Showing posts with label stop smoking aids. Show all posts
Showing posts with label stop smoking aids. Show all posts

COPD and Smoking Cessation Options

The primary cause of chronic obstructive pulmonary disease or COPD is smoking tobacco. Studies continue to show that people who suffer from COPD have a much more difficult time with smoking cessation. Smoking cessation is the only real way of slowing down the progression of the disease. The sooner someone stops smoking, the slower their disease will progress.

A recent study out of Nicotine and Tobacco Research looked at the ability of certain front line smoking cessation aids to meet with this COPD challenge. The primary outcome measured was continuous abstinence rates from 9 - 24 weeks, or between 2 and 6 months of smoking cessation. They found that severe and very severe COPD patients were primarily male. Interestingly, this large subgroup of the study population had a very high physical addiction to nicotine.

The results show a continuous abstinence rate between weeks 9-24 to be 48.5%. So just slightly less than half were able to stay nicotine free between the study period of 9-24 weeks. The abstinence rate differed according to type of stop smoking aid utilized.

Nicotine replacement therapy (NRT) had a 38.2% cessation rate. It also had the fewest recorded side effects. However, the dreaded psychiatric symptoms sometimes reported were rare in all stop smoking methods studied and evenly distributed across all groups. Bupropion (Zyban) had a quit rate of 55.6%, while varenicline (Chantix) had the highest cessation rate of 58.3%.

This study only points out the difficulty associated with smoking cessation in someone who is afflicted with a multi-dimensional disease like COPD. This disease carries with it many other complicatiang diseases which affect the physical, emotional and psychiatric status of the sufferer. It is no surprise that something more than simple nicotine replacement was needed to help these people break the cycle of nicotine dependence.

People often ask, " is nicotine bad for you?" I think the answer is pretty evident. The dependence creates a continuous assault on the health of your body. Then you suddenly wake up 30-40 years later with a disease, or more than likely, a mix of diseases, that affects everything from how you breathe, to how far you can walk each day.

According to this study though, it's not too late. You can still quit, despite your disease status. So get some help and do the right thing, for yourself and for your family.

Cost of Varenicline Versus Bupropion

So you've decided to quit but you're kind of a tight-wad and don't want to spend too much money to do it. You've heard some stop smoking aids are cheaper than others, but nothing can compare with quittig cold turkey which is...well, 'free'. What to do?

Well, a recent study published in the journal Int J Clin Pract  tells us which prescription stop smoking aid is more cost effective. They evaluated many articles and ran them through cost models. They make a point of noting that price and access will change how much you actually pay, but in general terms, there was a clear winner. So which was it, Varenicline or Bupropion?

Before we answer that question there are a couple things I'd like to point out.

The obvious one is that you shouldn't be a tight-wad when you are quitting smoking. I have a blog post in here that talks about the real cost of smoking. It's a pretty good read, if I do say so myself. Anyway, if a smoker is spending up to $10-15 per pack per day, then you can't be a tight-wad. Man, you are a free spender throwing around that kind of dough each day. Not to mention the cost of doctor's appointments and long term care for when you develop one of those nasty smoking related illnesses. But I digress. So don't let the cost be a stumbling block for you quitting.

Second, you shouldn't choose the stop smoking aid or quitting method based on cost. It needs to be tailored based on your nicotine addiction, smoking triggers, behavior, side-effects, etc. Certainly cost can be a consideration, but it shouldn't be the only consideration.

Okay then, which method won. Varenicline! As a reminder, the researchers did not look at the nicotine replacement therapies or the other non-first line therapies like hypnosis. They just looked at varenicline and bupropion. So there you go, you asked and now you know.

Smokeless Tobacco Is Not a Stop Smoking Aid

I had a friend who did quit smoking. He did so by using smokeless tobacco. He thought the risk trade-off was a good one. However, there is evidence which states this may not be the case as smokeless tobacco (ST) can lead to a whole host of medical problems in and of itself, such as: pancreatic cancer, fatal myocardial infarction (heart attack) and stroke.

Smokeless tobacco delivers a high concentration of nicotine directly into the bloodstream, making it extremely addicting. In fact, nicotine replacement therapy is only useful for cessation cravings for the short term, and have not been proven to maintain cessation over extended periods of time.

