We advise, cajole, complain, even beg…yet despite the dire fact that about half of long-term smokers die from smoking-related diseases, sometimes our loved ones simply cannot stop smoking. Why? Because tobacco is powerfully addictive. When a smoker takes a “drag,” nicotine attaches itself to neurons of the brain’s reward system within 10 seconds and triggers the release of the pleasure-inducing neurotransmitter dopamine.
According to the Centers for Disease Control and Prevention, 70% of smokers say that they want to quit and 40% try each year, but few succeed permanently. Yet maybe our loved ones could stop smoking — if they knew which “quit strategies” have been shown in recent research to be most effective… and if they had the right emotional support.
Michael Fiore, MD, MPH, founder and director of the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI), said, “Many smokers are discouraged, but I want to give a message of hope. We have new medicines, new counseling support, new interactive Web sites and more — so this is a great time to quit.” How you can help…
Encourage your loved one to speak with his or her doctor about these newer approaches…
Combining two drug therapies. To ease withdrawal symptoms, many people use a nicotine-replacement product (skin patch, gum, lozenges)… or prescription bupropion (Zyban), an antidepressant that reduces cravings and irritability. Recent UW-CTRI research showed that, compared with using one of these therapies, success was significantly more likely when two were used simultaneously. Best combinations: Use a nicotine patch for around-the-clock relief plus nicotine lozenges to quell sudden urges… or use bupropion plus nicotine lozenges. Cautions: Nicotine patches may not be appropriate for people with angina, arrhythmia or certain other medical conditions. Bupropion’s side effects may include dry mouth, insomnia, dizziness and, rarely, seizures.
Simultaneously quitting smoking and following a weight-control program. Without nicotine’s appetite-suppressing and metabolism-boosting effects, ex-smokers typically gain five to 10 pounds — a potentially discouraging prospect for anyone hoping to quit. Good news: A Northwestern University study contradicted the common notion that dieting undermines efforts to stop smoking. Women whose treatment addressed both smoking and weight control were more likely to give up cigarettes and gained less weight, on average, than women whose treatment addressed only smoking.
Extending use of nicotine patches. University of Pennsylvania researchers found that 32% of people who used nicotine patches for 24 weeks achieved prolonged abstinence from smoking… compared with only 20% of people who used patches for the standard eight weeks. (More research is needed to determine the appropriateness of combining extended nicotine patch use with nicotine lozenges, Dr. Fiore noted.)
Using varenicline (Chantix). This prescription drug reduces cravings by tricking the brain into thinking it is getting nicotine, which triggers dopamine release. It also blocks the brain’s nicotine receptors, so that smoking itself no longer results in a flood of dopamine, thereby reducing smoking’s reinforcing effects. Caution: Some users experience headache, nausea, vomiting, vivid dreams or, rarely, depression.
Support a smoker who’s trying to kick the habit by…
Telling him or her about free counseling support systems that offer information, coaching and/or opportunities to connect with other smokers who want to quit. According to the US Public Health Service, this doubles the chances of success. Options: The toll-free quit line 800-QUIT-NOW (800-784-8669), a federal/state partnership… and the interactive Web sites SmokeFree.gov and Women.SmokeFree.gov from the National Cancer Institute.
Emphasizing the advantages of quitting. Dr. Fiore suggested that you yourself call the quit line for coaching on how to “be supportive without being a nudge.” Interesting: In a Yale University study, smokers were more likely to abstain in the short term when quit-line counselors focused on the benefits of quitting rather than the dangers of smoking. Worth a try: Instead of warnings (“You’ll get lung cancer if you keep smoking”), use positive wording (“As a nonsmoker, you’ll feel healthier, have more stamina, live longer — and save a lot of money!”).
Helping your loved one avoid situations likely to trigger cigarette cravings, such as drinking together — alcohol lowers inhibitions and weakens resolve. If the would-be ex-smoker lives with someone who smokes, encourage them to quit together.
Being sympathetic. Tobacco withdrawal often causes irritability and sleep disturbances — so be tolerant during your loved one’s transition to a smoke-free life.