Research suggests that a person should quit smoking gradually to lessen the severity of withdrawal symptoms. Rates of relapse are highest in the first few weeks and months and diminish considerably after three months.
Studies have shown that pharmacological treatment combined with psychological treatment (such as psychological support and skills training to get through high-risk situations) results in some of the highest long-term abstinence rates.
Medications include nicotine chewing gum, the nicotine transdermal patch and the medication Zyban. A nicotine vaccine may be available in the future as an effective method for preventing and treating tobacco addiction.
Smoking cessation can have an immediate positive impact on a person's health; for example, a 35-year-old man who quits smoking will, on the average, increase his life expectancy by 5.1 years.
Nicotine replacement
Nicotine was the first pharmacological agent approved by the Food and Drug Administration (FDA) for use in smoking cessation therapy. Nicotine replacement therapies, such as nicotine gum, the transdermal patch, nasal spray and inhaler, have been approved for use in the United States. They help ease withdrawal symptoms, because they produce less severe physiological alterations than tobacco-based systems and generally provide users with lower overall nicotine levels than they receive with tobacco. These forms of nicotine have little potential for abuse as they do not produce the pleasurable effects of tobacco products. They also do not contain the carcinogens and gases associated with tobacco smoke.
While nicotine gum provides some smokers with control over dosage and ability to relieve cravings, others are unable to tolerate the taste and chewing demands. Estimates based on FDA and pharmaceutical industry data indicate that since the introduction of nicotine gum and the transdermal patch, more than 1 million individuals have successfully overcome nicotine addiction. A nicotine nasal spray and a nicotine inhaler are also available by prescription. All the nicotine replacement products—gum, patch, spray and inhaler—appear to be equally effective.
Non-nicotine therapies
Although the major focus of pharmacological treatments of nicotine addiction has been nicotine replacement, treatments are also being developed for relief of nicotine withdrawal symptoms. For example, the first non-nicotine prescription drug, bupropion, an antidepressant marketed as Zyban(R), has been approved for use as a pharmacological treatment for nicotine addiction. A Federal advisory committee recommended that the FDA approve bupropion as the first antismoking drug in pill form, and the first to contain no nicotine.
Behavioral treatments
Behavioral interventions can play an integral role in nicotine addiction treatment. Over the past decade, this approach has spread from primarily clinic-based, formal programs to numerous public health settings, and now to telephone and written formats as well. In general, behavioral methods are employed to discover high-risk relapse situations, create an aversion to smoking, develop self-monitoring of smoking behavior and establish competing coping responses.
Other key factors in successful treatment include avoiding smoking environments (and smokers) and receiving support from family and friends. The single most important factor, however, may be the coping skills for both short- and long-term prevention of relapse. Smokers need to learn behavioral and cognitive tools for relapse prevention and be able to apply those skills in a crisis.
While, as stated, more than 90 percent of the people who try to quit smoking relapse or return to smoking within one year, with the majority relapsing within a week, still an estimated 2.5 to 5 percent do in fact succeed on their own. Using pharmacological treatments can double the odds of their success. However, a combination of pharmacological and behavioral treatments, for example combining the nicotine patch with group therapy, further improves chances.
Nicotine. Last reviewed 12/31/1969
Source:
- National Institute on Drug Abuse
