Smoking cessation

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Smoking cessation

Smoking cessation is the effort to stop smoking tobacco products. With nicotine an addictive substance, many people find it hard to stop smoking without help. Various approaches are available, both psychological and pharmacological, although success rates are relatively low. The have been numerous advertising campaigns to help people quit smoking in many countries around the world.

Contents
1 Outline
2 Statistics
3 Methods
3.1 Screening
3.2 Modalities
3.3 Alternative techniques
4 References




Outline
Smoking is not safe for anybody, and every smoker should be encouraged to stop. The benefits of quitting include decreased cost, a significantly decreased risk of smoking-related diseases and generally feeling better.

Psychological support, group therapy or cognitive behavioral therapy allows many people to quit. Medication helps these approaches, although medication without psychological support is generally discouraged and some of the medical therapies themselves have proven addictive and, potentially, dangerous.

Success rates are increased by a serious commitment to smoking cessation and regular follow-up. After successfully stopping tobacco smoking, quitters should consider ways they can change their lifestyle to improve their chances of not restarting, especially under stressful circumstances.

Although a significant proportion is successful, many fail several times. Many smokers find it impossible to quit, even in the face of serious smoking-related disease in themselves or close family members or friends.


Statistics
No smoking cessation methods have consistently achieved better than a 25% quit rate after six months. About 1.5%–3% of smokers manage to quit each year without support from health services. Enrollment into the placebo arm of medical trial and receiving a minimum level of counselling increases this rate to about 5%–10% after one year, partly reflecting participants' motivation.


Methods

Screening
Health professionals may follow the "five A's" in every person they come in contact with:

Ask about smoking
Advise quitting
Assess current willingness to quit
Assist in the quit attempt
Arrange timely follow-up

Modalities
Effective techniques to increase smokers chances of successfully quitting are:

"Five-Day Plan": Oldest and most effective way of quitting smoking through acceptance of addiction and realization of smoking's harmfulness
Going "Cold turkey": stopping by force of will
Nicotine replacement therapy (includes transdermal patches, gum and inhalers)
Specific support and counselling
Self-help books (Allen Carr etc.)
The antidepressant bupropion (Zyban®, contraindicated in epilepsy and diabetes)

Alternative techniques
Alternative techniques, from which many patients report benefit, include:

Hypnosis
Herbal preparations such as Kava Kava and Chamomile
Nutritional nicotine detoxification
Acupuncture
Laser Therapy based on acupuncture principles but without the needles

References
Peters MJ, Morgan LC. The pharmacotherapy of smoking cessation. Med J Aust 2002;176:486-490. Fulltext. PMID 12065013.
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