New Year’s Resolutions Blog

What’s Available To Help You Stop?

Tuesday, January 16th, 2007

I’m a little bummed out today, since I went over my self imposed limit yesterday. It was one of those really stressful days. So, I’m jumping right back up on that bad boy horse today!

I’ve gathered a small list of non smoking aids in the hope that, if you have not committed to stopping smoking, maybe seeing what is out there to help you might inspire you to give it a try. If you don’t have the determination and will to stop smoking, it is unlikely that any of these methods will work for you. As Tommy Lasorda once said,

“The difference between the impossible and the possible lies in a person’s determination.”

So, let’s take a look at the methods and aids.

Cold Turkey

When I stopped before, this is the method I used and was very successful doing. This method uses no aids other than willpower. People who use a patch or other nicotine replacement are not really going cold turkey. The advantage of this method is that the nicotine leaves your body more quickly. The down side is that the withdrawal is immediate and can be intense. I only recommend this method if you are ready to just “suck it up”!

Nicotine Replacement Therapy

In the bad old days, the only thing available was nicotine gum, which incidently, tasted just awful! Now, we have so many products it’s hard to decide what is right for you. The principle involved in NRT is to deliver a measured dose of nicotine into your system to help ease withdrawal symptoms. This can help you deal with the psychological dependence while staving off some of the physical withdrawal symptoms. The goal is to wean yourself off of the replacement over a longer period of time by gradually reducing the amount of nicotine.

Products available for this method include:

Nicotine Patch

Formerly, a prescription was needed to purchase the patch, which resembles a square tan or clear bandage. The size depends on the dosage and brand used, but generally is between one and two inches square. It is now available over the counter. The nicotine patch provides a steady, controlled dose of nicotine throughout the day, thereby reducing the effects of nicotine withdrawal. Patch strength is reduced over time, allowing the user to wean themselves off of nicotine gradually. The 21mg patch is usually recommended as a starting point for people who smoke a pack of 20 cigarettes or more daily.

Side effects of nicotine patches may include:

• Itching, burning or tingling when the patch is applied. This usually goes away within an hour, and is a result of nicotine coming in contact with the skin.
• Redness or swelling at the patch site for up to 24 hours.
• Dizziness
• Headache
• Upset stomach
• Vomiting
• Diarrhea

If you take any other medications, be sure to check with your doctor before starting the patch, as it can change the way some medicines work. The good news is that using the nicotine patch can double the rate of success with smoking cessation.

Nicotine Gum

The principle involved in the gum is the same as that in the patch. This information was made available through Medline Plus.

Usually treatment is started by using the 2-mg gum. Heavy smokers (those smoking more than 25 cigarettes per day) may start by using the 4-mg gum. Nicotine gum may be used regularly by chewing one piece of gum every 1-2 hours at first, or it may be used by chewing one piece of gum whenever you have the urge to smoke.

Nicotine gum should be chewed slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the chewing gum between your cheek and gum. When the tingling is almost gone (about 1 minute), start chewing again; repeat this procedure for about 30 minutes.

Do not chew nicotine gum too fast, do not chew more than one piece of gum at a time, and do not chew one piece too soon after another.

If you are using the 2-mg gum, do not chew more than 30 pieces a day if you are under the supervision of a doctor or 24 pieces a day if you are not under the supervision of a doctor. If you are using the 4-mg gum, do not chew more than 24 pieces a day.

Gradually begin reducing the amount of nicotine gum used after 2-3 months. This reduced use over time will help prevent nicotine-withdrawal symptoms.

Suggested tips to help reduce your use of nicotine gum gradually include:

• Decrease the total number of pieces used per day by about 1 piece every 4-7 days.
• Decrease the chewing time with each piece from the normal 30 minutes to 10-15 minutes for 4-7 days. Then gradually decrease the total number of pieces used per day.
• Substitute one or more pieces of sugarless gum for an equal number of pieces of nicotine gum. Increase the number of pieces of sugarless gum substituted for nicotine gum every 4-7 days.
• Replace 4-mg gum with 2-mg gum and apply any of the previous steps.
• Consider stopping use of nicotine gum when your craving for nicotine is satisfied by one or two pieces of gum per day.

Use of nicotine gum for longer than 3 months is discouraged. Do not use nicotine gum longer than 6 months without talking with your doctor.

Nicotine Lozenge

Nicotine lozenge comes in the form of a hard candy, and releases nicotine as it slowly dissolves in the mouth. Eventually, the quitter will use fewer and fewer lozenges during the 12-week program until he or she is completely nicotine-free. Biting or chewing the lozenge will cause more nicotine to be swallowed quickly and result in indigestion and/or heartburn.

Nicotine lozenge is available in 2mg or 4mg doses. One lozenge is one dose; maximum dosage should not exceed 20 lozenges per day.

