Both the diet and the nicotine alternatives take account of the fundamental problem which has been ignored for so long, namely, that nicotine is an addictive drug and is apt to require some manoeuvring before you can get unhooked from it.
Chewing tobacco can serve as a stop smoking alternative, too, for some people. A Danish doctor writing in The Lancet reports that, after several unsuccessful attempts to stop smoking by other methods, he was finally able to overcome his heavy addiction to cigars — eight or ten a day — by placing a little wad of chewing tobacco between his gum and his cheek. “This remarkable result,” he says, “shows that the smoking habit can be broken in a surprisingly simple way. The probable explanation is that blood nicotine is kept at the ‘right’ level by absorption through the mucuous membranes of the mouth.”
Nicotine chewing gum is another stop smoking nicotine alternative. Developed in Sweden and called Nicorette, it is already sold in a number of countries, including Canada, England and Switzerland.
A special feature of the gum is that it is buffered; it alkalinises the saliva. And this, as you saw earlier, makes absorption through the membranes of the mouth much easier. The gum, which releases the nicotine slowly for about half-an-hour, comes in two strengths, 4mg and 2mg. The 4mg version gives roughly the same nicotine blood concentration as one high-nicotine cigarette without, however, the peak level. People trying to stop are advised by their doctor to reach for a piece of the 2mg gum instead of a cigarette when they get a strong urge to smoking a year later, compared to 14 per cent of a group that had received only psychological treatment in stopping clinics. Addiction to the gum occurred in no more than 3 per cent of the cases; the gum does not produce the very addictive highs of cigarettes but definitely eases withdrawal pangs.
An abrupt switchover from cigarettes to gum, using the gum for four months, even if daily consumption is low, and then tapering off. He advises keeping an emergency supply on hand for up to a year, in order to avoid falling back into the smoking habit.
These points can be of practical importance to anyone who uses snuff as a stopping aid. They suggest that one should not attempt to cut off the use of snuff too soon if there is a risk of resuming the far more dangerous practice of smoking cigarettes.
Pipe or cigar Would either a pipe or a cigar be a sensible nicotine alternative for somebody trying to kick the cigarette habit? Before answering that question, there are two or three points to consider.
First, how do the two habits — cigarettes on the one hand, and pipe or cigars on the other — compare as to long-range risks? A pipe or cigar smoker of the traditional sort, one who does not inhale, is in much less danger than a cigarette smoker. There is, of course, some hazard, such as that of developing cancer of the mouth or the throat.
However, the big problem is that if you have been a cigarette smoker and you switch to a pipe or cigars, you are likely to continue inhaling unconsciously out of habit. In that case, you really have not made any progress, even if you think of the pipe or cigars as simply a temporary measure. Worse still, if you end up by adopting a pipe or cigar long-term and inhale, then you are just as badly off as you were with cigarettes; inhaled pipe or cigar smoke is every bit as dangerous as inhaled cigarette smoke.
So there is a fundamental difference between the “primary” pipe or cigar smokers — as the medical experts call those who have smoked only a pipe or cigars from the start — and the “secondary” pipe or cigar smokers, who have switched over from cigarettes at some point or other. Because of this, neither pipe-smoking nor cigar- smoking seems to be a good nicotine alternative in a cigarette-stopping effort, unless one is sure not to inhale.
