Conference hydra::dejavu

    I went to him last fall about this time - for weight reduction -
    I liked his approach - my idea was to drop 20 pounds... which did
    not happen - he is an interesting person and attempts to transform
    his participants into changing their idea about food and the use of
    it.  One drawback is his accent - very difficult to understand -
    
    I went with a girlfriend who also wanted to stop some fattening
    behaviors - we felt alive when we left his office and Yefim has
    a sparkle about him.   My girlfriend did not lose weight but she
    did not gain much a few pounds but think she mentioned the weight
    and took it off ASAP and this maybe what it was for her.  For me
    I became determined last May that I did not like my size and
    went on a DIET!  I lost 18 pounds - and am stablizing now as
    Yefim told me not to get too thin.  And this is how it was for me.
    I don't think I got any more insight or had any breakthroughs
    although for me to drop the weight was a breakthrough so maybe
    there is something to it all.  
    
    I would do it again although parting with the money is a bumer -
    once you pay that fee you are free to go back again for nothing.
    I did take a seminar in March that was based on a cirriculum for
    living and that REALLY did it for me.  It made me see areas where
    I stop myself with things in life as in being over weight.
    
    Good Luck!
    
    CB

    I also went to the Mad Russian as several of my friends. Many of them
    have quit smoking. I did not. 
    
    Sandy
    

    The only way that you can give up smoking voluntarily is when you want
    to give up. All other props will not assist you if you do not really
    want to quit.

    Jamie.

    I went to the Mad Russian for smoking cessation...I quit for about 6
    weeks...this was about 3 years ago...he also told me to be careful
    about my weight...I was 3 months pregnant with my 2nd child at the
    time.   ;)
    
    and Jamie is right...you MUST truly want to quit or nothing will help you!
    
    I still smoke.
    
    Sandra

    It was quite painful for me to give up. So being a practical person I
    used the slight masochistic tendencies that I have to enjoy the pain,
    and so neutralize it. Mind you I did have a fantastic incentive to give
    up.

    Jamie.

    And your incentive was a new baby????
    
    Sandra

    His incentive was a new (for him) heart.
    
    							Ann B.

    Yes it did help focus my mind on the problem, who was in charge of my
    life - me or a little white tube of carcinogenic natural produce.

    Jamie.

    A new baby is a very good incentive for people to give up smoking.
    There are two main reasons for saying this.
    
    1) Smoking during pregnancy is known to be harmful to the foetus, and
       statistically causes all sorts of problems including low birth
       weight, and physical deformities.
    
    2) Passive smoking is known to be harmful. I have a choice as to whether
       or not I indulge in passive smoking, a small baby (or any child for
       that matter) does not have that choice. For parents to inflict their
       deadly habit on their defenceless offspring is criminal.
    
    Any pregnant mother who does not stop smoking at least during
    pregnancy is AT BEST selfish and irresponsible.
    
    Laurie.

    I must go along with Laurie on this one, I was looking into passive
    smoking the other day, I'll see what can find tonight and get back with
    it.

    There was a rather horrific case it the UK recently concerning a woman
    who chain smoked through pregnancy and now has a nicotine dependent
    toddler. The child will eat the cigarette stubs out of ashtrays to get
    a fix.

    Jamie.

    OK I went and looked up the effects of smoking during pregnancy.

    I found that cotinine, a breakdown product of nicotine, is evident in
    the blood of the newborn whose mother's smoked, either actively or
    passively. So the nicotine is getting to the unborn child. 

    There is also a fair amount of evidence that it causes thyroid
    enlargement in the newborn. Though how much long term damage this
    causes has not been established. 
    
    Smoking was associated with significant reductions in maternal weight
    gain, birthweights and placental weights. There appears also to be a
    link to perinatal survival.
    
    Prenatal exposure to cigarette smoking was significantly associated
    with poorer language development and lower cognitive scores at both 36
    and 48 months.

    Food for thought.
                     
    Jamie.

    re: new heart
    
    WOW!!!!  I would certainly think that would be an incentive...and many
    congrats on your decision and recovery (belated, I know, but still...)!
    
