Break the addiction

How to quit smoking and tobacco use

Nicotine is one of the most addictive substances known to mankind. Those who are addicted to both heroin and nicotine admit that quitting nicotine is much more difficult. This gives us an idea of ​​what the average tobacco user experiences when trying to quit.

So the first step in quitting smoking is to forgive yourself more for quitting, and perhaps start again with a different strategy.

Most people who smoke or chew tobacco know that it is harmful and would like to quit. Continued use means how addictive the substance is (quitting can be very difficult because it involves lack of concentration, irritability, and cravings), and how many times you try to quit. It reflects how low a person's self-confidence is, given that he or she could not quit. What behavioral strategies can help? Breaking the association can help. Those who drink coffee and smoke should switch to tea. If people smoke on balconies, make access to balconies more difficult (e.g. lock balconies). Consider quitting with a friend who smokes so you can support each other. Create a written action plan for switching from smoking (“When I have a strong urge to smoke, I listen to a playlist of my favorite songs instead”).

Drugs that help people quit smoking are more effective than behavioral strategies alone. They form the backbone of most scientific smoking cessation programs around the world. The drug tricks the brain into experiencing the same sensations as nicotine, without exposing the body to the hundreds of carcinogenic, oral and lung irritants that the body is exposed to when chewing or smoking tobacco. works as The strategy I use in my smoking cessation regimen is a combination of nicotine patches (a constant level of nicotine prevents cravings) and nicotine lozenges taken on demand. In addition, certain drugs such as bupropion and varenicline are used, depending on the severity of the addiction. Concerns such as weight gain and constipation that some people may face after quitting smoking must be addressed, but are often easily managed.

Please note. Addiction disorders are much more common in people with mental health problems than in people without mental health problems. People who are dependent on multiple substances (such as alcohol and tobacco) are more likely to have underlying depression and anxiety disorders, which often require the help of a psychiatrist to be treated. I have. However, this is a small fraction of tobacco users and most would benefit from a combination of behavioral strategies and pharmacotherapy (drugs) alone.

Tobacco use remains a major problem.

India is the second largest tobacco consumer and producer in the world. According to the latest Global Adult Tobacco Survey (GATS), 42.4 percent of men and 14.2 percent of women currently use tobacco in all forms (smoked and smokeless), for a total of 28.6 percent of the population. Addiction or dependence on a substance of abuse, in this case tobacco, is thought to be a brain disorder related to reward, self-control, and stress circuits. Giving up is a revolving door phenomenon of repeated attempts to quit, calls for help, and relapses. Positive factors for smoking cessation included later age at first use, taking first dose of the day one hour after waking up, recent smoking cessation attempts, and physician recommendations to quit. Nicotine is the main chemical addiction in tobacco use and enhances addictive behavior in individuals. Quitting tobacco use requires a multifaceted approach.

Combining nicotine replacement therapy with other therapies:

Nicotine replacement therapy (NRT) combined with supportive counseling is the most widely used treatment for ending tobacco dependence. Evidence that NRT (sometimes combined with bupropion) helps smoking cessation is now well established, and many clinical guidelines recommend NRT as first-line treatment for people seeking pharmacological help to quit smoking. I'm here. The Indian government has also added NRT to the list of essential medicines. This is an important step in smoking cessation therapy. NRT aims to reduce the motivation for tobacco use and the physiological and psychomotor withdrawal symptoms caused by nicotine administration. NRT is free of the harmful tars and carcinogens found in cigarettes and has lower nicotine levels. There are various NRTs. Nicotine gums (Nicotex, Nicorette, Nicotine Polacrilex) release nicotine when chewed slowly. Take up to 24 sticks of 2 mg per day in concentrations of 2 or 4 mg. The recommended total treatment duration is up to 3 months. Nicotine patches can stay on the skin for 16-24 hours a day (three benefits:

7, 14 or 21 mg) depending on number of cigarettes smoked per day and body weight. Nicotine lozenges are dissolvable tablets containing nicotine. Nicotine inhalers and nasal sprays are other NRTs. Combining multiple NRTs gives better results. Unlike the slow release of NRT, the release of nicotine from smoking is instantaneous. Patients should be advised to be patient with this delay.

Pharmacotherapy without nicotine replacement:

These address the urges and withdrawal issues associated with quitting smoking. One of the approved drugs is bupropion, starting at 150 mg and increasing to 300 mg per day. Combining bupropion with NRT increases the likelihood of discontinuing treatment. Second, initially he will consist of 0.5 mg varenicline, then increased to a maximum of 2 mg per day. Some drugs, such as nortriptyline and clonidine, are used intermittently but not as first-line therapy. The duration of most of these treatments he is 12 weeks.

Because addiction is a multifactorial problem, other therapies such as motivational interviewing, the 5 A's (ask, advise, judge, support, command) and the 5 R's (relevance, risk, reward, repetition, disability) has also been successful as a counselor. approach. Coexisting psychiatric disorders should be evaluated. If you have a history of suicide attempts, psychosis, or seizures, you may not need to use some of these treatments.

The risk of relapse is highest about 6 months after quitting, and only 4% of people who have quit for 2 years or more resume smoking. Our goal is to reach his golden second place by any means necessary.