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Anyone who has tried to quit smoking will tell you how difficult it is. There’s always the temptation to share a cigarette with a friend over a beer or run away from work for a quick ‘smoko’, as they say in Australia.
Research studies indicate that 60-75% of people relapse in the first six months after they attempt to quit smoking.
As with other forms of addiction, quitting smoking is a difficult psychological battle. Social events, depression, or simple daily habits can all make you crave one.
But the health benefits of long-term abstinence are enormous.
Risks of stroke, coronary heart disease and cancers And general health improves dramatically within weeks or months after quitting smoking.
Smoking is one of the biggest causes of death, with around 14% of deaths worldwide being attributed to smoking-related diseases, according to WHO data in 2019. Many of these deaths are attributed to higher rates of smoking in low- and middle-income countries. More recent studies show that this trend is continuing.
Smoking is an enormous global health burden. said Hazel Cheeseman, deputy chief executive of Action on Smoking and Health (ASH), a UK-based public health charity.
Why are cigarettes addictive?
when you smoke a cigarette Burning tobacco It releases nicotine that enters the blood through the lungs.
Nicotine is pumped into the brain, where it activates receptors on the surface of nerve cells called nicotinic acetylcholine receptors.
Activation of these receptors triggers the release of brain chemicals – neurotransmitters – such as dopamine.
Dopamine release does not necessarily cause addiction. But when it works in a specific part of the brain — where our so-called reward system resides — it can be addictive. This part of the brain is called the medial cortical circuit.
And this is how addiction works: When nicotine stimulates the release of dopamine in the reward system, it triggers a feeling of reward, like a little rush. Every cigarette you smoke reinforces this feeling, causing you to crave and eventually become addicted to cigarettes.
So, when we want to quit smoking, we have to cut that link between cigarettes and the feeling of reward. It’s tough and rough and you’ll need all the help you can get to make it work in the long run. But it is possible.
Interventions for smoking cessation
There are two main ways to break the psychological attachment to cigarettes: willpower and self-discipline.
You can also use the remedies to satisfy nicotine cravings, but without the health problems associated with active smoking.
For treatments there are three types. First, there are nicotine replacement therapies, such as patches, gum, or inhalers (also known as inhalers) that slowly release nicotine and stop the urge to smoke. Nicotine itself is not harmful, but the smoke you inhale from cigarettes is.
Then there are medications, such as varenicline and bupropion.
Varenicline enhances dopamine release in the reward pathway, mimicking the reward of smoking and reducing withdrawal symptoms from smoking cessation.
Bupropion works in a similar way but via a different neurotransmitter system known as GABA, which is the main neurotransmitter that suppresses brain activity.
“Although the drugs are a more expensive treatment, they are significantly more cost-effective when you look at the impact of smoking on health and health systems,” Cheeseman said.
Electronic cigarettes – good or bad?
E-cigarettes have a strange reputation when it comes to quitting smoking. Are they even safe?
“There is good evidence that e-cigarettes can help you quit smoking. But they are an unlicensed medical product, so they are not given as medicine,” Cheesman said.
She said e-cigarettes are safe in the short to medium term, or at least less harmful than traditional cigarettes. But, she added, “It’s unlikely (vaping) The products are risk free in the long run. “
Another concern is that e-cigarettes may create a new addiction or act as a gateway to smoking tobacco. It’s particularly worrisome in young people, as some evidence suggests that teens who vape are more likely to smoke tobacco in the future.
Try everything to quit smoking at once
What is the best way to help you quit smoking?
The scientific consensus says that using multiple methods at the same time is your best bet.
A 2020 meta-analysis of more than 700 clinical studies found that a combination of several methods has the best results for helping people achieve sustained abstinence from cigarettes.
While all of the individual treatments were more effective than a placebo—essentially, they do nothing—it’s when you combine them together that you really start to see results.
“The most effective way to quit smoking is with behavioral support that helps you develop strategies to deal with the psychological side of cravings,[along with]medication that helps deal with the physical side effects of quitting,” Cheesman said.
Everyone’s path to smoking cessation is different – some can quit smoking on a whim, others require years of free therapies. It may take some time to find the best method. The question is: how much do you want to quit smoking?
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