Smoking cessation is the act of no longer smoking. However, this state may last one day or it can last a lifetime. Lapsing is when you have 1 or more cigarettes during a quit or cessation attempt. Relapse occurs when you are no longer trying to actively quit and have returned to a regular habitual smoking routine.
So the question is this, can you get back on the wagon after you've fallen off? Can the quit attempt remain in place even though you had a 'bad day' and smoked half a pack of cigarettes? The answer is absolutely 'yes'! That's why it is important to review the definitions above. Lapsing does not have to lead to relapsing.
A recent study in the journal Addiction, looked at this phenomena and how to treat the lapse before it became a full blown relapse. Interestingly, they looked to the good old nicotine patch to see if it could promote recovery to abstinence.
As we all know, one of the effects of nicotine withdrawal is the craving. Nicotine patches were designed to counteract that craving with a dose of nicotine replacement to the brain using a far more clinical platform.
What happens when you relapse? You smoke for a day or two; you feel like a failure; you throw your hands up, put away your stop smoking aids and figure you've completely relapsed. This 'give-up' is one reason why smoking has such a high rate of recidivism. But it is possible to climb back up on that horse and start riding again without waiting two or three months.
The researchers discovered that using the patch increased the tendency to re-initiate abstinence at the critical 6 and 10 week interval, after lapsing. They conclude that continuing treatment with active patches does promote recovery from lapses and helps smokers regain their cessation 'mo-jo'. Let's face it, when you're trying to quit, you've got to have mo-jo and it looks like patches might be able to help you find it after a lapse.
Showing posts with label nicotine replacement therapy. Show all posts
Showing posts with label nicotine replacement therapy. Show all posts
Nicotine Replacement Therapy as a Quitting Tool
Nicotine replacement therapy (NRT) has been around a long time, with varying degrees of success. Most agree that NRT will double a person's chance of quitting over going cold turkey alone. But the outcomes, defined as smoking cessation, are still pretty small.
A recent study looked at the affect NRT had on smoking reduction and temporary abstinence in England. The researchers wanted to see if NRT use could predict smoking cessation attempts. I'm not really sure why they were asking this question and the end result of the study is not what I find important.
Rather, the scientists state that NRT was associated with an overall smoking reduction of about two cigarettes per day. They also found that people who used NRT were more likely to try to quit smoking that someone who did not use it - which I think is a patently obvious observation that didn't require a study. But that's just my two cents.
Anyway, I wanted to focus on this 2 cigarette per day reduction. Is it just me or does that seem kind of small? Yeah, that's what I thought. But I think I know why it is so small.
Since most NRT is available without a prescription, most people who want to quit can just go online or to a local store and buy nicotine gum or whatever. Lets say a guy wants to quit, but he's not completely sure about how to go through it. More than likely, he's heard about NRT and will probably "try" some nicotine gum or the patch. Hey, you don't need a script and nobody needs to know what you're doing. It's kind of a covert quit attempt. No real planning, no thinking about it, just try and see what happens.
In this scenario, smoking cessation success may be difficult to achieve. The biggest mistake people make is failing to plan a quit attempt. When you approach a serious addiction, which lets face it, nicotine is, you must be serious in your desire to quit. Testing the waters and trying things out are, in the end, not worth the trouble.
I've heard some people using nicotine gum for over a year. Now I don't know if they were addicted to nicotine gum or just felt the need to keep trying, but planning is the answer. So I believe these people in the study were not serious about quitting, rather they were just experimenting with NRT to see if it would magically take their nicotine addiction away. Obviously, it doesn't seem to work that way.
A recent study looked at the affect NRT had on smoking reduction and temporary abstinence in England. The researchers wanted to see if NRT use could predict smoking cessation attempts. I'm not really sure why they were asking this question and the end result of the study is not what I find important.
Rather, the scientists state that NRT was associated with an overall smoking reduction of about two cigarettes per day. They also found that people who used NRT were more likely to try to quit smoking that someone who did not use it - which I think is a patently obvious observation that didn't require a study. But that's just my two cents.
Anyway, I wanted to focus on this 2 cigarette per day reduction. Is it just me or does that seem kind of small? Yeah, that's what I thought. But I think I know why it is so small.
Since most NRT is available without a prescription, most people who want to quit can just go online or to a local store and buy nicotine gum or whatever. Lets say a guy wants to quit, but he's not completely sure about how to go through it. More than likely, he's heard about NRT and will probably "try" some nicotine gum or the patch. Hey, you don't need a script and nobody needs to know what you're doing. It's kind of a covert quit attempt. No real planning, no thinking about it, just try and see what happens.
