New Aide For Smokers

By  Action on Smoking and Health

WebMD Medical Reference from Action on Smoking and Health 

Smokers who can't quit can try the Nicotine Inhaler, a new stop-smoking product said to relieve the hand- to-mouth ritual that makes it hard to break the habit.

Nearly half of smokers who have tried to quit say they were unsuccessful because they lacked something to do with their hands, according to an American Lung Association/Yankelovich Partners survey of 1,001 smokers released today.

It differs from current Nicotrol products, including the skin patch, nicotine nasal spray and nicotine inhalation system, in that it is the only one to tackle the hand-to-mouth habit that is so difficult for smokers to break. Nicotine gum and the antidepressant drug bupropion, sold under the trade-name Zyban, also aim to stop smoking.

"This is unique in its ability to get nicotine to people in the way they are accustomed, which is the hand-to-mouth movement similar to smoking a cigarette," said Scott Leischow, a University of Arizona public health researcher who tested the patch, gum and inhaler in patients. "But puff for puff, it delivers about 10 percent of the nicotine in a cigarette," he said.

The inhaler, which looks like a hollow cigarette holder, will cost about $135 for a three-week regimen of six cartridges per day. Leischow recommends using the Inhaler for 12 weeks to break the habit. The inhaler serves as a nicotine replacement therapy. It works by delivering small doses of nicotine to satisfy the physical cravings as the smoker tries to quit.

But it doesn't have the harmful tars and toxins of cigarettes, said McNeil Consumer Products Co., the Fort Washington, Pa., company that makes the product. Smokers place a nicotine cartridge inside the mouthpiece of the inhaler, close it and puff on it. The nicotine turns into a vapor that is absorbed primarily into the mouth and throat, but not the lungs. Leischow said each cartridge contains about 400 puffs, the equivalent of 3-5 cigarettes. Leischow tested the Inhaler on 223 patients, about 20 percent of whom successfully quit smoking. "The inhaler doubles the chance of a person quitting, which is comparable to the patch and gum," Leischow said.

None of the products addresses the "rush" that smokers get when they first drag on a cigarette, said John Banzhaf, executive director for Action in Smoking and Health, a non-profit, anti-smoking group in Washington, D.C. Nicotine hits the brain within 5-10 seconds.

Banzhaf said smokers must tackle two problems, one a physical addiction to nicotine and the other the psychological habits formed when smoking. "If you don't deal with the psychological habituation, quit-smoking products won't work. Like the patch and gum, people could go to the doctor, get a prescription, puff on the Inhaler and then fail to quit and give up after five days," Banzhaf said. "People need support, they need to develop coping mechanisms and they need buddies who also went through quitting." Leischow said the inhaler is the first line of treatment for smoking cessation, and it should be used in conjunction with behavioral support. Patients also need to make sure they get enough nicotine to curb cravings. He and Banzhaf agreed that the more quit-smoking products that hit the market, the more people will become aware of their options and want to quit. About 25 percent of Americans smoke, according to the ALA. Only about 2-5 percent of those trying to quit "cold turkey" succeed in a given year. That figure goes up to about 15-20 percent when smokers use quitting aids and behavioral modification.

The ALA survey also found that 70 percent of smokers who want to stop smoking in the next six months already have tried to do so more than five times, and 75 percent of them tried to quit "cold turkey," one of the least successful ways to stop. "This indicates people desperately want to quit," said Dr. Alfred Munzer, a spokesman for the American Lung Association. Munzer also is director of critical care and pulmonary medicine at the Washington Adventist Hospital in Takoma Park, Md.

About 75 percent of the smokers surveyed by the ALA also believe nicotine is the ingredient in cigarettes that causes cancer, but it is the tars and toxins from burning tobacco that are linked to cancer, the survey said. Many smokers also are confused about options to quit smoking. "These findings show us that many of the 47.2 million U.S. smokers have a lot of mistaken ideas about smoking and how to quit," the ALA's Munzer said. The ALA is offering a new brochure, the "Quit Smoking Action Plan," available by calling 1-800-LUNGUSA.

"Action on Smoking and Health. Excerpts from Smokers Who Can't Quit Get New Aid: New Aide For Smokers. September 11, 1998. (Online) http://ash.org/sept98/09-11-98-6.html"