South Carolina Ignores Dying Nicotine Addicts

Imagine combining all our state’s annual deaths from auto accidents, AIDS, breast cancer, fire, liver disease, infant death, murder, suicide, and all illegal and legal drugs, and the total (4,216) not coming close to the number of nicotine addicts who will smoke themselves to death this year (5,992), half during middle-age. Imagine a society that ignores their dying.

CHARLESTON SC – Collectively, S.C. annually spends in excess of a billion dollars attempting to prevent the 4,216 deaths in the above non-smoking categories. Sadly, today’s state budget does not devote one thin dime toward helping save any of this year’s 6,000 doomed smokers, or to try and prevent the early demise of the hundreds of thousands of nicotine dependent citizens lined-up behind them to die.

If true, what does it say about the priorities of medical and health leadership that fully understand the smoker’s deadly struggle yet knowingly discriminate when it comes to treatment? What does it say about political conviction that expresses profound concern over any needless loss of life, liberty or happiness unless the villain is nicotine and the victim a citizen addicted to smoking it?

What message did our state send smokers when it took the first 5 million of our billion in tobacco settlement proceeds – dollars indirectly paid by addicted and dying S.C. nicotine addicts – and made it an outright gift to our 2,000 nicotine farmers?

What does it say about the real motives of hospitals across S.C. that collectively spend untold millions in marketing an image that pretends to be deeply concerned about preventive community health while turning a blind-eye to their community’s most preventable killer of all?

A persistent cough is often the first sign of lung cancer. What does it say about thousands of irresponsible nicotine merchants who smile while taking the coughing smoker’s drug money after hearing them proclaim “Dear God, I wish I could quit!” Why no moral obligation to help?

It isn’t that our smokers don’t want to quit. Annual CDC surveys consistently find that 70% are dying to taste freedom, and over one-third of S.C. smokers annually muster the confidence for another mad dash toward it. It’s that roughly half of our state’s 800,000 adult smokers won’t discover or be taught the secrets to success before their self-destruction is complete.

The Canadian government’s cigarette pack warning label reads, “Cigarettes are highly addictive.” “Studies have shown that tobacco can be harder to quit than heroin or cocaine.” Their government knows that drug addiction isn’t about getting high but about how the brain gets rewired to define a new sense of normal.

If true, as 2004 approaches, why do we continue to discriminate by providing illegal drug users effective treatment while denying effective treatment to those addicted to a legal chemical that almost all addiction experts agree is harder to arrest and far more deadly?

Why do Philip Morris commercials now fill our screens proclaiming that nicotine is addictive? For years it asserted that smoking was only habit forming but not truly addictive like heroin or cocaine. Are they now trying to set the record straight so as to avoid a flood of addiction warning lawsuits? Are we listening?

Those who insist on continuing to teach S.C. youth that smoking is just a “nasty little habit” are playing a deadly contributing role in helping doom one-quarter of them to a life of permanent chemical captivity. While 10% of regular alcohol drinkers and 15% of cocaine users will become chemically dependent, nicotine permanently enslaves the brains of up to 90% of regular users. But how?

Nicotine is the tobacco plant’s natural protection from being eaten by insects. Drop for drop it’s more lethal than strychnine and three times deadlier than arsenic. Yet, amazingly, by chance, this natural insecticide’s chemical structure is so similar to the neurotransmitter acetylcholine that once inside the brain it fits a host of chemical locks permitting it direct and indirect command and control over the flow of more than 200 neurochemicals, including dopamine, serotonin and adrenaline.

The brain’s defenses do their best to minimize the poison’s impact. In some neuro-circuits the number of receptors available to receive nicotine are diminished, in others the number of transporters are reduced, and in still other regions the brain grows millions and millions of extra acetylcholine receptors, almost as if trying to protect itself by more widely disbursing the arriving pesticide.

There’s only one problem. All the physical changes engineer a new tailored neurochemical sense of normal built entirely upon the presence of nicotine. Now, any attempt to stop using it comes with hurtful anxieties and powerful mood shifts. Returning home now has a price and a true chemical addiction is born.

The brain’s protective adjustments leave the quitter temporarily desensitized. Their dopamine reward system will offer-up few rewards, their nervous system will see altering the status quo as danger and sound emotional anxiety alarms throughout the body, and mood circuitry will temporarily find it difficult to climb beyond depression.

Here in Charleston County our drug treatment program is known as “Charleston Center” and has 125 full-time employees. It is a joint project of Charleston County and DAODAS and has an annual budget of million.

