Talk:Smoking cessation/Archive 2

Archive 1

Archive 2

Article reads like an FAQ / How to pamphlet

Alright ladies and gentlemen, there is a lot of good content in this article, but it reads more like a pamphlet than something you would find in an encyclopedia. I think the Q&A nature of the article needs to be eliminated and some more information about the current global situation should be highlighted. I was hoping to find a section discussing global statistics and what is or is not working. Please be sure to sign your comments when you respond to threads as the previous talk page was almost impossible to read without signing date and names. Alan.ca (talk) 04:34, 28 December 2008 (UTC)

2009 Copyedit

As part of the copyedit for Tobacco smoking, this is an essential article. I'll add notes as I go, diff from [1] to [2] :

• Top image dropped as unnecessary and irrelevant
• First paragraph is dropped, information is not in citations, does not define the article; duplicates pieces of Prevalence of tobacco consumption; wrote new lead sentence
• The entire section "What to expect when you quit" is dropped under verifiability (WP:V), and neutrality (WP:NPOV) — it contains potentially useful information if the statics are cited
• "Hazardous elements of Cigarette smoke" dropped, this article is not Health effects of tobacco, removed under neutrality (WP:NPOV); Citations are preserved for reentry [3]
• Merge "Statistics" and lead of "Information for smokers trying to quit" into "Factors"
• Dissolved section "Information for smokers trying to quit", all subsections are now sections
• "Physiological & Psychological Effects" to "Post-cessation effects"
• Unsourced information from Description are removed under verifiability (WP:V)
• Moved first three paragraphs including quote into "Factors"; moved the remainder to "Public policy"
• Moved "Public policy" below "Post-cessation effects"
• Dissolved "Information for healthcare professionals": remove second paragraph under verifiability, unencyclopedic tone, non-essential; merged first paragraph into "Public policy"; dropped last paragraph, citation preserved [4]

There work left to do: references need to be cited consistently (we're using both Harv and Non-invasive footnotes), this article is still non-neutral, lacks focus and consistency as the information seems to be there just because. ChyranandChloe (talk) 06:27, 16 February 2009 (UTC)

Suggested Improvement for the Opening Paragraph

Smoking cessation is the action leading towards the discontinuation of the consumption of a smoked substance, keenly tobacco, however it may encompass cannabis and other substances as well.

I feel that we should try and just stay on the topic of tobacco cessation and not lead into the cannabis factor.Rnwilli19 (talk) 22:40, 25 March 2009 (UTC)Rnwilli19 http://www.hc-sc.gc.ca/hl-vs/tobac-tabac/legislation/federal/tobac-tabac-eng.phpRnwilli19 (talk) 22:58, 25 March 2009 (UTC)Rnwilli19

Smoking has been identified as the single most preventable cause of death and illness. Therefore, a variety of nonpharmacologic and pharmacologic therapies have been developed to help with smoking cessation.

The opening paragraph about smoking cessation does not adequately summarize the scope of the article. While it does define smoking cessation, the introductory paragraph would be more useful for readers if a paragraph was added to include a mention of the variety of methods that have been developed to help with smoking cessation.

The resource can be found at: http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=519954

I also think a link should be placed on the word “pharmacologic” within the recommended edit because it further enhances the usefulness of the article. The page I found doing a search for pharmacologic was redirected to pharmacology, which is: http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?id=519954. I did not find a page for nonpharmacologic. —Preceding unsigned comment added by 209.190.187.4 (talk) 21:24, 2 March 2009 (UTC)

The purpose of the first sentence of the first paragraph of the article is to define the article (WP:LEAD). I don't necessarily like starting the article with advocacy, especially phrases that are overused. This article is "Smoking cessation" and no so much "Health effects of tobacco"; remember to always stay focused on the main subject, especially when you're trying to define the article. I like the second sentence though. Pharmacologic, is essentially pharmacology, or the study of drugs and their effects. This would essentially be implied in the section "Methods" and you don't need verification if you want to add it in. ChyranandChloe (talk) 04:36, 21 March 2009 (UTC)

Navy additions

Well in my past experiences with the whole idea of smoking cessation have been remarkable. I feel that this idea is very great when it comes to the Navy and treating our recruits. In a sense this adds to a better image for our society in general is kind of sets as a role model. My father is in the Navy and runs the tobacco cessation program over at Great Lakes. I just feel that this article should speak more about Recruitment processes in the Navy so people who are interested in the Navy will know what to do.Rnwilli19 (talk) 22:54, 23 March 2009 (UTC)Rnwilli19

I want to stress again that throughout this article there needs to be talk about the Tobacco Cessation Program in the Navy and how it puts a good image for our country.Rnwilli19 (talk) 23:00, 25 March 2009 (UTC)Rnwilli19

Well, if you can cite it, you can have it. This page isn't protected so you can edit it whenever you want. If you feel strongly about it, research it out and add it in. I would imagine that in order for the Navy to have such a remarkable program, someone somewhere must be keeping track of it. Programs cost money and this entails legislative oversight. Therefore, if you find a report (probably one going to the US congress) detailing statical evidence of the programs effectiveness and documentation of the methods used—this could be an interesting addition, probably "In addition to self-help... the United States military offers cessation programs which have shown (statics) using (methods)". Try you best to get a primary source with some secondary sources (e.g. Newsweek) detailing what it is and what its doing. ChyranandChloe (talk) 03:37, 26 March 2009 (UTC)

Research and affects of Facebook

Question: What effects does chew have on the stomach? (I swallow my chew & the juice) I have tried everything available to quit and just can't get past the 1st day. any options left for me?

Answer: A. The "spit" from your smokeless tobacco contains irritants and acids that can lead to stomach upset. By swallowing the juice, you increase your risk of stomach ulcers.

B. The options for quitting have really improved with the realization that multiple medications used at the same time can help. The use of the nicotine patch to help with daily nicotine need, plus the use of the nicotine gum for the breakthrough urges not covered by the patch, and the use of bupropion (Zyban) to help with the stress of quitting may all contribute to helping smokeless users quit. Recent studies show that many patients are now benefiting from the use of these three medications can be safely used together to defeat the pains of nicotine withdrawal. Ask your healthcare provider to assist you with finding a regimen of medications that are right for you. Also remember that you will benefit from some counseling and support from your local cessation program, community quit services, online quit support (UCANQUIT2.Org) or state quit line.”

