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Dr. Andrew Rynne

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Trying to quit smoking. Tried nicorette but got hiccups. Methods of quitting smoking?

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Dr. Ashish Mittal

Psychiatrist

Practicing since :2004

Answered : 1856 Questions

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Posted on Wed, 6 Feb 2013 in Mental Health
Question: Hello Doctor,

I am trying to quit smoking and I observe that there is an immense craving physically which I am not being able to handle. I smoke around 3 packs a day.

I tried nicorette but I got hiccups. I was also not sure whether to continue.

I have tried diversion tactics, cold XXXXXXX etc... I tried to quit by reducing the cigarettes but whenever I smoke there is no control over the limit. I have shown will power in all other spects of my life other than smoking.

Please help me by guiding on the methods of quitting or medications etc...

Regards,
XXXXXXX
doctor
Answered by Dr. Ashish Mittal 1 hour later
Hello,
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Cigarette contain nicotine. Nicotine addiction is one of most severe addiction. Every addiction in medical terms considered as chronic illness, means there is always risk of relapse. So, do not get de motivated or feel guilt due relapse (restart of smoking), and start again to quit as soon as possible after each relapse. But always remember in every quit attempt (smoke free period) body repair itself to some extent from the harm done by smoking.

It is good that you know harmful effect of smoking, as it affect every organ of body dangerously.

Cold XXXXXXX method is associated with severe discomfort for person and high failure rate, like in your case. So, many physician do not advise it. Similarly I would not prefer it in your case.

For de addiction following steps are followed:
-Consent of the patient: you himself seeking guidance from us
-Motivational interviewing: you are already motivated to quit smoking, but need to maintain this motivation
-Stoppage of smoking with prevention of discomfort or withdrawal: Nicotine replacement for short duration like use of nicorette.
-relapse prevention: by anti craving treatment with medicines like Bupron
-maintenance treatment.

First you reduce number of cigarettes smoked per day. You reduce it 1 cig every alternate day. Same time medicine like Bupron SR are given to reduce craving for smoking. We have many patients who stopped smoking with its help. But for that you need prescription from psychiatrist.

After 14 days of start of Bupron, fixed a quit date to stop smoking completely. Throw your all remaining cig and associated material like lighters on that day, otherwise they will create craving for smoking. Inform your friends and family member for quit date as it will increase your motivation.

After stopping smoking you may experienced some nicotine withdrawal like anxiety, headache, poor concentration, restlessness and increase appetite. For that you can use nicotine replacement in form of Nicorette gum according to your requirement given on pack for 1-2 month. You can also use mouth fresheners like Elaichi or Chewing gum during craving for smoking. After that you are free from smoking.

Always remember being smoke free, need high level of motivation. So maintain your motivation. I have simplified steps to quit smoking for you. It is better if you quit under some de addiction specialist (psychiatrist), as it is a specialized area and keep follow up to remain motivated. Avoid place, person and situations which create craving for smoking, as much as possible.

Many psychiatrist and psychologist provide relapse prevention sessions to prevent relapse, which is also helpful.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,
Dr Ashish XXXXXXX Mittal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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