Stop smoking: The benefits and aids to quitting. (Part 2/2)
- Medication
- Behavioural support
- Unproven aids to cessation
Medication
Nicotine replacement therapy (NRT)
Nicotine replacement therapy (NRT) includes nicotine chewing gum, patches, lozenges, mouth spray, inhalator and nasal spray and is usually taken for 8 to 12 weeks.
NRT products can be purchased from a pharmacist and in some shops or obtained on prescription from a GP or qualified NHS Stop Smoking Advisor.
NRT is designed to reduce the motivation to smoke by replacing nicotine from cigarettes.
By alleviating nicotine withdrawal symptoms, the transition from cigarette smoking to complete abstinence is easier. Clinical trials have consistently found that NRT increases the success of quitting smoking by 50– 70%.
The National Institute for Health and Clinical Excellence (NICE) recommends that smokers who are committed to quitting should be offered NRT to support their quit attempt and that more heavily addicted smokers may be offered a combination of NRT products if required.
There is a commonly held belief amongst many smokers that nicotine causes cancer and that NRT is therefore also unsafe. But it is the tar in cigarette smoke along with other toxins which causes lung cancer and other smoking- related illnesses. Some smokers express concern about becoming addicted to NRT. However, this is rare, a better alternative to smoking, and in studies looking at NRT use for up to five years there have been no health concerns.
Varenicline (Champix)
Varenicline (Champix) is a prescription only medication which comes as a course of tablets lasting 12 weeks, sometimes with the option of a further 12 weeks for those that are not smoking at the end of the initial treatment. Varenicline works by preventing nicotine from reaching nicotine receptors in the brain which make cigarettes less satisfying.
Bupropion (Zyban)
Bupropion (Zyban) is a prescription-only medication which comes as a course of tablets lasting around 8 weeks. It does not contain any nicotine but works by reducing (or entirely alleviating) cravings and nicotine withdrawal by blocking the pleasure smokers feel when using tobacco. Bupropion is safe for most healthy adults but there are some documented side effects including insomnia, dry mouth and headaches.
Behavioural support
Behavioural support aims to strengthen the smoker’s motivation not to smoke and advise on ways on avoiding, escaping from or minimising urges to smoke with simple practical strategies.
Specialist Stop Smoking Practitioners
Most Stop Smoking Services offer closed groups, ‘rolling’ groups and drop-in sessions as well as individual appointments, facilitated by fully trained advisors. Clinical trials have found that stop smoking groups double a smoker’s chance of quitting successfully. There is some evidence that groups are more effective than individual counseling.
Most smokers attending groups will also use medication to maximise their chances of success.
For details of your local Stop Smoking Service, please see the NHS Smokefree website (http://smokefree.nhs.uk).
Community Stop Smoking Practitioners
Most GP surgeries, pharmacies, hospitals, midwifery services and mental health facilities will provide a free Stop Smoking Advisor to assist smokers who wish to quit. Clinical trials have found that one-to-one support doubles a smoker’s chance of quitting successfully. The majority of smokers seeing an advisor will also use medication to maximise their chances of success.
Telephone support
The National NHS Stop Smoking Helpline (0800 022 4 332) is a free service for smokers who wish to stop smoking but do not require the more intensive support offered by the Stop Smoking Services. In addition to this, some NHS Stop Smoking Services will provide psychological support over the telephone for smokers who are mobility impaired or unable to attend face to face services.
QUIT is a national charity with a free-phone number for smokers who would like telephone support. QUIT provides advice in a number of languages. Clinical trials have found that this kind of support can help smokers to stop.
Unproven aids to stopping smoking
The above quit smoking programmes have been evaluated in controlled clinical trials in which success rates in smokers using the aid have been compared with similar smokers using a placebo, nothing or something else. There are a number of commercial companies selling materials, devices and treatments, often claiming higher levels of effectiveness, which have not be evaluated in this way. Success at stopping smoking is somewhat unpredictable and many people will report having succeeded after using one of these treatments but unless the aid has been subjected to comparative trials that are either independent of the company or audited by an independent agency, smokers would be advised to treat claims of effectiveness with caution.
The Health and wellbeing committee will be organising a Carbon Monoxide (CO) breath test for all members on Thursday 23rd May 2013 after the program. More details on this will be announced during the forthcoming jamaat programs.
Questions & Answers
- What does a CO breath test show?
It shows the amount of carbon monoxide (ppm CO) in the breath, which is an indirect, non-evasive measurement of blood carboxyhemoglobin (%COHb).
- What does ppm mean?
Parts Per Million. It is a unit of measure. In this case, one part CO in one million parts air (breath).
- How does smoking elevate COHb?
In a typical puff of a cigarette smoke there is about 5% CO by volume. This will compete with oxygen very successfully to form COHb (combination of CO and blood). This will eventually be excreted via the lungs; the same way it went in.
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What else does breath CO show?
It acts as an indicator as to the possible level of some 4000 toxic substances in cigarette smoke, some 60 of which cause cancer. - How quickly does the CO disappear from the body after smoking stops?
It takes about 5 to 6 hours to reduce the original level by a half. Usually after a maximum period of 48 hours the ex-smoker would show the level of a non-smoker living in the same environment. - How long after a cigarette should the test by conducted?
More than 10 minutes. - What levels of breath CO do you expect to see?
• 0-6 non-smoker
• 7-10 light smoker
• 11-20 smoker
• 20+ heavy smoker