Wednesday, January 24, 2007

Smoke gets in your eyes.

Most New Years we see a brief rush of punters resolved finally to sort out their smoking / diet / other general health issues. They jam up the surgery for a week or so, competing for appointments with the dyspeptically over indulged and the early winter lurgy sufferers. Then they either relapse or decide they don’t need our help, and it all calms down again.

Not so this year. Oh no. Not by a long chalk. Still they come in their nicotine tarnished droves, wreathed in the smoke of their fiftieth absolutely-the-last-fag-I’m-ever-smoking-honest. I reckon I must have passively taken in the equivalent of a pack a day for the past three weeks, and it’s starting to make me feel a bit dizzy and sick rather like Virgil Tibbses (what is the correct possessive form of Tibbs I wonder?) son in the movie.

So why the sudden stampede of fumeurs desperate to quit? I hear you ask.

Well it’s all the “fault” of Her Brittanic Majesties Government. After nigh on a decade of prevarication they have finally decided to take the plunge and ban all smoking in public places from this coming July. At the same time day-time TV has been bigging up a new wonder drug to help quitters.

The only tiny problem with this is that no-one has bothered to actually tell us poor Tommies in the trenches about it. Good old Google informs me that it might well be called Champix, and that it probably is now licensed for NHS prescribing. But nowhere on our state-of-the-art clinical system with prescribing support software, bells, whistles and unicycling performing mice* is there any really useful information about how it should be prescribed or taken, what its mode of action might be (apparently, according again to Google, it makes smoking so boring people descend into a pit of hopelessness and despair and just quit) or indeed its side effects or interactions.

I do hope it will turn out to be better than Zyban (the last smoking cessation wonder drug- you remember, the one where the manufacturers sent round the helpful circular three months after the granting of the license saying “we know fifty odd patients have died taking our drug, but we reckon thirty of them at least would have died anyway, and at least most of them had stopped smoking like we said they would…”**).

Sorry must stop now, I feel a craving coming on.

Just send in the next smoker please!

* I think I might have hallucinated that last one. Pity, they were bloody clever performing mice too.

** O.K. they were a bit more scientific in their explanation, but that was the gist.


Z said...

For this very reason, I avoid the doctors' surgery in January. I suspect I would not be taken seriously.

I also don't go if my ailment or concern has received any publicity in the last few weeks, for the same reason.

I am a physical wreck. But I still have Dignity.

steveg said...

"But nowhere on our state-of-the-art clinical system with prescribing support software, bells, whistles and unicycling performing mice*"



Nostrumdammit said...

Nostrumdammit has already been fielding requests for information from his own employers. Herewith are some links which may shed some degree of light on the situation.
I'm reminded of the snappy pop song of the late 60's by the Singing Postman "Have you got a light ? ". However I have no idea why that memory has surfaced. Perhaps I should pop out for a swift glass of port to get me through the morning.

Pfizer Schedule of Product Characteristics

Patient Information Leaflet

PS : this may be a second attempt at posting my comment. I'm really not well today you know.

Wendz said...

I think the correct form is Tibbs'.

If I stop smoking it'll be because I have decided to and it'll be cold turkey. Drugs? Pah! Willpower. That's all. Been there and it IS entirely do-able. Must just remember, even after years of not-smoking, to NTAP*....that's the downfall of all ex-smokers.

*Never Take Another Puff. said...

They smoke in your consulting room?
How rude!

Shinga said...

It's splendid that people are taking HMG's message so much to heart. Generations of children with ENT problems or families complaining that they couldn't taste their food for the smoke didn't work but enforce a public ban and they are waiting with baited breath in their GP's surgery.

Of course, in the US, various cities are introducing a ban on smoking in cars that are carrying children. Which is taking the public ban a little further.

Has the drug been promoted on actual day-time TV or the advertising - just interested?

I've no idea whether or not this drug works - one can only hope. The only thing that worked for my mother was going cold turkey - but she was unconscious and on a ventilator for several weeks so she reckoned that this was better than most people's experience of cold turkey.

Doctor Jest said...

So sorry folks, couldn't get back to do the moderator thing. I felt the need because of all the bloody Bingo Spam. I'll probably take it down again in a week or two....

z-- I'm always more than happy to see folk about their ailments whatever the trigger for their attendance. The thing that gets my goat here is the blatant "Advertorial" style of the drug release. Seems the companies would rather hype their product in the media than inform the professions, creating the demand in th ehope that we will meekly roll over and start dishing the stuff out willyy nilly and in an information vacuum. More worrying, since they've been doing it since even before Viagra, I assume some of my colleagues are doing so without bothering to ask too amny hard questions like "Will it work?" and "Does it kill people?"

Steveg-- pcs with th eall important "performing mouse" patch.

nostrum'-- thanks for the url's. I did manage to get the gist, but still feel it would have been nice to have had BNF data before the hype began...

Oh, and take a couple of aspirin and call me back if it isn't better in the morning!

wendz-- when the time is right and the will is there I agree entirely. When it's not, no ammount of supplemental chemistry is likely to have any lasting impact. You're so right about NTAP.

suze'-- no they do it in the car park and assume we can't see tham. I reckon we have our own little car park sized ozone hole.

shinga-- "I saw this bloke on the telly wot tried it." was what I was told. I think there was a slot on Richard and Judy or similar. they still aren't allowed to directly advertise to the public, so you get "Health Features" on the telly and in the Daily Mail instead. And that's journalism so it must be o.k.

Unconscious and vented is a pretty extreme form of cold turkey to be sure. But terribly effective IME.

Shinga said...

Oh, isn't that dumb of me. I know that we don't have DTC advertising in the UK but I'm so used to seeing nicotine therapy promoted everywhere alongside those OTC statins that I'm losing my appreciation for what is/not a prescription drug. Plus, I'm obviously spending far too much time in the US and getting confused.

A particularly egregious piece of advertising in the US is the HPV test; TBTAM has produced an excellent write-up of the cynicism and marketing involved in this.

Regards - Shinga