June 13, 2019

Medically Assisted Treatment for Smoking

Tobacco threatens all living species including humans, animals, plants and our entire environment. Smoking is the world’s leading preventable cause of death. More than 1.1 billion people smoke worldwide, according to the World Health Organization. And more are continually joining the ranks. Every day in the U.S. alone, more than 3,200 youth 18 and younger smoke their first cigarette, while another 2,100 youth and young adults move from smoking occasionally to having a daily habit. Cigarette smoking kills approximately 500,000 Americans each year and smoking-related illnesses cost more than $300 billion each year. It is known to cause lung cancer, mouth and oral cancer, colon cancer, asthma, chronic obstructive pulmonary disease (COPD), premature aging and other chronic illnesses in humans and studies have shown that tobacco use has a strong correlation with mental health disorders. Many tobacco users claim that quitting nicotine is harder than quitting heroin and a result nicotine addiction can last a lifetime, regardless of the consequences. Every drug of abuse, including nicotine, releases dopamine, which makes it pleasurable to use and when you stop smoking, you have a deficiency of dopamine release, which causes a state of dysphoria: you feel anxious or depressed. Medically assisted treatment for smoking involves providing nicotine users with medications to ease the withdrawal side effects. Medically assisted treatment is widely available for opioid abuse and alcohol abuse and nicotine addiction should be no different.

FDA-approved pharmacotherapies include various forms of nicotine replacement therapy as well as bupropion and varenicline. Research indicates that smokers who receive a combination of behavioral treatment and cessation medications quit at higher rates than those who receive a minimal intervention. Medication assisted therapy for nicotine use is successful and even more successful when used in combination with psychotherapy approached.

Nicotine replacement therapy

Nicotine replacement therapy (NRT) is the most commonly used class of smoking cessation medications and works by administering a small amount of nicotine into the body as a way to prevent cravings and withdrawal without the harmful chemicals that are found in cigarettes. NRT comes in a variety of forms that are used in different ways; from lozenges, patches, and gum to inhalers and nasal sprays, nicotine replacement therapy is over the counter or by prescription, depending on the specific form. Some smokers may have mild to moderate side effects when using NRT but the research has determined that NRT is safe and effective and is generally used in a step-down fashion, meaning that individuals will decrease their dosage of NRT after a certain amount of time until they are completely weaned off nicotine.

Buproprion

Buproprion is a prescription medication that was primarily used for depression but is also used to help individuals quit smoking. Buproprion, formally known as Wellbutrin or Zyban, does not contain any nicotine and it helps ease cravings and withdrawals. It can be combined with nicotine replacement therapy and is usually continued for the duration of 7-12 weeks.

Varenicline

Varenicline, is another medically assisted treatment for smoking more commonly known as Chantix, is a non-nicotine prescription medication that helps by easing the withdrawal symptoms and blocking the effects of nicotine from cigarettes if the user begins smoking again. Chantix works by primarily activating the same receptors in the brain that are affected by nicotine so the individual will experience mild-like nicotine effects without having the nicotine withdrawals. Secondly, Chantix has the ability to stop nicotine from attaching to the nicotine receptors if the individual does smoke while taking Chantix.

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