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Smoker. What Should I Do To Quit Smoking?

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Posted on Fri, 8 Mar 2013
Question: I smoke about 20 cigarettes per day since 1996.. Now i would like to quit smoking..
I never tried nicotine patches or chewing gums...
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Answered by Dr. Gourav Monga (8 hours later)
Hello XXXXXXX
Welcome to health care magic and thanks for your query.
I appreciate your concern to quit smoking.

First of all, let me tell you that smoking 20 cigarettes per day and that too for such a long time (about 17 years) is absolutely hazardous.

Nicotine dependence is the most prevalent, deadly, and costly of substance dependencies. 50 percent of smokers die of a smoking-related illness. Physical dependence on nicotine usually begins within a few years, so that periods of nonuse become uncomfortable.

Nicotine via cigarettes is rapidly absorbed directly into the arterial circulation and reaches the CNS in less than 15 seconds. If a dependent person does not take it, he gets withdrawl syndrome characterized by changes in mood, insomnia, difficulty concentrating, restlessness, decreased heart rate and weight gain.
Smoking is a huge risk for lung cancer and chronic obstructive pulmonary disease (COPD), accounting for more than 75 percent of all deaths from these disorders.

Smoking doubles the risk for cardiovascular disease deaths. Other common smoking-related diseases are cancers of throat, bladder, and pancreas (the tar in cigarette smoke is responsible for the cancers).

Since you have decided to quit, that’s a welcome step by you. Nicotine replacement therapies (like nicotine gum, nicotine patch, lozenges, inhaler etc) are effective, presumably because they reduce nicotine withdrawal. Replacement therapies use a short period of maintenance (6 to 12 weeks), often followed by a gradual reduction period (6 to 24 weeks).

Nicotine gum is a product that releases nicotine via chewing and buccal absorption. A 2-mg (for people who smoke less than 25 cigarettes per day) and a 4-mg gum variety (for people who smoke greater than or equal to 25 cigarettes per day) are available. Smokers are to use one to two pieces of gum per hour after abrupt cessation. Adverse effects are minor and include bad taste and sore jaws.

Nicotine patches are available in a 16-hour and 24-hour preparations. Patches are administered each morning and produce blood concentrations of approximately half those of smoking. Compliance is high. The only major adverse effects are rashes and insomnia.

Certain non nicotinic medicines are also available like Bupropion (used 150-300 mg per day) and Varenicline (a nicotinic partial agonist, both relieves craving and withdrawal).

Apart from these, there is a great role of behavior therapy along with pharmacotherapy.

I advise you to start the treatment as soon as possible but only in close work up with a qualified psychiatrist.

Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion, rate the answer and leave a review. Wish you good health.

Regards
Dr. Gourav Monga
Consultant Psychiatrist


Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Answered by
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Dr. Gourav Monga

Psychiatrist

Practicing since :2006

Answered : 295 Questions

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Smoker. What Should I Do To Quit Smoking?

Hello XXXXXXX
Welcome to health care magic and thanks for your query.
I appreciate your concern to quit smoking.

First of all, let me tell you that smoking 20 cigarettes per day and that too for such a long time (about 17 years) is absolutely hazardous.

Nicotine dependence is the most prevalent, deadly, and costly of substance dependencies. 50 percent of smokers die of a smoking-related illness. Physical dependence on nicotine usually begins within a few years, so that periods of nonuse become uncomfortable.

Nicotine via cigarettes is rapidly absorbed directly into the arterial circulation and reaches the CNS in less than 15 seconds. If a dependent person does not take it, he gets withdrawl syndrome characterized by changes in mood, insomnia, difficulty concentrating, restlessness, decreased heart rate and weight gain.
Smoking is a huge risk for lung cancer and chronic obstructive pulmonary disease (COPD), accounting for more than 75 percent of all deaths from these disorders.

Smoking doubles the risk for cardiovascular disease deaths. Other common smoking-related diseases are cancers of throat, bladder, and pancreas (the tar in cigarette smoke is responsible for the cancers).

Since you have decided to quit, that’s a welcome step by you. Nicotine replacement therapies (like nicotine gum, nicotine patch, lozenges, inhaler etc) are effective, presumably because they reduce nicotine withdrawal. Replacement therapies use a short period of maintenance (6 to 12 weeks), often followed by a gradual reduction period (6 to 24 weeks).

Nicotine gum is a product that releases nicotine via chewing and buccal absorption. A 2-mg (for people who smoke less than 25 cigarettes per day) and a 4-mg gum variety (for people who smoke greater than or equal to 25 cigarettes per day) are available. Smokers are to use one to two pieces of gum per hour after abrupt cessation. Adverse effects are minor and include bad taste and sore jaws.

Nicotine patches are available in a 16-hour and 24-hour preparations. Patches are administered each morning and produce blood concentrations of approximately half those of smoking. Compliance is high. The only major adverse effects are rashes and insomnia.

Certain non nicotinic medicines are also available like Bupropion (used 150-300 mg per day) and Varenicline (a nicotinic partial agonist, both relieves craving and withdrawal).

Apart from these, there is a great role of behavior therapy along with pharmacotherapy.

I advise you to start the treatment as soon as possible but only in close work up with a qualified psychiatrist.

Hope I have answered your query. If you have any further questions I will be happy to help.
If you do not have any clarifications, you can close the discussion, rate the answer and leave a review. Wish you good health.

Regards
Dr. Gourav Monga
Consultant Psychiatrist