Premise
Certainly, the path to take to quit smoking can be very long and involves a drastic change in the lifestyle of those who intend to say goodbye definitively to this dangerous vice.
To say enough to tobacco is possible but only when there is a great will power. The path can be difficult and tortuous, but the important thing is not to fall and continue to try, perhaps even asking for help from your friends and family or your doctor.
Before describing the tools that can be used to stop smoking, it is useful to understand what is smoking, what are its causes and what are the health risks associated with it.
What is smoking
Smoking (or addiction to tobacco smoke) is considered a real drug addiction and it is for this reason that many people are unable to quit smoking by simple willpower.
More in detail, the psychophysical dependence on tobacco smoke is caused by a particular substance contained in it: nicotine.
Nicotine is a stimulating alkaloid that acts on certain receptors (called nicotinic receptors) in the brain, thus inducing a sense of gratification and pleasure in smokers that leads them to smoke again and again.
Moreover, since nicotine creates an addiction, its failure to take it causes the classic withdrawal syndrome to be unleashed, characterized by symptoms such as anxiety, irritability, anger, frustration, drowsiness, sleep disorders, mood disorders, depression, decreased concentration and memory and increased appetite. The smoker, therefore, is inclined to continue smoking also to avoid the onset of these symptoms which may appear as early as a few hours after the last cigarette smoked.
Smoking is a serious health problem for both smokers and non-smokers who often find themselves breathing passive smoking unintentionally.
The data concerning the damages caused by tobacco smoke in Italy are definitely alarming. In fact, it has been estimated that in our country about 80, 000 people die per year from diseases directly related to tobacco smoking:
- 48% die due to oncological diseases (including lung cancer, mouth cancer, laryngeal cancer, esophageal cancer, etc.);
- 25% die due to cardiovascular diseases (including coronary heart disease);
- 17% die due to respiratory diseases (including chronic obstructive pulmonary disease, or COPD);
- 10% die due to other diseases related to tobacco smoke.
Furthermore, numerous studies have estimated that a smoker has an average life expectancy of less than ten years compared to a non-smoker.
Add to this the lower quality of life of smokers compared to non-smokers. Smokers, in fact, are at greater risk of developing non-neoplastic respiratory diseases (such as, for example, bronchitis, asthma, cough) and heart disease that can interfere with normal daily activities. Not to mention the damage that tobacco smoke can cause at the level of the gastrointestinal system (it can favor the onset of peptic ulcer), at the level of the reproductive system (it can cause impotence and decrease fertility in both men and women ) and at the level of skin, teeth and gums.
However, although the relationship between tobacco smoking and all these diseases is now clear, smoking remains one of the main causes of avoidable death in Italy.
Smoking cessation tools
Currently, there are several tools that can help all those smokers who have decided to definitively say that they smoke enough.
These tools will be briefly illustrated below.
Willpower
Willpower is the main tool that must be possessed in order to be able to give up tobacco smoke definitively.
Some people can quit smoking only with their own willpower, while others may need help.
At a time when willpower is not enough, then other avenues can be assessed, such as drug therapy and / or psychological support. Notwithstanding that if there is no real desire to quit smoking, even drugs may not be useful.
Pharmacological therapy
There are several types of drug therapies that can be implemented to help patients stop smoking. Among these, we recall:
- Nicotinic replacement therapy (or NRT: Nicotine Replacement Therapy); this therapy involves the administration of increasingly lower nicotine doses, in an attempt to remove the organism gradually and not abruptly. Generally, nicotine is dispensed in the form of chewable tablets, sublingual tablets, chewing gum and transdermal patches.
- Bupropion therapy ; this drug belongs to the class of tricyclic antidepressants, but has also been shown to be effective in reducing the desire for nicotine and the symptoms induced by its withdrawal.
- Varenicline therapy ; this drug binds to the α4β2 nicotinic receptors present in the brain (the same to which the nicotine binds) thus exerting a nicotine-like action. In this way, varenicline decreases the symptoms induced by abstinence from smoking and reduces the pleasure and gratification resulting from nicotine intake.
- Nortriptyline therapy ; nortriptyline is an antidepressant drug that has proven very useful in smoking cessation therapy. Indeed, nortriptyline decreases the desire to smoke and reduces secondary symptoms resulting from nicotine withdrawal syndrome.
- Topiramate therapy ; this drug has anticonvulsant activity and is used for the treatment of epilepsy and in the prophylaxis of migraine. However, it seems that it can also be a valid aid in smoking cessation therapy, but it is not a first choice drug.
- Cytisine therapy . Cytisine is a molecule of natural origin that has a mechanism of action very similar to that of varenicline, in fact, it also binds to α4β2 nicotinic receptors by exerting a nicotine-like activity. Cytisine, however, causes fewer side effects than varenicline and has a significantly lower cost.
Anti-smoking centers and psychological support
In Italy there are numerous anti-smoking centers that can provide support to all those who decide to quit smoking, but whose will power is not enough.
In the anti-smoking centers individual counseling services and group therapies are offered and pharmacological therapies can be prescribed to help the smoker on his cessation path.
A very important role is provided by psychological support. Indeed, some studies have shown that a drug therapy - accompanied by adequate psychological and behavioral support - is more likely to succeed.
Electronic cigarettes
Electronic cigarettes are an alternative method - which should be safer than tobacco smoke - to take nicotine. In fact, there are still very conflicting opinions regarding the efficacy and safety of use of these devices and the studies conducted so far are not able to provide reliable data about it.
Natural supplements
The path to smoking cessation can be very difficult, especially when symptoms of nicotine withdrawal syndrome arise. In this regard, some natural remedies can help. Among these, we recall:
- Preparations based on adaptogenic plants . Adaptogenic plants are plants containing active ingredients that allow to increase the resistance of the organism in a non-specific way, in response to external stresses of different nature. Therefore, these plants can also be useful in counteracting the stress resulting from abstinence from smoking. Among the most known adaptogenic plants, we recall ginseng, eleuterococcus and rhodiola.
- Preparations based on plants useful against depression and plants with sedative action, such as hypericum (or St. John's wort), valerian and kava-kava. Nicotine withdrawal syndrome is characterized by the onset of states of anxiety, irritability and depression, therefore, the use of preparations based on the aforementioned plants could be useful if these symptoms arise.
- Melatonin . Melatonin is a hormone that is produced by our body and is involved in regulating the sleep cycle and regulating the circadian rhythm. Melatonin has a sedative effect and can be an excellent help in counteracting symptoms of nicotine withdrawal such as irritability, agitation and anxiety.
Smoking cessation tips
When deciding to take a path to quit smoking, it can be very helpful to follow these tips:
- Establish a specific date to quit smoking;
- Eliminate from the environment where you live all that concerns smoking or who can remember it, such as lighters, ashtrays and, above all, cigarette packages;
- Avoid, as far as possible, stressful situations and situations that may lead to smoking;
- Avoid smokers if possible, especially when they are smoking;
- Increase motor activity and adopt a healthy diet;
- When the desire to smoke becomes urgent, try to distract yourself as much as possible, perhaps by drinking a glass of water or starting an activity that you like or can gratify. The compelling desire to smoke a cigarette, in fact, lasts only a few minutes and then decreases, therefore, it can be very little enough to let the crisis pass without succumbing to the temptation to start over.
