Intended for healthcare professionals

Rapid response to:

Feature Tobacco Control

Tar wars over smoking cessation

BMJ 2011; 343 doi: (Published 08 August 2011) Cite this as: BMJ 2011;343:d5008

Rapid Response:

Re:Smoking cessation trials should end use of placebo controls

I personally have seen on many occasions how the use of over the
counter Niacin tablets, can be used successfully to reduce and / or
eliminate the cravings when quitting. With the cravings eliminated all
that remains is the habit. Biologically this would seem to make perfect
sense in place of nicotine poisoning by direct and transdermal ingestion
of raw nicotine, few remember that smokers burn their nicotine [a product
with an ignition point below it's boiling point] producing nicotinic acid
and little nicotine remains in what is finally ingested, which is what
they actually crave. In spite of the physical realities the
denormalization myths, originating from the pharmaceutical industries,
reign supreme over the actual science.

Niacin is a valid alternative however the idea is continually
rejected by the medical community. When it allows a chance of success
beyond placebo, how can it be removed as a possible solution? If there is
a contender to compare with the Patches and gum, niacin in varied dosages
should be the product against which the official "alternatives" should be
judged and let the more effective method prevail.

It does seem quite the embarrassing situation; when a product with a
more than 95% failure rate reigns as the suggested "medical treatment" and
other similar products such as snus and electronic cigarettes which appear
to be more popular and ultimately more effective, are give immediate
Public Health rejection. Leaving a rather ominous appearance of
impropriety, whether legitimate or not. Many inconsistencies among
Tobacco control partners have similarly left an embarrassing sense of
disorganization for all to endure. None of which would be more evident
than the negative slant, bordering on bigotry toward people who smoke, and
the ever predictable; diminished confidences seen, in promotion of what is
supposed to be in support of self efficacy.

A plan that was doomed from the start.

Words of encouragement on cigarette packages that speak of people who
smoke as more than murderers and saboteurs, will gain a lot more respect
and legitimate attention, than all of the nastiest pictures you will ever

Competing interests: No competing interests

15 August 2011
Kevin M. Mulvina
Brampton, Ontario, Canada