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posted by Dopefish on Monday February 24 2014, @09:00AM   Printer-friendly
from the bender-might-be-less-cranky-if-he-ditched-cigars dept.

lhsi writes "A recent publication on the British Medical Journal finds that stopping smoking improves mental health: "Change in mental health after smoking cessation: systematic review and meta-analysis" (CC BY-NC 3.0).

A lot of smokers claim that smoking has mental health benefits; reducing depression and anxiety, and for relaxation and relieving stress. However the study suggests this is likely mis-attributing the ability of cigarettes to abolish nicotine withdrawal as a beneficial effect on mental health. The study notes that some health professionals are reluctant to recommend stopping smoking as a way to help mental health problems due to the fear that it might make things worse, but this study suggests that it actually would help.

The main conclusion of the study:

Smoking cessation is associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke. The effect size seems as large for those with psychiatric disorders as those without. The effect sizes are equal or larger than those of antidepressant treatment for mood and anxiety disorders."

 
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  • (Score: 2) by lubricus on Monday February 24 2014, @09:13AM

    by lubricus (232) on Monday February 24 2014, @09:13AM (#5692)

    I stopped smoking for the e-cigarette when my kid was born, I wasn't planning on stopping the e-Cig (of course he never sees me with it). I guess I have to now. It's amazing if the effect really is as large as antidepressants. Certainly feeling slower nowadays, but I couldn't attribute it to the new kid, getting older, whatever.

    --
    ... sorry about the typos
    Starting Score:    1  point
    Karma-Bonus Modifier   +1  

    Total Score:   2  
  • (Score: 5, Interesting) by Gremlin on Monday February 24 2014, @09:23AM

    by Gremlin (2959) on Monday February 24 2014, @09:23AM (#5695)

    I'd recommend reading the Allen Carr stop smoking book. It's not a magic bullet and won't necessarily make you stop smoking but it gives you a lot of food for thought.

    I read the book, stopped smoking for two weeks, started smoking again then a year later I just decided I wanted to stop. During this stopping phase I realised that a lot of what was said in the book was now popping into my head and I could use it to ward off the cravings.

    • (Score: 5, Informative) by Jerry Smith on Monday February 24 2014, @09:38AM

      by Jerry Smith (379) on Monday February 24 2014, @09:38AM (#5699) Journal

      I read the book, stopped smoking for two weeks, started smoking again then a year later I just decided I wanted to stop. During this stopping phase I realised that a lot of what was said in the book was now popping into my head and I could use it to ward off the cravings.

      Same here. It's not pushing anything, not scare mongering, just making you realise what smoking is all about. And what quitting is all about. It's not a shame to not be able to quit on the first try, it's something that needs practice. Just retry until the need to smoke again is gone.
      A strong book.

      --
      All those moments will be lost in time, like tears in rain. Time to die.
      • (Score: 5, Interesting) by threedigits on Monday February 24 2014, @01:43PM

        by threedigits (607) on Monday February 24 2014, @01:43PM (#5789)

        That is what, I believe, makes for part of the better mental health. In the months after the last time I stopped smoking I felt anxious whenever I felt the flavor of smoke. I discovered I could recognize what brand people were smoking next to me if I had smoked it previously.

        After that, I begun to realize that stopping smoking is quite a personal accomplishment. Not like running a marathon, but not that far. The proof is how many people just keep failing at it. And then It felt great to just keep avoiding that next cigarette.

        It's almost 10 years now, and I have just completed my first half-marathon. Man, it feels so great that avoiding that next cigarette is easier and easier each year, even if from time to time I get bugged by the flavor of my former favorite brand.

        I hope you could experience this feeling too.

        • (Score: 3, Funny) by Ezber Bozmak on Tuesday February 25 2014, @12:04AM

          by Ezber Bozmak (764) on Tuesday February 25 2014, @12:04AM (#6297)

          After that, I begun to realize that stopping smoking is quite a personal accomplishment.

          Quitting cigarettes is the easiest thing in the world.
          I've done it a thousand times!

      • (Score: 3, Interesting) by digitalaudiorock on Monday February 24 2014, @03:05PM

        by digitalaudiorock (688) on Monday February 24 2014, @03:05PM (#5844)

        It's not a shame to not be able to quit on the first try, it's something that needs practice. Just retry until the need to smoke again is gone.

