Smoked-out: Science obscured by public policy on quitting

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ACSH would like to applaud Dr. John Pierce and his colleagues from the University of California San Diego Cancer Center for their latest article, featured in the Annual Review of Public Health. The review article points out the discrepancy between science and public policy as it relates to smoking cessation strategies.

In their article, the researchers question the efficacy of pharmaceutical aids used to help smokers kick the habit for good. In fact, as the researchers point out, most smokers have successfully quit without the help of any aids:

While quit attempts have increased, widespread dissemination of these aids has not improved population success rates. Pharmaceutical marketing strategies may have reduced expectations of the difficulty of quitting, reducing success per attempt. Some policies actively discourage unassisted smoking cessation despite the documented high success rate of this approach. There is an urgent need to revisit public policy on smoking cessation.

Part of the problem of typical promotions for pharmaceutical cessation aids is that they may falsely imply that quitting smoking can be as easy as just chewing gum or wearing a patch. It appears that younger smokers in particular are now more likely to underestimate the amount of work needed in order to quit smoking successfully, the researchers write.

And despite the fact that most smokers quit unaided, current national policies discourage unassisted quitting and advise clinicians to make sure smokers who want to quit do so with pharmaceutical assistance, the article states.

ACSH advisor Dr. Mike Siegel, professor at Boston University's School of Public Health, draws attention to this important research on his blog, TobaccoAnalysis, and blames financial conflicts of interest between doctors and pharmaceutical companies as the source of this ongoing problem.

But ACSH's Dr. Gilbert Ross sees it differently: I feel that deeply entrenched (and well-deserved) antipathy toward the tobacco companies based on their duplicitous behavior over the 20th century is at least as important as simple corruption in driving this trend, he says. But whatever the actual reason for the abandonment of science by public health authorities, the victims are the 45 million addicted smokers who want to quit. This shameful situation needs to be changed by allowing truthful communication about the relative risks of the spectrum of smokeless tobacco products and alternative low-risk nicotine delivery systems that can actually help smokers quit.

And speaking of tobacco harm reduction, ACSH s Dr. Elizabeth Whelan has just submitted a brief to the Kansas House of Representatives, urging politicians to endorse a measure that would enable the Kansas Department of Health and Environment to conduct a study on the potential benefits of tobacco harm reduction for smokers.

I hope that my comments will encourage the House Federal and State Affairs Committee to pass this important piece of legislation, says Dr. Whelan, since I am confident that such a study, if undertaken, will provide evidence that tobacco harm reduction increases the cessation rate.