sc-talk

Imagine combining all South Carolina 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.

[ Link to SC  deaths graph -
http://whyquit.com/South_Carolina/SCDeaths.GIF ]

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 $115
million of our $2 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.

[see scanned Canadian Camel cigarette pack at
http://whyquit.com/South_Carolina/camel.jpg ]

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 neurons, 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
$10 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
$1,665 for each of the 1,670 persons seen by outpatient services,
$3,182 for each of the 121 participants in their recovery and
self-sufficiency program, $4,715 for each of the 171 participants in
their opiate treatment program, and $0 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 1993
that the relapse rate for second time or subsequent NRT 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?

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?

http://whyquit.com/South_Carolina/

John R. Polito
Nicotine Cessation Educator
December 2, 2003
john@whyQuit.com

1325 Pherigo Street
Mount Pleasant, SC 29464
(843) 849-9721