Smoking cessation
Smoking cessation, or the process of quitting smoking, is a challenging but achievable goal for many individuals. The addictive nature of nicotine complicates this journey, often leading to withdrawal symptoms that can include cravings, anxiety, and depression. Health experts highlight the significant benefits of quitting smoking, which include reduced risks of serious health issues like lung cancer and heart disease, as well as the mitigation of secondhand smoke impacts on loved ones.
Those seeking to quit can increase their chances of success through a combination of counseling and pharmacological aids, such as nicotine replacement therapies and medications like varenicline (Chantix). Various methods exist for quitting, including tapering down nicotine intake or stopping abruptly (cold turkey). Techniques such as practicing the "Three Ds" (delay, deep breathing, drink water) and maintaining a diary of cravings can provide additional support.
The rise of e-cigarettes has introduced a new dimension to smoking cessation strategies, with some advocating their use as a less harmful alternative to traditional cigarettes. However, the effectiveness and safety of e-cigarettes for this purpose remain subjects of ongoing debate among health professionals, as there are concerns about their potential to perpetuate nicotine addiction and attract younger users. Overall, successful smoking cessation requires a personalized approach, patience, and support.
Subject Terms
Smoking cessation
Smoking cessation, also known as quitting smoking, is the process of stopping use of tobacco products. The process can often be difficult because of the addictive properties of nicotine found in tobacco. However, data shows that assistance from counseling, medication, or both can substantially increase a person's chances of successfully quitting smoking. Health experts agree that smoking cessation is hugely beneficial because of smoking’s damaging effects on health, including greatly increased risks of lung cancer, emphysema, and heart disease, as well as the harmful effects of secondhand smoke on immediate family.
Overview
Smoking is addictive—both physically and psychologically. The physical addiction can be traced to the nicotine in each cigarette. Nicotine dependence leads to withdrawal symptoms—including cravings, anxiety, agitation, nausea, cramps, depression, and dizziness—when the substance is removed. These effects often make it very difficult for people to quit smoking long-term without assistance. Nevertheless, public health officials stress that quitting smoking is possible, and it is never too late to start trying.
Health experts emphasize the importance of patience, perseverance, support, and having a plan when it comes to smoking cessation. For many people, it is helpful to focus on a reason that they believe in to quit smoking, whether for their family or for their own personal health. Changing one’s environment is also useful, as it removes an individual from smoking triggers and can help that person avoid secondhand smoke. Some smokers may find that gradually cutting down or "tapering off" the amount they smoke each day makes it easier to eventually quit altogether. Others may prefer to quit “cold turkey,” or stop smoking abruptly.
Practicing the “Three Ds”—delay, deep breathing, drink water—can be helpful for smoking cessation. This involves delaying smoking a cigarette when the need or craving arises, breathing deeply (while often counting to ten), and drinking a target of eight eight-ounce glasses of water each day. Keeping a diary is also an effective technique. A person can simply write down the time of day that they feel like having a cigarette, using a scale of one to three, with one representing the worst craving.
Although some former smokers have achieved success in quitting smoking entirely by themselves, studies have shown that using one or more assistance methods leads to higher success rates. Many health professionals recommend some form of behavior modification counseling—whether in person, over the telephone, or online—in conjunction with nicotine replacement products to best increase one's chances of quitting successfully. Smoking cessation products approved by government agencies such as the US Food and Drug Administration (FDA) include over-the-counter nicotine patches, gum, and lozenges, as well as prescription nicotine inhalers or nasal sprays. Along with formal, clinical counseling, there are many other self-help options for smoking cessation support, including group programs or classes, telephone quit lines, and online resources. Alternative therapies such as hypnosis and acupuncture may be useful for some individuals, although there tends to be limited data about their effectiveness.
Medication may also help to increase smoking cessation rates for some people. A medication called varenicline (Chantix) works by stimulating the release of low levels of dopamine in the brain. Nicotine in the cigarettes causes dopamine to be released, resulting in the positive feelings associated with smoking. At the time of smoking cessation, a drop in dopamine levels is related to the many withdrawals symptoms. By stimulating the release of this chemical in the brain, varenicline may help to reduce the signs and symptoms of withdrawal. Varenicline also blocks nicotine receptors in the brain, so it helps the individual stay away from cigarettes. If a person resumes smoking while taking the medication, nicotine will not be able to stimulate the brain’s receptors the way it did in the past, making the habit much less pleasurable. It appears that varenicline works better than placebo and bupropion, another antidepressant used for quitting smoking. Taking varenicline has been associated, however, with some side effects. The most frequently reported side effects include nausea, headache, insomnia, bad dreams, and changes in the way food tastes. Varenicline and bupropion also may increase the risk of serious mood and behavior changes.
E-Cigarettes and Smoking Cessation
As electronic cigarettes (e-cigarettes, also known as vapes) became popular in the early twenty-first century, there was much debate about whether such products should be promoted as a tool for smoking cessation. Proponents have argued that e-cigarettes are a safer alternative to traditional tobacco products, as they deliver nicotine through an aerosol mist rather than smoke and therefore do not produce tar or most of the other toxins associated with smoking. Some also contend that e-cigarettes can be particularly effective in helping smokers quit or cut back because (unlike other nicotine replacement products) the devices allow users to go through the same motions and routines of smoking. This may make it easier for people to stick to a cessation plan. By the 2020s, some studies had provided support to the idea that vaping could help smokers increase their chances of quitting, although research remained ongoing.
However, many health experts have been skeptical of e-cigarettes for smoking cessation. They note that vaping often still exposes users to a number of toxic and carcinogenic chemicals, a problem that tends to be compounded by limited regulation of e-cigarette liquid or "juice." Some early studies also indicated that smokers who started vaping were more likely to continue using both traditional tobacco products and e-cigarettes than they were to quit smoking. Meanwhile, critics have raised concerns that e-cigarettes might actually draw more people into smoking, especially young people. Further research is needed to fully understand the long-term health effects of e-cigarettes and their potential role in smoking cessation.
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