Anuradha Varanasi
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Written By: Anuradha Varanasi | Updated : June 2, 2016 11:22 AM IST
After years of smoking, you have finally decided to get rid of this habit and kick the butt for good. First of all, congratulations on your decision to quit smoking because it shows that you are brave enough to walk down the long and arduous road of tobacco de-addiction. Now that you ve made the decision to stop smoking, the next big question is, how do you accomplish this goal?
After all, for the last few years, your day began and ended with cigarettes. The clich d phrase, Old habits die hard starts to haunt you. Most smokers I have known who decided to quit would start by either throwing away all the cigarettes and lighters they own or give it away to other friends.
They then declare that they won t be seen with a cigarette in their hands anymore and tell their family members and friends not to worry about passive smoking anymore. Did you know, 10% of tobacco related deaths are caused by passive smoking? However, it s only a matter of time before they snap and run downstairs to hunt for cigarettes.
Going cold turkey is not recommended because the success rate is as low as 3%, says Dr Lancelot Pinto, Consultant Respirologist and Smoking Cessation Therapy Specialist at P.D. Hinduja Hospital & Medical Research Centre, Mumbai.
This means, out of 100 smokers who decide to quit smoking, 97 of them start smoking again within a short period of time, adds Dr Pinto. While another strategy that smokers use is to gradually cut down the number of cigarettes they smoke each day, Dr Pinto says that the phasing out method doesn t really work either.
When you reduce the number of cigarettes you smoke, you will only end up inhaling a lot deeper while you re smoking to meet your daily tobacco requirements. This won t help in kicking the butt in the long run. Tobacco addiction is no longer treated as a mere habit but rather, a chronic disease that needs to be tackled aggressively, he says.
So, if trying to quit smoking without any medical assistance whatsoever isn t effective in 97% of the cases, what are the treatment options available?
Cognitive Behavioural Therapy (CBT)
With the help of CBT or what is more commonly known as talk therapy, your psychologist will deconstruct your learned behaviours and replace them with better ones by making new associations. The whole point of CBT is to equip the patient with new skills and tools to fight against their tobacco addiction. However, Dr Pinto says that the success rates of CBT aren t that impressive either as only 6-7% of smokers successfully kick the butt only with the help of CBT. You could also call the National Tobacco Quit Line 1800-11-2356 to quit smoking.
Nicotine Replacement Therapy (NRT)
For mild tobacco addiction, Dr Pinto says NRT can be quite effective. Nicotine or tobacco patches and nicotine chewing gum are used to deal with nicotine cravings and also help your body to adapt with lower nicotine levels. Nictoine patches look like band-aids and help in dealing with withdrawal symptoms. However, if you suffer from moderate to severe tobacco addiction, Dr Pinto says NRT by itself might not be sufficient to kick the butt for good as it is mainly known as the first line treatment for tobacco addiction. You could also try these foods that can help you quit smoking.
Pharmacotherapy
Pharmacotherapy or using drugs to treat tobacco addiction aims to fight against nicotine withdrawal symptoms. Most physicians are unaware about pharmacotherapy for tobacco addiction and they think it s all about willpower. However, the patient should be able to quit smoking comfortably and pharmacotherapy helps in dealing with their withdrawal symptoms, says Dr Pinto.
Studies have found that the success rates of pharmacotherapy are somewhere between 35-40% and Dr Pinto claims that in Asia it is as high as 60% after treatment that lasts for at least three months to one year. In pharmacotherapy, you will be prescribed a drug called varenicline and an antidepressant known as bupropion along with nicotine patches. We recommend out patients to undergo pharmacotherapy along with counseling sessions by the ending of their treatment which can last for up to an year. We also have a six months long follow-up period to ensure that the patient doesn t suffer from a relapse, adds Dr Pinto.
He further adds that if the patient does have a relapse, he is counseled and told to have nicotine chewing gums during stressful situations once they complete pharmacotherapy. We had a patient who was very depressed because his dog passed away. On that day, he went back to smoking and after speaking to our team of counselors, he stopped the very next day, says Dr Pinto. Here s how to deal with the toughest phase of quitting smoking.
What are the side-effects of pharmacotherapy?
Bupropion works by decreasing tobacco withdrawal symptoms and cigarette cravings. Studies have found that the most common side-effects of this drug is insomnia and dry mouth [1]. However, these side-effects are generally transient and often resolve quickly by dose reduction or even on their own.
Varencline is the most recently approved treatment for smoking addiction and you can quit smoking one week after you are prescribed these drugs. However, research has shown that nausea is the most common side-effect of this drug as 30-40% users have experienced it [1]. This side-effect can be mild to moderate and tends to diminish over a period of time. Other side-effects could include headaches and abnormal dreams. Around 3% of patients experienced depression after having varencline [2].
Here's what you should do the next time you see someone smoking. Watch this video:
References:
[1] Aubin H-J, Luquiens A, Berlin I. Pharmacotherapy for smoking cessation: pharmacological principles and clinical practice. British Journal of Clinical Pharmacology. 2014;77(2):324-336. doi:10.1111/bcp.12116.
[2] Drug Saf. 2011 Sep 1;34(9):763-72. doi: 10.2165/11594450-000000000-00000. Psychiatric adverse events associated with varenicline: an intensive postmarketing prospective cohort study in New Zealand. Harrison-Woolrych M(1), Ashton J.
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