If you call the Center and ask if they have a smoking cessation program you’ll be told, “yes but it’s only for staff members.” If you tell them you have emphysema, that breathing is getting hard and you beg to participate in it you’ll be told, “we’re sorry but it’s only for staff members.”

The Center’s online budget indicates that it spends an average of ,665 for each of the 1,670 persons seen by outpatient services, ,182 for each of the 121 participants in their recovery and self-sufficiency program, ,715 for each of the 171 participants in their opiate treatment program, and dollars to help zero nicotine addicts, unless you’re an addiction center staff member in need of effective treatment.

“But smokers don’t need real drug treatment programs like the one that recently benefitted Rush Limbaugh,” politicians assert, “they have the nicotine patch, gum and lozenge.” Oh, how the estimated 119,840 S.C. families today trying to cope with or survive a host of smoking induced cancers, C.O.P.D. (emphysema and chronic bronchitis), heart attacks and strokes wish it were so. The marketing hype surrounding over-the-counter (OTC) nicotine replacement therapy (NRT) products vastly exceeds reality.

A March 2003 study published in Tobacco Control combined all seven OTC patch and gum studies and found that 93% of study participants had relapsed to smoking within six months. Although a well kept pharmaceutical industry secret, NRT’s one year relapse rate is believed to be 96-97%. To make matters worse, we’ve known since studies in 1993 and 1995 that the relapse rate for second time or subsequent nicotine patch users is almost 100%.

But the bad news doesn’t stop there. A just released November study, also published in Tobacco Control, found that as many as 7% of all gum quitters are still chewing nicotine at six months and 2% of patch users are still wearing it. That’s three months beyond FDA use recommendations. When combined with the March study the obvious question becomes, are any gum users nicotine free at six months?

Another dirty little NRT industry secret revealed in the November study was that 36.6% of those using the nicotine gum are now classified as chronic long-term users.

There is absolutely no science or logic indicating that high quality drug treatment programs are effective for illegal drug users but ineffective for nicotine addicts. To the contrary, many short-term nicotine dependency programs are today generating six-month recovery rates ranging from 30 to 50% but search as you might you won’t find one here in the Charleston area.

Calls to the Charleston branch of the American Lung Association, Heart Association and Cancer Society will all generate similar answers, “no sir, no quitting program here.”

What is the combined price paid statewide to try and reduce or eliminate our fewer than 100 annual fire deaths? What logic is there in paying hundreds of millions to protect against the risk of being burned to death by fire but not one penny when the fire and smoke claiming 6,000 lives annually is the result of chemical addiction during youth? Why do firefighters campaign to raise funds for popular health causes while ignoring death by chronic smoke inhalation?

Almost ninety percent of S.C. smokers became hooked while children or teens. Is death an average of 5,584 sunrises early the proper punishment for trying to look more adult during childhood?

Our political leaders court the nicotine addict’s vote, accept and spend their tax dollars on every important cause but saving them, are now considering a substantial increase in the nicotine addiction tax without providing any avenue of escape, and continue ignoring the six thousand annual deaths that they know they have the ability to help prevent.

Our medical universities, hospitals and doctors seem almost content to use smokers as well. Most family physicians will repeatedly treat and accept payment for what they know are smoking induced respiratory and circulatory ailments while ignoring treatment of the underlying cause.

What incentive is there for our medical universities and hospitals to provide free, effective and ongoing treatment programs when they depend upon smokers to keep so many area cancer, respiratory and cardiac treatment centers in business, and hospital beds are being filled by bodies riddled by emphysema, cancer, heart attack or stroke?

The concepts of smoker fault and just punishment become apparent when we reflect upon the degree of public concern, public funding and literature devoted to detection and early screening for breast cancer, when lung cancer is a bigger annual killer of S.C. women.

Where is the lung cancer screening message or help in defeating its primary root cause? Is the disparity of concern and funding associated with the fact that politicians know that 87% of lung cancers are caused by smoking, while women with breast cancer are seen as innocent victims?

Is South Carolina at the very bottom of the barrel in almost all national health categories by chance, design, ignorance, a lack of political will, or because of ineffective leadership within the medical community?

When will the creed “first do no harm” cause physicians to stop ignoring and begin treating a powerful dependency that is slowly killing so many of their patients? When will politicians begin taking their constitutional oath to protect the public health seriously? How many more must die before we begin loving all neighbors equally, even those who became chemical slaves during childhood?

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FOR IMMEDIATE RELEASE

About the Author: John R. Polito is a South Carolina nicotine cessation educator and the 1999 founder of WhyQuit, a free online cessation motivation, education and peer support forum. Email – [email protected]

Fact References Available Upon Request