Question: I thought that I read several years ago that smokeless tobacco had also been banned from government buildings. I still see a lot of military members spitting tobacco at work. Is there a regulation concerning smokeless tobacco? Thanks.

Answer: “The Services do address smokeless tobacco use in the DoD-controlled workplace. The Army, Air Force, Navy, and Marine Corps ban tobacco (to include smokeless tobacco) products from the workplace except for designated tobacco use areas.

Question: How can commanders and health promotions personnel encourage healthy and smokeless tobacco-free lifestyles?

Answer: “The best way to promote health is leadership by example. All leaders at every level should be tobacco free. In addition, education and promotion of a tobacco-free lifestyle should be presented at every educational opportunity.”

Question: What is smokeless tobacco's impact on readiness?

Answer: “Being addicted to any drug can lead to significant problems if withdrawal occurs in a military environment. Irritability, anxiety, restlessness, sleep problems, nausea, and other withdrawal symptoms can adversely affect the mission. Nicotine withdrawal is controlled with the proper use of nicotine and non-nicotine medications such as the nicotine patch, nicotine gum, bupropion (Zyban), or varenicline (Chantix).”

Question: How can smokeless tobacco use degrade war fighter performance?

Answer: “While non-smoked tobacco may appear to be less of a burden on the military mission, it has some significant liabilities. The first issue is that of supply. Making room in your field pack for dip, chew, or snus means you have to sacrifice room for something else. Second, since non-smoked tobacco has greater amounts of nicotine, the sudden lack of non-smoked tobacco once your filed supply is gone will lead to nicotine withdrawal symptoms which would seriously impact the health and well being of the member and the mission assigned. Third, the by-products of non-smoked tobacco are easily tracked through deposited tobacco-byproduct residue in your spit or urine.”

Question: How prevalent is smokeless tobacco use in the military?

Answer: “A recent survey reveals that about 21% of military members have used smokeless tobacco in the past year. This includes chewed tobacco, dip, snuff, or snus. The newer snus product is supposed to be "spit-free" but it has the same poisonous by-products which are swallowed instead of spitting. Spit or don't, but there's no such thing as a safe or healthy tobacco product.”

Question: Do the drugs to help you quit smoking also work for smokeless?

Answer: “Yes, the medications used for tobacco cessation work for smoked or smokeless tobacco. Some people state that they are afraid of becoming addicted to the nicotine patch or gum. There is nothing wrong with using the gum or patch to stay tobacco free. The nicotine in the gum or patch is not cancer causing and it is safe to use indoors.

Quitting smokeless tobacco has a lot in common with quitting smoking-you need to follow the same 4 Steps to Quitting, make a quit plan, and get support of family and friends. But there are some differences, too. Here are some good ways to get the most out of your smokeless quit attempt:

• You may need to have something in your mouth to take the place of that wad of chew or tobacco packet. Try sugar-free hard candies or gum, cinnamon sticks, mints, beef jerky, or sunflower seeds. Be careful to watch calories.

• Nicotine replacement therapies, like nicotine gum or patch, often help.

Nicotine gum can be especially helpful because you hold it in your mouth, making it a substitute for chewing tobacco. You may need to combine these therapies, so ask your doctor.”

Question: What are the dangers of oral cancer associated with chewing? How fast can this happen? Are the effects reversible?

Answer: “The risk of oral cancer from non-smoked tobacco is low compared to the risk of smoked tobacco. However, the issue of oral cancer is quite disturbing as nearly 50% of people with oral cancer do not survive five years. The main oral change from non-smoked tobacco is hyperkeratosis which is the body's way of producing a barrier between the toxins in smokeless tobacco and your healthy tissues in the mouth. This whitish, roughened area where the smokeless tobacco is placed can show signs of dysplasia which is the very first stage of a cancerous change. The change will usually go away if the smokeless tobacco user quits using their smokeless product. The first step in determining whether the body can return to normal is to quit using tobacco and letting the area heal for two weeks. The whitish, roughened area should return to normal looking gum tissue.”

Question: Is smokeless safer than smoking?

Answer: “First, let's be very clear- there is no safe form of tobacco. Since tobacco is a means of delivering nicotine, anyone wishing to improve their health should use safe non-tobacco nicotine products such as the nicotine patch and the nicotine gum. Non-smoked tobacco has risks and is detrimental to the mission of the military. In addition, smokeless tobacco has higher amounts of nicotine than smoked tobacco thus making it a very poor choice to use as a method to quit smoking.”

Question: Why should I quit using smokeless tobacco?

Answer: “Each time you use tobacco, you are putting chemicals in your body that can cause major health problems. Every time you place non-smoked tobacco in your mouth you increase your risk of oral disease. It causes a range of problems that can reduce your fitness for service. While most problems take years to develop, some of the effects are very quickly realized such as bad breath, tooth staining, gum disease and recession, and tooth decay. The non-oral effects of non-smoked tobacco can be very devastating but are not seen until years later. Stomach ulcers, pancreatic cancer, stomach cancer, and bladder cancer have all been associated with non-smoked tobacco use.”

Question: What types of health effects are smokeless tobacco users most at risk for?

Answer: “First, one must realize that the tobacco product (smoked or non-smoked) is only a delivery mechanism for nicotine. Nicotine by itself, which is found in the nicotine replacement products such as patch and gum, is not harmful if used properly. It is the other approximate 4,799 chemicals in the tobacco that cause the health problems.

The use of non-smoked tobacco (smokeless tobacco, spit tobacco, chewing tobacco, snus) is linked to many specific health problems. These effects are grouped in two areas- local (oral) and body-wide. The local oral effects include bad breath, tooth discoloration, gum recession, tooth root exposure with resulting tooth sensitivity, gum disease, tooth decay, and oral cancer. Body-wide health problems include decreased healing, stomach upset, stomach ulcers, and increased risk for stomach cancer, pancreatic cancer, and bladder cancer.