        Absolutely. I quite 28 years ago (after being a serious chain smoker for 15 years). I'd quit once before then for several months and fell off the wagon. The second time I just got up one morning and never lit up again. One mistake I see many make trying to quit is a sort of "beat yourself up" or "I never should have started in the first place" attitude. The fact is that a lot of people become addicted smokers (none of them intentionally), it's difficult to quit, and quitting is very much something to be proud of.

        That, and starting a serious regular workout regiment about 21 years ago, are arguably the two most important things I've ever done.

      • (Score: 2) by mcgrew on Monday February 24 2014, @08:40PM

        by mcgrew (701) <publish@mcgrewbooks.com> on Monday February 24 2014, @08:40PM (#6151) Homepage Journal

        Another mcgrew blast from the past: How to quit smoking cigarettes [kuro5hin.org]

        I suspect that the e-cigs might contribute to COPD, has anyone studied it?

        --
        Free Martian whores! [mcgrewbooks.com]
        • (Score: 1) by Jerry Smith on Monday February 24 2014, @09:04PM

          by Jerry Smith (379) on Monday February 24 2014, @09:04PM (#6172) Journal

          I suspect the e-cigs to be bad for the health too, but not as bad as straight cigarettes.

          Nice long story though. Can remember buying tobacco for my dad late seventies.

          --
          All those moments will be lost in time, like tears in rain. Time to die.
          • (Score: 2) by mcgrew on Monday February 24 2014, @09:34PM

            by mcgrew (701) <publish@mcgrewbooks.com> on Monday February 24 2014, @09:34PM (#6202) Homepage Journal

            I doubt e-cigs will give you cancer, since you don't get smoke (unless niccotine itself is cancerous, is it?). Lots of nasty stuff in any smoke, which is why they thought pot caused cancer until they actually studied it (those who smoke both pot and cigarettes have half the cancers of those who only smoke cigs, and statistically insignifigantly fewer in those who smoke pot only than cancers in non-smokers).

            I see people with gray hair being carded for cigarettes and think "WFT"? When I was five I'd walk to the store to get cigarettes for my mother (that was in the fifties when almost all adults smoked).

            --
            Free Martian whores! [mcgrewbooks.com]
            • (Score: 1) by Jerry Smith on Tuesday February 25 2014, @06:44AM

              by Jerry Smith (379) on Tuesday February 25 2014, @06:44AM (#6433) Journal

              I doubt e-cigs will give you cancer, since you don't get smoke (unless niccotine itself is cancerous, is it?).

              Nicotine was used an an insecticide and although it's not considered a carcinogen, it promotes growth and the likes: it has a very supportive roll.

              --
              All those moments will be lost in time, like tears in rain. Time to die.
    • (Score: 1) by EvilJim on Wednesday February 26 2014, @12:07AM

      by EvilJim (2501) on Wednesday February 26 2014, @12:07AM (#7013) Journal

      Really? I've got that book sitting on my bedside table. if it was really the 'easy way to quit smoking' it wouldn't involve reading a 200+ page book ;)

  • (Score: 4, Interesting) by mrbluze on Monday February 24 2014, @09:37AM

    by mrbluze (49) on Monday February 24 2014, @09:37AM (#5697) Journal

    This is a meta analysis. Thing about it is it just confirms what was already known, that smoking worsens mood, worsens pain experience, worsens sleep, etc etc all with good studies to back it up. The interesting thing for me is that the tobacco industry knew this also, long ago.

    --
    Do it yourself, 'cause no one else will do it yourself.
    • (Score: 5, Interesting) by MrNemesis on Monday February 24 2014, @04:07PM

      by MrNemesis (1582) on Monday February 24 2014, @04:07PM (#5913)

      As someone who's smoked since I was 14, and currently about a year into Yet Another Quitting Attempt, I can't really say I agree with all of the above. Smoking itself is laden with 'orribleness but nicotine itself, if you ignore the rather fiendish addictive properties and the fact that it's about as lethal per milligram as cyanide, actually seems to be one of the more benign drugs. The wiki page is a good place to start reading: http://en.wikipedia.org/wiki/Nicotine [wikipedia.org]

      Most medical literature I've read on the subject says that nicotine has been shown to improve mood (it's indirectly a dopamine re-uptake inhibitor and as such gives it the fantastically addictive reward scheme), alertness and concentration which is why so many smokers like myself are prepared to go through the pains of smoking to get at the nicotine. Obviously as an individual user I'm incapable of justifying whether any given effect is attributable to taking or not taking the drug, but unsurprisingly there's been a lot of study done on the subject (some undoubtedly by tobacco companies so make of that what thou wilt) and the general concensus seems to be that nicotine does has some advantageous side effects.

