Quit Smoking
Smoking cessation (colloquially quitting ) is the process of discontinuing the practice of inhaling a smoked substance. Smoking cessation programs mainly target the smoking of tobacco, but may also encompass other substances that can be difficult to stop using due to the development of strong physical addictions or psychological dependencies resulting from their habitual use.
Methods of Tobacco Cessation
Nicotine patches
One popular method for discouraging tobacco consumption is the use of 'nicotine patches'. These patches deliver doses of the addictive chemical nicotine, thus reducing the unpleasant effects of nicotine withdrawal. These patches can give smaller and smaller doses of nicotine, slowly reducing dependence upon nicotine and thus tobacco. This method becomes most effective when combined with other medication and psychological support. In clinical trials, medical nicotine replacement patches or gum, the tricyclic anti-depressant nortriptyline, bupropion (Zyban, or Quomem in some countries), and the nicotinic partial agonist, varenicline (Chantix in the U.S. and Champix elsewhere) proved to be effective medication/pharmacological quitting-aids.
Smoking cessation services
Group or individual therapy can help people who want to quit. Some smoking cessation programs employ a combination of coaching, motivational interviewing, cognitive behavioral therapy, and pharmacological counseling.
It is believed that a very few smokers can successfully quit the habit in their very first attempt. On the contrary, many studies indicated that many smokers find it difficult to quit, even after they get afflicted with tobacco related diseases. A serious commitment and resolve is required to arrest nicotine dependency. Quitting can be even harder for individuals with dark pigmented skin compared to individuals with pale skin since Nicotine has an affinity for melanin-containing tissues. Studies suggest this can cause the phenomenon of increased nicotine dependence and lower smoking cessation rate in darker pigmented individuals.
There is an important social component to smoking, which can be utilized by the counselors while advising the addicts. Study analyzing a densely interconnected network of over 12,000 individuals found that smoking cessation by any given individual reduced the chances of others around them lighting up by the following amounts: a spouse by 67%, a sibling by 25%, a friend by 36%, and a coworker by 34%.
Weight gain
Some studies have concluded that those who do successfully quit smoking may gain weight. "Weight gain is not likely to negate the health benefits of smoking cessation, but its cosmetic effects may interfere with attempts to quit." (Williamson, Madans et al., 1991). Therefore, drug companies researching smoking-cessation medication often measure the weight of the participants in the study. In 2009, it was found that smoking over expresses the gene AZGP1 which stimulates lipolysis, which is the possible reason why smoking cessation leads to weight gain.
Depression
In the case of especially women, a major hurdle for quitting may emanate through Major depression and challenge smoking cessation. Quitting smoking is especially difficult during certain phases of the reproductive cycle, phases that have also been associated with greater levels of dysphoria, and subgroups of women who have a high risk of continuing to smoke also have a high risk of developing depression. Since many women who are depressed may be less likely to seek formal cessation treatment, practitioners have a unique opportunity to persuade their patients to quit.
Comparison of success rates
A U.S Surgeon General's report includes tables setting forth success rates for various methods, some of which are listed below, ranked by success rate and identified by the Surgeon General's table number.
- Quitting programs combining counseling or support elements with a prescription for Bupropion SR (Zyban/Wellbutrin) found success rates were increased to 30.5 percent, (Surgeon General's Table 25, page 72).
- Quitting programs involving 91 to 300 minutes of contact time increased six month success rates to 28 percent, regardless of other quitting method included Surgeon General's Report Table 13, page 59]
- Quitting programs involving 8 or more treatment sessions increased six month success rates to 24.7 percent (Surgeon General's Table 14, page 60)
- High intensity counseling of greater than 10 minutes increased six month success rates to 22 percent whether added to any other quitting method, nicotine replacement, or cold turkey Surgeon General's Report Table 12, page 58]
- A physician's advice to quit can increase quitting odds by 30 percent to ten percent at six months Surgeon General's Report Table 11, page 57]
- Just Seven percent of over-the-counter nicotine patch and gum quitters managed to quit for at least six months.