A significant underlying health problem which can truly harm military members’ readiness is the sudden withdrawal from non-smoked tobacco. Since manufacturers load more nicotine in smokeless tobacco than in smoked tobacco, the sudden lack of the nicotine can lead to poor mission focus because of the nicotine withdrawal effects of anxiety, irritability, lack of focus, nausea, headaches, and hand shaking.” http://www.ucanquit2.org

• • • • This is a very important find I made when dealing with smoking cessation. I found that making a facebook page for college students and other people helps a lot and this should be put in this discussion.Rnwilli19 (talk) 23:00, 23 March 2009 (UTC)Rnwilli19

(outdent) It's interesting, but before we can really improve the article there are three things we need to do: (1) we can't use a question and answer scheme, you have to remember Wikipedia is an encyclopedia, (2) some of the information would be more relevant elsewhere (e.g. Health effects of tobacco, Prevalence of tobacco consumption, so on), and (3) we need a reliable source, ucanquit2.org usually fabricate or cut out the data points from the full or actual reports in order to make a point out of it. It's advocacy, out of context, and violates neutrality. The World health organization and Centers for Disease Control and Prevention, although they follow similar ideologies, are usually able to provide good content that would help lead you to better sources (e.g. Global Burden of Disease → Mortality from Smoking in Developed Countries 1950-2000). I'm sorry if this ruins it for you. ChyranandChloe (talk) 03:55, 24 March 2009 (UTC)

United States Navy and smoking affects

According to the National Defense Authorization Act of 2009, the Navy now has an authorized tobacco cessation benefit. Prior to this time, the military healthcare system (known as TRICARE) was prohibited from funding a tobacco cessation benefit. At Great Lakes Naval Healthcare Clinic there are numerous opportunities for free tobacco cessation support to include walk-up cessation help available at the Pharmacy window, cessation care via medical visits, and cessation support during dental visits as well . By instruction, the Recruits that train at the Navy's only Boot Camp, cannot use any tobacco products. The Naval Healthcare Clinic has instituted a education program for all Recruits which advises them to remain tobacco free after they leave their 8-week training program .Rnwilli19 (talk) 22:45, 30 March 2009 (UTC)Rnwilli19

Good job, I really appreciate it. I'm putting it under a new section title "Programs". It seems oddball at this point and I'm sure to some people may object to its inclusion, but as the blanks are filled in seeing the big picture should be easier. Also make it easier on yourself when citing sources, there are templates such as {{cite web}}, {{cite book}}, or {{citation}} which helps speed along the process. ChyranandChloe (talk) 05:28, 31 March 2009 (UTC)

References

The nortriptyline reference sounds like something that should probably be removed. The science on that page seems sound, but the site is a heavily SEOed marketing site (not a spamtrap, but close), which is selling products for smoking cessation... Seems a bit fishy. DiamonDie (talk) 07:46, 4 May 2009 (UTC)

I'll maintain the text, which is believable, but lose the ref, which I agree is not up to RS-standards. carl bunderson (talk) (contributions) 03:48, 7 May 2009 (UTC)

Can anyone tell me why my external link was immediately removed? It links to a website I built which provides a method of weakening the addiction before quitting. The method works great. I used it, and am now in my 8th year of recovery after a 34 yr addiction and several failed quit attempts. No other site on the net provides this info. The people on the net who say this method does not work all have something to sell. Bleacher4OSU (talk) 01:01, 21 May 2009 (UTC)

The link was removed for a few reasons. The link advertises a website, albeit one with free information. The website is authored by you the person adding the link. These two points constitute a conflict of interest on your part as well as demonstrating a lack of neutral point of view (NPOV). The addition of the link accompanied with a statement as fact of the validity of the website's methods also means that you are adding original research to the article. Finally, since your website cites only anecdotal evidence in support of its methods (that being your personal experience), the link and accompanying claim are not adequately verifiable. I hope this clears up the issue for you. DoktorDec (talk) 01:40, 21 May 2009 (UTC)

It is amazing that I find my website unwelcome in so many places when the methods it advocates and assists with could help many people overcome their addiction. Indeed, the article cited by the third link listed here advocates weaning as the first step of the quitting process. But I understand your points, and thank you for your time. Bleacher4OSU (talk) 08:29, 21 May 2009 (UTC)

Introduction

Smoking cessation (or quitting smoking) is the action leading towards the discontinuation of the consumption of a smoked substance, mainly tobacco, but it may encompass cannabis and other substances as well.

The phrase "consumption of a smoked substance" needs review. It could be read as "eating smoked substances". e.g. "...is the action leading towards the discontinuation of the consumption of a smoked substance, mainly tobacco, but it may encompass cannabis and other substances, such as smoked beef and smoked ham."

The phrase "and other substances as well" should either be "as well as other substances" or simply "and other substances".

Autumnox (talk) 16:24, 23 August 2009 (UTC) Autumnox

Constipation?

"Smoking-related Constipation?" This appears to be vandalism to me, and I may try to find a more suitable heading name.--74.124.187.76 (talk) 16:18, 14 October 2009 (UTC)

Okay, the heading is appropriate, but another heading was obscured, making it appear that this type of constipation referred to most of the article. That is now fixed.--74.124.187.76 (talk) 16:41, 14 October 2009 (UTC)

Neutrality

This whole article seems to take a very personal tone, and should be more objectively medical. Aside from the countless spelling and grammar errors, it would be wise to revise this article to correct the preachy tone and to include more citations. —Preceding unsigned comment added by 66.253.140.103 (talk) 21:42, 1 November 2009 (UTC)

Outline for possible rewrite of this article

A health article of this importance does need to be well-organized, concise yet comprehensive. A nearly-complete rewrite will be needed before the existing article (as of 6 Nov 09) becomes satisfactory. This is discussed further on my talk page. JesseOfMarionHotel (talk) 21:51, 6 November 2009 (UTC)

I read the outline on your talk page. I appreciate what you're trying to do and think you're on the right path. However, I would not transclude the information about nicotine into this article about cessation. I think your sections about cessation techniques and the public policy around the issue would work well in this article. In Wikipedia fashion, I would suggest you start by introducing the new sections one at a time. Get them properly written with references and this will allow other editors to pop in with their own sources. The introduction is typically written last. There are wikipedia guides about these concepts, the introductory paragraph is covered by WP:LEAD. Alan.ca (talk) 07:33, 21 November 2009 (UTC)

Better version of this section

This shorter version goes directly to the health effects in explaining why people try to quit. The current article focuses on market products containing nicotine, even though they have a poor record of curing nicotine addiction. For instance in confounding studies where nicotine was combined with much more effective means, such as antidepressants and/or counseling the larger effect is attributed to the nicotine, not the antidepressant. The overall article markets nicotine products in text and image selection.

