Some Facts About Cigarette Smoking and Cessation
What are electronic cigarettes?
At the beginning of the 21st century, electronic cigarettes were commercialized as alternatives to smoking and an option for smoking cessation. They were electronic devices that looked like cigarettes and were used in the same fashion. However, they contained much less of the traditional toxins in a cigarette and produced only vapor for inhalation. The device consists of three parts: a plastic tube, an electronic heater, and a liquid cartridge. Electronic cigarettes offer the advantage of allowing smokers to simulate smoking, yet enable them to smoke less to zero amounts of nicotine. Some brands even say that their products are fireproof because they can prevent fires that could be started from a lit cigarette.
Should everyone use electronic cigarettes?
What are proven alternatives for smoking cessation?
Smoking cessation can be a difficult process to endure, especially for those that have smoked for many years, where it has become an undeniably pleasurable habit. Stopping “cold turkey” can be very difficult and otherwise unsuccessful due to such strong withdrawal effects like depression, insomnia, irritability, frustration, and restlessness. There are several smoking cessation strategies with more supporting evidence that can help smokers to quit smoking. Talk to a health provider such as a physician or pharmacist for more detailed information and counseling. They may recommend the following options:
These do not require a prescription. Compared to a cigarette, it does not have all the other toxic chemicals. Unlike any smoking device, it is not inhaled directly into the lung so has no potential for causing throat irritation or airway problems like bronchospasms. Randomized trials showed that 81.3% of patients had initial cessation of at least one day compared to 69.4% on placebo. There are two different strengths: 2 mg and 4 mg dosed according to level of smoking . They are available as fruit or mint flavor. They are like candy can easy to use. Hold in the mouth for 30 minutes and repeat every few hours. This can satisfy oral cravings and delay weight gain. The treatment is done for about 12 weeks. Side effects are mild.
This does not require a prescription and has the advantage of a once daily dosing. Dosing depends on level of smoking. One patch is worn every 24 hours or every 16 hours (removed at bedtime) if side effects occur. This treatment lasts for about 8 to 10 weeks. The nicotine patch approximately doubles the rate of long-term abstinence compared to placebo. The patch should be removed before bedtime as it can cause sleep disturbances such as vivid dreams.
Many times, combination strategies may give better success rates. The patches are used for long-term control, while the gum or lozenges is used to satisfy short cravings. A randomized trial showed that this combination had a higher effectiveness compared to either alone at 6 months. The combination showed 40.1% smoking cessation in participants.
It is recommended that smokers should start treatment 1-2 weeks before smoking quit date. These come in the form of pills that can be taken once to twice daily. The treatment lasts about 12 weeks. Chantix can be continued for an additional 12 weeks after successful quitting. Zyban is especially recommended in smokers who have diagnosed depression. A randomized trial showed that 31.8% of participants on Zyban abstained from smoking by 6 months compared to 22.2% on placebo. The result were higher when Zyban was combine with the lozenge at 33.2%. Another randomized study showed that Chantix 2 mg had a 44% success rate compared to 18% in the placebo group and 30% in the Zyban group. However, it should be cautioned that these medications have the potential to cause major changes in mood and behavior. Chantix may also worsen heart conditions, and should be used cautiously in smokers who have heart disease. Chantix is also associated with vivid dreams.
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Rigotti, N. 2002 Feb 14. Clinical practice. Treatment of tobacco use and dependence. N Engl J Med. 346(7): 506-12.
Yamin, C., Bitton, A., Bates, D. 2010 Nov 2. E-cigarettes: a rapidly growing Internet phenomenon. Ann Intern Med.153 (9): 607-9.
Vardavas, C. et al. June 2012. Short-term Pulmonary Effects of Using an Electronic Cigarette: Impact on Respiratory Flow Resistance, Impedance, and Exhaled Nitric Oxide. Chest. 141(6): 1400-1406.
Piper ME, Smith SS, Schlam TR, Fiore MC, Jorenby DE, Fraser D, Baker TB. 2009. A randomized placebo-controlled clinical trial of 5 smoking cessation pharmacotherapies. Arch Gen Psychiatry. 66(11): 1253.
This medication summary is for information only and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.
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