Patches are for Tyres.

Taken in its entirety from Chris Holmes's book, "Nicotine. the Drug that Never Was."

Credit, if any, and respect goes to Chris.

This is a brief extract where, as an ex-smoker, he tries a nicotine patch.

So in the end curiosity got the better of me and I asked if I could try one, for research purposes only, and after looking at me as if I was nuts my friend handed over a nicotine patch.
I fetched a pen and some paper upon which to make notes of the experience, and immediately noted down that it was a NiQuitin CQ 21mg 24-hour patch. I didn't intend to leave it on for 24 hours, but I did aim to leave it on for most of the day, just to monitor the experience. As it turned out, it didn't quite happen that way.
This was at 10.15 on a Sunday morning, April 22th 2007. We were planning to take the kids to the park at about eleven, which I was looking forward to because it was a nice day. This is an exact transcript of the notes I made at the time.
10.15am. Stuck patch on inside upper left arm.
10.20am. Tingling in both hands, mild tightening feeling in the throat.
10.25am. Feel nauseous, patch burning skin a bit.
10.30am. Feel like blood pressure is up, not a pleasant feeling. Tense. Uncomfortable, want to take it off actually. More nauseous, feel a bit ill. Patch really burning. Bowels upset a bit.
10.35am. Head fuzzy. Feel rather sick. Got that feeling like I don't know where to put myself. Feel really uncomfortable and irritable now.
10.37am. Took patch off. Don't feel safe. Big red mark on arm. Hands/wrists aching. Feel sick and faint, balance and even speech abnormal. Wrists and hands quite red. Bowels churning. Feel rotten, very definitely ill. Poisoned. Really want to feel normal again, regret trying this.
10.50am. Still feel just as rotten, but feeling of real alarm that made me take it off now subsiding. Just feel ill.
The patch was only in contact with my skin for 22 minutes. Before I began the experiment I felt fine - healthy and in good spirits. Now I felt absolutely terrible, really unwell and although I don't usually scare easy, actually afraid to leave the patch on any longer.
But here's the thing - according to the BMA, nicotine:

“stimulates the central nervous system, thereby reducing fatigue, increasing alertness, and improving concentration.”

So, did nicotine make me feel more alert, able to concentrate better, as the BMA described?
Well, by the time I took the patch off I was anxious, irritable and no longer able or willing to hold a normal conversation - so I would have to say no, it certainly did not.
Well, why not?
If that is what nicotine does, that is what it does. I would have noticed.
It just made me feel poisoned, and actually it did remind me of the first cigarette I ever tried, when I was eight. My pal stole a single Embassy No.1 from his mum, and we hid at the bottom of his garden and smoked it. It left me feeling pretty much like the experience I described above, but with a foul taste in my mouth as well. It was years before I tried one again, and even then it wasn't because I liked it the first time. It was just because I wasn't allowed to, and because smoking makes you look grown-up and cool, despite being twelve and pimply with awful hair and silly clothes.

At eleven o'clock, we all left for the park. Sure enough I felt very queasy, delicate and anxious I might suddenly need the toilet - that IBS feeling.
I really didn't want to go out at all now, I felt more like going for a lie down, which I only ever feel inclined to do if I am quite ill. Of course some fool might suggest that the dose was too high for a non-smoker, or that I was irresponsible to try that without medical advice, as if that were the reason it made me ill. But that's ridiculous: none of us took medical advice before we tried our first cigarette, did we? And very few kids start with a low-nicotine cigarette, certainly not my generation anyway, or the previous one. So it was, in fact, an experiment that roughly replicated most initial, real smoking experiences but this time focussing entirely on nicotine itself, and guess what? Nicotine just makes you feel ill, because it is nothing but a poison.
I'm not saying you can't get used to it - boxers get used to being slammed in the face, and I'm sure that stimulates the central nervous system too, but that don't make it medicinal.

The Die is Cast

I started work at sixteen in a design office in Liverpool.

In those days a lot of people smoked. Smoking was allowed at work, on the bus, top deck only of course, in pubs, clubs, cafes, restaurants and maybe even doctor’s waiting rooms for all I know. My mother smoked and one of my brothers smoked.

I didn’t think much about smoking at the time but now when I cast my mind back I can recall that some did it, some didn’t but I was simply too busy with spots, guitars and Airfix kits to pay it much attention.

The Engineer I worked for had the weirdest habit of completely eating an apple. He didn’t reach the core and stop, he just carried on until there was nothing left but a vague apple smell and juicy fingers. It was almost like he was concealing the evidence.

