27 Jun 2014

Quitting smoking is difficult ,Why ?

Principal content of tobacco is nicotine. It is responsible for its addictive behavior. Tobacco smoking produce physical as well as psychological dependence. Many smoke cigarette as way to cope up with stress and depression. So it is a part of many people’s daily rituals. On quitting smoking people experience withdrawal symptoms that is, unpleasant effects. Addicted smokers control nicotine intake by adjusting the frequency and dose of tobacco intake to obtain the desired psychological effect and avoid withdrawal. Even if they know that smoking is harmful, the addictive behavior prevents them from quitting. Not only addiction is preventing cessation other factors such as peer group pressure, advertisement of cigarette companies also make the attempt of cessation difficult.

Methods for smoking cessation
Smokers who are not motivated
  • Record smoking status at regular intervals
  • Anti-smoking advice should be given.
  • Encourage change in attitude towards smoking to improve motivation

Motivated light smokers (smoke < 10cigarette /day)
  • Anti-smoking advice
  • Anti-smoking support programme.

Motivated heavy smokers (10–15cigarette /day)
  • As above plus nicotine replacement therapy (NRT) (minimum 8 weeks).

Motivated heavy smokers (> 15 cigarette /day)
  • As above plus bupropion if NRT and behavioral support are unsuccessful and patient remains motivated. 

Placebo or will-power alone has a ~2% chance of abstinence for ≥ 6 months. This can be increased by the following
  • Written self-help materials: 1%
  • Opportunistic advice from doctor: 2%
  • Face-to-face behavioral support from specialist: 4–7%
  • Proactive telephone counseling: 2%
  • NRT with limited or intensive behavioral support: 5–12%
  • Bupropion with intensive behavioral support: 9%.

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