Aversive smoking: Carboxyhemoglobin levels before and after rapid smoking

Blood nicotine and carboxyhemoglobin (COHb) levels after rapid smoking were studied in IS smokers. Blood nicotine averaged 48.1 ng/ml after rapid smoking compared to 32.4 ng/ml after normal smoking (/><.002), and COHb levels averaged 12.1% and 8.9%, respectively (p < .001). Normal smoking levels of 92 smokers in other studies averaged around 30 ng/ml nicotine and 8.2 to 8.5% COHb. There was no evidence that the degree of nicotine and carbon monoxide intoxication produced during rapid smoking had any relation to the reduction in the desire to smoke immediately after the session or to the decrease in cigarette consumption on the following day. The potential risks of rapid smoking are discussed. It is suggested that these risks might be reduced by using a beta adrenergic blocker and that the procedure could be made completely safe, possibly without loss of treatment effect, if subjects were instructed not to inhale.

Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Blood nicotine and carboxyhemoglobin levels after rapid-smoking aversion therapy.

Russell

Raw²,

Taylor³

et al. 1978

“…Two studies have found no electrocardiographic abnormalities among healthy smokers undergoing rapid smoking (Miller, Schilling, Logan, & Johnson, 1977;Sachs, Hall, & Hall, 1978). Both studies, plus one other (Dawley, Ellithorpe, & Tretola, 1976), also noted mild respiratory alkalosis following rapid smoking. These changes suggested possible risk for persons with cardiopulmonary disease that required further study (Sachs et al, 1978).…”

mentioning

confidence: 76%

Two-year efficacy and safety of rapid smoking therapy in patients with cardiac and pulmonary disease.

Hall¹,

Sachs²,

Hall³

et al. 1984

Eighteen smokers with documented cardiopulmonary disease underwent rapid smoking therapy with follow-up visits 12-and 24-months posttreatment. Biochemically verified self-report showed 50% of all subjects had not smoked from posttreatment through the 2-year follow-up visit, whereas a waiting-list control group had 0% abstinent subjects at the 2-year follow-up visit (p < .0001). The same 18 smokers and an additional 3 smokers all with documented cardiac and/or pulmonary disease underwent extensive cardiac testing and monitoring after 12 hr of tobacco abstinence, normal smoking, and rapid smoking. No subject developed evidence of myocardial ischemia or significant cardiac arrhythmia during normal or rapid smoking. These findings support the use of the original method and its safe and effective use in patients with mild to moderate cardiopulmonary disease and those who have had previous, uncomplicated heart attacks.

“…The risk-benefit ratio 1 for rapid smoking therapy must obviously be derived from an examination of the benefits as well as the potential risks (Danaher, Lichtenstein, & Sullivan, 1976;Dawley, Ellithorpe, & Tretola, 1976;Hall, Sachs, & Hall, 1979;Hauser, 1974;Koran, Hackett, Nicholas, Linberg, Stone, & Lukaski, 1977;Koran, Linberg, & Hackett, 1977;Lichtenstein & Glasgow, 1977;Miller, Schilling, Logan, & Johnson, 1977;Sachs, Hall, & Hall, 1978).…”

mentioning

confidence: 99%

Clarification of risk–benefit issues in rapid smoking.

Sachs¹,

Hall²,

Pechacek³

et al. 1979

Several articles on rapid smoking have stressed the theorized danger of this smoking abatement procedure while providing little evidence to support the claim. Additionally, they have disregarded the benefits of not smoking. This consideration of safety without benefit is found to be simplistic and potentially harmful. An analysis comparing the known risks and benefits is made, and the current literature on the efficacy and safety of rapid smoking is reviewed. Risk-benefit analysis reveals that rapid smoking is safe and effective for healthy subjects, but additional research is required to determine its safety and efficacy for persons with cardiac and pulmonary disease.