Nicotine Anonymous (NicA) is a twelve-step program founded in 1982 for people desiring to quit smoking and live free of nicotine. [1] As of July 2017, there are over 700 face-to-face meetings in 32 countries worldwide [2] with the majority of these meetings occurring in the United States, [2] Iran,[ citation needed ] India, [2] Canada, [2] Brazil, [2] the United Kingdom, [2] Australia, [2] Russia [2] and in various online community and social media platforms.[ citation needed ]. NicA maintains that total abstinence from nicotine is necessary for recovery. [3] NicA defines abstinence as “a state that begins when all use of nicotine ceases. [4]
The first meetings began in February 1982 one on one meetings between a group of Southern California AA members to focus specifically on smoking cessation. These meetings began under the name Smokers Anonymous in Los Angeles. In June 1982 the founders, Rodger F, Robert K, Stephanie S, Dan H, began holding group meetings in Santa Monica California. Shortly thereafter another group independently started in San Francisco. [1] [5]
In 1983, a Manhattan, New York group of meetings formed independently, also formed by recovering AA members, specifically to address their smoking addiction. They called themselves "AA for Non-Smokers". During the same period, two groups started in Cleveland, Ohio.[ citation needed ]
Then in May 1985, Maurice Z., a California member, authored an article for Reader’s Digest. Thousands of letters poured in from people wanting to know more about this new Twelve-Step fellowship. That year Smokers Anonymous groups started independently in Woodstock, NY and in Islip, NY. Within a year there were a hundred meetings identified.[ citation needed ]
In 1986 the group members met for their first conference in Bakersfield, California to form a fellowship, originally known as Smokers Anonymous. [1] [5]
These groups met again in 1987 in Monterey, California. In April 1988, the fellowship’s first official World Services Conference was held in San Francisco.[ citation needed ]
The fellowship was renamed Nicotine Anonymous in Phoenix, Arizona at the 1990 World Services Conference because the Smokers Anonymous trademark was not available, but also, importantly, the delegates decided the focus of recovery should be on the drug nicotine rather than any single nicotine delivery system.[ citation needed ]
In 2000, "NicA" was selected to abbreviate Nicotine Anonymous at the annual World Service Conference. [1] [5] [6] [7]
Adapted with permission of Alcoholics Anonymous World Services, Inc., the Twelve Traditions are utilized by Nicotine Anonymous as fundamental guiding principles. Nicotine Anonymous operates with an elected, all volunteer, nine member board of officers and a set of by-laws. The board meets regularly to discuss how to be of service to the organization including organizing its annual World Service Conference and monitoring a number of appointed committee coordinators and the Nicotine Anonymous World Service home office located in Dallas, TX. The office keeps regularly updated meeting lists, manages the website and its online store, distributes NicA literature and free Meeting Starter Kits, and serves as a resource for members or any interested nicotine user.[ citation needed ] There are no dues or fees for NicA membership, as stated in Tradition Three: "the only requirement for Nicotine Anonymous membership is a desire to stop using nicotine." [8] [9]
There are several commercial and nonprofit programs supporting smoking cessation programs in the United States. Low-cost options, in addition to Nicotine Anonymous, are sponsored by groups such as The American Cancer Society, The American Lung Association, The American Heart Association and The Seventh-day Adventist Church. Commercial programs include cognitive-behavioral group therapy, nicotine replacement therapies and bupropion. Combinations of these approaches, marketed in commercial packages such as Smokeless and Smoke Stoppers, are licensed to treatment providers and conducted on an inpatient or outpatient basis. These are in addition to local programs ran by regional treatment facilities. [1] [10]
A weekly NicA meeting is ongoing and therefore unique among the array of treatment options because nicotine users and ex-nicotine users can enter and leave the process as they please. Most other treatment programs are structured as limited duration programs, with only a certain number of sessions, making it difficult for members to pick it up midway through or begin when a program is not being offered. [1]
