Quitting smoking is probably the hardest thing I ask my patients to do. (Losing weight is probably the second hardest.) Smoking is a profound addiction. Smoking feels good, and countless smokers have told me the calming pleasure they get from a cigarette.
Despite the health risks and financial costs associated with smoking, medications aimed at helping smokers quit have been only modestly successful. A very helpful article in Monday’s Los Angeles Times reviews the medications available to assist in quitting smoking. If you smoke, I urge you to read it. (See the link below.)
The oldest quitting aid is nicotine replacement. Nicotine is available over-the-counter as a patch, gum, lozenge or inhaler and has long been known to help some smokers kick the habit. There is some new information that makes nicotine replacement even more effective. It was previously thought that smoking while using nicotine replacement (for example smoking while wearing a nicotine patch) was very dangerous. It turns out to be quite safe (or no more dangerous than just smoking). The reason this option is helpful is that new studies show that many smokers prefer to quit slowly, by gradually decreasing the number of cigarettes smoked. So smokers can now use nicotine replacement during the slow weaning period rather than have to quit smoking abruptly. A recent study in the American Journal of Preventive Medicine showed that for smokers gradually decreasing their cigarette use over an 8 week period, nicotine gum during that time led to more successful tobacco abstinence than placebo gum.
There are also newer prescription medicines for tobacco cessation. Zyban (buproprion) is the same medicine as the antidepressant Wellbutrin. Studies have shown that it helps smokers quit more than placebo. Like all antidepressants it can have some side effects. The newest option for smokers is Chantix (varenicline) which I wrote about when it became available in 2006. Chantix, however, is plagued by new reports of psychological side effects, like depression.
The bottom line is that neither of these medicines is spectacularly effective. In the studies proving their effectiveness, most smokers in both the placebo and medication group went back to smoking, but the medication group did better than the placebo group. So you have to be determined, and you have to try more than once to finally quit successfully.
If you’re a smoker, discuss these options with your doctor, and take a look at the articles below. 2009 may be your year to quit.
Los Angeles Times article: Ready to quit smoking?
American Journal of Preventive Medicine article: Quitting by Gradual Smoking Reduction Using Nicotine Gum: A Randomized Controlled Trial
New England Journal of Medicine article: A Randomized, Controlled Trial of Financial Incentives for Smoking Cessation
My post about Chantix: Chantix is Modestly Helpful for Quitting Smoking