For every challenging medical issue, there’s a quick fix that exists in alternative medicine – and disappointingly, sometimes it’s sitting on a pharmacy’s shelf. This week I spotted an advertisement targeting an addiction, one that is the single biggest preventable cause of death worldwide: smoking. We associate smoking with lung cancer, but smoking kills in two other ways as well: cardiovascular disease, and chronic obstructive pulmonary disease. Tobacco kills 6 million people per year, causing hundreds of billions of dollars worth of pain, suffering, and economic damage. [PDF] Stopping smoking reduces the risk of dying – the damage lessens over time in those that quit completely.
Despite the known harms, quitting smoking is very difficult: 70% of active smokers say that they want to quit, 40% tried to quit over the last year, yet only 3-7% are smoke free after one year of quitting. With support and treatment, abstinence rates can climb to 30%+ (at best) but few seek medical attention and support. Some may be enticed by advertisements like the one I spotted. The website and ad have the same message:
Smokers Cleanse is a 3 part, 30 day program that works!!
Part 1 – Lung Support: This works to help expel mucous from the respiratory system, as well as soothe inflamed tissue and bronchial passages. Lung Support also contains powerful antioxidants that help to protect the respiratory system, allowing it to repair and rebuild faster.
Part 2 – Craving Support: This formula works to reduce cravings. By using a therapeutic dose of green tea extract, cravings are significantly reduced. Green tea extract has been shown in clinical studies to have a positive impact in helping people quit smoking. Craving Support also contains the amino acids GABA and L-Tyrosine, which work to curb the effects nicotine addiction have on the brain. “Keeping the supply of GABA at high levels has the potential to reduce the pleasurable effects of smoking, in terms of duration and intensity – American College of Neuropsychopharmacology (ACNP) Annual Meeting”.
Part 3 – Stress Relief: This formula helps to promote restfulness and relaxation. This is very important as two common problems associated with quitting smoking are anxiety and trouble sleeping.
I’ve blogged about cleansing and detoxing before. Popular with alternative providers like naturopaths, there’s no medical rationale for cleansing or drug store detox kits. Outside of detox units in hospitals, detox and cleansing are marketing slogans – not medical treatments. So what does a Smokers’ Cleanse do? To determine this, we’ll look at the ingredients, and the evidence that exists to support their inclusion. The cleanse is 3 different products:
Smokers’ Cleanse 1: “Lung Support” (2 per day)
- N-Acetyl L-Cysteine: 250mg
- NAC is an approved drug for Tylenol (acetaminophen) overdose, and has been studied treat lung disease in those with diseases like cystic fibrosis, but its role as a supplement has not been established in smokers. There is no published evidence demonstrating it helps expel mucous or reduce inflammation secondary to smoking.
- Thyme Leaf (Thymus vulgaris) 4:1 Extract 125mg
- Thyme is an herb with a long history of use for lung conditions, but there is no evidence to demonstrate it is effective.
- Fenugreek Seed (Trigonella foenum-garecum) 10:1 Extract 100mg
- Fenugreek seeds are used in cooking, but there’s no published evidence suggesting any role for smoking cessation or lung disease.
- Mullein Leaf (Verbascum thapsus) 50mg
- Also used traditionally to treat respiratory tract inflammation, but there is no evidence available to evaluate the dose or its effectiveness.
- Vitamin C (ascorbic acid) 40mg
- In the absence of a deficiency, there is no reason to supplement with this tiny amount of vitamin C. Supplementing vitamin C has been associated with effects on bone mineral density, but the relationship isn’t clear
Smokers’ Cleanse 2: “Craving Support” ( 2 per day)
- Green Tea Extract – 70% catechins (Camellia sinensis) 325 mg
- As I have blogged before, green tea is a product with a long list of claims but little evidence to substantiate them. While the manufacturer claims that “Green tea extract has been shown in clinical studies to have a positive impact in helping people quit smoking”, no published evidence was found in a search of the medical literature.
- L-Tyrosine 125 mg
- Tyrosine is a nonessential amino acid that the body synthesizes. Supplementing is unnecessary, except for those with phenylketonuria. There is no scientific rationale to think it has any value in modifying withdrawal effects from nicotine, or repairing damage done by smoking.
- Bilberry Extract (Baccinium myrtillus) 4:1 Extract 100 mg
- There is no published evidence to demonstrate or even suggest that bilberry extract has any effect at affecting “cravings” related to nicotine.
Smokers’ Cleanse 3: “Stress Release” (1 per day)
- Hops (Humulus lupulus) 4:1 Extract 150 mg
- While hops are consumed for anxiety, stress and other conditions, there’s no published evidence to suggest it has any meaningful effects.
- Skullcap (Scutellaria lateriflora) 4:1 Extract 150 mg
- Like hops, Skullcap is believed to be useful for anxiety and stress, but there is no persuasive evidence to demonstrate that it is effective.
- Lemon Balm (Melissa officianalis) 75 mg
- Also used traditionally for anxiety, there is an absence of evidence to suggest that has any effects.
- L-5-HTP (Griffonia simplicifolia) 25 mg
The manufacturer makes the following claims [PDF] about Smokers’ Cleanse:
Address the three main ‘triggers’ that cause people to fail in their attempt to quit smoking:
Reduce periods of intense cravings, reduce anxiety and promote restful sleep, and expel mucous and soothe bronchial passages
Based on a review of the evidence, we can conclude that there is no published evidence that substantiates these claims. While there are no obvious safety concerns with the ingredients, the data also suggest that this product will have no meaningful effects on nicotine withdrawal or any other consequences of quitting smoking. Furthermore, while this product is sold in Canada, it does not appear to be approved for sale in Canada by Health Canada’s Natural Health Products Directorate. While the approval requirements NHPD are embarrassingly low, an approval for sale would at least provide some additional degree of assurance that the ingredients are not harmful. Without such approval, there is no externally validated assurance of product quality or safety.
It’s a seductive idea to think that a 30-day “cleanse” can undo the damage of smoking, or ease the challenge of quitting. Unfortunately, there’s no published evidence demonstrating the ingredients in Smokers’ Cleanse will have any meaningful effects. Nicotine is a potent drug. Effective therapies for smoking cessation do exist: they include behavioral treatments (counselling) and drug treatments, such nicotine replacement. Smoking cessation programs are effective. Smoking cessation cleanses are not. If you’re a smoker and thinking about quitting, here’s a resource to get you started. Speak to your medical doctor or your pharmacist about science-based programs and treatments available. And ignore the quick fixes promised by cleanses.