    Laurie, I agree with the serious issues around smoking, and I am sure
    that most people in this notesfile have the insight and understanding
    of the different dependencies which some people have.  I must argue,
    vehemently at that, your last comment regarding selfishness.  It may
    very much seem that way and, in some cases, it very well may be that
    way, but to make such a statement...!!!  I certainly do not condone
    this habit, but.  Did you know that women who are already pregnant and
    addicted smokers can, do and will have a spontaneous
    abortion/miscarriage?  The shock to the system is very serious.  But
    this is not a forum on Smoking, so I won't bore you all, nor do I wish
    to engage in heated discussions over syntax.
    
    Sincere and hearty Congratulations to those who have kicked the habit
    and continue being as strong as you have been to stay off those
    wretched things.  I truly wish I had your strength and determination.
    
    Sandra

    DAMN!!!  I MEANT to say, those women who are already pregnant and
    attempt to quit smoking during that time can have a SA/miscarriage!

RE:                    <<< Note 1736.13 by STAR::SROBERTSON >>>

�    DAMN!!!  I MEANT to say, those women who are already pregnant and
�    attempt to quit smoking during that time can have a SA/miscarriage!
    
    Whilst it's clear that pregnant women can and do have miscarriages (I
    mean, who else is going to?), it's clear to me that you are saying that
    the act of attempting to stop smoking can be sufficient to bring on a
    miscarriage. Naturally you have a source of proof for this, not just
    anecdotal evidence. I've never heard of it, and doubtless Jamie will
    look for it in his medical database. Frankly, I don't believe it.
    
    Laurie.

    

    While it is quite possible for a woman to have a miscarriage while
    attempting to give up smoking there is no established link between the
    two. Current medical opinion is smoking during pregnancy is much more
    dangerous to the child than quitting the smoking.

    I think that you are consciously or subconsciously attempting to justify
    your continuing smoking.

    Jamie.

> Current medical opinion is smoking during pregnancy is much more
> dangerous to the child than quitting the smoking.

Hang on, I've heard the same thing about the stress of cold-turkey
cessation being implicated in miscarriages (with the resulting
recommendation of many physicians being that reducing smoking is better
than nothing). At this point, *nobody* has presented references, so
unless somebody intends to do so, why don't we just dispense with the
antagonistic speculation?

    Quite the contrary.  There is medical information which does link the
    the shock to the system and SA/Miscarriages, and that is why OB's are
    constantly telling women to stop smoking especially during childbearing
    years (and that timeframe is alot longer than it used to be) and they
    tell you to quit BEFORE getting pregnant because it is the safest.
    
    I don't feel I must justify my habits and try not to
    offend/inconvenience anyone with my habits.  I gave it a good shot a
    few times to quit and yes, I almost lost my son because of it, but
    that's immaterial now.  I have also 'seen' these things happen to women
    who tried to quit smoking while pregnant and have also seen others who
    did it with little to no duress.
    
    To those who successfully quit ANY habit or even attempt, I give as
    much support and praise as possible, because it is needed and they
    should be recognized for hard work...To those who become
    holier_than_thou reformists, I simply must ignore because they dropped
    one habit and doubled out on another one whatever it may be.
    
    Also, in one of the medical journals or periodicals a discussion on the
    addiction of smoking resulted in the finding that Nicotine addiction is
    as difficult to break as heroin.  So, for some people, it is a bit more
    difficult than any of us can imagine and, luckily, for others it is
    not.  But for either type of person, breaking a habit, whatever it may
    be, is a long hard road and they deserve credit whether or not they
    succeed.  Of course, this is only my opinion and we all have one;
    sometimes we concur and sometimes not.
    
    Sandra 

    Yes, my understanding agrees completely with Sandra's.
    
    Both the nicotine addiction and nicotine withdrawl are
    very dangerous to the child.  Nicotine is one of the most
    addictive substances known.  And severity of withdrawl
    is extremely variable from one person to the next, as has
    been found true of addiction in general.
    