In this scenario, smoking cessation success may be difficult to achieve. The biggest mistake people make is failing to plan a quit attempt. When you approach a serious addiction, which lets face it, nicotine is, you must be serious in your desire to quit. Testing the waters and trying things out are, in the end, not worth the trouble.
I've heard some people using nicotine gum for over a year. Now I don't know if they were addicted to nicotine gum or just felt the need to keep trying, but planning is the answer. So I believe these people in the study were not serious about quitting, rather they were just experimenting with NRT to see if it would magically take their nicotine addiction away. Obviously, it doesn't seem to work that way.
First Line Pharmacologic Smoking Cessation Drugs
A recent article in the Current Pharmaceutical Design by Aubin and others [Apr 2011] discusses first line smoking cessation drugs. It's kind of a where are we now article. It's called "Pharmacotherapy for Smoking Cessation: Present and Future".
In it, they mention the three FDA-approved smoking cessation medications: Nicotine replacement therapy, sustained-release bupropion (Zyban) and varenicline (Chantix/Champix). They state these are recommended for all smokers, even those with psychiatric or addictive co-morbidities. I guess that kind of sums up everything we've said here at Unbiased...
However, they do realize the limited success of these first line smoking cessation drugs. Because of the rather high relapse rate, they go on to mention alternative pharmacotherapies like clonidine and nortriptyline. These would be classified as second line stop smoking medications. Later on in the article, they discuss what is in the pipeline, like the nicotine vaccine.
However, there really isn't anything too new to talk about in this article. Sadly, there just doesn't seem to be any magic bullet in the stop smoking aid arsenal to guarantee the smoking cessation success that so many people desire. Which means only one thing. It's up to the individual to want to stop bad enough, that it doesn't matter which method they use - they'll quit in spite of the method they choose because they are so determined to succeed or so disgusted by the habit. Once you get to that point, it doesn't really matter any more.
In it, they mention the three FDA-approved smoking cessation medications: Nicotine replacement therapy, sustained-release bupropion (Zyban) and varenicline (Chantix/Champix). They state these are recommended for all smokers, even those with psychiatric or addictive co-morbidities. I guess that kind of sums up everything we've said here at Unbiased...
However, they do realize the limited success of these first line smoking cessation drugs. Because of the rather high relapse rate, they go on to mention alternative pharmacotherapies like clonidine and nortriptyline. These would be classified as second line stop smoking medications. Later on in the article, they discuss what is in the pipeline, like the nicotine vaccine.
However, there really isn't anything too new to talk about in this article. Sadly, there just doesn't seem to be any magic bullet in the stop smoking aid arsenal to guarantee the smoking cessation success that so many people desire. Which means only one thing. It's up to the individual to want to stop bad enough, that it doesn't matter which method they use - they'll quit in spite of the method they choose because they are so determined to succeed or so disgusted by the habit. Once you get to that point, it doesn't really matter any more.
Weight Gain After Smoking Cessation in First 30 Days
I have spoken to lots of people who tried to quit smoking. Those who really didn't try that hard always had this fall back excuse, "I didn't want to gain all that weight". Let's see, if I had to choose between the mortality and morbidity associated with smoking and smoking related diseases, and compare them to a 10-15 pound weight gain...I think I'd take the weight gain. Now granted for many, 10 or 15 extra pounds does seem like a lot. But I think the benefits outweighs the harm, pardon the pun.
Well, a new study looks at the use of nicotine gum in the first 30 days of a quit program. The researchers wanted to see if (and how much) nicotine gum helped keep the dreaded smoking cessation weight gain from materializing. Their work can be seen in the journal Addiction entitled, "Effect of compliance with nicotine gum dosing on weight gained during a quit attempt".
They utilized a randomized, double-blinded, placebo controlled trial. They only enrolled 103 participants, but that's not too bad. They found that when smokers were quitting, those who used more pieces of nicotine gum (> 9 pieces per day), had less weight gain in the first 30 days of the quit attempt. They saw a similar effect among participants with regard to the dosing of nicotine gum (2 mg vs. 4 mg dose).
Interestingly, the placebo group experienced an average of 1.6 kg of weight during the first 30 days. That's only 3.5 pounds of weight gain. So even if someone does gain weight when quitting, it's not a horrible amount, just a couple of pounds. Heck, I put on 5 pounds just this last Thanksgiving holiday.
So there you go. If you're a little hesitant to stop smoking , then just try using nicotine gum. But make sure you use it the correct way. Chew it until it softens, then park it between your cheek and gum. Continuous chewing will only cause you to ingest the nicotine by swallowing. That will cause gastric upset and will waste the nicotine. It is supposed to be absorbed in the mouth. Always read the stop smoking aid packaging to ensure you are using it the correct way.