The other habit he had was smoking. He used to smoke like a condemned man and suck on his cigarettes as though the hole was too small to get the smoke out and gave a fair impression of someone enjoying a thick milk-shake. You could see the suction in his cheeks and get the disturbing feeling that if he didn’t keep a firm hold on that Embassy it was going to rapidly follow the apple.

Being sixteen and pretty naïve I didn’t really understand the ups and downs of smoking but as a role model this chap was perfect. He was a cigarette advertisers dream. Every smoke seemed to reward him with so much satisfaction. At the time I was pretty naïve, in the practical sense, about human reproduction but if I’d been asked to paint a picture of an orgasm it would have closely resembled my boss having a smoke.

This was something I just had to be a part of.

Well it wasn’t long before the youngsters who had started their new jobs along with me and worked in other parts of the building had found their own similar mentors and had joined the smoking club and inevitably I too applied for membership and was instantly welcomed with smoky, slightly stinky, open arms.

Now if I could just sort out this coughing, spluttering, gagging and retching business I was going to look so cool and maybe, if I was lucky, a little older and sophisticated. You never know, I might even find a nice girlfriend too.

Well it didn’t take long to master the art of smoking in fact it was a doddle, you could say I was a natural and by the time I went to University I was a master. I could do smoke rings that were actually circular and that funny thing where the trailing smoke from the drag on the cigarette is simultaneously drawn into the mouth and the nostrils and looks simply fabulous. I was pretty confident that if there’s been an O level for smoking I’d have got a good mark in that one too.

I even started completely eating apples for a while but never really felt comfortable eating the pips.

Digital Smoking

The electronic cigarette is taking a very firm foothold and it’s not surprising.
When we decided to quit our filthy habit we all had good and variable reasons to do so. No doubt a long way up the list were ones like, “it’s killing me” or the slavery or the smell or the nagging.. just choose your own.
First things first I’m anti E-Cigs ok..? Therefore I’m not suggesting we should turn towards them. Why? Well, for the simple reason that despite what a lot of people will say we were never really nicotine addicts at all and the E-Cig will, I’m sure, eventually demonstrate that.

Do you want to stop smoking? Want to smell better? Want to have your cake and eat it? Try vaping then. It might need a new word in the dictionary, the act of taking atomized nicotine vapour into the lungs but it is here and it’s real and you can do it in pubs and on the plane.
Ok, there are issues regarding legality, taxation, clinical drug trials and medicinal nicotine but these are just hurdles not walls. The NRT manufacturers must be shitting their pants at the moment for two scary reasons.

Number 1, as we’re lead to believe, if smokers smoke because they’re addicted to nicotine and every puff just feeds the constant but gradual reduction of it in the body then the E-Cig conquers the world. It’s smoking without the smoke. The nicotine craving is fed instantaneously, straight to the brain in a puff, it’s not particularly expensive because it is the tobacco that’s taxed not the nicotine and it’s “therapeutic” nicotine so it gives us a buzz but it’s not actually bad for us. Every argument for smoking and continuing to smoke is covered by the e-cig and what possible reason can there be for continuing to smoke traditional cigarettes?
Transfer your addiction to e-cigs and you never need to spark up again or apply a patch or chew some gum or take any nasty drugs.
The smokers win, the e-cig manufacturers win but the government and the NRT guys lose big-time.

Number 2, we’re not addicted to nicotine at all. Ok, we get a little hit but it’s nothing to write home about and it staves off that low feeling associated with withdrawal. If we were really addicts we’d smoke the second we awoke and wouldn’t be able to function without our hit. We’d chew nicotine gum or summat if we couldn’t have a fag but we don’t. We tend to get up, mooch around, smoke our first fag then get on with the day. Most daily fags are triggered by breaks, getting in cars, getting off buses, hunger, finishing something, about to start something, commercial breaks etc etc and then given a social evening we smoked like a chimney. In those days when we were allowed to smoke in pubs our consumption rate had absolutely nothing to do with falling nicotine levels in our bodies”!
The startling fact that so many of us just wake up one day and say, “sod it, I’m giving up” and then do exactly that is a very poor argument for any sort of addiction.
So, if it’s nothing to do with nicotine and the e-cig and its nicotine and its act of drawing vapour into the lungs isn’t feeding your habit what is..?
Is it just a habit? If so it’s easy, gradually reduce the nicotine content of the smoking liquid and before you know it you’re vaping flavoured liquid (already available), no nicotine but still feeding the compulsive habit but pretty much in a un-harmful way.
Then you realise that your smoking habit didn’t actually have anything to do with nicotine but who cares, the smokers win, the e-cig manufacturers win but the government and the NRT guys lose big-time.