In 1996, NicA ranked twelfth in size among the thirteen twelve-step organizations studied by Klaus Makela. [11] Sponsorship and lifetime attendance is not emphasized as much as in other twelve-step programs. The average meeting size is about seven people. [1]
Although both drinking and smoking are recognized by many respondents as imposing burdens on the family, [12] there are no auxiliary support groups for friends and family of smokers related to NicA; as Al-Anon meetings were created for friends and family members of alcoholics. Nicotine Anonymous World Services does, however, offer a pamphlet, Are You Concerned About Someone Who Smokes or Chews Tobacco? with information for friends and family of nicotine users. [13]
Success in achieving smoking abstinence using current smoking therapies such as Nicotine Anonymous, cognitive-behavioral group therapy, nicotine replacement therapies and bupropion (Zyban) ranges from 9% to 40% in different studies. [10] Alcoholics and drug addicts have better smoking cessation success rates when attempting to quit smoking early in recovery. [14] Combining psychosocial and pharmacological treatments increases smoking cessation success rates. [15] Acupuncture, hypnosis, inpatient treatment, and Nicotine Anonymous have not been shown effective thus far. [16]
In a controlled study 205 alcoholics, with heavy tobacco dependence (an average of 26.8 cigarettes per day) and three months or more of continuous abstinence from drugs and alcohol, were placed at random in one of three treatment groups: an American Lung Association Quit Program plus Nicotine Anonymous meetings group, a behavioral counseling plus physical exercise group, or a behavioral counseling plus nicotine gum group. The effectiveness of the treatment programs was measured at post-treatment, six months, and twelve-months following post-treatment based on self-reports confirmed by confirmed biochemical and informant reports. Immediately following treatment the behavior counseling and exercise group had the highest quit percentage (60%) followed by the behavioral counseling plus nicotine gum group, with the ALA quit program plus NicA group at 31%. At the six-month follow up all groups had similar percentages of members maintaining abstinence from tobacco (29%, 27%, and 21%, respectively) and also at twelve-months (27%, 27%, and 26%, respectively). Out of all the participants, only 4% relapsed on alcohol or drugs. The alcohol relapse rate did not differ by treatment group. [17]
In a survey of 104 smokers (ages 18 and older) 78% reported they believed spiritual resources could be helpful in an attempt to quit smoking. In the same survey, male smokers, ages 31 and over, and females were found to be significantly more open to using spiritual resources in the smoking cessation process than controls. Heavy smokers, those smoking more than fifteen cigarettes per day, were also significantly more receptive to encouragement of spiritual resources in an attempt to quit. [18]
Alcoholics may have experienced twelve-step approaches to recovery and therefore may be more open to the possibility that same approach can be used to initiate and maintain abstinence from tobacco use. [19] The first edition of Nicotine Anonymous: The Book published results of an internal survey of members showing that 25% of members responding to a survey on the topic reported they had prior twelve-step experience. [1] Many smokers do not see group treatment as a potentially useful. [20]
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Nicotine Anonymous publishes eight books, sixteen pamphlets, two CDs, and one newsletter. [21] Nicotine Anonymous: The Book explains the various principles of the Twelve Steps as they apply to nicotine addiction and includes testimonials from NicA members. Nicotine Anonymous Newcomer’s Booklet is a pocket sized booklet that answers common questions about the program and includes helpful tips. Nicotine Anonymous Step Study Workbook briefly discusses aspects of each Step and is followed by questions for the member to answer. Our Path to Freedom: Twelve Stories of Recovery includes testimonials from NicA members. 90 Days, 90 Ways has 90 daily meditations on topics related to recovery from nicotine addiction. A Year of Miracles has 366 daily meditations further expanding on topics related to recovery from nicotine addiction. The Twelve Traditions of Nicotine Anonymous (Extended Version) includes a complete copy of the explanations for all Twelve Traditions. Bylaws of Nicotine Anonymous has the rules and regulations for how Nicotine Anonymous World Services operates.