A 'No Smoking' sign

Smoking cessation is the effort to stop smoking tobacco products. Nicotine is an addictive substance, especially when taken in by inhaling tobacco because of the rapid absorption through the lungs. Tobacco use is one of the major causes of death worldwide, according to the World Health Organization.

Description

Research in Western countries has found that approximately 3-5% of quit attempts succeed using willpower alone (Hughes et al, 2004). The British Medical Journal and others have reviewed the evidence regarding which methods are most effective for smokers interested in breaking free of the smoking habit, and concluded that

Nicotine dependence is most effectively treated with a combination of drugs and specialist behavioural support ...

(Managing smoking cessation | Paul Aveyard, National Institute of Health research career scientist, Robert West, professor of health psychology and director of tobacco studies | Clinical Review | BMJ 2007; 335:37-41 (7 July) | doi:10.1136/bmj.39252.591806.47 | http://bmj.bmjjournals.com/cgi/content/full/335/7609/37?fmr )

As detailed in the Statistics section below, multi-session psychological support from a trained counselor, either individually or in groups has been shown in clinical trials to provide the greatest benefit.

An even better chance of success can be obtained by combining medication and psychological support (see below) (USDHHS, 2000). Medication or pharmacological quitting-aids that have shown evidence of effectiveness in clinical trials include medical nicotine replacement patches or gum, the tricyclic anti-depressant nortriptyline, bupropion (Zyban, or Quomem in some countries), and the nicotinic partial agonist, varenicline (Chantix in the US and Champix elsewhere).

There are many people and organizations touting what are claimed to be effective methods of helping smokers to stop. Any smoker thinking of paying money for such help would be well advised to ask whether the claims of success are backed up by independent comparative clinical trials, how the success rates have been calculated and what numbers of smokers have been included in the figures. It is very easy to make misleading claims of success rates which are not adequately supported by evidence. A separate thorough review of the evidence for each of several methods and aids for stopping smoking is available via the Cochrane Library website, Cochrane Library. ( Cochrane Topic Review Group: Tobacco Addiction http://www.cochrane.org/reviews/en/topics/94.html )

A range of population level strategies such as Anti-smoking advertising (http://wiki.riteme.site/wiki/Tobacco_advertising#Anti-smoking_advertising), smoking restriction policies, and tobacco taxes have been used to promote smoking cessation. Of these, raising the cost of smoking is the one that has the strongest evidence (West, 2006).

Smoking cessation will almost always lead to a longer and healthier life. Stopping in early adulthood can add up to 10 years of healthy life and stopping in one's 60s can still add 3 years of healthy life (Doll et al, 2004). Stopping smoking is also associated with better mental health and spending less of one's life with diseases of old age.

The most effective programs for stopping smoking include strategies for dealing with common short-term side effects such as transient increased irritability, depression, anxiety, restlessness, difficulty concentrating, increased appetite, constipation, mouth ulcers or increased susceptibility to upper respiratory tract infections. The side effects are mostly gone within four weeks, though increased appetite typically lasts for more than 3 months. The most obvious adverse longer-term effect is weight gain (Hughes, 2007). Overcoming these temporary challenges is rewarded by the immediate enjoyment of lasting benefits including freedom from smoking and tobacco addiction, savings, health, and improving quality of life.

Statistics

A U.S Surgeon General's report includes tables setting forth success rates for various methods, some of which are listed below, ranked by success rate and identified by the Surgeon General's table number.

• Quitting programs combining counseling or support elements with a prescription for Bupropion SR (Zyban/Wellbutrin) found success rates were increased to 30.5 percent, (Surgeon General's Table 25, page 72).

• Quitting programs involving 91 to 300 minutes of contact time increased six month success rates to 28 percent, regardless of other quitting method included Surgeon General's Report Table 13, page 59]

• Quitting programs involving 8 or more treatment sessions increased six month success rates to 24.7 percent (Surgeon General's Table 14, page 60)

• High intensity counseling of greater than 10 minutes increased six month success rates to 22 percent whether added to any other quitting method, nicotine replacement, or cold turkey Surgeon General's Report Table 12, page 58]

• A physician's advice to quit can increase quitting odds by 30 percent to ten percent at six months Surgeon General's Report Table 11, page 57]

• Just Seven percent of over-the-counter nicotine patch and gum quitters quit for at least six months

Contradiction about Cold Turkey

The first paragraph of the section entitled "Methods of quitting the habit of tobacco use", states:

"By far the least effective method of quitting is the 'cold turkey' approach, where the smoker abstains from cigarettes through pure willpower. Tobacco is highly addictive, and this method only has a success rate of about 3-5%."

Later, in the section entitled: "Techniques which can increase smokers' chances of successfully quitting are:", it is stated:

"Quitting "cold turkey": abrupt cessation of all nicotine use as opposed to tapering or gradual stepped-down nicotine weaning. It is the quitting method used by 80[7] to 90%[8] of all long-term successful quitters."

You might want to decide one way or the other. —Preceding unsigned comment added by 74.128.197.58 (talk) 01:29, 6 November 2009 (UTC)

I noticed this too, but what I thought it meant was there's a success rate of 3-5% each TIME you try to quit cold turkey, but 80-90% of people who HAVE quit used that method. Still, it's kind of a lot, to suppose these quitters used the cold turkey method 14 to 23 different times (the number of times at 3 or 5% success rates at which it becomes more likely that you have quit). NickRinger (talk) 11:46, 16 November 2009 (UTC)

Noticed this as well, and I think it should be changed —Preceding unsigned comment added by 99.236.201.175 (talk) 03:38, 14 December 2009 (UTC)

I have removed this first paragraph. The source given was a paper with the conclusion that no actual conclusion could be made because there were not enough samples in the study. It also did not compare the results to other methods. The paragraph was also written in a very biased, casual tone. Since the claim contradicts virtually all other studies and reports, contradicts the article itself, was misinterpreted from a source (a source that clearly stated the data could not be used for statistical analysis anyways), it has been removed. The source in question was http://pt.wkhealth.com/pt/re/addi/abstract.00008514-200401000-00011.htm;jsessionid=Ln1CPBJSQnLGxLTKch2YGz6SdqvQQ2bZYdmbqwThvc0f9JVtT21v!2126095447!181195629!8091!-1 --24.188.249.142 (talk) 05:52, 15 December 2009 (UTC).