So now my friend no longer smells like cigarette smoke, but his smokeless tobacco habit is about twice as bad as his cigarette habit ever was. If you're going to quit, just quit, don't substitute.

Nicotine Free Inhalators

Smoking cessation rates are not where people would like them to be. There are a number of reasons for this. Let's face it, smoking is addictive. Many people are predisposed to the addiction which makes it harder for them to quit. Others face pressures in their life and feel like smoking is a crutch for them, a type of coping mechanism. But whatever the cause of a person's failed quit attempt, the person should not stop trying. Each relapse should be followed by a period of evaluation. The smoker should ask the question, "Why did I relapse?". This learning experience can then be logged away for future quit attempts. Studies say that it can take up to 7 quit attempts before someone is successful.

There are few smoking cessation methods which focus on the behavioral component of the nicotine addiction. Support groups try to get to this, but few methods actually help with the day to day ritual of smoking cigarettes. Nicotine free inhalators are one stop smoking aid which tries to address this component of smoking. They are plastic devices that may be used as a substitute coping mechanism for the triggers which cue the smoking ritual.

A recent study looked at how these nicotine free inhalators may improve the quit attempt. It was published in the European Respiratory Journal by Capponnetto and others and is entitled, "Effect of a Nicotine Free Inhalator as Part of a Smoking Cessation Program" [May 2011].

They looked at 120 healthy smokers who were attending a smoking cessation program. They assessed numerous factors like physical dependence, depression, behavioral dependence and motivation. The study participants were put into two groups: 1) received a nicotine free inhalator and 2) reference group. THey were followed up at week 4 and 24.

Overall, they found no significant difference in the quit rates between those who received the inhalator and those who did not. But, for those with a high behavioral dependence, the quit rate was much higher in the inhalator group (67%) compared to the reference group (19%).

The researchers conclude that nicotine free inhalators may be a helpful tool for those trying to quit who have a strong behavioral or ritualistic manipulation/handling of the cigarette. So check them out if you think you have a strong tie to the handling of the cigarette. They just might help you quit.

Smoking Cravings - Is Exercise the Answer

Smoking cravings are the number one challenge in getting people to quit smoking successfully. If there were no smoking cravings at cessation, then people would be quitting all over the place. If we hope to improve our nation's health and decrease the economic burden of smoking related diseases, we need to focus our attention on the two primary factors associated with smoking: 1) initiation and 2) smoking cravings.

We talked a little about initiation yesterday, so today, lets focus on one way to handle smoking cravings. Everyone has a tip on how they deal with the cravings. Some eat crunchy veggies, others drink a lot of water, while others us stop smoking aids like the patch or the gum. But what about exercise? If you have a smoking craving, it makes sense to occupy your mind and body with something else. It would appear that exercise would be a logical outlet for smoking cravings because it keeps the body and mind busy.

However, studies have shown that aerobic exercise doesn't help smoking cessation outcomes or withdrawal symptoms during quit attempts. While this may be true, laboratory studies also show that aerobic exercise does positively impact smoking cravings. So which is it, does aerobic exercise help or not?

Addictive Behaviors [2011 Aug;36(8):894-7. Epub 2011 Apr 15] published an article by Williams, et al called "Acute effects of moderate intensity aerobic exercise on affective withdrawal symptoms and cravings among women smokers". In there they conclude aerobic exercise does positively impact smoking cravings, but the affect quickly goes away. Obviously, you can't engage in aerobic exercise every time you have a smoking craving. It is simply beyond the human body's threshhold to engage in vigorous exercise every couple of hours, when the smoking cravings begin.

So aerobic exercise should be included in a smoker's quit program. It will help with their energy and relieve some of their smoking cravings. It may also help the smoker stave off the weight gain that can be associated with smoking cessation. But it cannot be the only strategy to battle smoking cravings.

People have to remember, that quitting an addiction is not simply following 1 step. There are many decisions that must be made each day, followed by more and more decisions. Behaviors must be changed, habits must be broken. It's like a catepillar transforming into a butterfly. When you emerge from your cocoon, you no longer crawl around eating leaves. Rather, you fly and search out nectar from flowers. It's a completely different lifestyle with different activities and approaches to problems.

So if you want to be successful in managing the smoking cravings, incorporate an exercise program. It will help with some of your smoking cravings. But it should be part of an overall quit strategy. Remember, if you fail to plan than you are planning to fail.

