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PAPERS: Thorsteinn Blondal, Larus Jon Gudmundsson, Ingileif Olafsdottir, Gunnar Gustavsson, Ake Westin, and John Stapleton Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up • Commentary: Progress on nicotine replacement therapy for smokers BMJ 1999; 318: 285-289 [Abstract] [Full text]

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Nicotine nasal spray

Alasdair J Macdonald   (4 February 1999)

Addiction to Nicotine

Roger Smith   (4 February 1999)

The real "enemy" is not the nicotine, it is the habit

Loni Klingenfuss   (1 June 1999)

Nicotine nasal spray 4 February 1999
Alasdair J Macdonald Send response to journal: Re: Nicotine nasal spray	EDITOR - Blondal et al (1) make a valuable contribution to the literature. However commercial snuff is a cheap and effective way of providing intranasal nicotine to reduce craving for smoked tobacco. There is no evidence that snuff will be hazardous over the seven month period recommended. The financial cost of snuff to the individual and to society is minimal by comparison. Alasdair J Macdonald, Consultant psychiatrist and former smoker, Garlands Hospital, Carlisle CA13SX 1 Blondal T, Gudmundsson LJ, Olafsdottir I, Gustavsson G, Westin A. Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up. BMJ 1999:318:285-9. (30 Jan)
Addiction to Nicotine 4 February 1999
Roger Smith, Primary Care Specialist in Drug Dependency Community Health Sheffield Send response to journal: Re: Addiction to Nicotine	I am concerned about the addictive nature of nicotine in the use of nicotine patches,gum and nasal sprays. This aspect of treatment seems to be neglected in the majority of articles dealing with the use of these patches, gum or sprays in stopping smoking. I can see that stopping smoking is of prime importance to a person's health, but an addiction to nicotine also has long term irreversible problems. Recently several patients have reported all the classic symptoms of addiction in trying to stop using the patches. The use of nasal sprays may" mimic the extremely rapid, rewarding,high arterial nicotine concentrations from inhaled tobacco smoke",but seems potentially even more addictive than nicotine patches or gum. In the effort to stop people smoking I do not think the addictive property of nicotine should be ignored, the patient has a right to know of the potential risks.
The real "enemy" is not the nicotine, it is the habit 1 June 1999
Loni Klingenfuss, Artist Home Send response to journal: Re: The real "enemy" is not the nicotine, it is the habit	I smoked for almost 30 years a very large number of self-rolled cigarettes every day.I knew that smoking is somehow stupid and bad for health. Finally I got a bad cough and connected with this big fear. So I analysed my behaviour. There was not much difference between me and a Junkie or an Alcoholic. This was the right argument for my mind. But the real problem was the psychological dependence. I heard, that for in example in USA herbal cigarettes are available. In Germany it is a law that cigarettes may be produced and sold only when made with tobacco. But finally I found a source where I got herbal cigarettes. After three days I smoked no more nicotin. I had no problem. There was no desire for nicotine at all, in contrary: the thought of consuming nicotine I found disgusting. Every now and then I still smoke a herbal cigarette. But I don't really need it any more. Most of the time I forget all about the desire for smoking. For myself it looks a bit absurd: the way to get rid of smoking by further application of the poison. The real "enemy" is not the nicotin, it is the habit. That ist my experience.