Few of Canada’s 6.3 million smokers will deny that puffing can be a slow form of suicide. Many, though, have also found that trying to quit can seem like only a faster, more agonizing way of reaching the same end. Although it. was scant consolation, it became evident last year at a symposium on quitting held in Toronto by the College of Family Physicians of Canada that the enemy was far more than merely a bad habit. Graphs showing the chances of permanent escape from alcohol and heroin addiction were superimposed on one for tobacco addiction: they were identical.
“This was a real eye-opener,” says Dr. Bernard Marlow of Toronto, “the most convincing argument yet that smoking is a physiological addiction and not just a habit.” But what was also “very definitely an eye-opener,” he says, were reports on what at first must have sounded like just another, all-toosimple aid to quitting: a nicotine-containing chewing gum called Nicorette. Now, however, after less than a year of prescribing it, Marlow and other doctors are expressing uncharacteristic enthusiasm. Says Gary Handelsman, director of marketing and sales for Dow Pharmaceuticals of Toronto, which manufactures and distributes the gum in Canada: “We’ve received about 200 letters from doctors, which is quite unusual. Frankly, I’ve never seen anything like this.”
Although the gum was introduced without much fanfare, Handelsman estimates there are now between 5,000 and 10,000 prescriptions being written for it every month in Canada. Chewed on a need basis, it releases enough nicotine to prevent physical withdrawal symptoms and at the same time frees the patient to concentrate on breaking the psychological and social dependency .While the gum contains more nicotine than a cigarette, the drug is released slowly, and unlike what happens with every inhalation of cigarette smoke, there is no pleasure signal sent to the brain, that fleeting but rewarding rush a pack-a-day smoker experiences 70,000 times a year. With the exception of the nicotine, the body also no longer has to contend with the 4,000 or so chemicals generated by lighting a cigarette.
The gum was developed in Sweden where it has been used in hospital smoking clinics for 10 years. Studies there indicate it may be by far the most successful approach yet to quitting: 68 per cent of those who use the gum for at least four months (the “magic number,” says Marlow) have remained nonsmokers in follow-up studies as many as three to four years later. Although it’s too early for comparable Canadian studies, Marlow says that among his patients 50 to 75 already seem to have successfully quit. “In the past our record as physicians was dismal. In the entire eight years I’ve been in practice I had maybe persuaded 10 people to quit.” One of his patients, Mehmet Ucar, a pack-a-day smoker until four months ago, admits the gum relieves the urge completely, but adds: “I never chewed gum before. In fact I loathe the darned thing. My jaws get tired.” Wayne Clark
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