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.
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.
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
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.
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.