It is common knowledge today that giving up smoking is a notoriously difficult habit to give up. And it’s not without good reason! Smoking isn’t just a habit, but also an addiction to nicotine which interferes with numerous neurotransmitters in the brain, naturally produced compounds that play a crucial role in regulating mood and, more specifically, causing the pleasurable sensations associated with smoking.
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According to Action on Smoking and Health, better known by acronym ASH, roughly two thirds of active smokers want to quit, while only around 40% actually attempt to do so. Out of those attempts, just 2 to 3% are successful in leaving cigarettes for good.1
However, despite this, the total number of active smokers is actually on the decline. Today, only 19% of adults in the UK are smokers, which a dramatic improvement from 50% in 1974.
This drop is explained by numerous factors. For one, health risks associated with smoking, including heart disease, several forms of cancer, COPD and erectile dysfunction, to name just a few, are now common knowledge thanks to numerous awareness campaigns aimed at promoting the knowledge about these health risks.
Secondly, governments of the world played a very active role in the previous decades by placing market restraints on tobacco trade. With taxes on cigarettes rising, this harmful habit has become exponentially more expensive. In addition to this, advertising and sponsorship restrictions have also been introduced in a vast majority of countries so, for example, in the UK cigarette manufacturers and traders don’t have easy access to their consumers.
Finally, with the accumulation of knowledge regarding the impact of smoking on health, different cessation methods and aims have been developed, including nicotine replacement therapies, prescription medications and support groups. Because of this, smokers who wish to quit have a number of options in front of them to choose from.
While every smoker’s goal should be to eventually quit their harmful habit, this is easier said than done. In addition to difficulties associated with actually quitting smoking, every smoker is different, so there is no single stop smoking method that will work for everyone. But, with numerous methods and aids available today, it is much easier to find something that will work for you. Smoker looking to quit in the 21st century has a number of options, including:
- Prescription smoking cessation medicines (Zyban and Champix)
- Nicotine replacement therapy
- Electronic cigarettes
- Quitting cold turkey
Prescription stop smoking medicines
As of now, there are two prescription smoking cessation medicines which have been developed specifically for aiding smokers in giving up their bad habit. Both Champix and Zyban will allow their user to cope with nicotine withdrawal easier, but they will require him or her to try and quit smoking early in the treatment, usually sometime during the second week.
Zyban is a stop smoking tablet developed by GlaxoSmithKline and approved for consumption in 1997. This medicine contains an active ingredient called bupropion that is used over the course of nine weeks. Its mechanism of action relies on the prevention of the reuptake of certain neurotransmitters in the brain which are usually released when nicotine binds to specialized receptors in the brain.
With these compounds remaining present regardless of nicotine intake, Zyban will significantly diminish the unpleasant withdrawal symptoms.
Champix achieves the same goal, although in a slightly different way. This stop smoking pill is manufactured and marketed by Pfizer pharmaceutical company and has been widely used ever since it was first approved in 2006.
Relying on its active ingredient varenicline, Champix works similarly to Zyban with quit smoking date being picked in the second week of the treatment. When commencing therapy, the user will start with a lower dose, increasing it gradually until second week, when it will hit maximum and remain constant for the remainder of the 12 weeks course.
However, unlike Zyban, varenicline works by directly binding to the nicotinic receptors in the brain, thus diminishing not only withdrawal symptoms, but also the subjective pleasure experienced when smoking a cigarette.
Both of these medicines come with certain risks and possible side effects – not the least because they act directly in the brain, so a doctor will have to assess patient’s medical profile before approving the treatment and issuing a prescription. It is also important to note that both of these prescription smoking cessation aids should be used as a part of a more comprehensive smoking cessation program which should include, ideally, motivational support, counselling and regular monitoring of progress.
Nicotine replacement therapies (NRTs)
Prior to the appearance of prescription medicines, nicotine replacement therapy was considered as the single most successful and efficient method of quitting smoking. Today, NRTs can be obtained in a number of different forms, including nicotine transdermal patches, gums, lozenges and inhalers, to name just a few.
All of these products work by delivering nicotine into the body – some through a prolonged release and some through an instant ‘hit’ – but in any scenario, they will reduce the cravings to smoke due to possibility of delivering nicotine via other routes.
Because of differences in the delivery routes, nicotine replacement therapies come with different concentrations of nicotine. For example, nicotine patches tend to have the largest nicotinic load, but one that is delivered gradually over the course of 16 to 24 hours, while gums, inhalers and lozenges will deliver smaller amounts of nicotine, but they will do so in more concentrated ‘hit’, making them more suitable for managing sudden cravings.
However, similarly to prescription medicines, when recommended by a doctor, NRTs can also be used over the course of 12 weeks with the goal of slowly and gradually reducing nicotine intake until the user becomes ready to start nicotine-free life.
In many cases, the doctor will advise to use a number of different nicotine replacement products for different situations – this combined treatment seem to increase the chances of quitting for good. However, the specifics will vary based on the patient’s smoking habits.
Electronic cigarettes (E-cigarettes)
Electronic cigarettes are a relatively recent addition to the array of smoking cessation aids, but despite this, they achieved amazing success and popularity. However, in the medical community, e-cigarettes are somewhat of a taboo topic and the consensus on their efficiency in quitting smoking is still greatly lacking.
Electronic cigarette is a device that has a container with a liquid infused with nicotine (and flavourings if desired). When heated, the liquid will vaporise and can then be inhaled by the user. This eliminates the whole process of burning tobacco from the equation, making e-cigarettes incomparably safer than conventional cigarettes as they don’t contain carbon monoxide nor tar which are cancerous and toxic substances commonly present in the cigarette smoke.
However, as electronic cigarettes still deliver nicotine and even retain the habit of inhaling smoke, their effectiveness in smoking cessation efforts is still a somewhat controversial topic. Still, the studies conducted into the topic seem to prove that e-cigarettes are more effective than NRTs, making them a very successful stop smoking method. But, these claims still need more scientific proof.
Quitting cold turkey
Quitting cold turkey is a colloquial term used for a method of stopping smoking that doesn’t involve any smoking cessation aids or medicines, but instead relies on willpower only, with occasional addition of mental techniques in some cases. However, the studies seem to show that quitting cold turkey yields the least successful results. Thus, it is seen as a most difficult route, but some claim, the most rewarding one.
Of course, quitting cold turkey can work for some and it should be recommended as a first method, with others being introduced only if quitting cold turkey proves to be too difficult. Some ex-smokers managed to quit cold turkey only after several attempts, so despite the relatively low success rates of this method, it should not be completely underestimated!