      The biggest problem with nicotine in my opinion is that its delivery system has classically been as an arsinous monoxide nicotinal preparation taken bronchially as an infumation which has the nasty side-effect of filling your body up with shite. Switching to a combination of patches (to minimise the long-term effects of withdrawal and give a pleasant baseload) and e-cigs (to satisfy the brief craving periods of the body going "I'm psychologically conditioned to want you to put a tube in your mouth and it give me nicotine NOW!") has gotten me much, much further than any other quitting method; I'm no longer a smoker per se but I'd still consider myself a nicotine addict and based on past experience I don't see that changing. It works out well for me because consuming caffeine (something most people like to do to boost alertness and concentration) brings me out in symptoms not unlike nicotine withdrawal - a marked reduction in my ability to concentrate and cold sweats feeling like you're being swarmed over by ants. So I appear to have made nicotine my socially acceptable drug o' choice, but I'm quite happy to have stopped inhaling all the crap in the process.

      As an aside, in the UK at least we're seeing an odd side-effect of the introduction of e-cigs; they're helping lots of smokers to kick the fags, but also thousands of non-smokers are buying them to get the nicotine without the smoking part. Some people have even asked to "borrow" a nicotine patch from me if they're going to need to maintain a higher level of concentration for the day.

      My 2 pence.

      --
      "To paraphrase Nietzsche, I have looked into the abyss and been sick in it."
      • (Score: 2) by mcgrew on Monday February 24 2014, @09:14PM

        by mcgrew (701) <publish@mcgrewbooks.com> on Monday February 24 2014, @09:14PM (#6187) Homepage Journal

        I'm no longer a smoker per se but I'd still consider myself a nicotine addict and based on past experience I don't see that changing.

        Niccotine is like any other addictive drug -- once you're an addict, you're an addict for life. That's why you never hear of a "cured" alcoholic or heroin addict, only a "recovering" addict.

        The longer you go without a cigarette, the less you'll want one. But smoke one single cigarette and you'll be back to a pack a day in less than a week.

        --
        Free Martian whores! [mcgrewbooks.com]
        • (Score: 3, Interesting) by dmc on Tuesday February 25 2014, @12:30AM

          by dmc (188) on Tuesday February 25 2014, @12:30AM (#6302)

          Niccotine is like any other addictive drug -- once you're an addict, you're an addict for life. That's why you never hear of a "cured" alcoholic or heroin addict, only a "recovering" addict.

          The longer you go without a cigarette, the less you'll want one. But smoke one single cigarette and you'll be back to a pack a day in less than a week.

          I was all set to burn though my 10 mod points on this thread, but now I have to respond to this instead. You hear your argument a lot. And while I really, really don't want to discount the seriousness of what you say, I have to object that you've taken your generalization too far to the extreme.

          I've had "addiction-like"(if not outright addiction) issues with- tobacco, cannabis, cocaine, gambling, alcohol, sugared soda, porn, coffee, internet debates, video games, shoplifting, and various political activism.

          Limiting my initial commentary to tobacco- I 'experimented' with it around the age of 13 or 14 (shoplifting rather enabled it). I let myself get up to the point of half a pack a day, at which point I quit because I was (i'd like to think) a fairly intelligent kid, and knew precisely the kind of bad choice I was messing around with. I 'quit' when I hit that half-a-pack-a-day level and noticed a kind of withdrawel symptoms that I knew were evidence that I was smart to 'quit' before it got worse. Now, that said, I am the bizarre outlier kind of person who can smoke a few cigarretes per year with no real issue. Now, being completely honest, I'll say that my 'quitting' of gambling and cocaine about 10 years ago was much more serious. It definitely got me over the 1st of the 12 steps. I accepted my life as being in the hands of a higher power, and that if I didn't accept that, I was on a one-way trip to absolutely completely ruining my life. But even that said, I'm also somehow the kind of spiritual kurmudgeon, that has been able to do about the same thing with gambling that I did with cigarretes. Probably 5 times in the last 10 years I've lost under $100 in gambling, and still regularly engage in weekly $5 'penny poker' style gambling.