Removed "Programs" section

Pfizer and its drug was already mentioned throughout the article, appropriately so. There is no reason for a separate section for it. —Preceding unsigned comment added by 189.27.252.197 (talk) 21:48, 6 June 2010 (UTC)

should this be there?

at the bottom there are links in the "see also" section to sites that i guess are supposed to help people quit, do these belong? i thought there were only supposed to be links to other articles on wikipedia in that section? —Preceding unsigned comment added by 74.64.65.111 (talk) 08:59, 13 January 2011 (UTC)

Leukoplakia from spit tobacco. (called "smokeless" tobacco or "chewing" tobacco by tobacco industry)

White patches inside the mouth or white spots on the tongue

White patches inside the mouth and white spots on the tongue may be leukoplakia. Leukoplakia is a pre-cancerous area that is caused by frequent irritation. It is often caused by smoking or other tobacco use. People who smoke pipes or use oral or spit tobacco are at high risk for leukoplakia. If it is not treated, leukoplakia can become oral cancer. Any long-lasting mouth changes should be checked by a doctor or dentist right away.

http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_What_are_the_signs_and_symptoms_of_cancer.asp

Also, from Wikipedia's Article on Chewing Tobacco:

"Health Effects

Chewing tobacco has been known to cause cancer, particularly of the mouth and throat. [1] According to the International Agency for Research on Cancer, "Some health scientists have suggested that smokeless tobacco should be used in smoking cessation programmes and have made implicit or explicit claims that its use would partly reduce the exposure of smokers to carcinogens and the risk for cancer. These claims, however, are not supported by the available evidence."[1]

[Italic emphasis added]

—Preceding unsigned comment added by Ocdcntx (talk • contribs) 15:49, 17 January 2010 (UTC)

why would smoking a pipe be any different then smoking a cigarette (in terms of health effects? i have a very hard time believing that it would be any different. and no i dont have a source, but just think about it. it makes no sense at all, on a very basic level. i feel like somebody is pointing at something that is red and saying its green even though it clearly isnt. —Preceding unsigned comment added by 74.64.65.111 (talk) 09:02, 13 January 2011 (UTC)

This article doesn't seem very good to me

This article seems to me to contain far too many of what I can only term "lists of ideas" with no judgment or evidence.

I just removed a link from the article not because it is necessarily a bad link (it might be, though) but because it seemed more or less placed randomly and might be spam. (Please put it back if there's a good reason for it...)

I wonder what we can do to improve this article.--Jimbo Wales (talk) 02:44, 15 May 2010 (UTC)

To give an example of what I mean by "lists of ideas" check out the Intervention and Prevention section. It just lists a bunch of possibilities with no information at all. Most of the other sections are similar.--Jimbo Wales (talk) 02:47, 15 May 2010 (UTC)

I agree with you. This article needs work. One problem is that it uses public domain information from the U.S. Surgeon General, but that information "did not examine evidence regarding unaided quit attempts". The PLoS study, which is Creative Commons text and also usable, is named "The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences" (which points in my mind to the U.S. government file as being sadly lacking). -SusanLesch (talk) 01:40, 21 May 2010 (UTC)

Listening to Dr. Regina Benjamin today,[5] the U.S. hasn't been reading my complaints here. She just published the 30th report from the Surgeon General, but in a conversation on PBS she offered a wide array of quit aids (patches etc.). If I find the Surgeon General has ever studied people who just quit I'll be sure to post here. -SusanLesch (talk) 03:30, 10 December 2010 (UTC)

As of January 2011, I agreed with Jimbo Wales's comments of May 2010. Therefore, in February 2011 I edited the article to remove unsourced/unverifiable/irrelevant material and to add sourced/verifiable/relevant material. The article's length increased by almost two-thirds (from 44K to 73K) and the number of references more than doubled (from 54 to 121). Hopefully readers such as Jimmy Wales will no longer level criticisms at the article such as sections containing "no information at all." –PrevMedFellow (talk) 07:59, 28 February 2011 (UTC)

Deleted "Unsuccessful methods" section

I just deleted the Unsuccessful methods section header and moved its contents to the Cessation Methods (or whatever it was called) section. "Unsuccessful" is quite the value judgement to apply to alternative medicinal methods of quitting smoking including herbal cigarettes; if Big Pharma gets represented in the "legitimate" section of the article while others are excluded, that creates bias within the article. 99.245.254.91 (talk) 01:27, 27 June 2010 (UTC)

Thank you. It wasn't a very good solution on my part. So how would you include the results? For hypnosis, electronic cigarettes etc. -SusanLesch (talk) 03:29, 27 June 2010 (UTC)

Delete un-cited "Immediate effects of quitting"

This should be deleted unless someone can promptly find a source of this information, these could possibly be myths. 88.104.153.14 (talk) 13:37, 16 September 2010 (UTC)

Hi. I reworded them to a 2001 booklet from California. Thank you for questioning them. -SusanLesch (talk) 15:06, 16 September 2010 (UTC)

Dismissal of snus

The section mentioning Swedish smokeless tobacco uses a value judgement and dismisses it as a cause of mouth cancer which, according to Wikipedia's article on snus, has yet to be determined. There is a scientific debate over this point, and trhat should be reflected.58.152.80.152 (talk) 07:02, 19 August 2010 (UTC)

There has been a relentless barrage of edits designed to use this article to market Snus, making the precise and false health claim you mention. Additionally, scientific studies showing the proven carcinogenic effects of spit tobacco have been systematically erased.

