06 novembre 2009
Treatment effectiveness is irrelevant if tobacco users
Treatment effectiveness is irrelevant if tobacco users are not aware of treatment options,
cannot access them, cannot afford them, or do not use them when they are available. Tobaccocessation
interventions can be delivered in many settings and formats. Health-care providers can
inform patients about the health effects of tobacco use and counsel them about treatment options
during routine appointments, patients can be referred to proactive or reactive telephone quitlines
for counseling and often medications, and patients can access computer-based programs that
offer counseling, support, and medications. Evidence-based systems-level interventions that are
particularly effective include tobacco-use identification systems, provider education, reminder
systems with feedback, and dedicated staff. For patients who are willing to quit, an evidencebased
algorithm known as the 5 A’s uses a decision tree to help health-care providers to
• Ask patients about tobacco use.
• Advise current users to quit.
• Assess smokers’ willingness to quit.
• Assist smokers who are willing to quit by providing appropriate tobacco-dependence
treatments.
• Arrange followup for smokers who want treatment.
That algorithm can be used by all health-care providers, including physicians, nurses,
psychologists, health educators, dentists, and pharmacists. For patients who are unwilling to quit,
health-care providers can use motivational interviewing to increase future cessation attempts.
Motivational interviewing can follow the 5 R’s: relevance (encourage patient to explain why
quitting is relevant to them), risks (ask patients to explain the adverse effects of tobacco use),
rewards (ask patients to identify the benefits of quitting), roadblocks (ask patients about the
barriers to their quitting), and repetition (use a motivational intervention each time a patient is
seen).
Many populations of tobacco users may be reluctant to quit, find it hard to quit, or be at
greater risk for adverse health outcomes from tobacco use; these special populations include
people who have psychiatric and medical comorbidities, deployed military personnel, and
hospitalized people. Tobacco addiction is much more prevalent in people who have mental
illness, including schizophrenia, major depression, posttraumatic stress disorder (PTSD), and
alcohol abuse. That is of concern given the increased numbers of veterans returning from the
conflicts in Iraq and Afghanistan with PTSD and the number of Vietnam veterans who have
PTSD. The PHS clinical-practice guideline provides evidence-based treatment protocols for
many special populations.
The issue of relapse from tobacco abstinence is well known; as many as 75% or 80% of
smokers who quit tobacco use will relapse within 6 months. Relapse-prevention interventions
include social support, use of medications, and avoidance of smoking cues.
Comprehensive tobacco-control programs also require surveillance information to help
staff to modify the programs to meet changing needs or to address disparities. Surveillance can
indicate whether policies are being enforced, medications are being correctly prescribed,
quitlines are being used, public-education campaigns are reaching target audiences, interventions
are improving health outcomes, and funds are being spent appropriately. Established
performance measures should be used to monitor program improvements. Surveillance tools
should be designed and operated to provide the necessary foundation for program evaluation,
which should be periodic and thorough and whose results should be disseminated publicly.
22 octobre 2009
Quitting Methods
Those standing to profit by selling quitting products paint cold turkey quitting as almost impossible with few succeeding. Take your own poll. What you will discover is that nearly 90% of all long-term ex-smokers and smokeless tobacco users quit cold turkey. Not only is it our most productive quitting method, it is fast and free. But quitting cold -- in ignorance and darkness -- can be frightening. When combined with education, skills development and ongoing support, no quitting product comes close. Not only do cold turkey quitters avoid potential medication side effects, they do not get hooked on the cure (nearly 40% of all nicotine gum users are chronic long-term users of at least 6 months). All pharmacology products share a common feature. They delay brain neuronal resensitization to varying degrees. What it means is that there is almost always some level of back-end re-adjustment, once they stop using the product, where they are left feeling temporarily de-sensitized.
Record Your Motivations - Once in the heat of battle, it is normal for the mind to quickly forget many of the reasons that motivated us to commence recovery. Imagine having a loving reminder letter listing all core motivations, carrying it with you, and making it your first line of defense - a motivational tool that can be pulled out during moments of challenge. As with achievement in almost all human endeavors, the wind beneath our recovery wings will not be strength or willpower but robust dreams and desires. Keep those dreams vibrant, on center-stage and calming the impulsive lizard brain and no circumstance will deprive you of glory.
