Smoking cessation
(commonly known as quitting, or kicking the habit) is the effort
to stop smoking tobacco products. Nicotine is a potentially
addictive substance, especially when taken in by inhaling
tobacco smoke, probably because of the rapid absorption through
the lungs. Tobacco use is one of the major causes of death
worldwide, according to the World Health Organization.
Research in western countries has found that approximately 3-5%
of quit attempts succeed using willpower alone (Hughes et al,
2004) and clinical trials have shown that Nicotine Replacement
Therapy (NRT) (see below) can double this rate to approximately
6-10% (Silagy et al, 2004). This is a small effect but very
worthwhile. Multi-session psychological support from a trained
counselor, either individually or in groups has been shown in
clinical trials to have an effect similar to that for NRT. The
best chances of success can be obtained by combining medication
and psychyological support (see below) (USDHHS, 2000). Apart
from NRT, medication that have been shown to be effective in
clinical trials are: the tricylcic anti-depressant nortriptyline,
bupropion (Zyban) and the nicotinic partial agonist, varenicline
(Chantix in the US and Champix elsewhere). Thorough reviews of
the evidence for all these methods of stopping are available via
the Cochrane Library website Cochrane Library.
There are many people and organisations touting what are claimed
to be effective methods of helping smokers to stop. Any smoker
thinking of paying money for such help would be well advised to
ask whether the claims of success are backed up by indepedent
comparative clinical trials, how the success rates have been
calculated and what numbers of smokers have been included in the
figures. It is very easy to make misleading claims of success
rates which are not adequately supported by evidence.
A range of population level strategies such as advertising
campaigns, smoking restriction policies, and tobacco taxes have
been used to promote smoking cessation. Of these, raising the
cost of smoking is the one that has the strongest evidence
(West, 2006).
Smoking cessation will almost always lead to a longer and
healthier life. Stopping in early adulthood can add up to 10
years of healthy life and stopping in one's 60s can still add 3
years of healthy life (Doll et al, 2004). Stopping smoking is
also associated with better mental health and spending less of
one's life with diseases of old age.
The most common short-term effects of stopping smoking are:
increased irritability, depression, anxiety, restlessness,
difficulty concentrating, increased appetite, constipation,
mouth ulcers and increased susceptibility to upper respiratory
tract infections. These mostly last for up to 4 weeks, though
increased appetite typically lasts for more than 3 months. The
most obvious long-term effect is weight gain (Hughes, 2007).
Statistics >>
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Smoking cessation
Statistics
Information for smokers trying to quit
1. Modalities
2. Alternative techniques
Information for healthcare professionals
1. Screening
Nicotine replacement therapy
1. Nicotine patch
2. Inhaler
3. Nasal spray
4. Gum
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