The pamphlets provide information to new and prospective members, and include titles as follows: Introducing Nicotine Anonymous; To the Newcomer and Sponsorship in Nicotine Anonymous; Out Policy of Openness; How Nicotine Anonymous Works; Nicotine Anonymous the Program and the Tools; A Nicotine User's View of the Twelve Steps; The Serenity Prayer for Nicotine Users; Slogans to Help Us be Happy, Joyous, and Free Living Without Nicotine; Abstinence: What is it?; Tips for Gaining Freedom From Nicotine; Facing the Fatal Attraction; To the Dipper and Chewer; Our Promises; World Services, My intergroup, and Me; Introducing Nicotine Anonymous to the Medical Profession; Are You Concerned About Someone Who Smokes or Chews Tobacco? For the Friends and Family of Nicotine Addicts. Voices of NicA is a CD that has audio shares from members covering their experience, strength and hope in their nicotine recovery. There is also a CD with an audio content of Nicotine Anonymous: The Book and Our Path to Freedom. Seven Minutes is a quarterly newsletter used to keep members informed about developments within the organization and members’ recovery contributions.
A NicA pamphlet, Tips for Gaining Freedom from Nicotine, was reviewed in 1999 by a convenience sample of twelve professional colleagues of psychologist Edward Lichtenstein. These professionals were asked to review the cessation tips from the pamphlet and rate them on whether they were cognitive, behavioral, or neither. To that extent, they also rated how consistent the tips were with current cognitive-behavioral cessation techniques. It was found that many of the tips were very consistent with modern cognitive-behavioral smoking cessation treatment programs. The cognitive behavioral tips included setting dates, making commitments, planning things to keep one's mind off smoking, having something to fidget with, having something to put in one's mouth, rewarding oneself when goals have been met, remembering that discomfort associated with withdrawal will subside within two weeks. One tip was found to be spiritual, "Pray instead of puff". [1] Since 1999 many of the NicA pamphlets have been updated and current versions may not contain the information analyzed. [13]
Alcoholics Anonymous (AA) is a global peer-led mutual aid fellowship begun in the U.S. and dedicated to abstinence-based recovery from alcoholism through their spiritually inclined twelve-step program. Besides stressing anonymity and offering membership to anyone wishing to stop drinking, AA's twelve traditions establish it as free to all, non-professional, non-denominational, apolitical and unaffiliated. In 2020 AA estimated its worldwide membership to be over two million with 75% of those in the U.S. and Canada.
Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), founded by Bill Wilson and Bob Smith, aided its membership to overcome alcoholism. Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.
Rational Recovery was a commercial vendor of material related to counseling, guidance, and direct instruction for addiction designed as a direct counterpoint to Alcoholics Anonymous (AA) and twelve-step programs.
Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive and can cause dependence. As a result, nicotine withdrawal often makes the process of quitting difficult.
Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin or amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused.
Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch, chewing gum, lozenges, nose spray, and inhaler. The use of multiple types of NRT at a time may increase effectiveness.
Quitline is a telephone helpline offering treatment for addiction and behavior change/issues. Presently most quitlines treat tobacco or alcohol addiction. Quitlines are treatment centres that offer advanced treatment and should not be confused with call centres.
Marijuana Anonymous (MA) founded in 1989 is an organization and twelve-step program for people with common desire to maintain abstinence from marijuana.
NicVAX is an experimental conjugate vaccine intended to reduce or eliminate physical dependence to nicotine. According to the U.S. National Institute of Drug Abuse, NicVAX can potentially be used to inoculate against nicotine addiction. This proprietary vaccine is being developed by Nabi Biopharmaceuticals of Rockville, MD. with the support from the U.S. National Institute on Drug Abuse. NicVAX consists of the hapten 3'-aminomethylnicotine which has been conjugated (attached) to Pseudomonas aeruginosa exotoxin A.
