Smoking Replacement Theory

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Smoking Replacement Theory

Postby Thulium » Fri Oct 23, 2009 5:53 pm

Smoking Replacement is the philosophy that rather than simply replacing the nicotine, we want to replace the experience of smoking through substitution or virtual reality. We are not attempting to treat, diagnose, or cure any medical condition, we are attempting to replace an unhealthy behavior with one that is equally or more rewarding. Smoking Replacement does not require FDA approval as smoking can be replaced with activities that may or may not involve food or drugs--you don't need FDA approval to publish a book designed to be read during your smoke break, but the "jury is still out" on whether you need FDA approval for smoking replacements that include nicotine. We can package this meme into a theory to be submitted for publishing in the appropriate reviews and evaluated on its legal, scientific, and medical worth.

This morning it occurred to me that this is a concept we might be able to rally behind. As an organization, we could conduct studies with MrKai's potential iPhone app to measure the relative effectiveness of various smoking replacements with or without nicotine replacement. As I mentioned above, I'd also be interested in finding various professionals (doctors, lawyers, psychologists) who might be interested in publishing a thesis for peer review.

I suspect that packaging this idea into a carefully crafted meme could make significant advances for our cause. FDA approval becomes somewhat irrelevant if our focus is on behavior replacement and self help. Smoking Replacement Therapy, like other homeopathic remedies, only advises the inclusion of pharmacologically active ingredients like nicotine when its benefit outweighs the risks.

I found this article on the topic: [url="http://quitsmoking.about.com/od/cravingsandurges/a/replacement.htm"]Replacement Therapy - Things to Do Instead of Smoking[/url]

One of the Smoking Cessation forum's spunkiest and most determined quitters has got to be Kerri (aka Wonder Woman). Kerri has an outstanding quit story on our site quitsmoking.about.com, and has always been a source of inspiration for myself and many other forum members. One of the things she has been very open about, is that at around three or four months, she experienced a real wall in her process. She realized that it had to do with the extra time we have that smoking takes up, something we don't always realize from the start.

When you think about it - it took me about 7- 10 minutes to smoke a sickorette, depending on whether I was in a rush, or lounging at home writing in my journal. I smoked about a pack a day, and was getting to the point of smoking more. There were 25 sicks in a pack. Times that by 30 and thats 300 minutes, or about 5 hours a day. So let's give some leeway and say you don't smoke as much, we'll even give more time and round it down to 3.5 hours a day. Three hours a day!! Spent feeding our addictions. OH what we could do with that precious, precious time. Not to mention the incredible life force and energy the poison sucks out of us (and we think we're the ones inhaling!).

So what does one do when one quits? For Kerri, it was discovering new hobbies and interests. First it was knitting, then it was running, now she's a marathon runner. Now that's finding a constructive way to fill your time. For Maria it was cycling with her husband and getting fit at the gym, after just over a year, she has a stomach you could slice bread on.

For me unfortunately, it's been food! But as mentioned earlier, that is definitely changing. I did start to crochet earlier on, but never really could stick to it. When we were kids, we always found time to play, time to explore, time to create. We never thought about smoking or missing a crutch. Perhaps this is like a second childhood in a way, an opportunity to re-discover new things, pour our energies into something we want to build, make or discover.

In the Nicotine Withdrawal Category of About.com Smoking Cessation is a list of 101 things to do instead of smoke. It's an excellent list, and I've copied some of my favourites below. If you're about to quit, start researching things you've always wanted to do (I really want a karaoke machine - now that I can hit those notes again, I used to love to sing!), and if you've already quit, keep exploring. There's a whole huge healthy world out there with tons to do and learn, and now you've got the money to do it, and the most precious commodity of all, time.

* Do a jigsaw puzzle, or work with clay.
* Go for a run or a swim, or even the best excercise of all...go for a walk.
* Write a poem, a short story, a love letter.
* Go outside and take pictures of your favourite park, building or statue.
* Take an exotic cooking class.
* Learn a new language.
* Organize your boxes of pictures, create memorable and interesting captions for them.
* Visit the SPCA and adopt a pet, or go get a fish - aquariums are loads of fun.
* Go to a Karaoke place and sing, sing, sing!

Find something you love. Make a list of your interests; it can even be things you wanted to do when you were a child. Anything goes, just rediscover what it was that brought you happiness and find ways to implement it into your life. Take the time you have and spend it on yourself.

It's your gift to you!



The 102nd thing to do instead of smoke? Use an e-cigarette (with or without nicotine).
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Re: Smoking Replacement Theory

Postby Thulium » Fri Oct 23, 2009 5:54 pm

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There is a difference between "Smoking Replacement" and "Smoking Replacement Therapy". "Smoking Replacement" refers to the activity of doing something other than smoking cigarettes. It does not rely on FDA approval as it is not a medical activity any more than exercise is a medical activity--some people use it for recreational purposes, and some people (leading into my next point) exercise for therapeutic purposes. Smoking Replacement Therapy happens as we gather evidence to back up the claims of therapeutic benefit from Smoking Replacement.