          Anyway, despite all that, I also allow myself to be a habitual cannabis consumer 11 months of the year. Currently I'm on my 3rd annual quasi-lent february free of alcohol and cannabis. But maybe I'm just juggling addictions as I'm playing non-gambling online poker in the background of typing this message, and I make myself 4-5 lattes a day as well as 2 liters of Dr. Pepper club-soda diluted by a factor of 3.

          Who knows, maybe you are right, and in march when I start drinking vodka again I'll run my life into the ground. But I don't think you are right, I think reality is a lot less black and white than you made it out to be. And I think unhealthy food is even more serious a problem for many than all the things I just described.

          Though as a final note, I will say that I've witnessed many dear, dear friends struggle with addiction to tobacco in a way that rings truer with what you said than my own experiences. I am 100% outlier and freak. No doubt. Now, I'll add that despite my willingness to dabble with all those other quite enjoyable (but dangerously tempting to exceed moderation) habits, I have thus far held my line of never sticking a needle in my arm, and still would consider it insanely stupid of myself to start smoking half a pack of cigarretes a day. Of course I have no temptation to do the latter, because I've found so many other more enjoyable, healthier, and less expensive habits to choose from.

          $0.02

          • (Score: 2) by mcgrew on Tuesday February 25 2014, @02:46PM

            by mcgrew (701) <publish@mcgrewbooks.com> on Tuesday February 25 2014, @02:46PM (#6628) Homepage Journal

            You may be an outlier, but not much of one since you did experience withdrawal symptoms. But you were no more addicted than someone waking up with a hangover is necessarily an alcoholic -- part of what a hangover is is withdrawal from alcohol.

            Like most people have no problem drinking without becoming an alcoholic, you seem to be that way with cigarettes.

            Addictive substances have physical withdrawal symptoms. Withdrawal from alcohol or heroin can be fatal.

            One needs to understand the difference between addiction and habituation. There is no such thing as "gambling addiction". That's habituation, and habituation can be more powerful than physical addiction. I found that at least in my case, the habituation to cigarettes was far stronger than the addiction. Of course, I'd smoked daily for three decades.

            I quit by using the patches, so I was still getting my dose of drug -- there were only withdrawal symptoms when I cut the dose down. But I still constantly wanted a cigarette, even though I was getting the drug.

            One can get habituated to anything. Like I mentioned in The Paxil Diaries, if there's an albatross hanging around your neck for 27 years and one day it disappears, you'll miss the albatross. If you have a glass of orange juice every morning before you drink your coffee for five years and all of a sudden can no longer get orange juice, you are going to suffer from your "orange juice addiction". Of course, this is even stronger when the pleasure centers of your brain are stimulated more than orange juice is capable of.

            Likewise, if you start smoking pot when you're thirteen and smoke daily until you're 23, you're going to have a hard time stopping, even though there is no physical addiction (same as gambling).

            I'm a long time reeferhead, started in 1971 when I was 19. Sometimes it's dry, at times I've been broke and couldn't afford it. But when I smoked cigarettes if I was out of money and had a choice between a cig and a joint, I would have chosen the cig every time. And come to think of it, if I could only have coffee tomorrow morning if I went without pot tonight, I'd go without pot. I'm worthless without my coffee, I'm hopelessly addicted to caffiene.

            --
            Free Martian whores! [mcgrewbooks.com]
            • (Score: 2) by dmc on Wednesday February 26 2014, @02:57AM

              by dmc (188) on Wednesday February 26 2014, @02:57AM (#7084)

              There is no such thing as "gambling addiction".

              Different people use words differently. I'm pretty sure that statement is highly debatable. I recall various science reports of chemical effects of gambling on the brain. I don't believe it requires chemical ingestion to stimulate chemical processes in the brain.

              Some people _define_ addiction as something which you would be willing to sell your firstborn child for to not go without. Those people are zealots and do more harm IMO to the discussion than benefit. Life is not that black and white. There are levels of addiction, and levels of habituation, and levels of psychological and physiological withdrawel symtoms.