    For example, there are a certain percentage of morphine addicts
    who can stop with a few days of of withdrawl symptoms, and then be
    free the rest of their lives.  There are others who will never
    be free and will always suffer desperate attempts to regain their
    chemical salvation.  I have known only about a half dozen smokers,
    who tried to quit, but even from that tiny sample, I've seen
    enormous differences in long term success and very different severity in 
    immediate withdrawl.
    
    							kind regards,
    
    							todd

    There is a discussion of this in, oddly enough, _The_Gentle_Art_of_
    _Verbal_Self-Defense_.
    
    The doctor says, "Don't you want to quit smoking?"
    
    The suggested defense against this insulting attack (See the relevance
    to the book's topic?) is to reply with something like, "Yes, I want
    that.  But you know that it's an addiction.  I need to know *how* to
    quit.  You are supposed to be helping me.  What are my possibilities?"
    
    						Ann B.
    
    P.S.  It's considered *harder* than quitting heroin.

    Last night I managed to access the Healthnet database. First I pulled
    every article that they had on miscarriages. Then I pulled every
    article on cessation of smoking and asked if there were any articles
    that were in both lists, the result was zero. For good measure I then
    pulled all the articles on abortion, all forms of abortion just to be
    sure. These also gave a zero result when compared with cessation of
    smoking.

    So there are no articles on that rather extensive database that link
    spontaneous abortion with quitting smoking. For the record there are
    over 1,000 articles linking abortion with smoking.

    Next I decided to harass our pet pathologist on the subject. He gives
    me funny looks with some of the questions that I ask him, I got one
    again. His subspecialty is gynecological pathology and he knows quite a
    bit about fetuses that don't make it to term, and why it happens. He
    was quite categorical and said that in his entire professional career,
    including his training period he has never seen or heard of a case of
    spontaneous abortion being caused by the mother giving up smoking. He
    has however heard of many complications that appear to be linked to the
    mother smoking.

    I asked him if stress could cause it and told me to use my brains, if
    stress caused a spontaneous abortion lots of unwanted pregnancies would
    suddenly terminate. He added that he thought that the term spontaneous
    abortion tended to mislead the lay person as it let them think that
    there was no reason for it to happen whereas this was not the case.
    When it happens early in pregnancy it is usually an unviable genetic
    defect which could never come to term or an ectopic pregnancy where the
    egg has implanted outside the uterus. If it happens later in pregnancy
    it is most usually a small placenta or the placenta has been damaged or
    partially pulled free by trauma.

    After that I went and checked up in the medical reference books that I
    have and again I could find no mention of quitting smoking as being a
    contributory cause of spontaneous abortions.

    Jamie.

    re: .20,
    
    That's interesting about no articles on withdrawl and fetal death,
    not quite what I'd have expected. 
    
    The link to spontaneous abortion being less well established, the question 
    remains, though, about other less catastrophic effects on the child.
    
    I very strongly suspect that the effects of smoking are, as you
    suggest, almost always more dangerous than those of withdrawl,
    (and so shouldn't be used to rationalize continuing the habit in
    pregnancy !), but I also suspect that the pathologist's comments may overly 
    trivialize the effects of maternal stress on the developing embryo or 
    fetus.   
    
    Damage to the baby's nervous system due to severe stress
    on the mother during pregnancy may not show up on the pathologist's 
    slides, but at a less visible level of functioning.  I'd be extremely
    surprised if there weren't a number of studies correlating
    infant and child psychological problems with maternal psychological 
    trauma during pregnancy.
    
    						kind regards,
    
    						todd

    Not only were there no articles, there was not even so much as a letter
    on the subject. Mind you I did not widen my scope beyond tobacco
    withdrawal. But just the same I was surprised that there was a total
    blank.

    I'll check up on stress and miscarriages tonight.

    Jamie.

    re: .22, Jamie,
    
    Does the database cover psychiatric articles as well ?
    
    						todd

    Yes.

    Last night I checked stress against miscarriage and abortion. There is
    plenty evidence that both miscarriage and abortion can cause
    psychological stress to the woman but there seems to be no evidence of
    stress causing miscarriages.

    >I'd be extremely surprised if there weren't a number of studies
    >correlating infant and child psychological problems with maternal
    >psychological trauma during pregnancy.

