Many Americans understand that cigarette smoking is harmful to their health but smoke anyway. A large number would like to quit, but they are stopped by the powerful effect of nicotine addiction.
There are options to help such individuals. One approach is to provide the addictive substance, nicotine without the harmful cancer-causing agents found in cigarette smoke. Nicotine replacement therapy has been beneficial to many smokers who want to quit.
There are a variety of delivery vehicles: gum, lozenges, spray, patches, and inhaler. Each has its own advantages and disadvantages. The patch is easy to use but can cause allergic reactions or local irritation. Vivid dreams, which may be upsetting have been found with patches used at night.
The gum is a good mimic for chewing gum but is hard to use for some people because you can't chew it like chewing gum. The nicotine gum is chewed but then is "parked" next to the gums so the nicotine can be absorbed. Inhalers have the advantage in that they resemble the familiar hand to mouth movements that are part and parcel of cigarette smoking. However, some people with asthma or other bronchial disease may develop bronchospasm.
Another treatment option includes using a variety of medications to reduce the urge to smoke. One such medication is bupropion, which was first developed to treat depression but was discovered to reduce craving for cigarettes as well. It can be used by itself or along with nicotine replacement therapy. There is evidence that it can also delay or prevent weight gain that may be seen with withdrawal from smoking.
A newer medication is varenicline, which limits the binding of nicotine to its receptors so that it is rendered ineffective. It does reduce the symptoms of cigarette withdrawal. It also blocks the impact that nicotine has on the pleasure centers in the brain so that smoking is not reinforced by the pleasure experienced by inhaling nicotine. It does appear to be more effective than bupropion.
Varenicline was thought to have a serious side effect of producing suicidal thoughts in users. However, newer research has shown that suicidal thoughts are no more common than with other methods.
A vaccine was developed to help smoking cessation but proved to be ineffective. The latest approach involves substituting eCigarettes for tobacco cigarettes. These substitutes are probably safer than actual cigarettes but we don't have good studies to show that it is an effective way to stop smoking. Long term effects are not known. One unfortunate problem is that the eCigarette device can be modified by drug addicts to inhale other drugs.
In terms of known effectiveness, it appears that nicotine nasal spray is more effective than varenicline, which is more effective than bupropion. It has also been shown that patients are more likely to quit smoking if given a clear recommendation to do so by their physician.
Advice and support on how to stop smoking can be gotten without cost by calling 1-800-QUIT-NOW. As a general rule, the most important thing you can do for your health if you smoke is to,stop smoking.