Do Not Skip Meals - Nicotine was our spoon, with each puff, dip or chew releasing stored fats into the bloodstream. It allowed us to skip meals without experiencing wild blood-sugar swing symptoms such as an inability to concentrate (mind fog), the shakes, irritability or hunger related anxieties.
24 septembre 2009
Kübler-Ross grief cycle
The Kübler-Ross model identifies five discrete stages in the grief cycle when coming to terms with any significant emotional loss. Albeit chemical, dependency upon nicotine may have been the most intense and dependable relationship in our entire life. Unless wet and it wouldn’t light, never once did it let us down. Unlike when hunting for a lost pet or when our parents were angry with us, nicotine’s “aaah” was always there. If we smoked nicotine ten times per day and averaged 8 puffs per cigarette, that’s 80 times a day that we puckered our lips up to some nasty smelling butt spewing forth scores of toxins and thousands of chemicals. What human on earth did we kiss 80 times each day? Who did we depend upon 80 times a day?
How many
times each day did we write or say our name? Imagine being closer to our
addiction than our own name.
In 1982
Joel Spitzer applied the Kübler-Ross grief cycle model to the emotional
loss encountered when quitting smoking.346 The five stages of emotional recovery
include:
(1) Denial: “I’m not really going to quit. I’ll just pretend and see how far I get.”
(2) Anger: “Have I really had my last nicotine fix? “This just is not fair!”
(3) Bargaining: “Maybe I can do it just once more.” “I’ve earned a little reward.”
(4) Depression: “This is never going to end.” What’s the use?” “Why bother?”
(5) Acceptance “Hey, I’m feeling pretty good!” “I can do this!” “This is good.”
It’s important in navigating emotional recovery to not get stuck in a stage prior to acceptance. Seeing and understanding each stage’s roots will hopefully help empower a smoother and quicker emotional transition home. As we review each stage keep in mind the fact that the Kübler-Ross’s grief cycle of emotional loss is not etched in stone. Some phases may be absent while others get revisited.
15 septembre 2009
Symptoms of caffeine intoxication
An earlier study found that the clearance rate of caffeine from blood plasma averaged 114
milliliters per minute in nicotine smokers and 64 milliliters per minute in non-smokers.
Symptoms of caffeine intoxication have been seen with as little as 100 milligrams of
caffeine daily, and may include restlessness, nervousness (anxiety), excitement, insomnia,
a flushed face, increased urination and gastrointestinal complaints. Intoxication
symptoms seen when more than 1 gram of caffeine is
consumed per day include muscle twitching, rambling
flow to thoughts and speech, irregular or rapid heartbeat,
irritability and psychomotor agitation.
Many of us can handle a doubling of our daily caffeine
intake without getting the jitters. But how can we tell
whether the anxieties we feel are related to nicotine
cessation or too much caffeine? It isn’t easy.
Experiment with an up to 50% reduction in daily caffeine
intake if at all concerned. Be careful not to reduce normal
caffeine intake by more than 50% unless you want to add the symptoms of caffeine
withdrawal to those of nicotine withdrawal.
Caffeine withdrawal symptoms can include headache, fatigue, decreased energy,
decreased alertness, drowsiness, decreased contentedness, depressed mood, difficulty
concentrating, irritability, and a foggy mind. Symptoms typically begin 12 to 24 hours after caffeine use ends, reach peak intensity at 20 to 51 hours, and normally last 2 to 9 days.
25 août 2009
Little habit
"Nasty little habit?" We are true drug addicts in every sense! That’s right, look in the mirror
and you'll see an honest to goodness drug addict looking right back.
This is one of the most harmful rationalizations of all as it minimizes the risk of using
nicotine products in the minds of our children. While it clearly takes time and repetition to establish a habit, research suggests that “experimenting” with smoking nicotine just once
may be sufficient to begin fostering a loss of the autonomy to stop using it.
Adoption of the “habit” rationalization is also disabling to those already enslaved. Instead
of learning and living on the right side of the “Law of Addiction,” we reside in a pretend
world where some day we’ll awaken and at last discover how to control, mold, modify or
manipulate our nicotine use, so as to allow us to use or not use nicotine as often as we
please. At last we’ll discover how to have our cake and eat it too, ” or so we dream.