    Well I couldn't find any, and our doctor can't seem to think of any
    valid reason why psychological stress to the mother during pregnancy
    should in any way affect fetal development. Although the fetus is
    totally dependant on its mother for all nourishment it is a totally
    independent being.

    Jamie.
                      

>    Well I couldn't find any, and our doctor can't seem to think of any
>    valid reason why psychological stress to the mother during pregnancy
>    should in any way affect fetal development.

I have to say that that is one of the most ridiculous things I've ever heard
about pregnancy, and goes against common sense, and everything else one has
heard about the incredible sensitivity of the fetus to its environment and that
of the mother.

Regarding common sense, surely your doctor would concede that (A) psychological
stress in the mother can have easily-measured physiological consequences
(including actual physical illness, for example). And he would also concede,
one would hope, that (B) physiological factors in the mother can affect the
developing fetus.

I realize that (A) and (B) are is not sufficient to conclude rigorously that
maternal stress can affect fetal development, but if not, then there must be
some unusual principle operating to block the effect, and occams razor would
tell us to suspect the more likely possibility, first.

    As far as I can tell the fetus is a total parasite that will take all
    it needs from its mother even when it is to her detriment. If she is
    severely short on any of the substances that the fetus requires, or has
    toxins in her system then the fetal development will be impaired.

    As the mother and child have totally separate nervous systems and it
    would appear that the mother being under mental stress during fetal
    development does not harm the fetus. Considering the amount of women
    who are in stress during pregnancy there would be a lot of affected
    fetuses.

    Re your questions. Yes actual physical illness will affect the fetus,
    and no physiological factors affecting the mother will not.

    Despite current popular myths a fetus is quite a sturdy little thing
    and it takes a lot to shake it loose or damage it seriously.

    BTW do you have any evidence of your claims? I can't find any. 

    Jamie.

    re: fetal response to maternal stress
    
    The mechanism wouldn't be direct contact between their
    'independent' nervous systems, but through metabolites in the blood 
    supply, which is not (entirely) independent.  I could have sworn there were 
    some studies done a while back showing at least a fetal adernergic 
    response to maternal stress.  I can't cite anything yet, though, so I 
    won't push it.
    
    							kind regards,
    
    							todd

I have no evidence other than what you've provided, which is, as we've
both said: (1) stress can cause physical illness, and (2) fetal
development is affected by the mother's physical condition. There's no
need to hypothesize or look for a direct cause-effect relationship
between maternal stress and fetal development.

Now we *must* return to the context of this discussion, which was the
proposal that cold-turkey smoking cessation could cause fetal distress.
Clearly, from the above, this is a possibility. But just how likely is
this, what should a physician advise, and what should a pregnant mother
do? I think the answer is reasonably clear: cold-turkey cessation will
not result in severe fetal distress in the vast majority of
pregnancies, and, in the vast majority, is the best course of action
for the well-being of the fetus. A physician should, in almost all
cases, advise the pregnant mother who smokes to give it up entirely and
immediately. There will almost certainly be a very small number of
cases where cold-turkey cessation causes the mother enough stress that
it affects her physical health, which, in turn affects the fetus. In an
even smaller number of cases, the effect on the fetus will be worse
than if the mother had not quit, but had simply cut down. This must be
a vanishingly small number of cases.

So, *in the context of this discussion*, which is "what's best for the
fetus of a smoking mother", the smoking mother should *not* console
herself with the fact that maternal stress can affect the fetus,
because, basically, this fact is highly unlikely to apply to her case.

    For starters there is no evidence that stopping smoking has caused any
    fetal problems. 
    
    There are masses of evidence that smoking does cause fetal problems. 
    
    So where you get you hypothetical cases of fetal distress from when the
    mother goes cold turkey I do not know. 
    
    Even if they did exist could you be sure that the continuing of smoking
    would not cause more damage to the fetus?

    Jamie.
                                             

    I agree, the case does seem very weak so far.  If it were my family, I'd 
    be *very* motivated to help my wife stop smoking.  Fortunately, I didn't 
    have to worry about it.
    								todd

    
    Re.26
    
    Mike,
    
    Re: psychological stress, mother and child
    
    I agree with you completely.    
    