Nicotine withdrawal is a group of symptoms that occur in the first few weeks after stopping or decreasing use of nicotine. Symptoms include intense cravings for nicotine, anger or irritability, anxiety, depression, impatience, trouble sleeping, restlessness, hunger or weight gain, and difficulty concentrating. Withdrawal symptoms make it harder to quit nicotine products, and most methods for quitting smoking involve reducing nicotine withdrawal. Quit smoking programs can make it easier to quit. Nicotine withdrawal is recognized in both the American Psychiatric Association Diagnostic and Statistical Manual and the WHO International Classification of Diseases.
Tobacco harm reduction (THR) is a public health strategy to lower the health risks to individuals and wider society associated with using tobacco products. It is an example of the concept of harm reduction, a strategy for dealing with the use of drugs. Tobacco smoking is widely acknowledged as a leading cause of illness and death, and reducing smoking is vital to public health.
Overeaters Anonymous (OA) is a twelve-step program founded in 1960 for people with problems related to food including, but not limited to, compulsive overeaters, those with binge eating disorder, bulimics and anorexics. Anyone with a problematic relationship with food is welcomed; OA's Third Tradition states that the only requirement for memberships is a desire to stop eating compulsively.
Nicotine dependence is a state of dependence upon nicotine. Nicotine dependence is a chronic, relapsing disease defined as a compulsive craving to use the drug, despite social consequences, loss of control over drug intake, and emergence of withdrawal symptoms. Tolerance is another component of drug dependence. Nicotine dependence develops over time as a person continues to use nicotine. The most commonly used tobacco product is cigarettes, but all forms of tobacco use and e-cigarette use can cause dependence. Nicotine dependence is a serious public health problem because it leads to continued tobacco use, which is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year.
Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members who found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorder. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for the twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.
SMART Recovery is an international community of peer support groups that help people recover from addictive and problematic behaviors, using a self-empowering and evidence-informed program. SMART stands for Self-Management and Recovery Training. The SMART approach is secular and research-based. SMART has a global reach, with a presence established in more than 30 countries. SMART Recovery is effective with a range of addictive and problematic behaviors
Workaholics Anonymous (WA) is a twelve-step program founded circa 1983 for people identifying themselves as "powerless over compulsive work, worry, or activity" including, but not limited to, workaholics–including overworkers and those who suffer from unmanageable procrastination or work aversion. Anybody with a desire to stop working compulsively is welcome at a WA meeting. Unmanageability can include compulsive work in housework, hobbies, fitness, or volunteering as well as in paid work. Anyone with a problematic relationship with work is welcomed. Workaholics Anonymous is considered an effective program for those who need its help.
LifeRing Secular Recovery is a secular, non-profit organization providing peer-run addiction recovery groups. The organization provides support and assistance to people seeking to recover from alcohol and drug addiction, and also assists partners, family members and friends of addicts or alcoholics. It is an abstinence-based recovery program with three fundamental principles: sobriety, secularity and self-empowerment. The motto of LifeRing is "empower your sober self."
Food Addicts in Recovery Anonymous (FA) founded in 1998 is a program of recovery based on the twelve steps of Alcoholics Anonymous. FA members are men and women of all ages. Some have been obese; others have been severely underweight, bulimic, or so obsessed with food or weight that normal life was difficult or impossible. The common denominator uniting members of FA is addiction and a relationship with food that parallels an alcoholic's relationship with alcohol. The program offers the hope of long-term recovery, evidenced by members who have continuously maintained a normal weight and healthy eating for periods of twenty-five or even thirty years.
Jed Eugene Rose is an American academic professor, inventor and researcher in the field of nicotine and smoking cessation. Rose is presently the President and CEO of the Rose Research Center, LLC in Raleigh, North Carolina. Additionally, he is the Director of the Duke Center for Smoking Cessation at Duke University Medical Center.
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