Lennox Johnston – Nicotine Man!

An excerpt from Nicotine: The Drug That Never Was (Volume II: A Change Of Mind) by Chris Holmes

ii). The tobacco story has so many curious twists and turns that I am never really surprised when another one pops up. In Volume One I mentioned that I hadn’t quite managed to discover exactly when the “nicotine addiction” story started, as an interpretation of compulsive use and I suggested that if anyone was intrigued about that then they should keep digging and if they found anything enlightening to let me know. This inspired Chepstow-based hypnotherapist Marc Bishop to investigate further and he contacted me recently to tell me about Lennox Johnston, of whom I had never heard.

The fact that I had never heard of him is interesting in itself, because it turns out that Lennox Johnston – and be honest, you’ve never heard of him either, right? – was the first person to use nicotine in isolation to offset the impulse to reach for tobacco. In other words he invented Nicotine Replacement Therapy (NRT) – the very thing my book denounces. Now, NRT is prescribed and sold all over the world, so if we all know about innovators like Alexander Fleming and Louis Pasteur, how come Lennox Johnston is never mentioned when people talk about NRT?

Actually it is probably because he was a bit like me: he made a bit of a nuisance of himself and everybody thought at first that he was wrong… which causes me to feel a certain, odd kinship with the chappie even though he is very much my adversary in this argument, for am I not in a very similar position here, trying to explain why smoking is not what most people presently think it is? Here is an extract from Johnston’s typical pronouncements to the editor of The Lancet circa 1953:

“I think it more sensible and scientifically satisfying to recognise tobacco-smoking as a drug addiction from start to finish. It varies in degree from slight to serious. The euphemism “habit” should be discarded completely… no smoker derives positive pleasure and benefit from tobacco. The bliss of headache or toothache relieved is analogous to that of craving for tobacco appeased.”

It is immediately clear that Allen Carr’s later observations in The Easy Way To Stop Smoking have their origins here in Lennox Johnston’s view, although I doubt Carr had ever heard of him either. He certainly never mentioned him in any of his own writings to my knowledge.

So what did the medical profession think of Johnston’s insistence that tobacco smoking was a drug addiction in the 1950’s? Well, we have managed to find this frank repudiation by none other than the Honorary Secretary of the Society for the Study of Addiction, one H. Pullar-Strecker, in response to Johnston’s assertions:

“Much as one may ‘crave’ for one’s smoke, tobacco is no drug of addiction. Proper addicts… will stop at nothing to obtain the drug that their system demands imperatively.”

Smokers often tell me that they are puzzled by the fact that although they wouldn’t normally go for nine hours without a cigarette during the day, when they are on a plane it doesn’t seem to bother them until they land, or very shortly before they land. The only exceptions seem to be smokers who resent the restriction, or have a problem with flying anyway. Likewise we hear of smokers seemingly untroubled by cravings during a spell in hospital, or more ordinarily whenever they go anywhere where smoking is commonly accepted as being out of the question, such as Mothercare or the Finsbury Park Mosque. It seems that as long as the smoker accepts that restriction, there will be no urge to smoke until they leave that situation. That is certainly not withdrawal, and falling nicotine levels in the body during the nine-hour flight (for example) are clearly irrelevant. The “nicotine receptors” in the brain are hardly in a position to appreciate the smoking ban on aircraft – or observe it – so this certainly begs the question “Why are they not ‘going crazy’ – as the NRT advert would have us believe is the cause of smokers’ cravings – in all of the situations mentioned above?” For of course Pullar-Strecker was right: the heroin addict cannot do that. If a heroin addict gets on a plane and the heroin level in the blood falls low then they are ill, it doesn’t matter what they are doing or where they are situated. That’s withdrawal.

Lennox Johnston was a Glaswegian GP who had been a smoker himself and according to his obituary in the British Medical Journal (Volume 292, dated 29/03/86) he quit smoking twice. It relates how he pondered his compulsion to continue smoking and “wondered what would be the effect of stopping” – only to find that it proved easier than he expected. A year or so later, he started smoking again and after that it took him “two agonising years” to give up.

Later he became an anti-smoking campaigner and began to experiment with pure solutions of nicotine which he often administered to himself, once with near-fatal consequences. He also wrote to The Lancet describing an experiment he devised himself which involved about thirty smokers who apparently allowed him to inject them with nicotine whenever they felt the urge to reach for tobacco, which Johnston claimed then subsided. Although this certainly does not qualify as a bona fide clinical trial, it can be regarded as the first ever attempt to trial nicotine replacement as a concept. The Lancet published Johnston’s letter, and so began the biggest medical mistake of the 20th Century – though of course, everyone thought he was wrong at the time.

Well – not quite everyone. Throughout the history of tobacco-smoking in Europe there have been occasional voices calling it an “addiction”, though quite what those individuals thought that term really meant is not easy to determine now. Yet for most of that history nearly everybody simply regarded it as a filthy habit – which is pretty accurate. A complex compulsive habit to be exact – for a full definition of that see Chapter Ten in Volume One, where I spell out the key differences between that and true drug addiction.

It is only very recently, in fact, that the “nicotine addiction” interpretation has become the general impression, and not everyone believes it even now. There have always been voices in the scientific community who have pointed out the inconsistencies, but they couldn’t explain the compulsive element because they didn’t have the key knowledge of the normal operations of the human Subconscious mind and how it organises and activates compulsive habitual behaviour. So they got shouted down – as did the tobacco companies who tried to point out that other habitual behaviours that did not involve any substances – such as shopaholics and compulsive gamblers – seemed to be of a similar order, but eventually they too accepted the new doctrine and dropped the argument. Not because it was invalid, but because they were pretty much on their own at that point, the anti-smokers were on a roll and have been ever since.

Factually, the tobacco companies were right… but because smoking is damaging to health they didn’t have a chance of getting their point heard as the scientific proof of real harm emerged during the 1960s and has continued to be the justification for everything that has changed since. Every anti-smoking policy or restriction that has been introduced since then has been justified with a reminder of the enormous harm tobacco smoking does to human health.

It’s a pity it never occurred to Lennox Johnston to wonder why he found it surprisingly easy to quit the first time, but it took “two agonising years” the second time. Surely the role of nicotine was the same in both cases and what that gives us straight away is the clue that nicotine isn’t the difficulty: the perception of ‘ease’ or ‘difficulty’ – even ‘agony’ – results from other variables, and that’s why expert hypnotherapy can usually resolve the matter on a single occasion but NRT does not.

The medical establishment thought Johnston was wrong, in fact they ignored him for years and don’t even talk about him now. The tobacco companies thought it was just a habit, as did virtually all smokers at the time. Some still do, despite all this mad nicotine propaganda that is really just marketing for NRT dressed up as medical orthodoxy.

The irony is, the medical establishment were in fact quite correct in the first place. So now it seems as if I’m the mad eccentric, when all I’m pointing out is exactly what everyone knew anyway before Lennox Johnston came along. If they had only stuck to their initial assessment that he was the mad eccentric, then they could have remained quite correct all along and we could have avoided this crazy detour around and around and around the poison nicotine, which is not the real reason people struggle to quit through their own efforts, as I explained in Volume One.

Lennox Johnston lived until he was 86, surviving long enough to see his initially-scorned pronouncements adopted as the standard medical view. By mistake.

Doubt if I will live long enough to see it corrected. Probably won’t get the credit either – but then, neither did Johnston -which is why none of us had ever heard of him!

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