    Cindy

    OK let's look at it logically. In other topics there have been
    discussions on whether we evolved or were designed but which ever it
    was we ended up fitting pretty well into our environment.

    So does a fetus. It is capable of dealing with any normal thing that
    may happen to it while it grows from a single cell to a child capable
    of a slightly independent existence.

    One perfectly normal occurrence is psychological stress in the mother.
    Any obstetrician will confirm that a mother generally undergoes far
    more psychological stress on her first pregnancy that any of the
    following ones. Were this stress to affect the unborn child
    significantly then it would show up in the eldest of every family.

    Also young girls getting pregnant, rape victims, women who are
    abandoned or become widows during pregnancy are all subjected to
    extreme psychological stress, yet produce normal children.

    Now on the other side of the coin, mothers who are subjected to
    psychological stress after the birth while the child is in its
    formative years most definitely will influence the child.

    Jamie.
                                                                    

Fine, as long as we're not experts, and can speculate, debate, and
cajole, let me offer this anecdotal evidence: I personally know two
women who had miscarriages or premature delivery shortly following
automobile accidents after which physicians pronounced them (and their
fetuses) to be unharmed. In both cases, the physicians later ascribed
the problem to "trauma of undetermined origin". That is, they could
find no physiological reason, but assumed that there could be.

By the way, I doubt that evolution has gotten caught up with tobacco
smoking, to provide the same level of fetal rubustness that it does for
naturally occurring prenatal psychological stress. They're hardly
similar mechanisms at work.

Frankly, this whole discussion has gotten petty and pedantic. I have no
idea what point there would be to any conclusion it could reach. A
pregnant woman should exercise moderation and common sense. If she
wants to eat meat during pregnancy, for heavens sake let her eat meat
in moderation.

    
>By the way, I doubt that evolution has gotten caught up with tobacco
>smoking, to provide the same level of fetal rubustness that it does for
>naturally occurring prenatal psychological stress. They're hardly
>similar mechanisms at work.

    Just a side-note on the mechanism.
    One of the ways that cigarette smoking influences
    the body, besides the well known peripheral effects of vasoconstriction 
    and such is by the effects of nicotine on receptors in the central nervous 
    system that are intended for acetylcholine (which mediates some memory, 
    learning, and higher mental functions).   The nicotinic receptors think 
    they're getting natural brain chemicals, but they aren't.  This is probably
    part of why smoking is so addictive, it locks right in to the neurons.
    
    As far as smoking and pregnancy, since the mother hasn't the least 
    evidence of an 'evolved' tolerance to nicotine, there's no reason at all 
    to believe the fetus would either, aside from their greater plasticity
    in neural development and such until the child reaches maturity.  If
    they are 'hardy' enough to counter the effects, it is more likely because 
    they are compensating for them probably at a biochemical/developmental 
    cost, not because they are immune to the effects.
    
    I've seen the data on low birth weights of babies born to smoking
    mothers.  There seems to be a very strong correlation.   
    
    							kind regards,
    
    							todd

    Re .34

    I think that an auto accident does not come under the range covered by
    natural phenomenon which the fetus is liable to expect. The chance of
    physical trauma is also much higher than you would expect.

    Re .35

    I can't remember.

> I think that an auto accident does not come under the range covered by
> natural phenomenon which the fetus is liable to expect. The chance of
> physical trauma is also much higher than you would expect.

Agreed. But my point was that the physicians in both cases had
determined that, physically, everything was ok. Later, when things went
awry, they effectively said "well, I could've been wrong, maybe there
was some physical trauma after all, but I have no idea". So if you had
to use these cases to conduct a study, you would've had two data points
which represented spontaneous abortion (or delivery) with no detectable
(but suspected) evidence of physical trauma.

My other point was that smoking cessation also does not come under the
range covered by natural phenomena which the fetus is liable to expect.

