Hey there Guys,
Today I had a patient visit who was asking about the best way to quit smoking.
John, now 42, has been a smoker since he was 17. After a recent health scare he’s very keen to start working on his health, and quitting smoking is one of his main goals.
Today I thought it would be a good idea to share some of the research on stopping smoking.
Before we get into any of the strategies for quitting smoking though, it’s important to discuss one of the most important predictors of success: wanting to quit.
You have to want to quit
For guys who want to quit smoking the most important aspect is motivation. Without any real drive to stop smoking it’s going to be a very difficult task indeed.
For some people it’s a recent health scare either personally or in a close friend or relative. For others it may be a desire to change. By far the most important aspect is that it must be you wanting to drive the change with an internal passion to want to quit smoking.
I used to be a moderate smoker when I was younger. For me the drive to quit cigarettes was when I noticed that my, umm, let’s say “bodily fluids” started to smell like cigarettes. This totally grossed me out and from that point quitting was much easier. I stopped smoking cold turkey. Other than the odd cigarette when I’ve had a few too many beers, I haven’t smoked now for more than 10 years.
While quitting cold turkey works for some people, the success rate is pretty poor. Getting over nicotine addiction can be a challenging hurdle and today I wanted to talk about additional supports that can help people quit smoking.
Nicotine replacement therapy
Nicotine replacement has had a spike in press recently with a study declaring that nicotine patches, gum and inhalors were no more effective than quitting cold turkey on long term quit rates.
To quote WebMD:
Nicotine replacement therapies … do not show any long-term effect on quitting even when combined with counseling,” says researcher Gregory Connolly, DMD, director of the Center for Global Tobacco Control and professor of public health at the Harvard School of Public Health. Behavioural counseling is widely recommended, with medication, to help smokers quit.
The results of the new study are published online in Tobacco Control. The findings are at odds with clinical trials, Connolly says. The new study, however, draws from the population. It gives a more ”real world” picture, he tells WebMD.
Smoking cessation experts and a maker of nicotine replacement therapies took issue with the findings.
Connolly does not advocate abandoning the nicotine replacement medication. Instead, he suggests understanding its use. “In the short term, what it is designed for is treatment of withdrawal,” he says. “Long term, our study would not say it would prevent relapse.” Better strategies are needed to prevent relapse.
As mentioned above, it’s important to remember that nicotine replacement is really only designed for the short term help with cravings when you first quit. Beyond 6-8 weeks after stopping smoking there is not much use.
If you choose to use nicotine replacement it’s suggested you use a combination of delivery methods: A patch that gives an even dose of nicotine through the day and a way to give a quick burst of nicotine for cravings. Gum, lozenges and inhalers can be a good choice for this purpose. Used in this combination you can double your chances of quitting smoking.
Medications for quitting smoking
Currently there are a number of doctor prescribed medications that were designed to help reducing the cravings when quitting smoking.
Zyban, also marketed as an antidepressant, has been shown to help increase the chance of successfully quitting smoking. It does have some side effects such as dry mouth, upset stomach and, very rarely, seizures.
Varenicline marketed under the name Champix has been shown to more than double the rate of people successfully quitting smoking. Reviews of the studies show it to be slightly more effective than Zyban in helping people stop smoking. It does have the side effect of mild nausea, however it appears that this reduces over time. There is some concern that it can lower mood in people with previous depression. Currently it’s not recommended for people who have severe depression or who have had suicidal thoughts or attempts in the past without careful monitoring.
Within my own practice I have seen some good success with Champix. Normally prescribed for three months, the first month is to help reduce the body’s cravings for cigarettes, while the second and third month are best focused on developing strategies to prevent relapse in situations you normally connect with smoking, such as when drinking alcohol, or just after dinner.
Using the phone to stop smoking
Current research shows that regular phone contact to be very helpful to stop smoking. In Australia services like the Quit Line are available to offer phone support. Currently the service is available to call if you want to talk with counselor. They also offer “check up calls” to phone you and see how you are going.
There is also some interesting research that shows regular SMS messages can help people succeed during their initial quit phase.
Quit Line also offers an online service “Quit Coach” that is an internet based guide to stopping smoking. You can check it out at http://www.quitcoach.org.au/
While the medical data does not show additional benefit of hypnosis for those wishing to stop smoking I have had many patients report great success with it.
In gaining the full benefit of hypnosis to quit smoking, the main factors that seem to help are:
- Being motivated to quit smoking
- Being sure to practice the suggested exercises on a regular basis
- Making sure to get a recording of your session so you can go through the session multiple times
Finding a good hypnotist can be difficult, however there are some good web based alternatives that appear to have good results.
Currently the evidence for acupuncture is very poor. Unfortunately it’s not as effective as nicotine replacement, medications or telephone based help, however it’s been noted to be “better than nothing”.
Guys I hope that this has helped a little in showing some of ways to help increase the chance of success in quitting smoking. By far the most important factor in your success will be your motivation to quit. If you are keen there are many ways to help reduce your smoking. Both medical and non medical help is available; don’t be afraid to try multiple different ways if you have not had success with one method. The key is to keep on working on it!
Yours in good health.
Have you had success with quitting smoking? Feel free to share your success stories, or failures in the comments below!