Each lozenge will last about 20-30 minutes and nicotine will continue to leach through the lining of the mouth for a short time after the lozenge has disappeared. Do not eat or drink 15 minutes before using the lozenge or while it is in your mouth.

The most common side effects of lozenge use are:

Soreness of the teeth and gums, indigestion and throat irritation.

Nicotine Gel

This is a new product, in gel form, that is rubbed into the hands. It is expected that it will be available first at Walgreens. For more information, please see Acceptable Alternative? .

Nicotine Inhaler

This consists of a plastic cylinder containing a cartridge that delivers nicotine when you puff on it. Use the inhaler when you have a craving for a cigarette. Use no more than 16 cartridges a day for up to 12 weeks.

Although similar in appearance to a cigarette, the inhaler delivers nicotine into the mouth, not the lung, and enters the body much more slowly than the nicotine in cigarettes. The nicotine inhaler is available only by prescription.

Each cartridge delivers up to 400 puffs of nicotine vapor. It takes at least 80 puffs to obtain the equivalent amount of nicotine delivered by one cigarette.

The initial dosage is individualized. The best effect is achieved by frequent, continuous puffing for 20 minutes. One cartridge will last for 20 minutes of continuous puffing and deliver 4 mg of nicotine; only 2 mg are actually absorbed. This is the equivalent of about 2 cigarettes. The maximum suggested dose is 16 cartridges per day.

Side effects include irritation of the throat and mouth in the beginning. You may also start to cough but you should get over this after a while, if not make sure to consult with your doctor.

Nicotine Nasal Spray

This is available through prescription only. Nicotine nasal spray, dispensed from a pump bottle similar to over-the-counter decongestant sprays, relieves cravings for a cigarette.

Nicotine is rapidly absorbed through the nasal membranes and reaches the bloodstream faster than any other NRT product, giving a rapid nicotine “hit”. This feature makes it attractive to some highly dependent smokers. The most common side effects due to the nasal spray are nose and throat irritations.

Non-Nicotine Pill - Zyban

Bupropion hydrochloride (Zyban) was approved in 1997 to help smokers quit. The drug, available by prescription only, is also sold as an antidepressant under the name Wellbutrin.

Treatment with bupropion begins while the user is still smoking, one week prior to the quit date. Treatment is then continued for 7 to 12 weeks. Length of treatment is individualized.

Dosing should begin at 150 mg/day given every day for the first 3 days, followed by a dose increase for most people to the recommended dose of 300 mg/day, starting on the 4 day of treatment. The maximum recommended dose is 300 mg/day, given as 150 mg twice daily. An interval of at least 8 hours between successive doses is advised. People who have not made significant progress towards abstinence by the seventh week of therapy are unlikely to successfully quit during this attempt, and bupropion treatment should be discontinued.

Common side effects include insomnia, dry mouth and dizziness.

The newest prescription drug Chantix, Varenicline tartrate, is only the second nicotine-free smoking-cessation drug to gain FDA approval. The active ingredient varenicline works in two ways — by cutting the pleasure of smoking and reducing the withdrawal symptoms that lead smokers to light up again and again.

Chantix has the unique ability to partially activate nicotinic receptors in the brain, reducing a person’s craving for nicotine when they quit smoking. Additionally, if a person smokes during the course of varenicline treatment, the drug impedes smoking satisfaction by blocking nicotine from binding with these same receptors. This could potentially help people break the cycle of addiction to nicotine.

The tablet will be taken twice-daily for 12 weeks, a period that can be doubled in patients who successfully quit to increase the likelihood they remain smoke-free.

The most common adverse side effects include: nausea, headache, vomiting, gas, insomnia, abnormal dreams, and a change in taste perception.

Hypnosis

I tried this one many years ago. I don’t think I can be hypnotized!

Hypnosis puts people into an altered state of mind where they become more susceptible to suggestion. It can be used to quit smoking, and while it seems to work well for some, it isn’t for everyone. The premise is that you will reach your subconscious mind through hypnosis. f you can get past the locked gates of your conscious mind to your subconscious mind, you can feed the subconscious “imagined reality.” So if you can imagine yourself as a non-smoker, your subconscious mind will accept that as reality.

Hey, don’t ask me! I just report it. If you think it can work for you, then definitely look into it.

Acupuncture

Acupuncture is an ancient Chinese medical practice which uses needles placed at specific spots in the skin to treat pain or disease. It can be used to treat addiction to nicotine. I would suggest, if you go with this method or the above hypnosis, make sure you do some research and find a reliable technician with a good reputation.

So, I hope you have found something here that appeals to you. If anyone has tried any of these methods and aids or maybe one not mentioned here, I’d love to hear your story.