Summer 2002 Vol. 12, No. 2 From Celebration to Frustration, and Back Again
Dr. Jesse Haven, Anchor Health Center, in Naples, and Dr. Allen Kuhn, Discover Wellness Clinic in St. Petersburg (both in Florida) have found through informal experimentation that the inhalation of nitrous oxide (laughing gas) on the day a smoker has decided to quit smoking tobacco cigarettes is an aid in removing the cravings for nicotine. According to Dr. Haven, “The nitrous oxide stimulates the pleasure receptors in the brain which leads to the replenishment of dopamine, a pleasure molecule. Although the effects in the brain last for three days, the feeling of being on nitrous stops shortly after the treatment is over and the patient is safe to drive home. This helps with a patient’s cravings and withdrawal symptoms in the first 72 hours, which can be crucial.”
As part of a comprehensive program Dr. Kuhn tells patients that nitrous oxide is a three day cure for a serious three day problem. The statistics indicate that the longer you can keep a person smoke-free the better the long-term odds will be. If patients remain smoke-free for a week, the chances are five times more likely that they will be so at six months. For those that can abstain for a month, 25% will be smoke-free for a year.
Some patients use the treatment in conjunction with other methods of smoking cessation, such as hypnotherapy, acupuncture, or nicotine replacement therapy (NRT). Other patients just utilize the nitrous oxide, along with willpower. The patients are treated once on the day that they decide to quit with a twenty-minute application of nitrous oxide. If withdrawal symptoms persist, they can be retreated in 48-72 hours with another twenty-minute treatment. This helps patients overcome the physiological withdrawal from nicotine, which is a huge hurdle for smokers trying to quit the habit.
A medical history is taken on each patient before they begin their treatment, and they are given a physical exam. They also receive a lung evaluation with lung age and a carbon monoxide level as additional motivators. Drs. Haven and Kuhn have developed a computer program to evaluate each smoker and determine the best smoking cessation program for that individual. The computer program scores the various components of the patient’s smoking habit and helps define why that unique person smokes: i.e., nicotine addiction, stress, situational circumstances, depression, anxiety, etc. Those patients who score high on the nicotine addiction component are good candidates for nitrous as are those who have failed other treatments.
Overall, Dr. Haven and his associates have found an 85% reduction in the number of cigarettes smoked per day in the three days after the patients took the nitrous oxide. Forty percent of patients were able to completely abstain from smoking during the first three-day period, and 92% said that their craving for tobacco had “noticeably decreased”. Haven reports that many of the patients who quit completely have remained cigarette-free for up to six months after the nitrous oxide treatment. He said that smokers who abstain for the first three days are more likely to quit for the long term than those who resume smoking within that first three day period.
Dr. Kuhn reports that the spontaneous ‘quit rate’ without nitrous is about 2.5% annually. About 70% of persons who smoke want to quit and 40% try to do so annually. The average number of attempts to quit before being successful is around eight tries. Of the people who have heart attacks, 70% go back to smoking, and of those who survive lung cancer surgery, 40% return to smoking. On a positive note, 1.3 million people quit smoking in the US each year. The quit rates reported on nicotine replacement therapy and Zyban vary depending on the study, but an accepted value is about 18% quit rate at six months. More research is needed to discover what the success rate is for the people who have received nitrous oxide for smoking cessation.
Dr. Haven said that nitrous oxide is an extremely safe medication and it has the benefit of making what can be the worst day in an addict’s life into a somewhat more pleasurable experience. “If there is any therapy that helps a few more smokers quit, physicians should be recommending it to their patients. Smoking is proven to take years off of one’s life. The will to quit has to come from within, but anything that makes that mountain you have to climb a little less steep, is definitely a positive thing.”
Drs. Haven and Kuhn continue to use nitrous oxide as an aide for smoking cessation in their respective practices. They did research together that was controlled but not double-blinded or compared to placebo. Initially they tried placebo-controlled research, but found that many of the patients had experience with ‘laughing gas’ from the dentist and could recognize the effects based on that experience. After the first few patients treated responded positively, they decided to treat all patients and then compare to known rates with other agents and published “cold turkey” rates of success.
Controlled studies would be helpful to evaluate this new treatment. Dr. Haven and Dr. Kuhn both feel that nitrous oxide is a needed addition to the medications already being used to help patients get the freedom that they want and to live longer and healthier lives. Both doctors would be open to conducting more research should the funds become available. Dr. Kuhn explains, “To provide funding for research and treatments that may help patients deal with the number one cause of preventable death in the United States is a worthwhile investment.” For more info, contact Dr. Jesse Haven (firstname.lastname@example.org), Dr. Allen Kuhn (email@example.com).