Ron Aspinall's booklet helps smokers kick the butts

By Adi Chiyoda

NUSA DUA, Bali (JP): Downing an umpteenth cut of coffee to get through the day is just one of the addictions which cut a swathe through humanity.

Eighty percent of the world's population is believed to suffer from addictions to nicotine, alcohol, cocaine and other drugs, sex, shopping, overeating, work and others. Some of these, such as drinking caffeine-laden drinks, may be considered normal as part of everyday functioning. Crucial is pinpointing when an addiction crosses over into destructive behavior.

By definition, addiction is something which causes harm and is out of control. Occasional use of cigarettes or alcohol will not cause addiction, but regular use will. Initially a drug is taken for the high it gives but, with repeated use, the brain's pleasure receptors that these drugs affect are overstimulated and become less sensitive. The brain is no longer dependent on the foreign substance for heightened sensation but needs it just to feel normal.

"Research has shown that addictions form in the hypothalamus, a relay area at the base of the brain," explains Dr. Ron Aspinall of Victoria, Canada.

This is also where primary survival drives -- hunger and sex -- are located. It is thought that addictions copy or take over these drives. Studies on addicted animals showed that when the hypothalamus was damaged, the hunger and sex drives disappeared, as did the addiction. This is why they are so strong, have so much influence over thinking and behavior and are resistant to change, he said.

Ninety-eight percent of nicotine users consume tobacco in an addictive way, as compared to 20 percent of drinkers who use alcohol in an addictive way.

Aspinall, who presented his work internationally for the first time at the annual Quality of Life Medical Conference held in Bali recently, has a new therapy to match these new concepts. He has compiled eight years of clinical research into "Kick Butt", a nicotine cessation program. The how-to-quit program is outlined in a booklet which will be published formally within the next year. Its humorous illustrations are in line with its quirky title.

What sets Aspinall's program apart from others before it is its combination of therapies. "Quitting an addiction is like baking a cake," says Aspinall. "You need all the ingredients baked at the right temperature to do the job." The most important aspect of Kick Butt, which Aspinall says has one of the highest cure rates in the world, is its utilization of a new psychology which focuses on separating the addiction from the individual.

"Addictions are a chemical takeover or 'infection' of the brain's survival mechanisms. Cravings are viewed not as what the self chooses, rather as an addictive switch in the brain ordering you around -- an enemy to be expelled," says Aspinall.

He calls the division process "externalizing the demon" and has his patients imagine the tobacco demon, even put a picture of it up on their wall, to remind them that they are not fighting themselves, but a powerful infiltrating force.

As the drug "infects" the brain's neurochemistry, it also perpetrates thinking in a rationalizing way. "Don't quit now, things are too stressful, quit next year, instead," or "Just cut back," are all considered the voice of the addiction. As one learns to separate self from the nicotine demon, it becomes easier to think of attacking an enemy rather than denying the self.

Isolation

In a preparatory period beginning four weeks before the projected quitting date, patients learn to isolate the act of "feeding the addiction" from the rest of their day-to-day lives. Aspinall discourages the use of the benign term "smoking". When people feel the need, they separate themselves from whatever activity they are engaged in and use.

Because of the prolonged chemical exposure, former smokers never quite return to previously normal levels, explaining why many of them experience mild residual craving for months and sometimes years after cessation.

Aspinall's Kick Butt booklet provides a user friendly tool for physicians to dispense and guide their patients through the process. Although he admits that most people who quit do so on their own, Aspinall says the large number of people who try repeatedly to cease but fail can benefit from a program like Kick Butt. Aspinall recommends using the program with the ongoing consultation of a physician and, ideally, a support group.

Sharing common experiences and finding understanding can help in preventing relapse. Aspinall says that when people do fall into old patterns, it is usually the result of an accumulation of contributing stresses. It is important to have outlets for expression and to receive encouragement from those farther along the same path who can explain how they passed through a particular stage. Studies also show improved rates of success for those who regularly seek group support.

In Canada, many more people were able to quit nicotine addiction after the government disallowed smoking in indoor public places. This was done to protect nonsmokers from secondhand smoke.

Aspinall's biggest hope is that one day his book will become obsolete if "societies can do more to help children from falling into the trap of addiction".