I am not suggesting that all e-cigarettes are for the treatment of a disease. The point here is the exact opposite, actually. The point is that smoking replacement therapy is the theory we can put forward as a "treatment", but it is a homeopathic treatment that does not rely on pharmacologically active ingredients for its therapeutic effect. Pretty much anything can be used as a replacement for smoking--some people read, some exercise, some eat, some people chew gum, some chew on a pencil...---but e-cigarettes are specifically designed for the purpose and e-cigarettes can be used with nicotine if you choose but we are claiming no therapeutic benefit from the use of nicotine. Doing something that is not smoking is where the therapeutic benefit lies, the nicotine is entirely optional.
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Re: Smoking Replacement Theory

Postby Thulium » Fri Oct 23, 2009 5:54 pm

Getting the health industry on the bandwagon is kind of the idea. If "Smoking Replacement" can be recognized as a homeopathic therapy because the pharmacologically active ingredients in e-cigarettes are optional, nicotine infused e-liquid could be sold as a homeopathic remedy as part of a Smoking Replacement Therapy the way that nicotine laced gum and candy are sold as Nicotine Replacement Therapy...but without the FDA telling us that we can't use PV's because homeopathic remedies don't depend on pharmacologically active ingredients for their purported benefit.

As this relates to what we're doing here and specifically in regards to the FDA vs. SE+NJ, I propose that personal vaporizers are neither a "drug/device combo" or a "tobacco product", they are simply a vaporizer for personal use. However, if SE+NJ want to sell a vaporizer in combination with a tobacco product (tobacco-derived nicotine infused e-liquid) as a recognized replacement for smoking suitable for use in a Smoking Replacement Therapy, they don't have to jump through all the FDA hoops. Instead, they would simply need to get the electronics safety approved and the liquid should be subject to the same regulations as other tobacco products OR in a homeopathic formula depending how the company wants to produce/market their e-cig.
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Re: Smoking Replacement Theory

Postby Thulium » Fri Oct 23, 2009 5:57 pm

I didn't post this concept to make myself feel better about myself so pointing out flaws in the logic aren't really going to hurt my feelings. I posted this here so that we could work all that stuff out and if I can get "buy in" from enough people, I honestly think that this might be the way to save e-cigarettes.

The FDA asserts that e-cigarettes are a "new drug", while while SmokingEverywhere/Njoy/AES are stating they are a tobacco product. There are pro's and con's to both viewpoints so I am offering a third.

E-cigarettes as a "drug/device combo":
PRO: FDA approval and regulation to assure consistent safety and quality
CON: FDA can ban them completely or make approval so difficult that only companies as large as Pfizer, Philip Morris, or R.J. Reynolds would have the financial resources to produce them.

E-cigarettes as a "tobacco product":
PRO: FDA cannot ban them...yet.
CON: They could not be sold without nicotine.
CON: They could be banned for public use like other tobacco products.
CON: States could force e-smokers to inhale secondhand smoke by forcing them into smoking areas.

E-cigarettes as a "Smoking Replacement Therapy"
PRO: Potentially eligible for homeopathic use
PRO: Can be used with or without nicotine or tobacco
PRO: Can be promoted as a treatment for smoking addiction without making unsubstantiated medical claims because we can conduct the appropriate studies comparing e-cigarettes to other smoking replacements...including those that don't use nicotine (herbal cigarettes, Jelly beans, bubble gum, toothpicks) and compare them to Smoking Replacements that do (NRTs, smokeless tobacco, snus, homeopathic remedies like NicLite water).
PRO: Correctly identifies the intended use of e-cigarettes.
CON: SRT has not yet been established or legally defined.
PRO: Since "SRT" has not yet been defined, we have the opportunity to shape the definition to accurately describe e-cigarettes and promote their use.

If you have other objections, please post them.
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Re: Smoking Replacement Theory

Postby Webby » Fri Oct 23, 2009 6:21 pm

"Thulium's Theory" will be required reading in major universities in 2012.
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Re: Smoking Replacement Theory

Postby mtndude » Sun Oct 25, 2009 12:33 am

Webby wrote:"Thulium's Theory" will be required reading in major universities in 2012.


somehow I believe that
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Re: Smoking Replacement Theory

Postby Kate » Tue Nov 03, 2009 4:11 pm

I think there's a lot of merit in getting away from nicotine being regarded as the only treatment for smoking addiction and if a middle ground away from medical and tobacco definitions can be opened up then that would also be a more accurate way to present PVs.

Just a couple of things I noticed here though:

'Therapy' is a medical definition. 'Smoking Replacement Technique' or something like that might be less likely to be seen as having health claims, although even 'Smoking Replacement' might be expected to have proof of effectiveness before marketing is allowed.

Homoeopathic doesn't seem to be being used in the correct context in the above posts. It might be that I'm misunderstanding but homoeopathic means that there are traces of the active substance (nicotine) present.



It's possible that if nicotine becomes the sticking point with regulators then vaping hardware could be made available as toys or smoke simulating devices rather than alternatives to smoking. If the nic is removed other possibilities are opened for the hardware, much in the way water pipes are available in the US as long as they're not sold for use with drugs.