              You are free to discuss the issue as you wish (as am I). I just think you are innapropriately turning it into a black/white issue with statements such as "Niccotine is like any other addictive drug -- once you're an addict, you're an addict for life.". What is your scientific test that you can perform on a person to determine if they are an addict? And this- "But smoke one single cigarette and you'll be back to a pack a day in less than a week.". I guess you are defining your scientific addiction test as this latter, but must the subject have a firstborn and an island where the price of that carton of cigarretes is their firstborn to make your determination? Or do you have an alternate blood test available? MRI brainscan? I'm just saying the world involves a lot more shades of gray than I think you give it credit for. And when you speak about addiction in such black and white terms, I think many people who have legitimate issues they may be trying to self-educate about will tune out anything else educational you have to say.

              $0.02

              • (Score: 2) by mcgrew on Wednesday February 26 2014, @02:46PM

                by mcgrew (701) <publish@mcgrewbooks.com> on Wednesday February 26 2014, @02:46PM (#7302) Homepage Journal

                Different people use words differently.

                Indeed, and they've been bending the word "addiction" for quite some time, even in medical circles. That's a bad thing IMO, as addiction is physical and habituation is mental (or was, the distinction isn't really being looked at closely any more). I see that Wikipedia makes the distinction with only the nomenclature changed; now, habituation is called addiction and addiction is called "Physiological dependence".

                As to "once an addict, always an addict" there are usually exceptions to any rule, but those in the field of addiction will all tell you that. They do have tests to determine whether or not one is an addict. I'm not in the field, but I do know those who are.

                --
                Free Martian whores! [mcgrewbooks.com]
    • (Score: 2, Informative) by digitalaudiorock on Monday February 24 2014, @10:57PM

      by digitalaudiorock (688) on Monday February 24 2014, @10:57PM (#6259)

      The interesting thing for me is that the tobacco industry knew this also, long ago.

      Absolutely. What unnerves me when people defend that industry making the libertarian "personal responsibility" and "everyone knows smoking kills you" arguments is that, while surely everyone knows smoking can kill you, I can tell you with absolute certainty that many people are still very misinformed as to just how addictive cigarettes are...and it wasn't long ago that the tobacco industry was still denying that one up and down, in front of Congress no less.

      I started smoking by simply grubbing one here and there from friends. When I realized that was becoming too common (after literally a few weeks of that), I realized I needed to stop...and I did...fifteen years later.

      Nobody smokes their first cigarette saying "Cool, I'm going to do this chronically until it kills me", but rather become smokers inadvertently...many of them in large part due to this misinformation campaign.

    • (Score: 0) by Anonymous Coward on Monday February 24 2014, @11:37PM

      by Anonymous Coward on Monday February 24 2014, @11:37PM (#6280)

      The drawn conclusion does not contradict the studies that show that nicotine improves focus and concentration in people who have schizophrenia.

  • (Score: 3, Interesting) by cockroach on Monday February 24 2014, @11:37AM

    by cockroach (2266) on Monday February 24 2014, @11:37AM (#5749)

    As somebody who has tried to switch to the e-cig a few times I have yet to succeed. It seems that, as ridiculous as it may sound, the lack of time limit (i.e. a normal smoke lasts a few minutes, the e-cig would potentially last for hours) makes the "smoking" experience a bit weird. If you don't mind me asking, how did you get used to that?

    • (Score: 2, Informative) by egcagrac0 on Monday February 24 2014, @11:59AM

      by egcagrac0 (2705) on Monday February 24 2014, @11:59AM (#5753)

      Analog vs e-cig is just ... different.

      The upside of the e-cig is that you can have "just a puff", with no particular need to keep going for a whole cigarette. The other big win in some cases is no need to step outside.

      But yes, the draw is different, the consistency of the smoke is different, etc.

      • (Score: 1) by EvilJim on Wednesday February 26 2014, @12:25AM

        by EvilJim (2501) on Wednesday February 26 2014, @12:25AM (#7026) Journal

        Exactly this, I wondered when to stop the first few times I was using e-cig. time it with other people to start, stop when they've finished a normal cig, I found I didn't need that whole cigarette time to get the satisfaction and it got down to just a couple of puffs, then I started forgetting to bring it to work and that wasn't even a problem anymore. now just using occasionally at times when I feel I would be at risk of bumming a cig from someone else such as out on the drinks.

