About 120,000 people die each year as a result of smoking cigarettes. At any one time approximately two thirds of smokers express a wish to give up the habit. Nicotine though is a very addictive chemical and stopping smoking is easier said than done.
Nicotine is one of the many chemicals contained in smoke from cigarettes, cigars, pipes. When breathed in it is absorbed in the lungs and carried by the blood to the brain. In the brain nicotine triggers the release of natural chemicals that, in regular smokers, produce feelings of comfort or satisfaction. Unfortunately after a short while the brain gets used to these feelings and attempting to stop smoking suddenly can cause a craving for more nicotine which, if not satisfied by smoking, leads to unpleasant withdrawal symptoms such as irritability, depression and poor concentration. In other words the smoker has become a nicotine addict in just the same way that an alcoholic is addicted to alcohol and a heroine addict to heroin.
Stopping smoking is not easy. Indeed, on average, only two in a hundred smokers who try to stop without help will succeed. The most important key to success lies in the person being committed to stopping. Willpower is crucial!
Nowadays Nicotine Replacement Therapy and a tablet called Bupropion are available to help smokers who want to quit. Neither of these is a substitute for willpower though and, to reiterate, the most important factor is the person's strong desire to kick the habit.
Nicotine Replacement Therapy (NRT) works by releasing a fixed amount of nicotine into the body without the other harmful chemicals found in cigarette smoke. Although NRT is overall less satisfying than smoking, the nicotine released is able to reduce the cravings that would otherwise develop when smoking is stopped abruptly. In this manner the physical act of smoking can be avoided and the dose of the nicotine replacement gradually reduced to allow the person to 'wean' him or herself off cigarettes.
Nicotine Replacement Therapy is currently available in several different forms including chewing gum, skin patches, nasal sprays, inhalers and tablets. All of these are available without prescription in pharmacies and a range of nicotine doses is available.
In essence a person's starting dose depends on how heavy they smoke and this dose is then gradually reduced to zero over about a three month period. Many people complain that NRT is not prescribable by their general practitioner and object to the cost (approximately £10.00 a week for nicotine patches, depending on the strength). However, it is worth remembering that smoking 20 cigarettes a day costs about £30.00 a week.
Clinical research has shown that, on average, using Nicotine Replacement Therapy doubles the chance of successfully kicking the habit. However, this amounts to (only) a one in six chance of stopping smoking for a whole year. So if you try and fail don't be disheartened but try again, as we know that with each successive attempt to quit the chances of success increase. Also there is no need to 'go it alone'. Your practice nurse will be pleased to help provide a structured Smoking Cessation counselling programme, as we know that having professional support whilst trying to quit further increases the chances of success.
At first thought it may seem a little bit odd to treat a drug addiction by giving that same drug simply by another route (i.e. by patch/gum rather than by smoking). However, many illnesses caused by smoking result from other chemicals within cigarette smoke such as tar and carbon monoxide rather than from nicotine per se. So taking nicotine as NRT is not as bad for you as smoking and your GP would much rather you took NRT for the rest of your life rather than smoke - although we would all hope that it wouldn't take you this long! Remember that Nicotine Replacement Therapy is precisely that - it is giving you nicotine as a substitute for smoking, with the hope that you will be able to wean yourself off the addiction in a controlled fashion over a period of time. Not surprisingly if NRT is stopped suddenly, withdrawal effects similar to those associated with stopping smoking will usually occur.
Bupropion (or Zyban) was released in the UK in 2000 as an additional way of countering nicotine addiction. This medication is known to have anti-depressant properties and is thought to work on parts of the brain responsible for nicotine addiction.
Clinical trials suggest that, in smokers keen to quit, Bupropion at least doubles their chances of doing so. Once again willpower is of paramount importance and professional support and advice strongly recommended.
Bupropion can only be obtained by prescription from a doctor and then only as part of a Smoking Cessation package, including counselling from specially trained individuals (e.g. practice nurses). The tablet is started 1-2 weeks before a planned stop smoking date and is taken for a total of 7-9 weeks. Although Bupropion has been extensively studied, it is not suitable for everybody. People with epilepsy in particular are not recommended to use it as it can cause fits.
To recap, stopping smoking is not easy but the benefits are significant. New measures are available to ease the discomfort associated with stopping and, when combined with professional support, a significant number of smokers are able to kick the habit.
If you want to stop smoking, ask at the surgery for an appointment in the Smoking Cessation Clinic or ring the Quitline now on 0800 00 22 00.
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Disclaimer: This page is for informational purposes only and should not be considered as medical advice or substituted for professional advice. Always consult your doctor with your questions and concerns.
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