Smoking may be declining in the US but there are still around 60 million smokers here and in terms of harm reduction they are increasingly sidelined. This assumes that they choose not to migrate to smokeless - and not everyone will.

That leaves the cigarette business in a bit of a quandry - and the public health community too - strange bed fellows to say the least.

I don’t buy it that smokers will migrate en-masse to smokeless. It may have worked in Sweden but I content it won’t work (completely) here.

This leaves US cigarette smokers without harm reduction choices at present. Is this the way to treat your customers?

By CARLA K. JOHNSON,

CHICAGO (May — The federal government’s new advice to doctors for helping smokers quit recommends the drug Chantix, which has recently been linked with depression and suicidal behavior. The new guidelines mention the psychiatric risks but also say the popular Pfizer Inc. drug is the most effective at helping people get off cigarettes.

The guidelines mention other options, too, and highly recommend combining counseling and medication. But doctors are encouraged to talk to all smokers who want to quit about trying medication.

Consumer advocates cautioned that the safety picture on Chantix is incomplete because it’s a relatively new drug, on the market just since 2006.

“It is somewhat better than other therapies; on the other hand, it appears to have more risk,” said Dr. Sidney Wolfe of the watchdog group Public Citizen. “That part of the risk-benefit equation is missing, and it’s changing rapidly.”

Another issue with the quit-smoking guidelines, released this week by the U.S. Public Health Service, is the lead author’s past connections with Pfizer. Dr. Michael Fiore, an expert on smoking and health issues, was a consultant to the maker of Chantix. But he said he cut those ties in 2005.

Fiore’s views are shaped by his past ties to the drug industry, and those ties still pose a conflict, at least one consumer advocate said. John Polito, a smoking cessation educator who runs the WhyQuit.com site advocating quitting “cold turkey,” called the revised guidelines “a sales pitch” for the drug industry.

The task force overlooked research showing that quitting cold turkey works, Polito said, and studies showing Chantix is superior don’t reflect how it’s used “in the real world.”

“People are quitting smoking to save their lives,” Polito said. If Chantix’s risks outweigh its benefits, “then it’s insane for people to risk their lives” by using it, he said.

So what do you think is the risk worth it?

Do you know of anyone that has either a positive or negative experience with this drug?

Recently at a speaking engagement in Chicago, I met a user that quit smoking using the drug but refused to proceed to the fourth step as he feared the side affects  that he was experiencing.

Whose side are you on that of Fiore? or Polito?

Share your thoughts!

Let others know your opinion!

A study by the joint International Agency for Research on Cancer (IARC) and the World Health Organization’s (WHO) TobReg group seeks a new strategy to regulate cigarettes based on product performance measures with the goal of moving away from current measures involving the quantity of the smoke generated and the use of Tar, Nicotine and Carbon Monoxide values as measures of human exposure. Instead it recommends establishing median levels for 9 identified toxicants per mg nicotine in existing cigarettes and prohibiting the sale or import of cigarette brands that have yields above these levels (Tobacco Control April 1, 2008). But the authors acknowledge that no science exists to validate their choice of the 9 toxicants identified out of the 4,000 in cigarette smoke and that eliminating these 9 may increase the presence of others that may be more harmful. According to Prof. Michael Siegel of Boston University’s School of Public Health a regulatory approach that acknowledges that it is unclear whether it will make cigarettes safer or more harmful, “is too baffling… to comprehend” and the only way to describe it is “insanity.” Siegel noted that there is no evidence that the approach would even lower actual exposure to the regulated constituents, and it might even raise the risks of smoking by increasing the levels of non-regulated toxicants. He writes that the tobacco control movement is now admitting to “making recommendations that are not based on any science.” “TobReg wants to regulate cigarettes merely for the sake of regulating cigarettes, not because that regulation will make cigarettes safer,” he writes. He concludes that if this scheme is implemented, it would mislead the public about the risks of cigarettes on the market and transfer the “fraud that the cigarette companies have been found guilty of committing (by marketing “light” cigarettes as being safer alternatives) over to the federal government,” (tobaccoanalysis.blogspot.com 4/3)