The phrase "nasty little habit" is just more junkie thinking. Such soft fuzzy words are used
to self minimize the hard cold reality of being chemically married to and dependent upon
nicotine. It’s much easier to tell yourself that all you have is some "nasty little habit." The
warmth of the phrase is akin to that found in the word "slip," a means to sugarcoat relapse
and failure.
Failing to use turn signals while driving is a "nasty little habit" and so is using too many
cuss words, cracking our knuckles or maybe even losing our temper too often.
But, we will not experience physical withdrawal symptoms if we start using turn signals, stop using cuss words, stop cracking our knuckles or when we learn to keep our temper in check. Chemical addiction does foster habits but it does so by forcing each of us to select patterns for the regular delivery of our addictive drug. Our addiction fathers our drug feeding habits, not the other way around. We would never develop a habit of sucking smoke into our lungs while talking on the telephone or after a meal unless the consequences of constantly falling reserves compelled us to do so. Nicotine dependency is extremely dependable. Our blood-serum nicotine level always declines by roughly half if we fail to replenish within two hours. We can depend upon our mind to begin issuing subtle urges to remind us that it is time to bring more nicotine into our body. Calling nicotine addiction a habit is like calling a young child a parent. It didn't take any two hours for my mind to generate the anxieties needed to compel me to smoke more.
At three packs-a-day, if I was on the phone and had not filled my nicotine tank in the past 15 to 20 minutes, then, like call waiting, a second message from my brain’s insula arrived, reminding me of my need to feed. Even food refueling would take a backseat to nicotine replenishment if the meal lasted much longer than 30 minutes. It limited uninterrupted driving time, romance, learning, exercise (if you can call it that), work, living and nearly every aspect of my life. Yes, it was almost always nearing time for another fix. Yes, I developed habits but not just for the sake of having habits. There were only two choices - smoke more nicotine or prepare for withdrawal. I wish it were just a "nasty little habit," I truly do. But, truth is, my name is John and I’m a recovered nicotine addict. Comfortably, I live just one puff away from three packs a day.
02 juillet 2009
Tobacco prices at producer level
Almost all tobacco produced is sold unprocessed either to private traders or to TEKEL. Private sector purchases are generally export oriented, dependent on foreign orders. TEKEL’s purchases are for both domestic cigarette production and for export as leaf tobacco. Hence, the prices received by farmers are a weighted average of the prices paid by TEKEL and the private sector. Over the last decade, TEKEL’s share in the purchase of unprocessed tobacco has fluctuated between 48 percent and 83 percent.
Each year, support prices are announced for tobacco of a certain standard (80 percent yield). However, the actual prices paid to the farmers are below the announced prices, since, on average, the quality is substandard. As the private sector buys better quality tobacco, their average purchasing price is higher than that of TEKEL. Figure 6.9 presents the trends in average support prices for tobacco over the last two decades, together with the trends for wheat and cotton, which are grown in the same regions and are the major possible alternative crops to tobacco. The trends are presented as US$prices of the crops, indexed to 1970 = 100.
Over the last three decades the average price of unprocessed tobacco has more than tripled, as have the prices for wheat and cotton. Except for a few years, the prices of the three products have tended to move in the same direction. It has mirrored the trend in overall prices received by farmers in the period. Prices all increased in the early 1970s, fell through the late 1970s and early 1980s, and have generally increased since.
25 mai 2009
The Smoking Vaccine
Scientists create a
miracle cure – a shot of medicine to take away the kick that keeps people
hooked on nicotine. Two companies are developing a vaccine that will neutralize
nicotine’s hold on the brain by keeping it from getting there first of all. If
either of them has success, millions of smokers could trash their soft packs
for good, reducing their risk of dozens of ailments, including heart stroke,
disease and 10 different types of cancer. Vaccine is designed to stimulate
antibodies in the bloodstream that identify and bond with nicotine and protect
it from entering the brain.
Henrik Rasmussen,
M.D., Ph.D., of Nabi says: “It’s based on the assumption that the main reason
smokers can’t quit is that they miss the rush they get when the nicotine hits
the brain. We are basically attempting to block that, so you lose the feeling
of well-being that cigarettes give you.” The vaccine is going to be a
revolutionary approach to tobacco-addiction treatment.
The NicVax vaccine
offers a lot more protection than other treatment methods. Eight shots over a
12-month period will cover patients for the year. With NicVax, a smoker is
stuck and that is what he needs. Researches have shown that if a smoker makes
it past a year without relapse, his chances of staying smoke-free are very
good.
