Smoking Cessation Tools and Strategies
There are many well-known and established techniques that can assist a person in smoking cessation. These include medical intervention, behavioral therapy, support groups, and awareness of triggers. Each approach has advantages and disadvantages that need to be taken into account when an individual is deciding the best approach for them.
NICOTINE REPLACEMENT THERAPY (NRT)
- When stopping smoking, a person may experience physical side effects due to nicotine withdrawal. These side effects include headaches, mood changes, weight gain, and decreased energy levels.
- NRT uses a range of products to provide a low dose of nicotine. These products include patches, gum, lozenges, inhalers, and nasal sprays.
- NRT therapy should be tapered as side effects and urge to smoke dissipate.
- The advantage of NRT is it helps minimize the effect of withdrawal and controls the urge to smoke. This improves a person's likelihood of success.
- NRT works. It doubles a smoker's chances of stopping smoking.
- When used properly, the likelihood of remaining abstinent for more than 6 months, is greatly increased.
- There is a much lower risk of becoming addicted to NRT products than cigarettes.
- This therapy is safer than smoking cigarettes. NRT reduces the number of carcinogenic chemicals entering a person's body.
- The average daily cost is less than buying cigarettes.
- Most people can use NRT, including those with heart disease or diabetes.
- Unfortunately, NRT does not assist with the mental addiction or the emotional connection a person may have to cigarettes.
- Nicotine replacement products, like any medication, have side effects. The common side effects include elevated heart rate, nervousness, nausea, sleep disturbance, and headache.
- It is not recommended that a person use NRT if they are under 18, pregnant, or breastfeeding as the potential side effects carry increased risk.
- It should not be used unless you have completed stopped using all tobacco products.
- Smokers perceive NRT products as less harmful than cigarette smoking.
- It is easily accessible and convenient. Most NRT products can be obtained over the counter without a doctor's prescription.
- A study found 17% of people using NRT successfully quit smoking.
NON NICTONE BASE MEDICATION — ZYBAN
- Zyban is an atypical antidepressant.
- It works by inhibiting the re uptake of dopamine and noradrenaline in the brain. This is important in managing addiction and assisting with withdrawal.
- Zyban also makes smoking less satisfying.
- The one-year abstinence rate when using Zyban is 18-23%.
- One study that compared Zyban to NRT found it to be more successful in achieving long term abstinence (23% vs 10%).
- Zyban provides an alternative for people who do not wish to use nicotine-based products.
- The medication is both safe and effective.
- Depression after smoking cessation is directly related to relapse. Zyban directly assists with this symptom.
- Research has shown Zyban reduces all the symptoms of withdrawal and increases the rates of abstinence of smoking.
- It is a safe option for people who have stable heart disease as it does not affect blood pressure or heart rate.
- To maximize success, it requires cessation of the use of all tobacco products.
- It requires a prescription to access.
- Zyban can not be used by people under 18 and pregnant women or those with seizure disorders, hepatic cirrhosis, a history of bipolar disorder or anorexia and those withdrawing from alcohol or benzodiazepines.
- There may be a need to reduce the dose in the elderly, people with renal or hepatic impairment, and those with diabetes. Given this, there is a greater potential for these groups to suffer adverse effects when starting the medication.
- There several possible adverse effects. These include agitation, constipation, dry mouth, nausea, insomnia, headache, and seizures.
- It is not recommended if a person is breastfeeding.
- Overall, consumer satisfaction scores show it is perceived as highly effective and easy to use.
- Most consumers indicate high satisfaction levels.
- The side effects need to be weighed against the reduced symptoms of addiction
- One consumer said, "Don't dwell on the side effects. They are worth it".
- Another who had been trying to quit for 30 years said, "This worked. It amazed me."
- Behavioral Therapy is counseling that focuses changing current patterns of behavior.
- This type of therapy helps people identify quit strategies and incorporate them into their day to day lives. This maximizes the chances of success.
- Research suggests that even a couple of sessions can help.
- People do not experience the physical side effects associated with NRT or non nicotine based-medicines.
- Behavioral Therapy addresses the mental side of addiction.
- Research suggests that smoking is part of a set of learned behaviors. Behavioral Therapy is invaluable in resetting and redefining these learned behaviors.
- The sessions provide the tools for navigating the temptation of smoking and as a result, helps to increase abstinence.
- Individual sessions are tailored to individual needs.
- It can require a significant time investment.
- Unfortunately, behavioral therapy does not help with the physical symptoms of withdrawal.
- It can be costly.
- The tailoring of behavioral therapy toward individuals' needs increases the likelihood of success.
- The cost of formal behavioral therapy can often outweigh the financial cost of smoking.
- The ongoing cost of this approach sees people "drop out". This decreased the efficacy of this approach.
- An integral part of smoking cessation is support.
- Support groups consist of regular meetings with other people trying to stop smoking.
- People pool their experiences and techniques for overcoming the addiction and get support in maintaining abstinence.
- People do not have the physical side effects associated with NRT or non-nicotine based medicines.
- By adopting this approach. people receive help in dealing with the mental aspects of addiction.
- These groups are usually free or low cost.
- Regular support groups are held in most communities and are easily accessible.
- They provide participants with a pool of knowledge to assist in their ongoing abstinence.
- They ensure people realize they are not alone in their journey and reduce feelings of isolation.
- Support groups do not assist in providing relief from the physical symptoms of withdrawal.
- They require a reasonable time commitment, which can be off-putting to some people.
- Support groups require the participant to feel comfortable discussing matters of a personal nature. This can be an issue for a number of people.
- There can be concerns regarding nagging or the policing of anti-smoking behaviors. People can develop a fear of failure, which places undue pressure on them.
- Criticism or disapproval from other members can reduce the chances of success.
- People who have support when they are quitting smoking are more likely to remain abstinent at 3 months.
- Support is seen as a key factor in a persons' success.
- The success of this approach depends on the success of the support group as a whole. This can often involve the balancing of a range of interpersonal issues between participants.
- These groups have the most chance of success if people feel comfortable, and the dynamics of the group focus on the positive aspects of a person's journey.
- Personality issues between members can lessen the chances of success.
AVOIDANCE OF SMOKING TRIGGERS
- This strategy sees people avoiding situations or behaviors that trigger smoking.
- By avoiding triggers the chances of stopping permanently are increased.
- Often smoking is associated with other unhealthy behaviors such as excessive drinking. This approach can see people adopting a more holistic approach to life.
- As a result, the health benefits can be maximized as the persons' lifestyle as a whole becomes more healthy.
- Work and daily commitments can make the avoidance of triggers almost impossible in some instances.
- Stress is often one of the key triggers. It is also an unavoidable part of life.
- Avoidance does not address the physical symptoms of withdrawal. In some instances, these symptoms can become triggers in their own right.
- The daily commitments of life make this approach difficult.
- It is more likely to be successful if it is used in combination with other strategies.
We searched a range of scholarly articles and research to ascertain the various approaches to smoking cessation. We cross-referenced each of these approaches to availability in a range of countries. By doing this, we were able to identify the strategies that were most widely available on a global basis. Once we had determined the most popular strategies, we considered the advantages and disadvantages of each. We searched research articles and surveys, to better understand the success of these strategies and the reasons they can be unsuccessful. We also reviewed several consumer articles, blogs, and reviews that provided personal accounts of people's individual experiences of each of the strategies. This provided us with a better understanding of the perceptions associated with each strategy.