Unfortunately, the article should probably be semi-protected to hamper this ongoing abuse. — Preceding unsigned comment added by Ocdnctx (talk • contribs) 13:44, 11 November 2011 (UTC)

Smokeless tobacco (snus) is a well established cessation tool in Sweden. Seems a pity to erase the whole section over abuse. Better to provide references (which btw another wikipedia article can not qualify as). — Preceding unsigned comment added by Magnus.ramstrom (talk • contribs) 13:23, 18 July 2012 (UTC)

The only misleading informationi about Swedish snus has been that there are still a small number of companies in Sweden who continue to produce snus manufactured with flue-cured tobacco (two I believe)...for the others who produce it with percolation cured tobacco there has been a twenty year study proving it does not increase incidence of mouth or pancreatic cancer. If we could say "percolation cured snus" instead of "Swedish snus" the nay-sayers would have to shut up. Tobacco does not cause cancer, TSNA's cause cancer, and the main way they are produced in tobacco is by curing the tobacco with smoke. OasisMike I've learned a new way of thinking. (talk) 18:37, 31 October 2012 (UTC)

meditation

Under alternative methods there is nothing about meditation. Any reason for that?Oxford73 (talk) 15:35, 31 May 2011 (UTC)

Why Nicotine Replacement Therapies Fail

There should be some mention that nicotine, while addictive, is not what gets us hooked on cigarettes & snus. It is the MAOI's present in the whole tobacco alkaloids (WTA) we really get hooked on, and not so much the nicotine. The main reason nicotine replacement therapies fail is because they only offer nicotine, and The People are deprived of the important information that there are MAOI's they also have become dependant upon. If you stop using tobacco altogether withdrawal only lasts a few days, but coupled with nicotine replacement therapy that period is extended to ten days. Thus the hamster-wheel effect that big pharma gets from users coming on and off of their "socially acceptable" products.

It would also be good to let People know that many undiagnosed with ADHD (or "Reward System Dystrophy" as I call it) will continue to have urges because they've learned to modify their dopamine, or brain chemistry, through the use of tobacco, and lack the proper context for understanding this and their condition. As long as ADHD is not connected to dysfunctional use of the Reward System we can expect a certain population of People to continue to have difficulties giving up cigarettes. (Which is why prohibition is not the right answer, and harm reduction products such as percolation-cured snus are important.

But, because of the public back-lash against the confusion big tobacco injected into the public debate, we continue to confuse tobacco with the cigarette companies (instead of realizing tobacco was popular for a reason, and offer a less harmful way of using it - it has become political, and least understood by those who would continue to criminalize ADHD behaviors instead of helping people develop the natural pathways to appropriate use of dopamine).

Why can't we tell the truth on wikipedia about this important topic, and maybe start saving some public money's used for tobacco related illnesses? Does anybody doubt smokers want to do things better? Just look at the number of people who try nicotine replacement therapies for a clue. Thanks, OasisMike I've learned a new way of thinking. (talk) 18:52, 31 October 2012 (UTC)

It isn't entirely clear what you're talking about, Mike, but the simple reason that it may be difficult to represent your views on Wikipedia at present is that this looks like 'Original Research'. Can you cite any scholarly articles which explain the point?Hypocaustic (talk) 23:36, 31 October 2012 (UTC)

Terminology: a question

The article states that tobacco can be difficult to stop using due to the development of strong physical substance dependence or psychological dependence (addiction). True enough. So why does everyone (including this article) always refer to someone who has given up smoking as an "ex-smoker" yet people who were addicted to alcohol, cocaine or meth are referred to as "recovering" alcoholics or addicts, the implication being that they're still addicts but are fighting a daily battle against their addiction (which is probably true, and Goddess bless them) while the implication is that "ex-smokers" are 'sorted, giving up was a one-off decision and they're now off their drug which was a piece of piss in the first place'". Not good terminology, really. I'd describe myself as a "recovering smoker". 213.122.225.6 (talk) 00:47, 16 November 2012 (UTC)

Fair question. Such points are often discussed within the varius addiction recovery professions and forums. Some different consenses apply, often depending upon the dominant theory or model. At one extreme, members of AA don't even describe themselves as recovering, just 'alcoholics' - albeit no-longer-drinking alcoholics. In the middle, many more mainstream addiction-recovery approaches do indeed describe those who use their services as recovering. In the smoking cessation arena, where it is known that there is no safe level of tobacco smoke exposure, there is a tendency (perhaps for convenience and calrity as much as theoetical purity) to refer to those trying to stop, often over several attempts, as recovering, while those who have succeeded and no longer smoke at all as ex-smokers. The language currently used in this article broadly reflects the actually used in the field at the moment. But, of course, this is Wikipedia; if you can do better, edit!Hypocaustic (talk) 17:52, 16 November 2012 (UTC)

External link

Hi. I added one external link underneath "Further reading". Dr. McFarland and Pastor Folkenberg came up with the first method to quit smoking, and it still works. We do readers a serious disservice to avoid listing it. -SusanLesch (talk) 19:06, 21 December 2013 (UTC)

Please ask on my talk page if there is discussion of this edit. I checked back and don't see any comments now but there might be some in the future. Thank you. -SusanLesch (talk) 15:11, 27 December 2013 (UTC)

Meditation May Aid Smoking Cessation

Meditation May Aid Smoking Cessation Treatment Medscape

A computational hypothesis for allostasis: delineation of substance dependence, conventional therapies, and alternative treatments Levy YZ, Levy DJ, Barto AG and Meyer JS (2013) A computational hypothesis for allostasis: delineation of substance dependence, conventional therapies, and alternative treatments. Front. Psychiatry 4:167. doi: 10.3389/fpsyt.2013.00167

Meditation Reduces Cigarette Consumption, Curbs Cravings Medscape

Brief meditation training induces smoking reduction PNAS — Preceding unsigned comment added by 99.190.133.143 (talk) 01:00, 7 January 2014 (UTC)

"smoked substance"

The introduction says that smoking cessation is discontinuing a "smoked substance", and yet the source cited refers only to nicotine. I've never seen "smoking cessation" refer to anything other than tobacco, and I don't think any major authorities use it to refer to anything other than tobacco. What is the WP:RS to support that definition? If nobody can provide one, we should change it. --Nbauman (talk) 15:12, 25 July 2013 (UTC)

Calendar of a person who gives up smoking — Preceding unsigned comment added by 178.66.196.138 (talk) 14:53, 31 August 2014 (UTC)

Electronic cigarettes as smoking cessation. New Studies

The section about e-cigs not being recognized as a smoking cessation aid should be updated as per this discussion on the e-cig talk page.TheNorlo (talk) 23:28, 17 December 2014 (UTC)