The government puts
its money on NicVax – the National Institute on Drug Abuse (NIDA) has given a
healthy dose of funding to carry out clinical trials at the University Wisconsin University Minnesota University of Nebraska
18 mai 2009
Philip Morris Sues to Block Internet Cigarette Sales
The New York-based company's cigarette unit, Philip Morris U.S.A., said
it filed eight lawsuits in New York and Los Angeles against more than a
dozen Web sites, seeking to block the sales. The suits accuse the Web
vendors of using Philip Morris trademarks to promote and sell illegally
imported cigarettes and making false claims about the legality of the
sales. The tobacco industry increased prices after agreeing to a $206
billion settlement with 46 states in 1998, and many states and cities
also levied additional taxes, putting the price of a pack of cigarettes
to as much as $7.50 in New York City.
More than 600 Web sites illegally
sell cheaper cigarettes and ``it appears to be growing,'' said Philip
Morris spokesman Brendan McCormick. ``In the past, we have brought
lawsuits against people using the black market in more traditional
ways,'' he said. ``Now they are using the Internet.'' The sites, with
names such as cheapmarlboro.com, 18orless.com and
dutyfree-cigarettes.com, are based overseas, such as in Russia, Spain
and Switzerland, according to the suits. Shares of Philip Morris rose
46 cents to close at $43.15 in New York Stock Exchange composite
trading. Black Market The black market cigarettes are either made in
the U.S. and packaged for overseas sales or made overseas for sale
there, McCormick said. All Philip Morris cigarettes sold in the U.S.
are made in this country, and the company has notified the U.S. Customs
service that it has not given permission for anyone to use its
trademarks on imports, he said.
The only legal remedy for Philip Morris
is to sue for trademark infringement, false advertising and unfair
competition. Only the states and federal government can sue for the
lost tax revenue, McCormick said. The Web sites fail to ensure the
cigarettes aren't sold to children and don't pay taxes, falsely
claiming their products are tax-exempt, Philip Morris said.
The company
said it expects to file more suits as its investigation continues. In
the suits, Philip Morris asks that a court order the sites to stop
using company trademarks and halt the illegal importation. It also can
ask the court to order the Internet service providers to shut down the
sites, McCormick said. ``Philip Morris U.S.A. is committed to pursuing
all available options to ensure that its products are sold in strict
compliance with the law,'' Jack Holleran, vice president of brand
integrity for Philip Morris U.S.A., said in a statement. In the 1998
settlement, the cigarette makers said they would pay about $206 billion
over 25 years to settle the 46 states' lawsuits seeking to recover
their cost of treating smoking-related illnesses. As part of the
settlement, the industry agreed to restrictions on outdoor advertising,
brand-name sponsorships, and distribution of free samples and apparel
that display cigarette brand names. The companies settled separately
with the other four states.
05 mai 2009
Cigarette Man Ad
1969 Camel Cigarette Man Walk a Mile Ad
“I’d walk a mile for a Camel.” This message is strictly for smokers who never tasted a Camel cigarette. Camel smokers, you know what we mean. You other guys, start walking.
1969 chesterfield coupon ad
Who stole the Chesterfield coupon? Chesterfield introduces the coupon worth stealing. A new cigarette coupon now
1969 chesterfield coupon ad - Who stole the Chesterfield coupon? Chesterfield introduces the coupon worth stealing. A new cigarette coupon now
1969 Marlboro Cigarette Cowboy Drinking From Pan Ad
Come to where the flavor is. Come to Marlboro Country.
1969 Marlboro Cigarette Cowboy Drinking From Pan Ad - Come to where the flavor is. Come to Marlboro Country.
1969 Marlboro Country Man Cigarette 2-Page Ad
Come to where the flavor is. Come to Marlboro Country.
1969 Marlboro Country Man Cigarette 2-Page Ad - Come to where the flavor is. Come to Marlboro Country.
1969 Marlboro Country Man Filling Coffee Pot River Ad
Come to where the flavor is. Come to Marlboro Country.
1969 Marlboro Country Man Filling Coffee Pot River Ad - Come to where the flavor is. Come to Marlboro Country.
23 avril 2009
Lucky Strike Tobacco - fine tobacco
