Thursday, April 5, 2018

The Cost of Tobacco Addiction and Cessation


Addiction is being forced to buy cigarettes to relieve withdrawal symptoms. This sets in after every cigarette. It trains the addicted person to fear quitting.
Quitting requires, in general, a three-day withdrawal, and a strong desire to quit. The emotional desire to quit must be greater than the fear of withdrawal symptoms, to successfully quit and stay quit.
Successful cessation programs span “cold turkey” at zero cost to several hundred dollars (often covered by insurance), that include hypnotism, directed meditation, alternative nicotine sources, drugs, counseling, and a variety of help groups. All of these have a very high rate of failure, if the addicted person has not had the time to unlearn smoking behavior and/or find a replacement behavior, or had a significant emotional event of sufficient magnitude.
The short-term cost of addiction is simple to calculate. In this discussion it is set at $5 per pack in Columbia, MO. In 12 weeks, Chart1, the cost is over $400 for a pack-a-day smoker. [The 12 week period makes all the charts have the same time as given in some product insert instructions for nicotine lozenges.]
About 30% of smokers do not plan on quitting. They can buy cartons and save $100.
Preventing people from experimenting with tobacco eliminates the cost of addiction and cessation. The price barrier of a 20 cigarette pack was set by stopping the sale of “singles” and smaller packs.
The price of a carton stops people from buying a carton, as well as, the desire to quit smoking. Each pack just might be the last pack. There is no need for a carton.
The cost of maintaining no third hand tobacco smoke in memory care or other residential health care facility, is set as 35 cents per lozenge (Chart 2). Using three lozenges a day, the cost would be about $1.05 per day; and using 5 for $1.75. These two rates are comparable to smoking 5 cigarettes (25 cents each) per day on the job.

Chart 3 doubles the number of lozenges to cover a 24-hour day. The cost for nicotine replacement therapy (NRF) now compares to smoking cigarettes ($1.75 to $1.25 per day).  By prescription, this is covered by many health insurance policies (in fact, twice per year).


Columbia/Boone County, MO, Health Department provides a 14-day supply of patches with counseling free. This removes the price barrier ($35) posed by the first box of lozenges when ready and prepared to quit. Paying for each box of lozenges from a $3/day contribution to your own savings removes the next barriers.

Using Walmart prices, in March, 2018, people addicted to nicotine are forced by their addiction to spend between $913 to $1,825/year to manage their blood nicotine levels (sales tax not included).

It would cost them about $1,095/year to switch to nicotine lozenges at work. This eliminates third hand tobacco smoke exposure for residents and for people wanting to quit (70% of smokers), quitting, and wanting to stay quit.

With insurance, it costs zero to quit and only $209 without insurance; smokers burn this much in the same 12 week period suggested by the makers of nicotine lozenges! [After considering when, where, why, and how they got addicted. Are any of those conditions still valid?]

This pricing of nicotine lozenges to cigarettes over a 12 week period is not just a chance event in Missouri; the state with the lowest cigarette tax. Tobacco companies need to keep their nicotine addicted customers away from the current fad of vaping. The federal government helps by providing free counseling and a 2 week supply of safe nicotine sources in nicotine replacement therapy (NRT).

There is no tobacco smoke when there are no smokers. Visitors wanting to smoke and immediately return to a resident’s apartment are offered a nicotine lozenge in some facilities.

Australian Nicabate lozenge label: “For adult smokers who want to stop over several months. Use a lozenge whenever you have a strong urge to smoke instead of smoking a cigarette.” (Effective before 2018) [A nicotine lozenge is always safer than the toxic smoke from a cigarette.]

Every smoker will quit someday. It is only a matter of grief and denial of the addiction. Non-smokers are healthier, more productive, and less expensive to maintain. The public health effects are now recognized as so severe that free help is available to any smoker to start to become a former smoker (CALL 800-QUIT-NOW).

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