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.

Does Acupuncture Help People Stop Smoking

Every person who has tried to stop smoking, considers almost anything. They order some liquid off the internet or get pills from health food stores. They explore just about all the stop smoking aids available. And sure, sometimes they work, but not for the reason you might imagine. There is an effect which is very powerful in creating a desired medical outcome. That effect is known as the placebo effect. People become so motivated to quit that it really doesn't matter what they try, because their motivation and belief that something will work is so great. Heck, they might quit if they believed that eating peanut butter and jelly sandwiches twice a day for 2 weeks would help them to stop smoking.

Enter acupuncture. Most researchers agree that acupuncture works about as well as quitting cold turkey, somewhere around 3-8% success, depending on which journal you read. But there is new evidence published in the Complementary Therapies in Medicine (Jan 2011) journal, that acupuncture might actually help attenuate withdrawal symptoms and smoking cues-induced autonomic responses.

The researchers compared two groups which they labeled real acupuncture (RA) and sham acupuncture (SA). The cigarette withdrawal scale (CWS) of the RA group was significantly lower than the SA group. However, there were only 15 and 14 participants in each group (respectively). I would have liked to see a larger group enrolled. However, this does provide some kind of scientific proof that acupuncture can help with smoking cessation. Is it all placebo, were the participants highly motivated, were some more addicted than others? Well, those are questions that could be answered by enrolling more smokers.

But if you're motivated and still struggling with withdrawal symptoms, perhaps acupuncture will help take the edge off. Then again, it may not, so stay tuned.

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.

Quit Smoking Nature's Way

NEW YORK - MAY 26: Herbal and dietary supplements are seen for sale in a shop May 26, 2010 in New York City. A U.S. government probe into herbal and dietary supplements found that some contain contaminants and use false marketing claims. (Photo by Mario Tama/Getty Images)

Can you really quit smoking by using herbs and spices? What about those natural smoking remedies we hear so much about? Let's take a moment and discuss what it means to quit the natural way.

I know the answer to the question, before I even ask it; but I'll ask it anyway. "How does one quit smoking naturally?" Lets see, most people are doing something that is not natural to begin with. They are taking a manufactured product, setting fire to it, inhaling its exhaust and then they are reading this article hoping to find a natural way to stop smoking. Sort of ironic is it not? It really is like the obese man eating 3 hamburgers and then drinking a diet cola. Or better yet, the man who has heart disease, walks in the morning for 45 minutes at a brisk pace, then comes home and lights up a cigarette - just so he can catch his breath. We humans can be pretty ridiculous sometimes.

Okay, so what about this natural remedy stuff. Well lets look at it scientifically for a moment. Many healthcare marvels came about from natural sources. Penicillin is a great example. Who knew that bread mold could cure so many diseases, huh? Well, I think we'd all agree that our scientists continue to find quirky little health aids by turning over rocks, sampling spores and basically just digging around. So how does that help with smoking cessation and my quest to quit smoking the natural way.

First up, lets examine Lobelia (aka: puke weed). This was used by Native Americans to help treat asthma symptoms. In the late 1900's people were using it as a nicotine substitute with varying degrees of success or failure, depending on how you want to look at it. By the 1990's, it was debunked as a smoking cessation aid. However, it has made a recent comeback (as most things do) and is being studied as a possible helper for addictions, although, usable results are still years away.

Next up, Chantix. But wait you say, this was created by the fine folks at Pfizer and is a multi-million dollar chemical that makes smokers quit, but also makes them throw temper tantrums and dream crazy dreams, right? That is still up for debate, but the base ingredient in Chantix comes from a tree, cystius laburnum. Back in the day, soldiers used to chew on the tree's leaves when they ran out of cigarettes, and surprisingly, it worked. Now I don't know if they experienced the psych fallout seen with Chantix, but this is just another example of how we can find helps by looking to nature's bounty.

Well, what about all these other herbal remedies on the market. The trouble with many of these is three-fold.

