For Your Health: Treating tobacco dependence
At the time of the first Great American Smoke Out in 1976, there were not many resources to help smokers “kick the habit.” Smokers were advised to chew gum, suck on mints, puff on a straw, drink lots of water. My own father gave up cigarettes with the help of about 5,000 lifesavers, but it was misery for him (and us.)
Progress has been made since then. In 1981, the American Lung Association began offering a series of in-person cessation groups called Freedom From Smoking. In 1984, the nicotine patch was introduced, the first prescription medication designed to help smokers quit. All states now have a Smokers’ Quitline that offers free counseling and support. The internet has improved access to online, interactive programs and resources.
One important change is that smoking is finally being called what it really is: nicotine addiction, a medical condition to be treated, not just a bad habit. This is important because it encourages smokers to seek help, which significantly improves chances of success, and has sparked research into new treatments and the most effective means of using those that have been developed so far. Doctors are more knowledgeable now and more proactive in treating tobacco dependence with their patients.
The key to breaking nicotine addiction is being able to deal with the intense cravings and irritability, anxiety, and restlessness that are common symptoms of withdrawal. There are three types of FDA approved medications designed to help make withdrawal manageable:
n Nicotine replacement products (NRT) work by taking the edge off of cravings and by gradually weaning the person off nicotine. NRT patches, gum, and lozenges come in “step-down” doses and are available over-the-counter. NRT nasal spray and inhaler require a prescription from a doctor or dentist. It is safe, and even recommended, to use more than one form of NRT at a time. For example, a person wearing the patch who experiences a strong urge to smoke can take an NRT lozenge or piece of gum. (It is not true that if a smoker “slips up” with a cigarette while wearing the patch, it will cause serious or fatal results.)
n Chantix is the brand name for the prescription drug Varenicline. Chantix works by blocking the nicotine receptors in the brain, which takes away the satisfaction associated with cigarettes and reduces the desire to smoke. Another unique feature of this medication is that smokers are instructed to continue smoking in the first week after starting it. This has the psychological effect of reducing anxiety and feelings of loss. Abstinence begins the second week, when the drug has begun to take effect and the desire to smoke may already be starting to wane.
n Wellbutrin and Zyban are brand names for the drug Bupropion, an anti-depressant approved to help with smoking cessation. This drug helps to calm the restlessness associated with withdrawal and is often prescribed in combination with NRT products.
The most effective treatment combines medications with some form of counseling and support. With the whirlwind of modern life, it is rare these days to find an actual in-person cessation group, but there are a number of highly-rated resources online and as Apps available to download. These programs are free and allow individuals to customize a plan based on personal factors like level of dependence, level of motivation, severity of withdrawal, physical and emotional conditions, and living environment. All of them offer on-going support in various forms such message boards, chat rooms, text messages, and tools for tracking progress.
Among those ranked most effective are:
n Become an EX: www.becomeanex.org · Quit Net: www.quitnet.com · Freedom From Smoking: www.ffsonline.org
n LIVESTRONG MyQuit Coach: available for iPhones
n Smoke Free: available for iPhones and Android phones
A list of these and other recommended online and app resources along with a full description of each is available on our website: www.rvwtobaccofree.org
Breaking nicotine addiction is a marathon, not a sprint. It takes practice to become a smoker—beginner’s cough is the body’s attempt to repel the toxic mix being inhaled—and it take practice to treat and overcome dependence. Nov. 21, the day of this year’s Great American Smoke Out, is a good time to start talking with your doctor, lining up a coach, getting your support team in place, and start practicing.
The Healthcare Consortium is a non-profit organization with a mission of improving access to healthcare and supporting the health and well-being of the residents in our rural community. The agency is located at 325 Columbia St. in Hudson. For more information, visit www.columbiahealthnet.org or call 518-822-8820.
