Smoking cessation

Smoking cessation (quitting smoking or stopping smoking) is a process of discontinuing tobacco smoking. Tobacco smoke contains the addictive substance nicotine, which often causes Substance dependence dependence. Nicotine withdrawal typically makes the process of quitting difficult. The commonly prescribed medications varenicline, nortriptyline, and/or bupropion help some individuals with smoking cessation. Electronic cigarette Vaping is likely to be far less harmful than tobacco smoking, but is harmful to health. Vaping might help many individuals to quit smoking, but vaping cessation could be quite difficult. Quotes This variant plays essentially no role in whether an individual initiates smoking or not, which is strongly driven by environmental factors. However, if a person with the high-risk allele does begin smoking, they will smoke a higher number of cigarettes per day, have a higher intensity of smoking, and have a higher age of smoking cessation than those with the low-risk variant, increasing their risk for lung cancer. The problem with smoking cessation pharmacotherapy using nicotine replacement therapy is that it works modestly, at best, and the vast majority of smoking cessation is done without any medication. However, data suggest that people with the high-risk variant rs16969968 have the greatest difficulty quitting and stand to benefit the most from medication, although the evidence is still controversial. This makes sense since this variant affects Nicotinic acetylcholine receptor nicotine receptor function. Improved implementation of pharmacotherapy, using patients’ genetics as a guide, could have a huge public health impact. Laura Jean Bierut, Q & A with Dr Laura Bierut June 1, 2016 IASLC Lung Cancer News, published by International Association for the Study of Lung Cancer (IASLC) https://www.ilcn.org/q-a-with-dr-laura-bierut/ (in answer to the question "Does the rs16969968 variant have any implications for smoking prevention or cessation strategies?") Smoking increases mortality from all causes and has a crucial role in Atherosclerosis atherosclerotic cardiovascular disease (ASCVD). Active smoking and Passive smoking secondhand smoke exposure determine more than 30% of Coronary heart disease coronary heart disease (CHD) mortality. The exact mechanisms of cardiovascular damages are not well known, but the detrimental effect of smoking on endothelial function has long been recognized. Smoking elicits oxidative processes, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function; all these proatherogenic effects double the 10-year risk of fatal events in smokers compared to non smokers. An intriguing issue about smoking is the vulnerability of female gender. The mortality from cardiovascular diseases (CVDs) is higher in female than male smokers and female smokers show a 25% higher risk of developing CHD than men with the same exposure to tobacco smoke. This female vulnerability seems to be related to genes involved in thrombin signaling. The effects of smoking cessation have also been extensively studied. Cessation at an early age (40 years) has an impressive 90% reduction in the excess risk of death. Giuseppina Gallucci, Alfredo Tartarone, Rosa Lerose, Anna Vittoria Lalinga, and Alba Maria Capobianco, Cardiovascular risk of smoking and benefits of smoking cessation Journal of Thoracic Disease 12 7 2020 3866–3876 https://pmc.ncbi.nlm.nih.gov/articles/PMC7399440/ 7399440 10.21037/jtd.2020.02.47 There is high‐certainty evidence that bupropion can aid long‐term smoking cessation. However, bupropion also increases the number of adverse events, including psychiatric adverse effect AEs, and there is high‐certainty evidence that people taking bupropion are more likely to discontinue treatment compared with placebo. However, there is no clear evidence to suggest whether people taking bupropion experience more or fewer Serious adverse event SAEs than those taking placebo (moderate certainty). Nortriptyline also appears to have a beneficial effect on smoking quit rates relative to placebo. Evidence suggests that bupropion may be as successful as Nicotine replacement therapy NRT and nortriptyline in helping people to quit smoking, but that it is less effective than varenicline. There is insufficient evidence to determine whether the other antidepressants tested, such as Selective serotonin reuptake inhibitor SSRIs, aid smoking cessation, and when looking at safety and tolerance outcomes, in most cases, paucity of data made it difficult to draw conclusions. Seth Howes, Jamie Hartmann-Boyce, Jonathan Livingstone-Banks, Bosun Hong, and Nicola Lindson, Antidepressants for smoking cessation Cochrane Database of Systematic Reviews 4 2020 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000031.pub5/full 10.1002/14651858.CD000031 Cigarette smoking is the primary cause of chronic obstructive pulmonary disease, and smoking cessation is the most effective means of stopping the progression of chronic obstructive pulmonary disease. Worldwide, approximately a billion people smoke cigarettes and 80% reside in low-income and middle-income countries. Though in the United States there has been a substantial decline in cigarette smoking since 1964, when the Surgeon General's report first reviewed smoking, smoking remains widespread in the United States today (about 23% of the population in 2001). Nicotine is addictive, but there are now effective drugs and behavioral interventions to assist people to overcome the addiction. Available evidence shows that smoking cessation can be helped with counseling, nicotine replacement, and bupropion. Less-studied interventions, including hypnosis, acupuncture, aversive therapy, exercise, lobeline, anxiolytics, mecamylamine, opioid agonists, and silver acetate, have assisted some people in smoking cessation, but none of those interventions has strong research evidence of efficacy. To promote smoking cessation, physicians should discuss with their smoking patients “relevance, risk, rewards, roadblocks, and repetition,” and with patients who are willing to attempt to quit, physicians should use the 5-step system of “ask, advise, assess, assist, and arrange.” Scott P. Marlow and James K. Stoller, Smoking cessation Respiratory Care 48 12 2003 1238–1256 https://rc.rcjournal.com/content/48/12/1238.short If I mention Free base freebasing, I am sure most people in this room understandably think of cocaine — but freebasing was invented by the tobacco industry. You add ammonia and formaldehyde to the tobacco leaf mixture — the smoke that's produced is more basic, more alkaline. And, as a consequence, nicotine is delivered across the {[w|Pulmonary alveolus|alveolar membrane}} even more rapidly than would otherwise be the case. And we know that the rapidity — with which a drug is delivered and sating a need for a drug — is an important determinant of its propensity to induce and maintain addiction, et cetera, et cetera, et cetera. And we could take the entire hour talking about the elements of cigarette design. … It is important that we understand that we have the most addictive substance in our community — whose use is facilitated by a perversely engineered drug delivery device. Andrew Pipe, Dr. Andrew Pipe: The Zombies of Smoking Cessation CAMH Professionals Video, YouTube July 25, 2014 https://www.youtube.com/watch?v=8nUDS9g46Uc&t=254 (quote at 4:14 of 45:59) Allen Carr’s (AC) method is a pharmacotherapy-free approach to quit smoking that is delivered through seminars, online courses, or in the form of a book. It has gained popularity, but its effectiveness remains controversial due to a lack of scientific evidence. Irene Possenti, Marco Scala, Alessandra Lugo, Luke Clancy, Sheila Keogan, and Silvano Gallus, Tobacco Prevention & Cessation September 2023 9 29 10.18332/tpc/172314 The effectiveness of Allen Carr's method for smoking cessation: A systematic review 10540232 37780488 https://pmc.ncbi.nlm.nih.gov/articles/PMC10540232/ See also Addiction Chewing tobacco Tobacco industry External links Smoking Cessation - 3 steps to quitting American Cancer Society, YouTube July 11, 2023 https://www.youtube.com/watch?v=qdhwmZml-Hk Category:Health Category:Health care Category:Pharmacology Category:Psychology