10/12/06 roll call [Archive] - BrainTalk Communities

teddiebears

10-12-2006, 11:48 AM

:D Here's another article with some interesting information -

Combining treatments may be key to quitting smoking

With more tools and aids to kick the nicotine habit than ever, smokers need to find the right one, or combination, to succeed.

By R.J. Ignelzi
COPLEY NEWS SERVICE

If there were a three strikes law for failed attempts to quit smoking, they would have put Paul Jeffers away years ago and thrown away the key.
As a smoker for more than 50 years -- who went through three packs a day during the last 20 years -- he struggled to give up the habit nearly a dozen times with no luck. Trying everything from hypnosis to the nicotine patch to stopping cold turkey, the cigarette's powerful lure always drew him back.

Jeffers isn't alone in this tough endeavor. While California's adult smoking rate has fallen to a historic low -- just 15.4 percent still smoke -- 70 percent of those want to quit.

Perseverance seems to have finally paid off for Jeffers, who had his last cigarette April 4. He thinks he finally has the nasty habit licked thanks to a combination of group counseling, the prescription medication bupropion (Zyban), and an occasional nicotine replacement lozenge.

"This is the first time I feel like I'm successful (at quitting). I think I'm over the worst of it," says Jeffers, a 66-year-old retired millwright worker from Escondido. "I've been wanting to quit for a long time, but now I think I've finally found what works for me."

And that's the key, say smoking cessation experts. Today's smokers have more tools and aids to help them stop the nicotine habit than ever before, but until they find the right one or combination that suits their personality and lifestyle, chances are they'll keep on puffing.

"There is no one approach that works for everybody. It's a very individual thing," says Dr. Rick LeMoine, a lung specialist at Sharp Medical Center in San Diego. "The trick is finding the right match for the individual, and sometimes that means going through a few (options) before you find the right one. If you try one and it didn't work, try another approach. And, if that doesn't work, try yet another."

The statistics aren't encouraging. Only 8 percent to 10 percent of those who try to quit smoking without any aids succeed. And it takes most smokers five to seven attempts at quitting before they're successful.

"There's a real lack of appreciation for how insidious this addiction is," says Gary Tedeschi, a licensed psychologist and clinical director of the California Smokers' Helpline, a telephone counseling service headquartered at the University of California, San Diego. "For a pack-a-day smoker, there's no other behavior that a smoker does as repetitively as put a cigarette to their mouth. It's a very entrenched behavior, and that makes it very difficult to stop."

Nicotine replacement aids can help, but only minimally. By using the nicotine patch, gum, lozenges, inhaler or nasal spray, the success rate climbs to an unimpressive 15 percent. Taking bupropion (known as Zyban or Wellbutrin), an anti-depressant drug approved by the Food and Drug Administration to help smokers quit, may increase the success rate to between 18 percent and 20 percent, according to some studies.

Add some kind of counseling and support to the mix, and you have the best chance of successfully kicking the habit.

The smoking cessation success rate can be as high as 35 percent to 40 percent when nicotine replacement aids or Zyban are used in combination with some kind of counseling, according to registered nurse Kay Kimball, manager of the cancer resource center at Palomar Medical Center in Escondido and director of its smoking cessation program.

"Smoking is both a physical and a psychological addiction. Unless you treat both, the chemical dependence and the addiction to the habit, there is no way you will be successful at quitting," LeMoine says.

The nicotine-replacement aids or prescription medications target the physical dependence. By delivering a measured dose of nicotine into the bloodstream minus the poisons and tar in smoke, nicotine-replacement products can help reduce the withdrawal symptoms and help curb cigarette cravings. Bupropion works by elevating two brain chemicals associated with nicotine craving.
Counseling, on the other hand, works with the behavioral addiction. Smoking cessation programs usually focus on helping smokers develop a quitting strategy that's right for them. Today, smokers have a choice of one-on-one professional counseling, group support programs, plus cessation help via phone, the Internet and by mail.

Most counseling programs educate smokers about the perils of tobacco, suggest relaxation and stress-management techniques and provide tips on overcoming the psychological triggers that cause people to light up.
"Nicotine is very addictive, but it's not just the nicotine that keeps smokers hooked -- it's the whole habit," Kimball says. "It's what you do with your hands, it's associating it with certain activities or places, it's using it to relax or wind down. It's all these things that you become addicted to."
The addiction to cigarettes has been compared to dependence on hard-core drugs such as heroine and cocaine, and some people contend that cigarettes are the most difficult drug of abuse to quit.

"Drugs like heroine or alcohol have strong social problems attached to them, and it's difficult to work, have successful relationships and perform socially (when using them)," says John Pierce, professor of cancer prevention at UCSD and a smoking cessation researcher. "But with smoking, you can still do everything. Smoking doesn't have the dire consequences of the other drugs, so you're not as motivated to quit."