Smoking: let’s quit againAccording to data at the Surgeon General’s office, twenty-five percent of all Adult Americans still smoke, resulting in over four hundred thousand deaths attributable to smoking annually. Research from the National Institute on Drug Abuse reveals that between one half and two-thirds of all teens have smoked, nearly twenty percent smoking regularly. Nicotine, the principle drug in cigarettes, cigars and chewing tobacco, is highly addictive. Chronic users are at much higher risk of developing life threatening and health compromising conditions, such as heart and lung disorders and cancer. Each inhale is fully activated in the brain within about ten seconds – and the body soon starts craving for more. When a smoker feels the urge to light up, chances are that he or she is actually going through the first steps of drug withdrawal. Psychosocial stress both increases the need to smoke and increases the dosages needed to forestall painful withdrawal symptoms. When a chronic smoker tries to quit (or just can’t get a break to smoke) he or she goes through a withdrawal syndrome, including increased irritability, impaired sleep, increased appetite and cravings to use the drug. Withdrawal also causes impairments in thinking and attention. Treatments for nicotine addiction Basically, there are several available effective treatments for nicotine addiction. First, there are replacement therapies, such as a nicotine chewing gum, a transdermal (through the skin) nicotine patch, an inhaler and a nasal spray. These are all about equally effective, though the gum and the patch seem to be more widely used. An antidepressant medication, bupropion, marketed under the name Zyban.®, can be prescribed to reduce cravings and perhaps treat the depression-related aspects of quitting. Some smokers have used acupuncture or hypnosis to be helpful. Work is underway to bring to market a nicotine vaccine, currently under then name, NicVAX, which may be available by 2004. Cognitive-behavioral treatments take advantage of our understanding of the psychological processes of addiction and behavioral change. These treatments help users to monitor cravings and avoid high-risk situations, when the urge to smoke is greater, and rely on healthier alternative activities, that support a smoke-free lifestyle. Finally, the very best way to avoid the addiction and health risks associated with nicotine is – don’t even start smoking. Prevention campaigns have found minimal success, but we can all play a role by not smoking, quitting, if we do smoke, and extolling the virtues of abstinence ourselves. I sometimes use the following strategy to assist smokers to cut down their usage, before quitting. First, count the number of cigarettes that you smoke, per day. If it’s one or two packs a day, that’s where we begin. At the start of a day, open a fresh pack of your usual cigarette brand. Then take one cigarette out from the pack. That day smoke no more than what is in that pack, each day taking another one from the pack. This method can help a two-pack a day smoker become a one-pack smoker in less than a month. Continue taking one out per day (you can keep them in reserve to fill an empty pack for another day – but don’t go into your stash for more on any given day. Your body will barely notice the gradual reduction in total nicotine consumed from one day to the next. It may take more than one try to finally quit the smoking habit; so quit, and then quit again, if you need to. |