Edits by medical student on 5/9/15

I made a few edits to this article today - simplified the lede section and emphasized key points. Also made some changes to improve accuracy and readability of medications section based on current evidence. A number of the Methods sections could still use similar attention. Apheinz (talk) 19:04, 9 May 2015 (UTC)

Cost-effectiveness of cold turkey

While it is perhaps obvious to most, maybe it should be mentioned that the cost-effectiveness of cold turkey outperforms the other methods of smoking cessation. ('Cost-Effectiveness' section) — Preceding unsigned comment added by 81.206.211.104 (talk) 15:57, 30 June 2015 (UTC)

USPSTF

Review and guidance on smoking cessation: doi:10.7326/M15-0171 and doi:10.7326/M15-2023 JFW | T@lk 15:01, 24 September 2015 (UTC)

Editing An Existing Article

I am a nursing student and I have chosen this article to work on and edit over the next couple of weeks. I wanted to include the importance of smoking cessation and tobacco use in general through patient education by nurses. Below I have included some citations to articles I may use in my new section.

Monteiro Mantovani, V., Rodríguez Acelas, A. L., Lucena, A. d. F., Abreu Almeida, M., Paz da Silva Heldt, Elizeth, Klockner Boaz, S., & Echer, I. C. (2017;2016;). Nursing outcomes for the evaluation of patients during smoking cessation. International Journal of Nursing Knowledge, 28(4), 204-210. doi:10.1111/2047-3095.12138

Lepage, M., Dumas, L., & Saint-Pierre, C. (2015). Teaching smoking cessation to future nurses: Quebec educators’ beliefs. Western Journal of Nursing Research, 37(3), 376-393. doi:10.1177/0193945913510629

Siddiqui, F., Huque, R., & Dogar, O. (2016). Updated evidence-based guide to smoking cessation therapies. British Journal of Community Nursing, 21(12), 607-611. doi:10.12968/bjcn.2016.21.12.607

Christinacarnagie (talk) 22:14, 31 October 2017 (UTC)

I added a few areas of clarification to the introduction paragraph, which includes why smoking cessation has been emphasized in the past 10-15 years. Christinacarnagie (talk) 18:56, 16 November 2017 (UTC)

Welcome, Christina! Thank you for editing this crucial article. I'm not sure if you're new to Wikipedia, but if you are I encourage you to make sure you're familiar with WP:MEDRS guidelines. Again, welcome and happy editing! TylerDurden8823 (talk) 04:02, 17 November 2017 (UTC)

Dead Reference

Citation 108, attributable to:'Ossip-Klein DJ, McIntosh S, Utman C, Burton K, Spada J, Guido J (2000). "Smokers ages 50+: who gets physician advice to quit?" (PDF). Prev Med. 31 (4): 364–9. doi:10.1006/pmed.2000.0721. PMID 11006061.[permanent dead link]' is no longer accessible through the following web-link: http://cvhpinstitute.org/hls396/pdf/Smokers%2050+.pdf.

I am proposing a functioning link source for the cited research. It can be found here in .pdf format, https://themarijuanafacts.com/smokers-ages-50-who-gets-physician-advice-to-quit/

— Preceding unsigned comment added by Joseph.Berlingieri (talk • contribs) 15:29, 27 May 2019 (UTC)

Semi-protected edit request on 30 September 2019

This author (myself) has been renamed due to too many other authors with the same name, and the book has been rebranded - the inside is virtually unchanged

change ... Jason Wright (2013). Knowing How To Quit Smoking. 1. p. 38. ISBN 978-1494238452. to ... Jason Blackwolf (2013). Fag Off!. 1. p. 38. ISBN 978-1695873896 ICaveBear (talk) 09:39, 30 September 2019 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. Would have needed some sort of proof for this, though I can't see how the original book was notable enough to be suggested in Further Reading in the first place so have removed it. Cannolis (talk) 15:20, 30 September 2019 (UTC)

CP133 2019 Group 3 proposed edits

Jason: Under “Methods” -> “Medications” -> “Nicotine Replacement Therapy”, we would like to replace the word “nicotine spray” with “nicotine nasal and oral spray” instead, so that people will be more informed regarding the drug delivery method being used. The citation will remain the same as the source also mentioned about both oral and nasal spray formulations. Source is its current one at [25]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353172/ Jwei3 (talk) 05:13, 17 October 2019 (UTC)

Carmen: Under the section: “Substitutes for Cigarettes”, the wikipedia article makes the claim at the end of the first bullet point that NRT success rates are “evidently low; an estimate of 6.8% for patches and 7.9% for gums” and cited citation 115 which leads to what has been flagged as an “unreliable medical source”. I agree with this flag since it sites a website called “quitwithnerd” rather than published literature. I suggest remove this sentence and replacing it with the information from the source (below) stating that NRTs actually increase the rate of qutiting by 50-60%. This source comes from a published paper that compiled data from 136 studies gathered from the Cochrane TObacco Addiction Group trials. Source includes: doi: 10.1002/14651858 Cleung160 (talk) 05:42, 17 October 2019 (UTC)

Miranda: Under the section: Medications, when talking about the different types of NRTs it mentions the nicotine gum, inhaler, spray, etc and only lists local skin irritation and rarely non-ischemic chest pain as the only known side effects. This is untrue, as there are a number of different side effects specific to each formulation. For gum, one of the main side effects are mouth soreness and dyspepsia, the lozenge can cause nausea or heartburn, the patch can cause insomnia, and sleep disturbances in addition to a local skin reaction. The spray and the inhaler both cause local irritation Sources include: PMC 4465757. PMID 18617085. (2) doi:10.3322/canjclin.55.5.281. ISSN 0007-9235. PMID 16166074. Mwade94 (talk) 05:11, 17 October 2019 (UTC)

Christina: Section: Pregnant women, It’s mentioned that smoking during pregnancy may lead to pre-term babies that are underdeveloped, have weaker immune systems, and may become smokers later in life. We would like to add that it due to underdevelopment and weaker immune systems, these children may later develop metabolic conditions such as diabetes, kidney diseases, and hypertension [1]. Additionally, smoking during pregnancy increases the chance of sudden unexpected infant death (SUID). According to a study published by American Academy of Pediatrics, the odds ratio of SUID ([aOR] = 2.44) doubled with maternal smoking compared to non smokers (aOR = 0.77) [2]. Sources include: 1. doi: 10.3390/ijerph10126485 and 2. DOI: 10.1542/peds.2018-3325 — Preceding unsigned comment added by Jwei3 (talk • contribs) 05:10, 17 October 2019 (UTC) Chrliao (talk) 05:19, 17 October 2019 (UTC)