    • (Score: 2) by lubricus on Monday February 24 2014, @04:44PM

      by lubricus (232) on Monday February 24 2014, @04:44PM (#5947)

      This was really strange. I actually find I do the opposite. I run into a problem, need to pace around a bit, but now when I go outside, I take a couple puffs, and head back in after only 2 or 3 minutes. It's only after I'm back at my desk that I realize that I'm not satisfied. I guess the lack of a natural time constraint merely exposes your previous relationship to cigarettes (maybe you wanted to stay longer, maybe you were waiting to go back in).

      --
      ... sorry about the typos
    • (Score: 1) by Wierd0n3 on Monday February 24 2014, @06:22PM

      by Wierd0n3 (1033) on Monday February 24 2014, @06:22PM (#6021)

      My ex-gf tried e-cigs, It was actually kinda funny. she set it up, puffed a few times and said it "felt weird" My mom was visiting at the time, so she went outside to be more polite about the cig. after a few minutes, she jumps back in, and says "I know whats wrong! I feel like im puffing a BONG!" she realises my mom is right there, (we had only been going out a few months and this was their first time meeting) turns beet red, and starts apologising "im a good person, Honest!" mom just laughed.

      she kept at it for a couple weeks after that, but then she broke down crying saying she didn't feel in control while she was quitting, and went back to smoking. although she smoked less after that, just 3 a day where it was half a pack.

      • (Score: 1) by egcagrac0 on Monday February 24 2014, @07:24PM

        by egcagrac0 (2705) on Monday February 24 2014, @07:24PM (#6080)

        "I feel like im puffing a BONG!"

        This. Exactly this. It feels like a bong or a hookah, and little like a cigarette. The draw is often very easy, and the "smoke" is very very smooth.

  • (Score: 0) by Anonymous Coward on Monday February 24 2014, @04:04PM

    by Anonymous Coward on Monday February 24 2014, @04:04PM (#5909)

    Smoking studies are like global warming studies. They adopt a new form of scientific method that goes as follows:

    1) Start with a political/social agenda disguised as a hypothesis

    2) Cherry pick data, carefully rig experiments, and cook numbers--anything that can be manipulated to support hypothesis

    3) Release report confirming the hypothesis that you intended to be confirmed all along, whether true or not.

    4) Make a big deal about it in the press, use it to get grant money for another study and/or tenure.

    5) Goto 1

    • (Score: 2, Insightful) by lx on Monday February 24 2014, @04:32PM

      by lx (1915) on Monday February 24 2014, @04:32PM (#5933)

      6) anonymous industry shills show up in the thread and start attacking the source and ignoring the data.

      • (Score: -1, Troll) by Anonymous Coward on Monday February 24 2014, @05:30PM

        by Anonymous Coward on Monday February 24 2014, @05:30PM (#5978)

        Fanatics always personally attack all non-believers as infidels. Guess the truth hurts.

    • (Score: 2, Insightful) by DeathMonkey on Monday February 24 2014, @07:08PM

      by DeathMonkey (1380) on Monday February 24 2014, @07:08PM (#6070) Journal

      Smoking studies are like global warming studies.
       
      Supported by a massive pile of irrefutable evidence?

    • (Score: 1) by lhsi on Tuesday February 25 2014, @10:00AM

      by lhsi (711) on Tuesday February 25 2014, @10:00AM (#6519) Journal

      I take it you didn't follow the link. Its directly to a research paper, not a report in the press.

  • (Score: 1) by SuperCharlie on Monday February 24 2014, @10:48PM

    by SuperCharlie (2939) on Monday February 24 2014, @10:48PM (#6253)

    My wife and I smoked for many years but her health made her quit. I did kinda like you except I traded cigs for nicotine gum. It works for me, is about 1/2 the cost (Walmart Equate brand) and no one bitches about you chewing gum.

  • (Score: 1) by EvilJim on Wednesday February 26 2014, @12:04AM

    by EvilJim (2501) on Wednesday February 26 2014, @12:04AM (#7012) Journal

    I've gone to e-cig as well, wasn't a pack a day smoker but maybe 40 cigs a week, using the ecig for a while, it wasn't so much of a routine, not having to smoke it down meant I would just take a couple of hits then head back to work, started feeling like a waste of time and a hassle to go do it, hadn't touched it in three weeks until I went drinking this last weekend, haven't touched it again since Sunday. I reckon its a good alternative even if you never fully kick the nicotine addiction, the lack of carcinogens has the be less harmful.