"The Heart of the Matter"

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Transcripts: 520-1 and 520-2

Week: 520.1 Guest: Alan Blum, M.D. Topic: Quitting Smoking - Part One Host: Richard Roeder Producer: Ed Graham

ROEDER: This is the first half of a conversation on quitting smoking with Dr. Alan Blum from the organization DOC or Doctors Ought To Care.

ROEDER: Dr. Blum, certainly any of us who have ever smoked know how hard it was to quit and certainly quitting is big business. Talk a little bit about the industry of helping people stop smoking and how successful are these techniques?

BLUM: Richard, I don't use the word "quit." That's the first lesson. When I think of quitting, I think of Ross Perot in the last election or Richard Nixon maybe but I don't that quitting is a very positive word so I really try to take it out of my vocabulary and the word that I use would be "not buying" or "stop buying." I don't ask people - do you smoke and how much do you smoke? I say, let's say to a big truck driver, "What brand do you buy, Virginia Slims or Misty or Capri?" and the guy's likely to laugh and say "No no, I smoke Marlboro," and I say "Marlboro what, Marlboro Lights, Marlboro Ultra-Lights Menthol Lights, Marlboro Leaded, Marlboro Unleaded?" There are 15 different Marlboros and what you need to realize in that is that these companies have created these identities for consumers to pretend that they've got their own unique brand. All that Lights means is more sugar and candy flavorings. The filter is a fraud, low tar is just low poison and so when you focus instead of on people and their addiction on the product and what a waste it is and what a garbagey product it really is, people are really amazed. They've never focused on the product. They've never realized that the filter offers no advantage whatsoever. It just in fact concentrates all the gases and you wind up smoking more and low tar - the same thing. So I think that by becoming a consumer advocate for people and explaining more about what a cigarette is and how much it costs to make - it only costs about 15 cents a pack to make, that they sell for two dollars and how much that ultimately will cost the individual. A pack a day is almost $800 bucks a year. This is in my experience so much better in getting people thinking than handing out all of the nicotine patches or what have you because people go out of the office saying "Gee, I never thought about it like that before" and they get a little angry at how they've been duped. As for some of the methods - I joke about "You've heard about Nicoderm and Habitrol and Nicotrol and Nicoret." Well we have our own product that we're developing called Nicopositories. I guess you could try that. I mean, we're going to test it out on all the pharmaceutical people that want us to prescribe all these patches but I think that before anyone would want to chose a pharmacological method for smoking cessation, they should do some very simple measures such as learning how to breathe deeply when they're ready to light up, instead of lighting up to spend one minute slowly breathing in and out, using lemon drops or mints or cinnamon from the time they get up in the morning as an alternative and lastly drinking a lot more ice tea and other juices. These are, believe it or not, as simple and wonderful methods for cutting down and eventually stopping smoking than all the expensive gimmicks that you're going to hear about. 90% of people who stop smoking say they did it on their own. They didn't use patches, they didn't use gums. They did it because they really made up their mind to do it.

NEMA: Join me for the second half of my conversation on quitting smoking with Dr. Alan Blum.


Week: 520.2 Guest: Alan Blum, M.D. Topic: Quitting Smoking - Part Two Host: Richard Roeder Producer: Ed Graham

NEMA: This is the second half of a conversation on quitting smoking with Dr. Alan Blum from the organization DOC or Doctors Ought To Care.

NEMA: There's no question that nicotine is addictive and addictive substances tend to be the kind of things that induce people to do anything they have to get those substances.

BLUM: 90% of people who stop smoking say they did it on their own. They didn't use patches, they didn't use gums. They did it because they really made up their mind to do it and the design of the patch is designed to reinforce that decision. But in my experience, when somebody comes in off the street and wants something and I don't know that patient, they say "I'm ready to stop smoking and I need the patch," that's almost a guarantee that they won't stop smoking because it says there's nothing they're willing to do on their own and I think the patch is really a last resort, not a first resort. People have to be willing to try some very simple measures before they stop smoking and I think that it's a lot easier than people think and that's the tragedy of this whole issue. If I were to tell you every day, "Richard, you'll never be a syndicated journalist. You'll never be listened to all over the country on 260 stations. You just won't make it," if I keep hammering that into your head every day, I think you might feel a little bit bad and feel a little bit down and you might believe that but instead I say "Hey, I know you're going to do well because you're a terrific journalist," every day and I reinforce that, that's the positive thinking that people should be taking to this and I think that when they do that it's a lot easier for them to stop smoking.

NEMA: All of us that study issues related to health inevitably run into tobacco as a major issue. It's certainly one of the first things mentioned by a cardiologist who sees high blood pressure or by a pulmonary specialist who sees lung disease or an internist or anyone else when they hear tobacco, they justifiably go nuts. However, we've all heard stories from people who say "I did the patch, I chewed the gum, I was hypnotized, I used this, I wore a hat, you name it and I can't seem to quit." Do you believe there is such a species or is that just a cop-out?

BLUM: I'm sure that without any question there is and my only comment is that that's too bad. I mean, sorry, maybe medical science can't help you, that there are people who are going to be dependent for every need. I think it's a matter in part of maturity. All I'm saying is that I guess that I'm finding it a bit of a cliché‚ to constantly hear that nicotine is a more addictive drug than heroin or cocaine. Well, I'm sure in certain scientific circles, measuring the number of nicotine receptors on the head of a pin or what have you, that that may be the case but that is irrelevant to getting people not to use this stuff and I think that the more people think they can and think they can, they can whereas if you constantly tell them how addictive it is and how no, no, no - don't stop now, no, no, no - you've got to set a quit date, what date do they all select? They all select New Year's Eve, and that's when the cigarette companies have these wonderful discount promotions so it's really sort of sad that health people and psychologists don't really think in terms of the product and what a rip-off it is. Instead they concentrate on people's behaviors and they get people so obsessed about themselves that they forget that they can laugh and relax and don't have to be as caught up in this nicotine addiction crisis as they've been led to believe.

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