Unfortunately you still have the compulsive habit though...

Smoke Alarm

Ever wondered why you're a few puffs into a fag and don't really want it; can't work out why you lit it; and want to stub it out as you've other stuff to do?

It's because lighting up the fag silenced the inner klaxon of your subconscious mind.

If you don't respond to the initial beep of a craving then the signal gets stronger and more insistent and it makes you irritable and distracted. It's just like a drug addict desperate for a fix.

The longer you ignore the alarm the louder the klaxon becomes until you light up a smoke and feel that relief, peace and relaxation as quietness is restored and you can finally concentrate on whatever you were trying to do.

Many people, some of them quite knowledgeable, will try to argue that this was your body craving nicotine and administering it by smoking will restore the calm.

In reality just lighting up the cigarette turned off the alarm, nothing in the smoke played a part.

If falling nicotine levels in our bodies triggered a response to replenish the supply then some things would be obvious:

We'd crave most when we were the longest distance from our last smoke.

Very few people wake up and light up. There's usually a morning procedure involved before the first fag.

We'd shut down a crave by consuming nicotine.

Quitters still dosed up on Nicotine still crave.

Our habit would follow a regular pattern based on nicotine's transit through the body.

Actually we smoke heavily in some situations and sporadically in others.

Don't have the wool pulled over your eyes and spoil what could be your one and only quit just because you've been fed duff information.

Pointless

When people decided to quit smoking it's very common to cite things like;

I want to live longer,

I want to stop blowing all this cash on fags,

I want to be healthier,

I want to stop lurking in cold doorways puffing away.

Typically these responses suggest that if fags were benign, free, healthy & permitted to be consumed in company then there would be no need to stop.

In reality, the most obvious reason for quitting is that there's no point in smoking.

To repeatedly stab yourself in the thigh with a kebab skewer so that you can experience the blissful pleasure when you cease is analogous to cigarette smoking in that we smoke to relieve the urge caused by not smoking.

Quitting 'cos it's expensive, wishing to smoke and envying other smokers is a sure way to fall off the wagon.

Quit 'cos you've no wish to smoke and it's the proverbial piece of cake.

Well it’s that time of year when a smoker’s thoughts often turn to giving up the evil weed and it’s a bit scary what with being an addict and all that…

Smokers do not really smoke because of nicotine at all, even if they are utterly convinced they do. (Were you expecting that I wonder?) If they’re addicted to anything it’s possibly dopamine but even then it’s stretching things a bit.
At first glance the nicotine addiction theory holds a lot of water and luckily any leaks can be plugged by an astonishing amount of myths and creative statistics. Bear in mind that it’s part of a multi-billion dollar industry and there are good grounds for its success.
As sophisms go it’s not dreadful, after all, if a smoker can use their perceived nicotine addiction as a weapon to quit then it’s advantageous, however, the reverse is more often than not the reality.

When I look back at my own quit I’m quite surprised how long I managed to stick with the addiction theory, modifying it to suit the way I smoked even to the ludicrous conclusion of separating my fags into “wants” and “needs” so that I was able to identify those smokes that fed my addiction and those that were casual fags for the fun of it. I managed to answer most of my questions but there were some biggies that seemed to have accepted answers that were frankly rubbish. Bizarrely in every packet of fags I smoked there was my morning fag, my after eating fag, my after sex fag and my calming bedtime fag. There were a few ‘calm me down’ smokes, a few ‘perk me up’ smokes and one or two ‘help me concentrate’ smokes and despite looking, not one of them was labelled yet I managed to select the correct one each time.

Every study I read, every published paper I worked through added more questions and fewer answers until I realised I was looking in the wrong place. The vast majority of stop smoking data is indirectly connected to the pharmaceutical companies and therefore biased towards their products. Not unsurprisingly the pro-smoking groups with the burden of the smoking ban chip-on-their-shoulder are very good at winkling out the data and had done a fabulous job. Of course their reasons were more of a battle with the smoking ban, their loss of ‘freedom’ and the myths surrounding secondhand smoke. Exploding the nicotine myth is very low on their agenda and I’m sure a goodly proportion of them think of themselves as addicted. (Addicted to a substance more addictive than Heroin apparently, but sold on the lower shelves of ASDA, fancy that.)