1. Poor quality control
2. No scientific studies to back up claims
3. Finding an ingredient list is challenging at best and downright impossible at worst

But there are these wonderful testimonials and claims of 100% success. Remember, for everyone who quits, that person was 100% successful. If any natural remedy was truly 100% successful, wouldn't we be talking about it on the news every night and wouldn't doctors come out to support it by the thousands? So although testimonials are fun to read and have tremendous enthusiasm, just remember they're just testimonials from people you don't know. But hey, there could be something to their products, who am I to say it won't work. Or perhaps, it's just having a placebo effect on the smoker. Some people are very affected when given a placebo.

But again, I want to bring up my earlier point. I hear people say they don't like to take medications because they prefer to take the natural route. That's great and all, but you're still sticking a processed cigarette in your mouth, setting it on fire and inhaling the exhaust. Why do you want the natural route again? It just doesn't make a lot of sense to me. I'd rather find something that has a proven track record of success, be dedicated to the process, make and stick to my plan and then follow through with some accountability partners.

Every smoker wants to quit smoking at some point or another. Studies prove this point over and over again. When the times comes for you to quit, you need to think about how you're going to do it. Which stop smoking aids will you use, where will you get your stop smoking help? These are questions you need to get answers to.

While you're thinking about that, I'm going to get on the treadmill for 30 minutes and have a glass of water. No cheeseburgers and diet drinks here. Remember, we're here to give you honest, unbiased information. We hope you enjoy the humor too.

Could Hypnosis be for You?

The more I research the topic of smoking cessation, the more I find the topic of hypnosis coming up. Any search of a smoking cessation website will invariably include some advertisement for hypnosis as a stop smoking aid. When you visit stop smoking forums on-line, you also get a chance to read how real people are trying to use hypnosis as a stop smoking aid.

First of all, let's review the primary stop smoking aids considered as frontline tools used to help smokers quit. They are nicotine replacement therapy, Zyban and Chantix. These aids have been studied and tested by many scientific minds over the last several decades. So we have lots of outcome data to support their use. Unfortunately, stop smoking aids are just not that successful, although they will usually double your chances of success over quitting cold turkey. In comparison, if you have a headache, you have your choice of several pills to make your headache go away. For the most part, there's probably at least a 90% chance that the headache will go away after you take the said pill. With smoking though, it's more like an 8-10% chance; maybe 20% if you mix in a support group.

Now, let's look at the second-line tools used for smoking cessation. These include hypnosis, acupuncture (include laser here), and of course, the "natural" herbal remedies (which could include just about anything). There are no scientific studies detailing their success. We just don't have any outcome data from which to judge their effectiveness. However, the smoking cessation community agrees the probability of success with these second-line aids is probably somewhere around that of quitting cold turkey or anywhere between 3-7%.

So why does hypnosis get so much advertisement? Well, hypnosis is a burgeoning profession. I have a neighbor who just finished going to "hypnosis school" and wanted us to go over to house so she could practice on us. She told us that hypnosis is a growing healthcare profession and she wanted to be on the ground floor.

Secondly, hypnosis appeals to a certain type of person who is more liberally minded and open to the mystic possibilities of the mind and spirit. Artists and crafty people typically fall into this category; you know, people who think with "that" side of their brain. As it turns out, most would agree that actors and most celebrities can be described in this way and, as luck would have it, many of them smoke. Ben Affleck, Matt Damon, and Drew Barrymore are all actors who recently came public with their smoking addictions and talked at length how hypnosis was helping them. Ben Affleck even went to Oprah to discuss how hypnosis helped him "kick the habit".

With this kind of public advertisement, and the relative poor success of traditional stop smoking aids, who wouldn't want to at least give hypnosis a try. And that is what the scientific community says. They frequently describe these second-line approaches as having an appeal to a certain type of person who just may be open minded enough to the idea and thus, have a greater potential for finding success with them. They also suggest hypnosis and acupuncture to those who have relapsed after numerous quit attempts. But, don't expect your addiction to melt away with the soothing voice of the hypnotist. Many smokers on message boards around the internet still say how difficult the withdrawal cravings are even after hypnosis and it still only has a small, albeit estimated, success rate.

Ultimately, when looking for stop smoking help, you have to match up your personality, your tendencies, and your addiction with the stop smoking aid that best suits you. If you don't believe in the power of hypnosis but like the idea of taking a pill to help you, then Zyban or Chantix might be for you. But if you believe we humans have a vast unlocked potential in our minds and that by unlocking that power, we can achieve great things, then hypnosis might be right up your alley.