    Well, I still think it's sad that someone clearly addicted to nicotine
    can attempt to justify continuing to smoke during pregnancy by citing a
    possibility that there might be some danger to the foetus caused by
    psychological shock. It is clear that while there is no evidence to
    support this view, there is an abundance of it showing the *likelihood*
    (not possibility) of foetal damage due to smoking. Such behaviour is
    selfish; IMO.
    
    Laurie.

>    Well, I still think it's sad that someone clearly addicted to nicotine
>    can attempt to justify continuing to smoke during pregnancy by citing a
>    possibility that there might be some danger to the foetus caused by
>    psychological shock.

  We agree. In .29, I said:

> [...] There will almost certainly be a very small number of
> cases where cold-turkey cessation causes the mother enough stress that
> it affects her physical health, which, in turn affects the fetus. In an
> even smaller number of cases, the effect on the fetus will be worse
> than if the mother had not quit, but had simply cut down. This must be
> a vanishingly small number of cases.

> So, *in the context of this discussion*, which is "what's best for the
> fetus of a smoking mother", the smoking mother should *not* console
> herself with the fact that maternal stress can affect the fetus,
> because, basically, this fact is highly unlikely to apply to her case.

  So what's your point? Or were you just casting a vote a month after
  everyone else lost interest in the discussion?

    Given the fact that the tobacco industry is grasping at every straw to
    convince you that smoking in not lethal, I think that were there any,
    even very tenuous connection, between the psychological shock of giving
    up smoking and damage to the fetus they would have been screaming it
    from the roof tops.

    I suspect that it is an urban myth which is used be smoking pregnant
    women as an excuse to avoid giving up. 
    
> There will almost certainly be a very small number of
> cases where cold-turkey cessation causes the mother enough stress that
> it affects her physical health, which, in turn affects the fetus.
   
    This is pure supposition on your part. Do you have any, even one,
    documented case to back this claim up? If you don't then it is just
    your personal opinion, which incidentally seems to run contrary to all
    the available evidence.
     
    Jamie.

> This is pure supposition on your part.

That's true, but it's a reasonable and probable one.

There is, in fact, documented evidence of problems caused by
cold-turkey heroine withdrawal. There may be documented evidence of
this for nicotine withdrawal, though I doubt it, since the number of
cases would be so low. If you actually cared, I'm sure you could easily
look it up, since you appear to have convenient access to the
information. I don't (have convenient access, nor care).

    >> This is pure supposition on your part.

    >That's true, but it's a reasonable and probable one.

    I totally disagree. It is just an unsubstantiated opinion which is
    subtly being paraded as a fact. Now stop trying to be coy, you know
    well that if there were any cases of going cold turkey on tobacco
    causing fetal damage the tobacco industry would make sure it was
    well documented.

    I also doubt strongly, and would like some evidence of your claim, that
    the physiological trauma of going cold turkey from tobacco is even in
    the same league as doing it from heroine I suspect that this again is a
    supposition that is being taken as a fact.

    >There may be documented evidence of this for nicotine withdrawal,
    >though I doubt it, since the number of cases would be so low. If you
    >actually cared, I'm sure you could easily look it up, since you appear
    >to have convenient access to the information
    
    Fact. There is not one case on the entire medical database, which is
    world wide, that suggests any form of fetal harmful trauma is caused by
    stopping smoking during pregnancy. 
    
    Not one single entry even suggesting it. 
    
    There are loads listing the potential damage that smoking can do during
    pregnancy.

    Theory. There may be some out there that have never been noticed. 

    Your theory has no factual base.

    Jamie.
          

    RE: .40
    
    I registered a vote because (as you obviously haven't noticed) I
    haven't noted in here for around a month. I've been busy with a capital
    'f'.
    
    Laurie.

 this note is interesting to many people at many times (look at the 
date of my note), not just when it is interesting to (1- 1/e)% of people.

Yes, it seems very bad for a pregnant mother to continue smoking (power and
good will to those people who are trying to quit anything that is harmful
to themselves and their loved ones). 
 
There are many things that people do that are bad to other people.  Why I know 
of some people who will actually speak loudly and publicly about the faults of 
others while keeping any harmful acts that they themselves have committed quiet 
and out of public view. 

-ag