New survey consistent with longstanding evidence – no benefit from nicotine replacement treatment (NRT), medications, or e-cigarettes

by Clark Miller

Published March 23, 2022

It’s established that despite decades of provision in medical settings and mass messaging of benefit, neither nicotine replacement treatment (NRT, nicotine administered in the form of patches, lozenges or gum) nor medications have clinically significant benefit for smokers wanting to stop use of combustible tobacco cigarettes to administer nicotine. 

The public health costs and yearly mortality tied to cigarette use eclipse those due to all illicit substances combined (opioids, meth, and other drugs).  

Nor benefit by use of e-cigarettes (“vaping”) to administer nicotine in order to stop smoking of tobacco cigarettes. 

teenaged girl vaping

That lack of beneficial effect due to NRT, medications, and vaping would not be understood by the millions of Americans who will die of smoking-related illness over the next decade, because the life-or-death information is not available to them, to inform their choices on what professional services and interventions can potentially help them stop the life-threatening compulsive behavior, and what treatments cannot, are not supported by evidence as effective. Instead, they rely on the advice from sources entirely out of scope of practice to assist them with the compulsive, potentially lethal behavior – medical providers. 

It would be hard for them to understand  that the evidence does not support benefit to them in trying to stop the potentially lethal behavior, confusing, after being prescribed those substances by their doctors and assured by them that they are effective, when they are ready to stop smoking. Just as difficult as it would be to understand the dispensing to them of addictive opioids with risk of dependence and  without benefit for their chronic pain, from their doctor. 

They trust their medical professionals, and many trust what they read in mass media and from authoritative, trusted sources. They would have no way of knowing that the reports of expert consensus in legitimized media and from identified authorities are in fact fabrications and representations of profound disregard and lack of competence to accurately understand and ascertain what facts are supported by the evidence, and are not, about what they need to help stop smoking and lower their risk of serious illness and death.  

They would have no way of knowing – because they’ve never been exposed to the truth, instead to useful fabrications – of knowing that compulsive use of tobacco cigarettes, like all compulsive use of substances, is not remotely a medical condition or disease, has no medical treatments, or that advice from and visits to medical settings for those problems diverts them from effective factors in the evidence-based treatments for compulsive substance use. 

Nicotine patch applied by a doctor

Protection of that lethal fabrication that there are medical interventions and treatments for compulsive substance use is the business of America’s Medical-Media collusion, as effective now as in generation of the opioid crisis

That’s evident in recent mass media reports on a study covered extensively and predictably with consistent interpretation and messaging of the meaning of the study, the CNN headline representative of a consensus of thought. 

(CNN)People using e-cigarettes to quit smoking found them to be less helpful than more traditional smoking cessations aids, a new study found.

That consensus media message is clear – 

Among the various treatments that medical professionals prescribe their patients to stop cigarette smoking, vaping is somewhat less effective in stopping the potentially lethal compulsive behavior than are medications or NRT. 

As in generation of the opioid crisis, that consensus medical expert and mass media message is a lethal lie, supporting ineffective medical “treatment” for a  non-medical condition, diverting trusting patients away from evidence-based treatments. 

Let’s take a look at the research report and the results. 


Electronic cigarettes (e-cigarettes), which were first sold in the USA in 2007, had become a popular cessation aid for US smokers by 2014–2016.1 2 From 2013 to 2017 US sales of e-cigarettes almost doubled,3 which was associated with rapid uptake among adolescents.4 If there was a similar increase in e-cigarette usage attributed to smoking cessation (either as a cessation aid or an alternative nicotine source) and effectiveness was demonstrated, we would expect that successful cigarette cessation would increase in the population.

So far, so good. Let’s take a look at the results. 

Under the first column (“Product used to assist . . .”) are the types of  medically prescribed substances reported to have been used by smokers participating in the survey. Note that the next-to-last category is no product at all – smokers who attempted to quit and did not use any medically prescribed or advised administration of nicotine (by vaping or NRT) or medication. 

The salient results are simple and without need of complex analysis – successful quit rates were higher for smokers using no medically prescribed or advised intervention compared to all other groups, and there were no medical interventions providing success rates statistically greater than those for the no treatment (“No product”) group. 

It’s important to note that this was a retrospective, comparative cohort study, without design and features of a randomized controlled trial (RCT) needed to confidently attribute cause or efficacy to different treatments. Another major weakness is that results are based on self-reports. 

Apart from that, the study design did provide a reporting group functioning similarly to a “no treatment” control group in a RCT. The function of a control group is to “control for” or manage in interpretations the confounding factor of effects that would have occurred without the treatments and to avoid attributing effects to a treatment that would have been expected even without the treatment due to other factors, in this case the effect of successful cessation of cigarette smoking by choice and motivation of smokers not using any “product” or medically prescribed substance. 

The one salient, clinically important, justified, and potentially life-saving conclusion

to be drawn from these results is – consistent with longstanding evidence –   that no medical interventions for the non-medical condition of compulsive tobacco use is more effective than no medical intervention, no more effective than control, that is has no beneficial effect. 

We know why that is

What evades explanation is the continued diversion of trusting smokers away from evidence-based treatment and to medical settings and advice that can only predict no benefit or harm. 

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

Latest Stories

Sign Up For A Critical Discourse Newsletter

You'll receive email alerts of new or upcoming posts.

A Critical Discourse

Fog Image