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Giving Up Smoking?

You may need some help ....

Giving up smoking is essentially a matter of self-motivation and determination. Most ex-smokers have stopped without using drugs or any kind of assistance, but products which have been shown to be helpful are available for those who feel unable to give up unaided. The effectiveness of smoking cessation products is in part due to an attention-placebo effect, because almost any treatment which provides positive expectations, structure and encouragement will have some success. Nevertheless, smoking cessation products do have a real effect.

In the past, products available included some which used an aversion therapy approach, but they were found to be little better than placebos and have been discontinued. Today, nearly all smoking cessation products licensed as medicines are forms of nicotine replacement therapy, either chewing gum, patches or, recently introduced, a cigarette-shaped inhaler. (A nasal spray is also available on prescription.) Nicotine lozenges and a product which claims to alleviate the unpleasant effects of stopping smoking are also available.

NICOTINE REPLACEMENT THERAPY

Nicotine replacement therapy (NRT) assists smokers to give up by providing nicotine, although at a lower eve than is obtained through smoking, to help prevent withdrawal symptoms and cravings. After a period at a steady state, nicotine intake is progressively reduced to zero over two to three months.

Patches

There are two types of transdermal patches, both of which are changed daily: one is left on for 24 hours, and the other is used for 16 hours daily during waking hours only and removed on going to bed.

Chewing Gum

Nicotine is absorbed from chewing gum through the mouth; peak blood concentrations are reached within about two minutes and the contents of a piece of gum are intended to be released over about 30 minutes. A piece of gum is chewed whenever the urge to smoke is felt, and the method mimics the pattern of nicotine intake obtained by smoking. The method is also useful because putting a piece of gum in the mouth and chewing provides some of the same kind of behavioral involvement as smoking.

Inhaler

Inhaler in Hand The inhaler is intended to address both the physical and behavioral components of smoking cessation, as it involves putting the inhaler to the mouth and inhaling as in smoking, and may be particularly useful for the highly behaviour-dependent smoker. Nicotine is contained in an impregnated polyethylene plug inside a plastic tube, and is used in the same way as a cigarette with "puffs" being inhaled as desired.

Effectiveness

NRT is one of the few categories of non-prescription medicines for which claimed effectiveness is supported by a large body of clinical trial evidence. Many trials and some meta-analyses have been published, and the overall opinion is that NRT is significant in helping smokers to give up.



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