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Smoking cessation (commonly known as quitting, or kicking the habit) is the effort to stop smoking tobacco products. Nicotine is a psychologically and physically addictive substance, and quitting smoking is commonly considered to be difficult. Psychological and pharmacological aids are available to help people quit smoking, although success rates are relatively low. As part of the wider tobacco control movement, there have been numerous advertising campaigns, smoking restriction policies, tobacco taxes, and other strategies to encourage people to quit smoking. According to the World Health Organization, tobacco use is one of the major causes of avoidable death worldwide.
Outline
Smoking has been associated with many negative health effects, and quitting smoking helps to reduce the risk of developing later health problems.
Psychological support, group therapy or cognitive behavioral therapy help people to quit. Medication, such as a nicotine replacement therapy product or Zyban/Wellbutrin, can also supplement these approaches. Medication without psychological support is generally discouraged, and some of the medical therapies themselves have been proven to be addictive and potentially dangerous if misused.
One effective way to assist smokers who want to quit is through a telephone quitline which is easily available to all.
Success rates are increased by a serious commitment to smoking cessation and regular follow-up. After successfully stopping tobacco smoking, quitters should consider ways to change their lifestyle to improve their chances of not restarting, especially under stressful circumstances.
Although a significant proportion are successful, many people fail several times. Many smokers find it impossible to quit, even in the face of serious smoking-related disease in themselves or close family members or friends. The best predictor of smoking cessation success is past quit attempt(s).
Studies have concluded that those who do successfully quit smoking often 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.
Women and Smoking Cessation
Major depression may influence smoking cessation in women because depression is twice as common among women as men, the history of depression and negative affect have been associated with smoking treatment failure, 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.
Statistics
No smoking cessation methods have consistently achieved better than a 25% quit rate after six months. About 1.5%–3% of smokers manage to quit each year without support from health services. Enrollment into the placebo arm of medical trial and receiving a minimum level of counselling increases this rate to about 5%–10% after one year, partly reflecting participants' motivation.
Methods
Screening
Health professionals may follow the "five A's" with every smoking patient they come in contact with:
- Ask about smoking
- Advise quitting
- Assess current willingness to quit
- Assist in the quit attempt
- Arrange timely follow-up
Modalities
Effective techniques to increase smokers chances of successfully quitting are:
- "Five-Day Plan": quitting smoking through acceptance of addiction and realization of smoking's harmfulness
- Quitting "cold turkey": stopping smoking without external assistance
- Nicotine replacement therapy, NRT: pharmacological aids that (its makers claim) help with withdrawal symptoms, cravings, and urges (for example, transdermal nicotine patches, gum, lozenges, sprays, and inhalers)
- Smoking-cessation support and counselling
- Self-help books (Allen Carr etc.)
- Medication:
- Antidepressant bupropion (Zyban®, contraindicated in epilepsy and diabetes) that also helps with withdrawal symptoms, cravings, and urges.
- Nicotinic receptor agonist varenicline (Chantix®)
Alternative techniques
Alternative techniques which have been used for smoking cessation:
- Hypnosis
- Herbal preparations such as Kava Kava and Chamomile
- Nutritional nicotine detoxification
- Acupuncture
- Smokeless tobacco
- Attending a self-help group such as Nicotine Anonymous
- 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.
See also
References
- World Health Organization, Tobacco Free Initiative
- Peters MJ, Morgan LC. The pharmacotherapy of smoking cessation. Med J Aust 2002;176:486-490. Fulltext. PMID 12065013.
- Williamson, DF, Madans, J, Anda, RF, Kleinman, JC, Giovino, GA, Byers, T Smoking cessation and severity of weight gain in a national cohort N Engl J Med 1991 324: 739-745
- Henningfield J, Fant R, Buchhalter A, Stitzer M. "Pharmacotherapy for nicotine dependence". CA Cancer J Clin. 55 (5): 281–99, quiz 322-3, 325. PMID 16166074.
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Notes
External links
- NHS UK website on giving up smoking
- SilkQuit.Org - free community support and information for smoking cessation
- WhyQuit - dedicated to cold turkey smoking cessation
- Nicotine Anonymous - a 12-Step self help group for those with a desire to stop using nicotine