How did the one-quarter of Americans who have successfully stopped smoking succeed? A July 2013 Gallup Poll asked them this open-ended question: "Trying to be as specific as possible, what strategies or methods for quitting smoking were most effective for you?"

The poll found that 48 times as many credited cold turkey for their success than credited nicotine gum, 48 percent to only 1 percent.

And that's after 30 years of nicotine gum being a cornerstone of U.S. quitting policy, 30 years of government and pharmaceutical industry cold turkey confidence bashing, with billions having been spent on Nicorette marketing.

If you add up all Gallup Poll responses falling under the generally accepted definition of cold turkey (abrupt and complete cessation of a drug without use of quitting medications or procedures) the percentage of cold turkey quitters skyrockets to at least 75 percent.

Joel Spitzer is education director at WhyQuit, the most popular cold turkey quitting site. Excited about the new Gallup Poll, Spitzer made two YouTube videos reviewing it. The first is entitled "Gallup Poll: most quitters credit cold turkey" and the second, "Whatever you do, don't quit cold turkey."

"Whenever I was dealing with anybody when it came to understanding how people quit smoking I said, 'if you want to find out how to quit, the successful way to quit, talk to people you know who quit smoking,'" Spitzer states in his first video.

Referring to the new poll, "It's a study I've been looking for for decades." "The real significance here is, the #1 way that former smokers say that they quit smoking was cold turkey, which is wonderful to see finally," says Spitzer.

Boston University School of Public Health Professor Michael Siegel agrees. "Overwhelmingly, the method identified by ex-smokers as most effective for quitting was cold turkey," wrote Professor Siegel in his August 13 blog.

"It is very clear that despite the findings of clinical trials, when you examine the question on a population basis, cold turkey quitting is the most effective strategy and the 'recommended,' 'FDA-approved' quitting methods are not particularly useful," noted Dr. Siegel.

"What does this mean? It demonstrates what I've been arguing for months: that although clinical trials have found that NRT and drugs are effective, the absolute cessation rates are dismally low. Thus, these approaches cannot be said to be 'effective' strategies for smoking cessation on a population basis."

Pharma & Friends Ignore Gallup Findings

"I didn't see anything in the news about this," notes Spitzer. "I haven't seen anything in normal search engines I use on a regular basis, on smoking and nicotine and addiction. Nothing, nothing! I haven't seen a word about this in the media, and it looks like this has been out for a few days now."

"I've got to tell you, that if this Gallup Poll was commissioned and it showed that some pharmaceutical product was #1 on the list, oh my God, this thing would have been blasted on every news station. This would be in every newspaper. This would be all over the media right now," contends Spitzer. "Right now, you can't find it. It's not there for anyone to see."

"This is telling," suggests Spitzer. "It goes to show you that unless there's a way of making money out of this - this is a public health issue - unless there's a way that someone is going to make big bucks out of a result, you just don't see the result."

The bottom line? The Gallup Poll reflects, what should be, common sense. The addicted brain cannot adjust to functioning without nicotine by replacing it.

Replacement Nicotine: a Weapon of Mass Destruction

The Gallup Poll also screams the message that three decades of teaching nicotine addicts that nicotine is medicine and its use therapy has cost millions their attempts, and ultimately their lives. It's a concern NRT credentialed U.S. health leadership will likely continue to ignore.

This writer's February 2012 letter published in the British Medical Journal was entitled "Nicotine replacement: Are those who quit smoking paying with their lives because of NRT's failure?" It shares a similar study. "A 2006 Australian study of family practice patients found that 88% of 2,207 former smokers quit on their own, roughly double the rate of those taking NRT or bupropion."

This Gallop Poll and the Australian study evidence why U.S. government assertions such as those appearing on the just revamped SmokeFree.gov website are so disturbing. There, it's asserted that "most people who quit don't quit cold turkey on their own" and that "medications can double your chances of quitting for good."

Clearly, both assertions are false. But what possible motivation could U.S. health officials have for actually lying to smokers and discouraging their natural quitting instincts?

CDC & FDA Leaders Have Strong NRT Ties

As Professor Siegel notes in his August 12 blog, the pharmaceutical industry helps fund Centers for Disease Control (CDC) research. Not mentioned in that blog was the fact that in 2010, Dr. Siegel awarded the telephone quitline business founded by the director of the CDC's Office on Smoking and Health, Dr. Tim McAfee (bio), his runner-up "Liar of the Year Award"). That award was given after noticing that Free & Clear, now Allere Wellbeing, was using highly deceptive math ("responder" rates) in "falsely asserting that its smoking cessation program has a 45% six-month success rate."

A primary goal of the CDC's Office on Smoking and Health is to "Promote tobacco use cessation among adults and youth." The problem is that its director, Dr. McAfee, learned early on that calls to his telephone quit line business doubled when he offered nicotine addicts free nicotine via patches.

Dr. McAfee, the CDC's smoking cessation general since 2010, owes his credentials and career to advocating use of taxpayer dollars to put free replacement nicotine into the bloodstreams of those addicted to it. Is it realistic to expect him to care that it's been a massive waste of precious tax resources, and a squandering of millions of priceless periods of cessation confidence (also see quitting product studies co-authored by Dr. McAfee: 2013, 2011, 2011, 2010, 2010, 2009, 2009, 2008, 2008, 2008, 2007, 2007, 2006, 2004, 2004, 1998, and 1993)?