Nicotine is a toxin, one of many in cigarette smoke, and certainly present in nicotine patches, gums, sweeties, puffers, lozenges, creams, cheese slices and Nick O’Tine’s medicinal jam. Unfortunately it’s not actually physically addictive, despite a lot of research, and you can’t get lab rats, monkeys and beagles hooked on it. The tobacco giant denied its addictiveness for years until it was in their interests to change their tune.
As smokers we eventually learn to tolerate its presence in our bodies and when we stop consuming it our bodies take a week or two to acclimatise to its absence. You can purge it quickly by just stopping consuming it or you can drag it out over twelve profitable weeks if you’re feeling a bit gung ho with taxpayer’s money. Either way combating the effects of nicotine cessation is actually a little easier than slipping off a Teflon coated log floating in a pool of oil. The cold-turkey quitter and the NRT quitter both have exactly the same battle against stopping smoking but the NRT quitter chooses to purge the nicotine from their system gradually, both very different things.

No-one started smoking for nicotine, no-one smokes for nicotine and no quitters relapse onto nicotine. Smokers relapse to smoking every time.

You don’t even have to believe me, I’m not trying to sell anything, the exact opposite in fact. In these times of coming austerity I’d rather the NHS didn’t have to prescribe one useless single NRT prescription and let my gran have a new hip instead.

Smokers do smoke because of cravings, but cravings are nothing to do with nicotine or any other part of the smoke.
Cravings disappear when the smoker lights up, but that is because a craving is simply a mental prompt to repeat the habitual behaviour, triggered by the brain, not by falling nicotine levels, but experienced as a physical compulsive urge that seems to the smoker like a real bodily need. The craving disappears long before the cigarette is smoked and well before the seven second myth of nicotine to brain transit.
Staggeringly the craving is often gone without even lighting up. (Damn clever stuff that nicotine, it’s not safe even being in the same room as it..)

Now that NRT has no novelty value it’s no surprise to see cessation rates stabilising around 7% which is comparable with cold-turkey, placebos and bupropian (Zyban). This is just as you’d expect for being prescribed a toxic insecticide to somehow combat a compulsive habit of tobacco use. Similar results can be expected from prescriptions of liquorice allsorts or green tea and I’m more than happy to volunteer for their trials.

The big winners, acupuncture, hypnosis and Mr Carr’s clinics still seem to be achieving 30% success rates and hopefully sooner rather than later the world will wake up to the reasons, which are:
We quit smoking in the subconscious as that’s where we smoke. There isn’t a magic pill that stops us smoking but a method that directly or indirectly passes the message to the subconscious that we no longer have any desire to smoke is proven to be the most successful. Any method with support shows better results that the same method without.
Of course many of us quit without any help or even the “wrong” help by getting “our minds right” (is this self-hypnosis?)

I used to have a nagging question. I repeatedly tried and failed to switch from cigarettes to rollies. It used to frustrate me and I’d find myself lighting up a proper fag pretty much straight after I’d smoked a rollie. On at least two occasions I managed to wean myself exclusively onto rollies for a few months and then I’d have a relapse back onto normal cigarettes. It wasn’t until I quit this time that it finally dawning on me I was simply craving a cigarette. I wasn’t craving a smoke, a cigar, a pipe, nicotine, burning paper, singed flesh or tar, I just wanted a cigarette and only a cigarette would feed the crave.

My advice is to spend one smoking day, maybe a couple, looking at how you smoke. Not just when but also how. See what triggers you to light a fag and how much you smoke and how much you wave it around. If you’re feeling very honest with yourself make a note of how many lit cigarettes you wish you’d not lit because they’re now getting in the way of what you were previously doing.

Once you know why you smoke the steps to cessation become a lot clearer.

Busy Hands

Keeping our hands busy.

If left to their own devices, do they wander off and cause mischief in the neighbour's garden or something. Do you find them watching cheap TV or tormenting the cat?

How did smoking keep our hands busy? Holding a fag is not exactly stimulating for them and the lighting and extinguishing is hardly a complex task.

The smoking itself, especially for us seasoned veterans is an incredibly dull experience of simply breathing smoke in and out and to think it made us less bored is a bit embarrassing.

When we're busy smoking just gets in the way. It becomes annoying and disruptive but as smokers we've got to do it at some point during the day. Therefore we choose to do it when we're least occupied, when we're bored and then the association begins.

Now, as quitters, we realise that those moments when we're unoccupied don't seem to have a point and we're reluctant to be seen doing nothing so we now need to find something to do to stop those unruly hands amusing themselves despite the obvious that the hands didn't really get involved much in smoking anyway.

Personally I'd recommend giving shadow puppets a go?

It Does Get Easier

Even better, it gets easier quicker once you know what to expect and how to react.

