Pharmacist focus- January 2007
Patient Education Series January 2007
Smoking Cessation
Why do people use tobacco?
People generally use tobacco for the following reasons: to relieve tension, control weight, to boost their energy or to fit in socially. Knowing when and why you smoke can help you choose the quitting strategy that is most likely to be successful.
Why quit?
Smoking increases your risk for heart attack and stroke, lung cancer and other lung diseases, other cancers, impotence and fertility problems, gum disease and other dental problems, and early death.
What are the different smoking cessation options available?
- "The Patch", a nicotine transdermal system, delivers a steady measured dose of nicotine to the body. In a graduated program, special patches are placed on the skin, which over time administer varying dosages of nicotine. There are few side effects and the patches need to be applied only once a day, although the nicotine is delivered more slowly than in some other methods. Skin irritation can occur at the patch sites.
- Nicotine gum comes in doses of 2 milligram (for smokers of 24 or fewer cigarettes a day) and 4 milligram (for smokers of 25 or more cigarettes a day). Chewing the gum requires a bit of re-training, since you must chew it in a certain way to make it work. It is chewed slowly until a "peppery" taste comes out. Then, the gum is "parked" between the cheek and the gum. The nicotine from the gum is absorbed through the lining of the mouth. Nicotine gum is convenient, but you may want to avoid it if you have dental or jaw problems.
- Nicotrol® nasal spray, available by prescription, provides a quick nicotine delivery system. The usual dose of 1 milligram (1 spray) into each nostril can be used up to 40 times per day. The rapid absorption through nasal membranes makes it a desirable cessation aid, although it is sometimes irritating to the nose, especially during the initial treatment.
- Bupropion (Zyban®) - Bupropion is an antidepressant medication available by prescription, under the brand name of Zyban®. It has been proven to be effective in treating nicotine addiction by stimulating the release of dopamine and norepinephrine, two amino acids in the brain that help smokers deal with the anxiety that comes with quitting. Zyban® comes in a sustained release formula. Zyban® causes few side effects, but there is a small risk of seizures, as with any antidepressant. If you are currently taking any other medications, be sure to remind your doctor of them before he or she writes you a prescription for Zyban®.
- Nicotrol® Inhaler is a plastic cylinder almost the size of a cigarette. A cartridge containing nicotine is inside the cylinder. When you "puff" on the device, nicotine vapors are absorbed through the lining of the mouth. It takes about 80 "puffs" to equal the amount of nicotine in one cigarette. The Nicotrol® Inhaler is flexible to schedule through the day, although it may have to be used frequently. Nicotrol® mimics the physical habits of holding and puffing on a cigarette, which some smokers find helpful in quitting. Mouth and throat irritation are the most common complaints.
Do the smoking cessation aids increase my chances of remaining smoke free?
Any of these methods, used in conjunction with structured behavioral and psychological support, will greatly increase your chances of success. Studies show that smokers who use a combination of cessation aids greatly increase their chances of remaining smoke-free.
How Will I Feel When I Quit Smoking?
When you first quit smoking, you may go through withdrawal and:
- Crave cigarettes.
- Feel very hungry.
- Cough often.
- Get headaches.
- Have difficulty concentrating.
- Have constipation.
- Feel very tired.
- Have a sore throat.
- Have difficulty sleeping.
Although withdrawal symptoms will be the strongest when you first quit, they should go away within a few weeks.
If you have specific questions, contact your doctor or pharmacist 216.445.MEDS
source: WebMD