If anything, Dr. McAfee's indefensible defense of the measly 6 percent in this Gallup Poll who credit NRT for their success is getting worse not better.

On May 16, 2012, in replying to a British Medical Journal article, Dr. McAfee identified himself as director of the CDC's OSH and then openly attacked a negative NRT study finding. In closing, Dr. McAfee cited two studies in asserting that "multiple studies in the US have found that cyclical promotional campaigns offering brief courses of NRT can dramatically increase quit attempts, with 10-fold and 20-fold increases in calls."

The problem isn't only that attempts and success are two different things, but his credibility: the same concerns associated with Free & Clear's funny math.

Far from 10 to 20-fold, one of the two studies Dr. McAfee cited found a 4.3-fold increase in calls (2006). And to quote from the other, a study co-authored by Dr. McAfee, the quitline "fielded 27,000 calls during the first 3 months of 2008, almost a three fold increase from its prior annual call volume."

Dr. McAfee has created his own objective integrity concerns. Aside from knowingly allowing use of inflated and highly deceptive "responder" rates in marketing Free & Clear's quitline success rate, and as shown here, more than doubling quitline call volumes, Dr. McAfee has a rich history of hiding the truth about how most quitters succeed.

In his defense, he has had no choice. Imagine what would happen if the CDC started sharing the truth and taxpayers became aware that only 1 in 100 ex-smokers quit with Nicorette, that NRT is a fraud and sham, that smokers were not quitting because of having toyed with pharma grade nicotine, but despite having done so. In his mind, it would dry-up and destroy his crowning lifetime accomplishment, the quitline he founded.

What would happen to Nicorette gum or NicoDerm patch sales if the CDC started alerting smokers to the truth, that more ex-smokers quit cold turkey each year than by all other methods combined, that approved quitting products were benefitting only a tiny fraction of all successful ex-smokers, about 8 percent?

Also, try to locate any Free & Clear annual data showing long-term cessation rates for callers who did not use NRT as compared to those who did. Good luck. If long-term cessation rates for quitline NRT quitters were superior to quitline counseling only quitters, Dr. McAfee and his pharma friends would most certainly make sure we knew.

Dr. McAfee also deserves scrutiny for the CDC spending more than $100 million in taxpayer dollars since March 2012 on high visibility campaigns designed in part to motivate smokers to call the national quitline number, 1-800-QUIT-NOW. It begs examination because the quit smoking company he founded is part of the 1-800-QUIT-NOW network and is boasting about calls having spiked by more than 200,000.

And if you expect things to be better at the Food and Drug Administration's new Tobacco Products Center, don't hold your breath. Not only is the office funded totally by fees paid by the nicotine industry, on March 13, 2013, Mitch Zeller was named its director. Talk about handing the fox the hen house, between 2002 and 2013, Mr. Zeller served as a senior vice president for Pinney Associates, GlaxoSmithKline's exclusive quitting products marketing corporation. GlaxoSmithKline sells Nicorette gum and the Nicoderm line of NRT products.

400,000+ Smoker Deaths: A Health Leadership Failure

Next year we will again see more than 400,000 smokers smoke themselves to death. Remember, this Gallup Poll only polled successful ex-smokers. Missing are the millions of failures that U.S. health officials either coaxed into toying with replacement nicotine, or whose cold turkey attempt was undermined by government quitting literature such as "Clearing the Air," which suggests that quitting cold turkey is nearly impossible, with few succeeding.

To quote from the 1983 "Basic Text of Narcotics Anonymous," "Insanity is doing the same thing over and over again but expecting different results." It makes you wonder, do Zeller and McAfee really expect replacement nicotine to at last begin producing results during NRT's 40th year, or are they content with the status quo and current annual death toll?

What would happen if Mr. Zeller and Dr. McAfee decided that it was time for U.S. policy to stop undermining successful cessation and instead begin supporting and encouraging the quitter's natural instincts? It's not going to happen.

Both will continue to point to more than 200 placebo-controlled clinical trials that they know were not blind as claimed, while totally ignoring the population level effectiveness evidence-base, which overwhelmingly suggests that replacement nicotine is costing lives (see Pierce 2012, Doran 2006, NCI, Hartman 2006, West 2006, Ferguson 2009, Cheong 2007, Gallup 2013, and Weaver 2018).

It's ironic, as in regard to NRT's newest threat, the e-cigarette, Mr. Zeller has announced that the FDA will regulate e-cigarettes based upon "population-level harm." Career bias blinders in having been part of the problem, there is zero hope of objective FDA analysis under Zeller's leadership as to how the FDA was duped by junk-science in approving replacement nicotine, Zyban and Chantix, or analysis of the annual death toll product ineffectiveness has caused.

It's hard to imagine either of these men developing the courage or desire to speak truth to power. We should expect bone deep NRT biases will continue to trump their common sense. Thus, we should fully expect the U.S. government - the USDHHS - to continue to lie and deceive smokers and quitters as to their real-world chances ("your chances") and how most succeed.

Let history record that both knew the problem and solution yet failed to act.

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