CP133 Group 2 Peer Reviews

Jimmy's Response: I believe that group 3 made reasonable contributions One of the value propositions of group 3 was that their edits improved clarity and succinctness of the syntax/nomenclature used in Nicotine Replacement Therapy. Because this is a clinical topic, it is important to use laymen's terms and cite the sources, which they correctly did. They also included data points from several sources about NRTs, which adds to the credibility. In all, I believe that the group has achieved its overall goals for improvement based on their Wikipedia edits, citations, and choice of syntax/diction. I especially commend Christina for her section that included an odds ratio and citation in order to provide quantifiable data sources for the readers.

• Is there any evidence of plagiarism or copyright violation? Upon inspection, there is no evidence of plagiarism or copyright violation. Each data point was correctly cited with the link to the study or name of the author. It was written from a neutral, objective point of view with a very professional style. Januvia Nguyen (talk) 23:40, 6 November 2019 (UTC)jimmy

Kaycee's Response: I think that the contributions made by Group 3’s members do improve the Wikipedia article. They added information such as important side effect information and special population considerations/warnings which are well supported from the resources the cited. They also did well with adding better sources to other editor’s comments making their work more valid compared to other less valid sources that were cited previously. I do believe that they met there proposed overall goals and executed them well.

Are the points included verifiable with cited secondary sources that are freely available? If not, specify - In regards to one of Chrliao's sources for an edit she made adding in pregnancy information, although it was a good source, it is actually a primary resource article: "Maternal Smoking Before and During Pregnancy and the Risk of Sudden Unexpected Infant Death". However after asking other people outside of pharmacy school if they could look up the source, it seems like it is still accessible by the public so I believe it is still a good source that can be used. It may be good to also find a secondary source to cite as well to help meet wikipedia's citing requirements. Ksangustinnordmeier (talk) 20:40, 6 November 2019 (UTC)

I believe this group's edits improve the article as described by Wikipedia's peer review "Guiding framework". It provided depth to the existing sections, such as the addition of citations from review articles that examined a large number of studies and elucidation of the effects that nicotine therapy may have on pregnancy and infants. Another thing they did well was adding the side effects to various NRTs along with the appropriate citation. All of the goals set by the group were accomplished in their edits. Their edits thus far reflect a neutral point of view. I was impressed by the removal of information from sources that were perhaps less credible and not neutral, as evidenced by Carmen's edit. There was no opinions or overstatement of facts in their edits. Kwokt (talk) 21:13, 6 November 2019 (UTC)

Ai's response: I believe that group 3 made some good edits that improve the quality of the article’s content. Specifically, Carmen pointed out the unreliable source and replaced it with the information from a more reliable published paper. I’m also impressed by how Miranda’s edits provide more insights in side effects of different formulations. This information will help the patients to notice the side effects easier and have appropriate modifications to their treatment. Christina also made a great discussion about the consequences of smoking mothers on the development of babies. Overall, I think their edits are presented in clear structure with neutral content, and all are cited from reliable sources. With that being said, Group 3 has achieved its goals for improvement. Aivu93 (talk) 22:17, 6 November 2019 (UTC)

Semi-protected edit request on 19 December 2019

Change "web applications" to "web and phone applications". Rocboronat (talk) 10:34, 19 December 2019 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Eggishorn (talk) (contrib) 21:31, 19 December 2019 (UTC)

Weight Gain

Hello, I noticed a well-written contribution today adding more detailed info to the weight gain sub-section. I have moved it to the talk page so that we can work to find a WP:MEDRS source, as the PLOS paper is a primary research study (cross-sectional study). @Rkrukows: thanks for article improvement. Please reach out to the community if you need help finding sources so we can add your sentence back in.

Here is the content that I moved to the talk page:
Individuals with normal weight or overweight who quit smoking, in particular, gain significant amounts of weight.

JenOttawa (talk) 19:21, 30 January 2020 (UTC)

stop smoking? have you thought about a smokers rights?

even if you are a doctor or my parent: i enjoy what i enjoy and attacking my choices is not your right to free speech. free speech in not having speech controlled by government and not the right to harass those you disagree with how they choose to live. just so you know. i get angry & start to hate someone when they tell me to live by their choice instead of mine. i have the right to pursue happiness without harassment

as a smoker: every time someone says to stop smoking it is only not Harassment if it is the first time you say it. Repeating unwanted statements at someone is a legal definition of Criminal harassment. i have put up with most people saying to quit smoking because they think it would make my life better. i decide what i enjoy and what i want and repeated verbal attacks to stop smoking are harassment.

so: if you think you have the right to say stop smoking remember i have the right to pursue happiness and that includes enjoying a cigarette. if you interfere with my choosing to smoke you are violating my right to pursue happiness. — Preceding unsigned comment added by ThoughtlessFool (talk • contribs) 23:33, 30 July 2020 (UTC)

Get over it, people these days are too pussified, can't even hear people express a view they dislike without feeling harassed. Nobody's interfering with you choosing to smoke by writing a wikipedia article about quitting. It's not like they're smacking the cigarette out of your hand. — Preceding unsigned comment added by 68.6.117.105 (talk) 17:00, 20 August 2020 (UTC)

Within the year before they were surveyed in 2010, 52.4% of adult smokers had made an attempt to quit smoking. Overall, 68.8% want to stop.

According to a large survey of Americans in 2010,

"... 68.8% of adult smokers wanted to stop smoking, 52.4% had made a quit attempt in the past year ...

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a2.htm?s_cid=mm6044a2_w

Morbidity and Mortality Weekly Report (MMWR) November 11, 2011 / Vol. 60 / No. 44

Quitting Smoking Among Adults — United States, 2001–2010

The above-cited survey report by the CDC tracks many interesting statistics germane to this article.— Preceding unsigned comment added by Ocdnctx (talk • contribs) 14:47, 11 November 2011 (UTC)

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