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Calling it quits -

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Calling it quits

Broadcast: 01/06/2011

Reporter: Deborah Cornwall

Are we doing enough to help smokers who can't quit?


CHRIS UHLMANN, PRESENTER: Plain packaging is the latest in a raft of anti-smoking plans about to
hit Australia, but addiction specialists argue the Government's war on tobacco companies doesn't
help hardcore smokers who want to kick the habit. They say up to four out of five smokers may need
specialist help that's often difficult to find.

Deborah Cornwall reports.

WENDY BECKETT: The scare campaigns never worked. And anyone who's smoked knows that's true. It's
actually an addiction that I've struggled with.

DEBORAH CORNWALL, REPORTER: It's more than three decades since Australia, along with the rest of
the developed world, stepped up the war on smoking.

Tobacco advertising is now effectively shut down and while half the population smoked in the 1970s,
today it's just 18 per cent.

Can you tell me, then, how many cigarettes a day you are having now, roughly? Just give me an idea.

PATIENT: I'd say 10.

DOCTOR: 10. From what?


DOCTOR: From 60. OK.

DEBORAH CORNWALL: But while those smokers left behind have now been banished outdoors, they still
fill our hospital beds. And according to tobacco addiction experts, even though some 94 per cent of
smokers are now desperate to quit, well over half have no real prospect of giving up unless they
can get the kind of serious treatment they need.

RENEE BITTOUN, TOBACCO ADDICTION SPECIALIST: In the beginning, it was so easy to help smokers quit.
You said "Don't smoke" and they didn't. But today things are a little different in the sort of
people I'm seeing. ...

DEBORAH CORNWALL: Australia's leading tobacco treatment specialist, Renee Bittoun, says while our
anti-smoking campaigns have been very effective in demonising smoking, standard treatments for
smokers, be it the family doctor or quit line, fall far short of what's needed by an estimated 40
to 80 per cent of smokers now categorised as pathological nicotine addicts.

RENEE BITTOUN: I believe that those who could have quit have quit. What we're trying to look at is:
it valid today still to see a GP or to ring a quitline, certainly for the clientele that we see who
are so sick who see those ads on TV and it's them on the ad and they can't quit smoking.

DEBORAH CORNWALL: Tobacco treatment specialists offer tailored programs for smokers, including
counselling and a range of nicotine replacement therapies. But while they're widely used in
countries like the UK or New Zealand, in Australia they're only a handful.

To see Renee Bittoun at Sydney's Royal Prince Alfred Hospital you'll generally have to wait until
you've either lost a limb or are dying of emphysema.

In the past month, the Federal Government has widely boasted its global credentials in taking on
the tobacco giants. Its plans to impose plain packaging and graphic health warnings on every
cigarette pack are world first.

NICOLA ROXON, FEDERAL HEALTH MINISTER (April 7): If you are starting again setting laws for a new
country, it would not be a legal product. But the truth is it is currently legal, there are many
people who are addicted. We need to do all we can to break those addictions.

DEBORAH CORNWALL: But experts in the field say Australia still isn't doing nearly enough for those
smokers who, despite repeated attempts, just can't stop. The latest research in fact suggests
nicotine has such a diabolical call effect on the brain, many smokers simply can't function without

RENEE BITTOUN: What can happen to a smoker who started at 12 who quits at 60 and tells you, "I find
this extremely difficult. My brain doesn't work. I'm not functioning properly. I might need these
nicotine products for the rest of my life." And we think that that might be the case.

WENDY BECKETT: I feel very cross that smokers are vilified in the way they are. I have beaten
myself up over smoking because will power's not something I lack. It shocked me that - and
continues to surprise me that I've not been able to quit nicotine.

DEBORAH CORNWALL: Sydney playwright Wendy Beckett spent three decades trying to quit, signing up
for every treatment she can find, from psychiatrist to smoke-enders, even solo mountain retreats.
But not one of them worked. It was only after she found Renee Bittoun four years ago she finally
realised she could live without cigarettes, but not without nicotine.

WENDY BECKETT: I consider that I will be on nicotine gum for the rest of my natural life. I think
it's time we stopped all this nonsense with making smokers look like ugly monsters and people that
harm their babies and none of this is true. No-one wants to die of smoking-related illnesses.
Education about the ill effects of smoking do not help an addict any more than they help a heroin
addict or an alcoholic.

DEBORAH CORNWALL: While there's still a fierce debate about just how many nicotine addicts fall
into the category of pathological smoker, Sydney respiratory specialist Professor Matthew Peters
says most of his patients certainly seem to; many still unable to quit, even after being diagnosed
with emphysema and lung cancer.

MATTHEW PETERS, RESPIRATORY SPECIALIST: These are not people who it's good if they quit some time
in the next few years; these are people who need to quit in the next few weeks. Showing them
commercials and giving them a quitline number when they haven't worked till now is not a full and
adequate approach to their health care problem.

DEBORAH CORNWALL: For now at least, there appears to be a major standoff between public health
policymakers and clinicians on the ground as to just how effective specialist smoking services can

SIMON CHAPMAN, PUBLIC HEALTH, SYDNEY UNI.: Only two per cent of people are even willing to pick up
telephone and call the quitline, despite it being on every pack and on every television
advertisement. Far fewer are prepared to go along, often several times, to a suburban location or
at a hospital to receive counselling about quitting smoking.

DEBORAH CORNWALL: Anti-smoking guru Professor Simon Chapman effectively shut down plans two years
ago to employ a team of specialist councillors to treat high-risk smokers across NSW.

SIMON CHAPMAN: We have very poor evidence that people attending these places in fact do better than
people who try to quit in other ways. The pharmaceutical industry of course have a vested interest
in saying, "Oh, don't use will power. Whatever you do, don't try to quit without using drugs."

DEBORAH CORNWALL: But Renee Bittoun and her colleagues say Professor Chapman is simply ignoring the
reality. 92 per cent of smokers who do quit, they say, are back smoking within two weeks.

RENEE BITTOUN: There is more to quitting smoking than just saying, "Don't do it anymore." That
isn't all there is to it. There is a great deal more to this, as there is to all addictions.