The big “it” of the quitting world? Smoking. Perhaps not, but it would be a close race for sure. While smokers are a minority in Canada and in BC — according to the Provincial Health Officer’s Report, 24% of British Columbians smoke (1997 data) — the topic continues to garner a great deal of attention. This is partly the result of the health implications of smoking, but also because so many smokers regularly express the desire to quit.
Today, few smokers don’t know of the health risks of their habit, to say nothing of the social risks! The same PHO Report says that about half of all smokers are “considering quitting in the next six months.” That so many do not succeed is testament to the powerful addictive grip of nicotine.
Smoking cessation strategies can be loosely grouped into four categories: nicotine replacement, drug therapy, counselling and hypnosis, and cold turkey. It is rare that any one of these strategies can work all by itself. Most successful quitters do so with a combination of methods.
Nicotine replacement is about providing the body with nicotine in alternative ways, thus reducing nicotine withdrawal effects. Among these, “the patch” is perhaps most common. It is an oversized adhesive bandage: the outer part sticks while the inner portion presses against the skin, slowly releasing nicotine into the body. These are usually sold in kits containing different strengths of nicotine, allowing users to step down the dosage over 8-10 weeks. While the period can vary between individuals, there seems to be little benefit to using the patch for more than eight weeks.
Nicotine gum is not actually gum, but a nicotine-containing compound with a texture similar to gum. It is not designed to be chewed like normal gum. Rather, users will “chew and park” the gum. This way, the nicotine is slowly released into the mouth.
Other replacement methods include nicotine nasal sprays, used like any nasal spray by squirting mist into each nostril. Dosage can be difficult to control using this method. Nicotine inhalers are another alternative. These look like cigarettes but hold a cartridge containing nicotine which deliver a puff of nicotine vapour into the mouth and throat area when inhaled.
Zyban is one prescription drug that has been successfully used to aid in smoking cessation. It is an anti-depressant approved for such use. While it contains no nicotine, it is believed to mimic nicotine’s effects on the brain by boosting levels of the chemical messengers dopamine and norepinephrine.
Counselling and hypnosis are other approaches that have had some success. The latter is often viewed as being mysterious, but it is quite straightforward. Hypnosis is simply being in a trance while someone makes suggestions to you. It can be a powerful way to plant the seeds of change in your mind. As a method for quitting smoking, hypnosis alone has mixed results. It is unclear how much of the benefit came from hypnosis, and how much from other interventions such as counselling going on at the same time.
And the old standby: going cold turkey. It has been known to work for some people, but it is very difficult as a standalone method. There are things that can help improve the chances, though. Among these, planning to quit is probably the best strategy. In other words, having a plan makes it easier: get ready mentally, get support, learn new behaviours, choose a medication that can help, and be prepared for difficult situations, or even a relapse.
Really and truly wanting to quit smoking is the best tool for success. Unless a person genuinely desires to quit, it is very unlikely that any of these methods will work. Be ready to quit. Want to quit. Get a plan. Quit. Good luck.
— 30 — Call-out: “Be ready to quit. Want to quit. Get a plan. Quit. Good luck.”