Making a distinction between the hardware and consumables might help to keep it available and folk can then choose to get nic from elsewhere like snus or NRT products to use in tandem with vaping for the ritual and habit.
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Re: Smoking Replacement Theory

Postby Thulium » Thu Nov 05, 2009 4:55 pm

Kate wrote:I think there's a lot of merit in getting away from nicotine being regarded as the only treatment for smoking addiction and if a middle ground away from medical and tobacco definitions can be opened up then that would also be a more accurate way to present PVs.


Dr. Seigel seemed to agree. :)

Just a couple of things I noticed here though:

'Therapy' is a medical definition. 'Smoking Replacement Technique' or something like that might be less likely to be seen as having health claims, although even 'Smoking Replacement' might be expected to have proof of effectiveness before marketing is allowed.


Using the word 'Therapy' was simply a suggestion for moving this from just a concept into a peer reviewed medical theory. I'm not the one to do this, but the whole point in posting this idea is to perhaps find a PhD who might be interested in taking this concept and running with it. The outcome I'd like is to have e-cigs classified as "SRTs" theway that nicotine polacrilex products are classified as NRTs, the difference being that SRTs are not completely reliant on pharmacologically active ingredients for their intended use: You don't need nicotine for jelly beans to help you quit smoking, but using nicotine in conjuction with an activity that closely mimics that of smoking should have synergistic benefits.

Homoeopathic doesn't seem to be being used in the correct context in the above posts. It might be that I'm misunderstanding but homoeopathic means that there are traces of the active substance (nicotine) present.


Yes, I probably misused homeopathy in this context. Perhaps "naturopathy" would be more accurate? Either way, the distinguishing factor in both is the fact that pharmacologically active ingredients are not the primary source of therapeutic benefit since most of the effect is more like a placebo than actually changing the structure or function of the body--nicotine is an optional addition that makes PV usage the closest thing we currently have to smoking without actually smoking.

It's possible that if nicotine becomes the sticking point with regulators then vaping hardware could be made available as toys or smoke simulating devices rather than alternatives to smoking. If the nic is removed other possibilities are opened for the hardware, much in the way water pipes are available in the US as long as they're not sold for use with drugs.


Yes, exactly! The idea behind this is that "Behavior Replacement Therapy" has an established medical basis and the specific behavior of smoking can be replaced by using vaping hardware and thereby any claims of health benefits can be documented as part of Smoking Replacement plan in the same way that experts establish health benefits from exercise but that doesn't mean that exercise equipment necessarily needs FDA approval.

Making a distinction between the hardware and consumables might help to keep it available and folk can then choose to get nic from elsewhere like snus or NRT products to use in tandem with vaping for the ritual and habit.


Right! Hopefully most countries will make some sort of accommodation for liquid nicotine for use in Smoking Replacement products directly, but even if that doesn't happen...If we can at least continue vaping to replace the psychological aspect of the activity of smoking, there are plenty of harm reducing alternatives we could use to replace the physical craving for nicotine.
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Re: Smoking Replacement Theory

Postby Kate » Fri Nov 06, 2009 5:00 pm

Do you mean it's something that's worth us trying to get tested for effectiveness as a replacement for smoking - a cessation device? That would make vaping a definite medical issue in the US since smoking is considered an addiction. It would mean compliance to medical standards and probably reduction of desirability and effectiveness of the product. Formfactor, nic levels, tamperproofing and price will all change and be regulated.

I'd suggest considering a new category of recreational use - not marketed for medical purposes and not a tobacco product. If the hardware is unavoidably linked to nicotine use then we should campaign for nicotine to be allowed as a recreational drug like caffeine. Regulation in that case might not be any more strict than enforcement of purity, packaging and production standards; no proof of medical effectiveness is needed. Without the medical definition people could use it as a smoking alternative and quit smoking if they choose but the primary purpose would be to introduce and normalise a new vice/habit/hobby that may or may not replace established ones.

Ultimately, unfortunately I think the medical definition will be applied by authorities simply because vaping is effective with cessation but that could destroy the attractiveness of vaping. My opinion is that it's not something we should aim for, we enjoy vaping in its current form because it hasn't been regulated into uselessness.
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Re: Smoking Replacement Theory

Postby Thulium » Mon Nov 09, 2009 11:13 am

IMO, being a "medical issue" is not really the problem. Smoking is a medical issue, after all. The problem is the myopic view of the FDA: That drugs are the only cure for diseases. Obesity is a medical issue that can be treated with drugs, but the most effective treatment for obesity is not a drug (and its not really food either, innit?): The safest and most effective treatment for obesity is replacing an unhealthy activity (poor diet and sedentary lifestyle) with one that reduces harm (changing diet and exercise). I'm simply suggesting that we approach smoking the same way.

What you are suggesting is basically the same thing, I'm simply saying that we need not fear the use of "therapy" any more than athletes fear the fact that some exercising and the related equipment is used for therapeutic reasons, because that does not preclude recreational use.
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