Definition
The term "smoking" refers to a toxic addiction to tobacco smoke syndrome: we are talking about one of the most heartfelt modern health problems, which involves a good portion of the world population. It is common knowledge that smoking, or addiction to smoking, if you prefer, is a habit that is not very intelligent and very harmful to health; however, despite this assumption, it seems that abstention from this defect is not among the good intentions of the smokers.
Causes
We cannot speak of a real cause that causes the subject to smoke; it often starts as a game, as a challenge, to imitate "the greatest". The most important problem is that "the beginning of the game" soon turns into a dependency in all respects, which often cannot be controlled (a real drug addiction). In fact, tobacco smoke contains a known alkaloid, nicotine, which is responsible for addiction, which must be understood both in chemical and psychological terms.
Symptoms
Smokers do not realize the consequences they can have on smoking (or when they understand it they can no longer stop smoking); in addition to addiction, smoking has a surprising impact on health:
- favors diseases affecting the respiratory system (eg COPD, cough)
- increases the risk of kidney cancer, lung cancer, stomach cancer, pancreas cancer, bladder cancer
- it is a risk factor for cardiovascular diseases
- promotes weight gain
- increases the risk of anxiety and depression
- seems to reduce life expectancy
Information on smoking and smoking cessation drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Tabagismo - Drugs to Stop Smoking.
drugs
It is understandable how abstention from smoking is the smartest thing to do to safeguard the health of oneself and of others: in fact, let's not forget that passive smoking - involuntarily and inevitably breathed by non-smokers in contact with people who they smoke - it is very dangerous, given that it favors the development of multiple diseases, including cancer and even death.
Drugs for smoking cessation can exercise their therapeutic activity only if the person is convinced of it: it is in fact useless to take drugs if there is no intention to actually do so. Before following a therapeutic procedure to abandon the habit, it is also advisable to turn to assistance centers for behavioral treatment: not surprisingly, it seems that for an inveterate smoker, stopping smoking is a difficult challenge to overcome, for some an insurmountable obstacle.
Nicotine triggers a series of extraordinary mechanisms: this stimulating alkaloid determines an extremely gratifying effect, acting at the level of the dopamine neurotransmitter; according to this, we understand how stopping smoking is difficult precisely because a withdrawal syndrome is established, characterized by anxiety, depression, mnemonic difficulties and worsening mood.
When willpower is not enough to stop smoking, it is possible to take advantage of the help of specific drugs: in general, drugs with a very low dose of nicotine are introduced, which is useful to avoid triggering the withdrawal syndrome.
Let us once again remember that the smoking habit is also a form of drug addiction.
Nicotine and nicotine substitutes : nicotine -based drug therapy ( nicotine replacement ) consists of the administration of this alkaloid in the form of chewable gums or transdermal patches that release nicotine. The drugs belonging to this category are prescribed when the patient is strongly convinced to abandon the habit, but good intentions and willpower are not enough. Before starting therapy it is essential to refrain from smoking as much as possible.
- Nicotine sublingual tablets (to be kept in the mouth until completely dissolved, about 20-30 minutes): indicated for patients who smoke more than 20 cigarettes a day and strongly intend to quit. Indicatively, take 2mg / hour of medication. Increase the dose to 4 mg / hour in case of marked secondary symptoms. Generally, in the initial treatment (lasting 6 weeks) it is recommended to take 9 tablets a day; for the next three weeks, take 2-4 mg tablets every 2-4 hours. From the tenth week, it is recommended to reduce the dosage to one tablet every 4-8 hours. In general, the duration of the entire therapy is 3 months (12 weeks).
- Nicotine chewable tablets (eg Niquitin Mini, Nicorette): take a 4 mg gum every 1-2 hours for 6 weeks. In the following three weeks, it is recommended to take a 2-4 mg gum every 2-4 hours. Continue from week 10 with a 4 mg gum every 4-8 hours. Do not take more than 24 tires per day. It is recommended to chew the gum slowly, up to 30 minutes. Do not continue therapy for more than 6 months.
- Nicotine-based smoking cessation patches (eg Nicopatch): generally, apply one patch a day, on dry, cleansed skin; the patch should be applied on the arm, or on an upper part of the body, always trying to position it at a different point, to avoid local irritation.
- Bupropion hydrochloride (eg. Elontril, Wellbutrin, Zyban): start the treatment by taking 150 mg of active oral, once a day. Maintenance dose: the dosage may increase up to 300 mg per day (given in two divided doses during the day), but not before three days from the start of therapy. The drug is not indicated for patients with a history of epilepsy and eating disorders.
Other smoking cessation drugs:
- Varenicline (eg Chapmix, 25-28-56 tablets): it is a partial agonist of nicotinic receptors, able to bind to nicotine receptors (nicotinic acetylcholine receptors α4β2), imitating its action and alleviating symptoms of compulsive smoking. To quit smoking, it is recommended to take 0.5 mg of active per os once a day in the first three days of treatment. From the 4th to the 7th day of therapy, increase the dose to 0.5 mg of active twice daily. From the eighth day on, take 1 mg of active twice a day.
- Topiramate (eg Topamax, Sincronil): anticonvulsant drug inhibitor of carbonic anhydrase, also used in therapy for weight loss. It is a second-choice smoking cessation drug.
- Nortriptyline (eg Dominans, Noritren): tricyclic antidepressant drug, used in therapy to stop smoking and to counteract the secondary symptoms that derive from smoking (depression). The dosage must be established by the doctor based on the severity of the secondary symptoms related to smoking.
- Clonidine (eg Catapresan, Isoglaucon): the drug is an agonist of imidazoline receptors, a first-line antiadrenergic agent used to treat hypertension in pregnancy. It is also sometimes indicated for smoking cessation. Indicatively, administer the drug orally at a dose of 0.1 mg, twice a day; alternatively, to stop smoking, apply a clonidine-based patch once a week. Consult your doctor for more information.