1. Nicotine withdrawal.
It'll be gone from your system over a couple of days and you'll feel like you're coming down with a cold. If you want to avoid those minor feelings at a time when you're dealing with the mental side then take some NRT and withdraw over whatever timescale you're comfortable with. Cravings are not withdrawal symptoms. Don't confuse the two. If you subscribe to NRT you will still want to smoke regardless of what the TV, nurse or NHS tell you. Conversely the psychological effect of taking a 'medicine' may reduce your desire to smoke.

2. Stopping Smoking (physical)
Not inhaling smoke increases the oxygen levels in your blood making you feel odd, intoxicated and spaced out. Many report insomnia and weird dreams. Taking NRT, particularly 24hr stuff can intensify this. The resulting repair of your body throws up all manner of things like ulcers, acne, lethargy and so on.

3. Stopping Smoking (mental) This is your actual quit.

Every time a smoking opportunity arrives your subconscious will prompt you to smoke. It doesn't make the blindest bit of difference whether you're sucking on an inhalator or whether you've smeared peanut-butter on a piece of sellotape and slapped it on your forehead. You will be prompted continually until you decide to light up. You don't even have to smoke, just lighting up will kill the prompt. The prompt isn't a need for nicotine, it's purely a need to smoke.
The prompts don't happen when there is no smoking opportunity. Flying is a classic example. I believe that traditional flight smoking etiquette is to try not to think about smoking until about 30 minutes before landing, panic through customs and baggage retrieval and then rush outside and smoke 2 with the cab drivers.
If you can convince your brain that you're on a flight that's never going to land then the prompts will be non-existent.
OK, that sounds a bit weird but we know that prompts don't occur when smoking is not permitted so the trick is to convince your subconscious that from now on that it's prohibited continually.

If you can out-stare a mental prompt that manifests itself as a physical need you're laughing and each little battle gives you better ammunition for the next one.
The craves come thick and fast in the early days but slow down due to the prompts being less regular. For example you get the morning prompt every morning whereas the lying on a beach in the sun prompt is a little less frequent!

Never forget that it was YOU who forced your subconscious to allow your lungs to admit smoke into them when the natural reaction is dramatically the opposite and it is YOU who has to put a stop to it.

A note on Willpower

"A conscious application of effort against a subconscious desire to smoke is unlikely to be successful.
If we imagine a burglar trying to crack a safe with a combination lock we can all appreciate the futility of grim determination and continual attempts. Sure, he might strike lucky and mathematically, given enough attempts, he'll crack it.
However, turn up with the combination in his pocket and he's out of there with the contents.
Unfortunately far too many of us seem to get bogged down with the make of the safe, the burglars choice of mask and stripy sweater, what time of day the burglary was, what car he drove, what picture the safe was hidden behind etc etc and we forget that all we need is the goal, the combination and the opportunity."

Very few of us have the inner strength to maintain the effort necessary to consciously ignore the desire to smoke.
We can all summon the willpower to leave the sofa and empty the dishwasher or take the dog for a walk in the rain but we can’t do that for months on end. There are far too many demands on our conscious to keep the finger in the dyke and before you know it the habitual behaviour has returned.

If our conscious mind truly had control then a conscious desire to do anything would require no effort at all to achieve it whether eating less, or quitting fags.
Irrespective of how flamboyant we make our conscious desire to quit and who we tell or what we plan, failing to let the subconscious in on it will rarely prove successful.

People who quit, “just like that” aren’t hit with a massive dose of willpower one day or some super inner strength, they have something more akin to a change of heart rather than a change of mind.

I really wish I could tell you what it is and how to make it happen.
Many expectant mothers seem to manage it, a major bombshell from your GP or a genuine appreciation of our own mortality sometimes does it. For many others there comes a sudden realisation that they no longer want to smoke, the subconscious has in effect 'changed its mind.'

If you plan to quit, but really want to smoke, willpower will keep you off the fags until either you achieve the change of heart or run out of willpower.

Failing that, read widely and there’s a good chance your subconscious will find something that brings it in line with your conscious desires. Bear in mind that your subconscious doesn't necessarily (or usually) read what your conscious reads!

We are also our own worst enemies. Even if we've managed to quit, by either stubbornly hanging on or we've had a change of heart, we can still stumble when faced with a new dilemma that makes us open up the big bag of smoking clichés and pull out a corker.
I've fallen off the wagon at 6 months because I was stressed and we all know a fag "calms us down." That might have been my proper quit if I hadn't had that nugget of codswallop tucked away in my head...

Education is the key, it really is!