The WHO has failed miserably to get smokers to quit. The problem is an over-reliance on nicotine replacement therapy. That's according to doctor and smoking cessationist Riccardo Polosa.
Medicated nicotine such as patches and gum, anti-addiction medicines such as Champix and Zyban. These are the WHO recommendations for smokers trying to quit. These are also the drugs at the top of the list when doctors in Sweden and other countries help smoking patients. But according to the doctor Riccardo Polosawho has been running a stop-smoking clinic in Sicily for 20 years, it is no longer sustainable.
"The WHO has not understood how smokers work, on a psychological level. Smokers don't like to be seen as sick. And using drugs to get smokers to quit doesn't work in the long run." says Ricardo Polosa during a conversation about the future of the WHO Tobacco Convention.
Medicines only work temporarily
He is supported by Professor Jed Rose, the doctor who invented the nicotine patch at the end of the last century. The nicotine patch has long been promoted as an aid for smokers trying to quit. But according to research conducted by Jed Rose himself, at his clinic at Duke University, different nicotine medicines are a problematic approach.
"Patches, gum and medicines like Zyban and Champix are effective in the short term. According to our studies, half of the patients are smoke-free after 12 weeks. The problem is what happens later, after 6 months up to a year. Then we see many relapses to smoking. Only between 10 and 20% are still smoke-free. We have a great need for innovation here" says Jed Rose.
And that's where products like e-cigarettes and other smokeless nicotine products come in, says Jed Rose.
"These are smoke-free products suitable for long-term use. They have the potential to replace nicotine intake from cigarettes, but in a less harmful form." he says.
E-cigarettes more effective
Jed Rose's observations have been supported by several independent studies. According to the Cancer Research UK (CRUK), e-cigarettes are the most popular way to quit smoking among smokers. Moreover, when combined with professional support, e-cigarettes are very effective, twice as much as traditional nicotine medicines. CRUK sees vejpning as an important weapon in the fight against cancer. Especially in the long term.
Smoking despite lung disease
The doctor Riccardo Polosa has been using electronic cigarettes for 10 years as part of his smoking cessation program. He has also researched the technology and its health effects for smokers with documented lung diseases. He argues that smokers, especially older people with medical conditions, do not want to give up cigarettes. Despite life-threatening diseases and failing health
"Smokers are difficult to work with. Most smokers want to quit smoking, but they don't want to stop using cigarettes. They know the risks, but cigarettes are worth much more to them. Cigarettes are part of a social context, something to do, to enjoy with a cup of coffee, a way to socialize, meet friends and so on." says Riccardo Polosa.
Motivation disappears
Nicotine replacement therapy has no chance of replacing this value, says Riccardo Polosa. And that is why the preparations do not work in the long run.
"The motivation to quit eventually disappears. And at the same time, the value of all the 'benefits' of cigarettes remains. So they start smoking again," he says.
Smokers keep the rituals
Not only do smokers not like to be medicated, they are also not interested in paying expensive money for their medicine, according to Riccardo Polosa. So when e-cigarettes appeared as an alternative 10 years ago, he was quick to test them in treatment at the clinic.
"Electronic cigarettes are a tool that allows smokers to maintain their rituals. This is a psychological aspect of smoking and smoking cessation that we doctors often miss when we talk about harm reduction and smoking cessation"
Support from authorities
Men The WHO's influence is strong. Several countries have either banned e-cigarettes or regulated technology in the same way as traditional cigarettes. Some exceptions are the authorities in United Kingdom and New Zealand which instead actively encourages smokers to switch to e-cigarettes. According to the UK Department of Health e-cigarettes 95 less harmful than cigarettes and the Agency regularly updates its analysis of the research. In these countries, both health professionals and doctors are trained based on the independent research available today, mainly from the UK and the US. The view is that the nicotine in question is not particularly harmful in itself. Rather, it is the smoke as a delivery method that causes the main harm.
"Turning a blind eye to addiction"
Riccardo Polosa is now calling on the WHO to change its approach and encourage harm reduction products such as e-cigarettes, instead of turning a blind eye to the potential risks of nicotine addiction.
"The fact that we now have a much cleaner method of delivering nicotine is a huge advance. And innovations in e-cigarettes have given smokers really effective ways to keep the nicotine, which they find so hard to give up, without smoking. Addiction is a price to pay, but it's the key to a successful smoking cessation strategy" says Riccardo Polosa.
