The existence of about 300 methods for giving-up smoking reflects the extent of the difficulty in trying to overcome nicotine addiction, lung-cancer specialists meeting in Dublin have been told. Despite the various techniques outlined in medical research literature, 90 per cent of smokers who successfully quit do so without outside help, according to Dr Daniel Ihde of Washington University School of Medicine in St Louis in the US.
Prevention of lung cancer is theoretically simple. No one should ever begin to smoke cigarettes, he said yesterday, but reality was different. The US has 50 million current and 40 million former smokers, notwithstanding a 0.5 per cent decline in smoking over the past decade - a similar trend of decline has occurred in Europe.
The specialist in lung cancer prevention said the most effective smoking-cessation clinics helped clients to prepare for quitting and continued contact through what was known as "maintenance". Am ong 46 centres with this approach, a cessation rate of 27 per cent was achieved when analysis of most of the programmes was done a year later - the wish to give up smoking was indisputable but fewer than 3 per cent on average succeed.
Pharmacological treatments using nicotine could aid smokers in coping with the effects of withdrawal. "Nicotine polacrillix can reduce symptoms of withdrawal such as anxiety, weight gain, decreased concentration and diminished task performance. Controlled trials support [the view] that behavioural interventions given in conjunction with nicotine are superior to nicotine alone."
On passive smoking, he said analysis of 30 studies had concluded that environmental tobacco smoke was associated with a 35 to 50 per cent increased risk of lung cancer. "Of these studies, 24 found an increased risk of lung cancer in non-smoking wives of smoking husbands." An analysis of lung cancer deaths due to passive smoking found that workplace exposure was responsible for a clear majority of cases in comparison to exposure at home. Passive smoking was also found to increase significantly the risk of heart disease.
Production of filter cigarettes and cigarettes with less tar and nicotine were probably a response by the tobacco industry to the negative health consequences of smoking, Dr Ihde told the eighth World Conference on Lung Cancer.
Filter cigarettes were claimed to remove certain harmful substances from tobacco smoke yet these were never acknowledged to be harmful by the manufacturers.
Such low-tar/nicotine cigarettes were now the product of choice for about 97 per cent of smokers, yet they could in many instances deliver the previous doses they were used to. "Individuals who smoke these products often utilise `compensatory smoking' - inhaling more often and more deeply - to continue receiving the level of nicotine to which they have been accustomed or addicted."
The rate of lung cancer "continues to increase rapidly in women and has begun to decline in men" fuelled by advertising targeted at women over many decades. Its roots, he noted, went back as far as the 1920s with "Reach for a Lucky instead of a sweet" and was typified by "You've come a long way, baby", from the 1960s.
Despite the US tobacco industry agreeing to pay $368 billion in settlement of claims by 40 states for medical compensation, Dr Ihde stressed it was not a one-sided agreement. Their product was in effect going to be sponsored by the US government. He acknowledged that the agreement would only apply to 4 per cent of the world's tobacco industry.
