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Nicotine, Please! The Odds of Quitting Smoking

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Mad Men, AMC’s Emmy award–winning drama concerning the lives of ad men (and women) in the 1960s, has drawn heavy fire and heavy praise for its depiction of heavy smoking. Almost every character with a spoken line can be seen lighting up at some point—children included.

Even the critics have to admit the show is true to its era. The zenith of America’s nicotine habit was 1965 when 1 in 2.39 adults smoked—that’s 1 in 2.97 women and 1 in 1.95 (a full 51 percent of) men. Since that time, smoking has been on the decline, but behind every quitter is a story.

The odds a daily smoker eighteen or older has tried to quit smoking in the past year are 1 in 2.49—meaning for every smoker who lights up at least once a day, 2 out of 5 have tried to cut it out. But beating the urge is, for some, an overwhelming, backsliding, Sisyphean trial. Of those adults who resolved at New Year’s to quit smoking, only 1 in 3.45 will keep their resolution throughout the year.

Enter the smoking-cessation industry. There are quite possibly as many ways to wean off nicotine as there are ways to consume it—snuff included.

The Nicotine Patch: First available by prescription in 1992, and one of the first anti-smoking systems to be heavily marketed, the patch was co-invented by Drs. Jed Rose (director of Duke’s Center for Nicotine and Smoking Cessation Research) and Murray Jarvik (pioneer LSD researcher and uncle of Robert Jarvik, inventor of the first artificial heart). The idea for the patch came in 1981, from Rose’s brother, Daniel. The latter had heard of transdermal delivery of motion sickness medication, and the three began researching the effects of nicotine absorbed through the skin. Jarvik, a nonsmoker, was diagnosed with lung cancer the same year his patch became available to the public. He survived it, living until 2008.

Nicotine Gum: Also made available in the United States in the 1990s, nicotine gum—another form of nicotine replacement therapy (NRT)—gradually releases 2 to 4 milligrams of nicotine into the body, temporarily eliminating the symptoms of nicotine withdrawal. Over time, quitters are encouraged by most nicotine gum brands to decrease the frequency of (or dosage level of) gum chewed.

Inhalers and the Electric Cigarette: Like nicotine inhalers, the “e-cigarette” delivers a dose of nicotine to stem cravings. While both are tobacco-less, the inhaler aerosolizes nicotine like an asthma inhaler—the two are often indistinguishable—whereas the electronic cigarette, shaped like a cigarette or pen, vaporizes the nicotine solution with an embedded lithium battery. Due to the presence of traces of tobacco-specific carcinogens and the potential for misuse, the U.S. Food and Drug Administration, Health Canada, and the World Health Organization have all advised against the use of e-cigarettes.

Smoking Vaccine: Finally, the newest smoking cessation method, still in development in the United States and Europe, is the so-called “smoking vaccine.” The most heavily publicized, NicVAX, developed by Nabi Biopharmaceuticals, is the first anti-nicotine vaccine to reach Phase III trials. Anti-nicotine vaccines work by introducing a nicotine-like molecule into the bloodstream, prompting the body to produce nicotine-binding antibodies. Unlike NRT, the vaccine prevents the addictive chemical from ever hitting the brain. Over the course of a year, multiple injections increase one’s immuno-resistance to nicotine. One may smoke, but he or she will receive no pleasure from it. The vaccine’s effects are not permanent, but they last long enough to discourage smoking in individuals who cannot—or will not—quit cold turkey.

But what if you happen to smoke on camera, for a living—how do you avoid getting hooked? In an interview with New York magazine, Jon Hamm of Mad Men was asked this very question. It turns out, most of the show’s actors smoke herbal, nicotine-less cigarettes, which taste, according to Hamm, “like a mixture between pot and soap.” A few actors smoke the real thing, “but not to the extent we smoke the fake ones, or we’d all be dead.”

And whatever the cause—smoking cessation methods, anti-smoking campaigns (like, a court-ordered ad campaign funded by Philip Morris), increased health awareness, higher tobacco prices—Americans today are, per capita, smoking less than ever: the odds an adult smokes are 1 in 5.08. An adult is likelier to believe in reincarnation—1 in 5—than to smoke.

Originally published on Book of Odds


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