Jump to full article: Crikey (au), 2009-09-18
Author: Simon Chapman, Professor of Public Health at the University of Sydney
Intro: Pharmaceutical giant Pfizer is in the middle of a major campaign to convince Australian smokers that they should not try to quit without taking anti-smoking medication.
The company sells over-the-counter nicotine replacement therapy (NRT) and prescription drug varenicline (brand name Champix). A Pfizer brochure "what makes you think you can quit this time?" and website stress that "only 3-5% of people who try to outsmart cigarettes without treatment succeed", that "a serious quit attempt needs a plan" and that most smokers "require help from a health-care professional".
Each of these claims is highly contestable. Pfizer and other pharmaceutical companies see cold turkey as the enemy of their efforts to medicate as many smokers as possible. Smoking cessation has become increasingly pathologised to the point that public awareness of its natural history has become heavily distorted.
For years, cold turkey has been denigrated as a hopeless strategy and ignored in public campaigns. But ask 1000 ex-smokers how they stopped and you get a very different answer. As occurs with personal efforts to stop problem drinking, gambling and narcotics use, population studies consistently have shown that a large majority of smokers who permanently succeed in quitting do not use any form of assistance. . . .
Pfizer’s claim that "most require help" is not only nonsense, but contrasts with a reference it cites in its own brochure, which states "about one-third of smokers now use a medication when they try to stop", meaning that two-thirds don’t. Its claim that smokers need a plan is also highly debatable. A recent study (Nicotine Tob Res 2009;11(7):827-32) of unplanned cessation found that unplanned cessation attempts were twice as successful as planned attempts and significantly, that most unplanned quit attempters do not use any assistance.
The emphasis about the futility of people trying to stop smoking unaided acts to exclude popular understanding of what is the most common story of cessation: doing it without professional or therapeutic help. When citizens have common, ordinary and self-limiting ailments, traits and behaviours constantly redefined as needing treatment, avoidable iatrogenic consequences and burgeoning health-care expenditure can follow. But the steady erosion of human agency and self-belief as people lose confidence in their ability to recover or change unhealthy practices is perhaps of greater concern.
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