research Associate at the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
See also: Cigarettes: What the Warning Label Doesn’t Tell You