If you are still concerned about gaining weight, then map out a set of new habits to replace the old ones. Try a new exercise program ir start munching on crunchy vegetables like carrot sticks or celery. These are not only great ways to lose weight, but will also help with your cravings. Good luck.
Well, a new study looks at the use of nicotine gum in the first 30 days of a quit program. The researchers wanted to see if (and how much) nicotine gum helped keep the dreaded smoking cessation weight gain from materializing. Their work can be seen in the journal Addiction entitled, "Effect of compliance with nicotine gum dosing on weight gained during a quit attempt".
They utilized a randomized, double-blinded, placebo controlled trial. They only enrolled 103 participants, but that's not too bad. They found that when smokers were quitting, those who used more pieces of nicotine gum (> 9 pieces per day), had less weight gain in the first 30 days of the quit attempt. They saw a similar effect among participants with regard to the dosing of nicotine gum (2 mg vs. 4 mg dose).
Interestingly, the placebo group experienced an average of 1.6 kg of weight during the first 30 days. That's only 3.5 pounds of weight gain. So even if someone does gain weight when quitting, it's not a horrible amount, just a couple of pounds. Heck, I put on 5 pounds just this last Thanksgiving holiday.
So there you go. If you're a little hesitant to stop smoking , then just try using nicotine gum. But make sure you use it the correct way. Chew it until it softens, then park it between your cheek and gum. Continuous chewing will only cause you to ingest the nicotine by swallowing. That will cause gastric upset and will waste the nicotine. It is supposed to be absorbed in the mouth. Always read the stop smoking aid packaging to ensure you are using it the correct way.
If you are still concerned about gaining weight, then map out a set of new habits to replace the old ones. Try a new exercise program ir start munching on crunchy vegetables like carrot sticks or celery. These are not only great ways to lose weight, but will also help with your cravings. Good luck.
Nicotine Replacement in Pregnancy
Congratulations. You're pregnant. But you still smoke...ugh! What are you going to do? This scenario plays out every day for thousands of women. Most women know that smoking has extremely hazardous effects on their unborn child. They might even know that smoking, while pregnant, increases their risk for bleeding during delivery. But how are they going to stop? The addiction seems too strong despite the motivation found right under their nose.
Many of these women have probably already tried to stop before, but were unsuccessful. So in an effort to protect their baby, they try to stop cold turkey. The last thing they want to do is put some other toxic pharmacutical in their body, so cold turkey is tried. And who knows, maybe this time, they'll beat the addiction without any help.
Well, The Annals of Pharmacotherapy evaluated the safety of nicotine replacement and it's effect on pregnancy outcomes. Forinash and others performed a 44-year literature search to find this answer. Their findings were simple.
The first treatment to be offered pregnant women is behavior modification - that should always be the first attempt. There are obviously, no deleterious side effects to the mom or the baby. This is different than simply quitting cold turkey. This is figuring out what cues trigger smoking, developing new habits/routines and discussing what may be at the root of the addiction. Not to mention an accountability program and help for when the cravings get their toughest. But after that, nicotine replacement therapy (NRT) should be the next smoking cessation method offered. The researchers concluded this because NRT has a decreased risk for low birth weight and preterm delivery when compared to continued smoking in pregnant woman. They also state that NRT doesn't seem to increase the malformation risk to the child.
But as always, pregnant women should consult with their physicians prior to beginning any smoking cessation treatment. NRT is a pregnancy category D medication. Here's a good place to look for more on quit smoking aids.
Many of these women have probably already tried to stop before, but were unsuccessful. So in an effort to protect their baby, they try to stop cold turkey. The last thing they want to do is put some other toxic pharmacutical in their body, so cold turkey is tried. And who knows, maybe this time, they'll beat the addiction without any help.
Well, The Annals of Pharmacotherapy evaluated the safety of nicotine replacement and it's effect on pregnancy outcomes. Forinash and others performed a 44-year literature search to find this answer. Their findings were simple.
The first treatment to be offered pregnant women is behavior modification - that should always be the first attempt. There are obviously, no deleterious side effects to the mom or the baby. This is different than simply quitting cold turkey. This is figuring out what cues trigger smoking, developing new habits/routines and discussing what may be at the root of the addiction. Not to mention an accountability program and help for when the cravings get their toughest. But after that, nicotine replacement therapy (NRT) should be the next smoking cessation method offered. The researchers concluded this because NRT has a decreased risk for low birth weight and preterm delivery when compared to continued smoking in pregnant woman. They also state that NRT doesn't seem to increase the malformation risk to the child.
But as always, pregnant women should consult with their physicians prior to beginning any smoking cessation treatment. NRT is a pregnancy category D medication. Here's a good place to look for more on quit smoking aids.
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