Quitting smoking is often a difficult task. Annually, about 30% of smokers attempt to quit smoking, of which a little over 1/3 manage to achieve permanent abstinence. Despite the relatively high awareness of the society about the harmfulness of smoking, getting rid of the addiction is a serious problem. Quitting smoking is difficult, but it is possible. Quitting can be helped by drug-based drug treatments and other supportive measures.
Why quit smoking so hard?
The difficulty in quitting smoking is caused by the extremely complex mechanism of addiction. Addiction to cigarettes consists of mental dependence and dependence directly related to influencing the physiology of the body.
- Mental addiction – repeated smoking, often in pleasant circumstances, “programs” our brain to associate a cigarette with pleasure.
- Physical dependence – nicotine affects nicotinic receptors, the stimulation of which indirectly activates the secretion of dopamine to the nucleus accumbens in the brain (reward center). Regular stimulation of dopamine secretion with the help of cigarettes changes the dopamine secretion in such a way that the basic dopamine secretion is lower in the smoker than in the abstinent. Therefore, weaning cigarettes may cause the withdrawal syndrome, caused, inter alia, by a lower basic level of stimulation of the reward center in an addicted person.
Addiction mechanisms make quitting smoking difficult. The problem is further exacerbated by the low motivation of people recovering from addiction. Motivation tends to increase in the presence of damage to the body caused by smoking and the fear of death. The first acute coronary syndrome (myocardial infarction) is often motivating sufficiently to maintain complete abstinence from smoking. It is worth mentioning a few statistics: 87% of lung cancers, 61% of deaths in lung diseases and 32% of deaths caused by coronary heart disease are caused by smoking.
If the motivation to quit is not high enough, it is worth seeking specialist help, and you should not wait for the potentially fatal consequences of addiction to appear. Recently, behavioral-cognitive psychotherapy has been gaining popularity. This is not the only possibility of psychological help, it is worth consulting your problem with the low motivation to quit the addiction with a selected psychological care facility.
In addition to maintaining adequate motivation in quitting smoking, drug-based methods help. All the above-mentioned methods clearly increase the effectiveness of quitting smoking, but their use requires a sufficiently strong motivation to get rid of the smoking problem. The studies to prove efficacy are based on a comparison of a group of people taking the medicine versus people who think they are taking the medicine (taking a placebo).
- Nicotine replacement therapy (NRT)
Nicotine replacement therapy is a therapy that has been used for years and allows to replace tobacco smoke with a less harmful form of nicotine delivery, and consequently to completely abandon it.
Nicotine is most commonly taken in the form of chewing gums, lozenges or patches. The disadvantage of the method is the need to properly dose nicotine throughout the day, depending on the demand. The topic of NRT assisted smoking cessation during pregnancy is complex. There is insufficient evidence for the safety of NRT for the fetus. There is no doubt, however, that the effects of the therapy are less harmful to the child than maintaining the addiction. In cases other than during pregnancy, NRT smoking cessation therapy has no negative side effects when the recommended doses are adhered to.
A controversial method of quitting smoking is the use of e-cigarettes. Despite the health doubts about e-cigarettes, scientific reports allow for an optimistic approach to this method. Long-term smokers of e-cigarettes are more likely to try to quit than smokers of classic cigarettes. Smoking e-cigarettes also allows you to reduce the amount of smoking traditional cigarettes, which definitely has a positive effect on your health.
Bupropion is an antidepressant drug. There is a correlation between bupropion intake and smoking cessation. Research shows that the drug helps to quit to a degree similar to that of nicotine replacement therapy. Taking the drug also allows you to reduce the negative effect of quitting smoking, which is weight gain.
Bupropion therapy lasts from 7 weeks to a year. The most serious side effect with choosing this method is the risk of seizures. Therefore, bupropion is not used in people with risk factors for seizures such as head trauma and epilepsy. Therapy is also not recommended for pregnant women.
Varenicline is a substance that acts on nicotinic receptors. It allows for effective suppression of nicotine craving. Therapy with varenicline requires regularity, related to, among other things, the need to saturate the body with the substance. Treatment should begin approximately one week before the date you plan to quit smoking. The high effectiveness of the method is paid for by side effects. Nausea is the most commonly reported side effect. Side effects such as changes in behavior towards aggression and suicidal ideation have been reported.
Cytisine is only a smoking cessation substance in Eastern Europe. The principle of operation is similar to that of varenicline. Cytisine is a relatively old drug, over 50 years old. Less efficacy than other pharmacological methods is balanced by the presence of few side effects, usually limited to intestinal ailments.
How to quit smoking?
Trying to quit smoking shows responsibility. Maintaining abstinence requires additionally systematic and sufficiently high motivation. Medicine has a variety of tools on the way to free yourself from addiction, from psychotherapy to drugs that help to relieve nicotine craving.
Quitting smoking is always a good idea. Receiving professional help in quitting the addiction requires reporting to appropriate facilities or medical consultation, including e-consultation.