Nicotine replacement has no proven benefit in quitting, say all the papers

Here is an example. And another, from north of the border.

Stories like this used to be commonplace. Sometimes, like this one, they were brought out to herald national no-smoking day. As ever their aim was to convince people that the best way to stop smoking was to rely on a nicotine crutch and under no circumstances to depend on your own will power.

Freedom 2 Choose (the UK group) has long campaigned for recognition that the claim 'four times more likely to quit with the NHS' was based on as much hot air as the claim that the Scottish smoking ban resulted in a 17 per cent drop in heart attacks (press release from 2009 can be read here). The Scottish group, Freedom to Choose group (Scotland) held its own demonstration at the 2010 (Glasgow) conference of the United Kingdom National Smoking Cessation Conference: the annual trade fair of smoking cessation professionals (the 2012 conference has yet to be announced).

The announcement that smoking cessation medications don't work any better than will power has had a muted reception from anti-smoking professionals. John Britton, of the UK Centre for Tobacco Control Studies, says it is 'not a surprising revelation' (is he about to resign, then?) He seems to feel that the availability of NRT gives people the necessary inspiration to quit, even though it doesn't actually make them any better at doing it. Deborah Arnott of Action on Smoking and Health seems to have her head in the sand:

Deborah Arnott, chief executive of the Action on Smoking and Health (Ash) charity said there was good evidence that the provision of medication and counselling to help smokers quit, as provided by the Stop Smoking Services in the UK, was effective and cost-effective. "Ash agrees, however, that it is essential that such support is provided as part of a comprehensive tobacco control strategy, which includes mass media campaigns to encourage smokers to quit."

Arguing along the same lines, research leader Gregory Connolly (Center for Global Tobacco Control, Harvard School of Public Health) adds:

"We have to think about, when we go into the real world, what are the other factors out there that are contributing to the relapse that the drug is not [addressing]," he said. "Clearly we know that social interventions such as price, clean indoor air policies and very strong public education campaigns do have a long-term effect and we can show that through population research." [emphasis added]

What do we know about clean air policies and strong public education campaigns? That they have led directly to stagnation in the long-term decline in smoking. The driver to smoking cessation is volition. Wanting to give up is key. Mass media campaigns don't help when their intent is to frighten people into quitting or otherwise ostracise or demoralise them.

The only effective starting point is wanting to quit. And being aware that some of the people and institutions who tell you how difficult it is want to make money, or prove their worth to society, by helping you.