Other techniques for quitting
- Quitting "cold turkey": abrupt cessation of all nicotine use as opposed to tapering or gradual stepped-down nicotine weaning. It is the quitting method used by 80 to 90% of long-term successful quitters in some populations.
- Smoking-cessation support and counseling is often offered over the internet, over the phone quitlines (e.g. the US toll-free number 1-800-QUIT-NOW), or in person.
- Nicotine replacement therapy when used for less than eight weeks helped with withdrawal symptoms, cravings, and urges (for example, transdermal nicotine patches, gum, lozenges, sprays, and inhalers).
- The antidepressant bupropion, marketed under the brand name Zyban, helps with withdrawal symptoms, cravings, and urges. Bupropion is contraindicated in epilepsy, seizure disorder; anorexia/bulimia (eating disorders), patients use of psychosis drugs (MAO inhibitors) within 14 days, patients undergoing abrupt discontinuation of ethanol or sedatives (including benzodiazepines such as Valium)
- Nicotinic receptor agonist varenicline (Chantix) (Champix in the UK and Canada). Varenicline Tartrate is a prescription drug that can be used to alleviate some of the withdrawal symptoms. It can also be taken as a form of aversion therapy by smokers to make the act of smoking more repulsive.
- Recently, an injection given multiple times over the course of several months, which primes the immune system to produce antibodies which attach to nicotine and prevent it from reaching the brain, has shown promise in helping smokers quit. However, this approach is still in the experimental stages.
- Hypnosis clinical trials studying hypnosis as a method for smoking cessation have been inconclusive. (The Cochrane Database of Systematic Reviews 2006, Issue 3.)
- Aromatherapy based treatments and herbal preparations such as Kava and Chamomile, the efficacy of which has not been established.
- Acupuncture clinical trials have shown that acupuncture's effect on smoking cessation is equal to that of sham/placebo acupuncture. (See Cochrane Review)
- Attending a self-help group such as Nicotine Anonymous and electronic self-help groups such as Stomp It Out
- Interactive web-based programs which specialize in teaching participants how to quit.
- Laser therapy based on acupuncture principles but without the needles.
- Quit meters: Small computer programs that keep track of quit statistics such as amount of "quit-time", cigarettes not smoked, and money saved.
- Self-help books.
- Spirituality Spiritual beliefs and practices may help some smokers quit.
- Smokeless tobacco: There is little smoking in Sweden, which is reflected in the low cancer rates for Swedish men. It is claimed that Swedish men are more likely to use smokeless tobacco than to smoke. However, claims that spit tobacco might reduce the exposure of smokers to carcinogens or the risk for cancer (and even be used as a way to stop smoking) are not supported by the available evidence. Oral and spit tobacco increase the risk for leukoplakia a precursor to oral cancer. Chewing tobacco has been known to cause cancer, particularly of the mouth and throat.
- Vaporizer: heats to 410°F. or less, compared with 1500°F./860°C. in the tip of a cigarette when drawn upon; eliminates carbon monoxide and other combustion toxins.
- Electronic cigarette: Shaped like a cigar or cigarette, this device contains a rechargeable battery and a heating element that vaporizes liquid nicotine (and other flavorings) from an insertable cartridge, at lower initial cost than a vaporizer but with the same advantages including significantly reducing tar and carbon monoxide. However in September 2008, the World Health Organization issued a release proclaiming that it does not consider the electronic cigarette to be a legitimate smoking cessation aid, stating that to its knowledge, "no rigorous, peer-reviewed studies have been conducted showing that the electronic cigarette is a safe and effective nicotine replacement therapy."
- Titration, slowly reducing over time, one's daily intake of nicotine, to levels below the "minimum daily amounts" required to maintain an addiction.
- Screened single-toke, "semi-vaporization" utensil: substitutes 25-mg. single servings ("dosage regulation") for the heavily advertised overdose format of each time lighting an entire 700-mg. commercial cigarette.
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Smoking herb substitutions (non-t
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