Make 2020 the year you stop smoking!

Smoking cessation

All body parts need oxygen to survive. Without oxygen, cells die and by extension, the body dies.  The lungs are a crucial organ that ensures the proper exchange of oxygen into the body to nourish cells and the removal of the waste product carbon dioxide.  Damage to, or the introduction of harmful substances into the lungs, can impair this gas exchange and have detrimental effects on the body.  

Cigarettes contain tobacco. Tobacco contains nicotine and other harmful chemicals that are damaging to lung function and overall health.

Nicotine

Nicotine is a dangerous and highly addictive substance.  Addiction to a drug/substance means that there is a psychological and physical inability to stop using this substance even though it is causing bodily harm.  Nicotine can cause an increase in blood pressure and heart rate.  It affects the flow of blood to the heart causing narrowing of the blood vessels which can lead to heart disease, stroke, heart attack, other chronic diseases, and early death.  Smoking also increases the risk of cancer of the throat, mouth, kidneys, bladder, cervix, and pancreas. 

With knowledge of such serious effects, some persons desire to quit, however, due to the addictive nature of nicotine, it is very difficult to even stop smoking. Also, when attempting to quit, the withdrawal effects can be overwhelming.

Symptoms associated with Nicotine withdrawal

  • Urge to smoke Depressed mood. 
  • Trouble sleeping
  • Irritability Frustration Anger
  • Feeling anxious
  • Difficulty concentrating Restlessness
  • Decreased heart rate
  • Increased appetite Weight gain
  • Suicidal thoughts

Approaches to smoking cessation.

Behavioral Modifications

  • One must want to quit and set a date to do so
  • Be aware of your triggers (i.e. what propels you to smoke)
  • Change habits

Pharmacotherapy

Some persons can just quit “cold turkey”, that is, abruptly stop smoking even enduring any unpleasant side effects. They don’t need any other assistance.  Other persons, on the other hand, need a more gradual reduction process and drug therapy.  Nicorette and Chantix are two such drugs that have been approved for assisting smoking cessation.  

Nicorette (nicotine)

Nicorette is classified as a nicotine replacement treatment.  When used as prescribed, Nicorette may control cravings and lessen withdrawal symptoms by introducing a therapeutic dose of nicotine, then gradually stepping down the dose, until you don’t feel the urge for nicotine at all.

Nicorette presents in three dosage forms, 

In consultation with your doctor, you can select the best dosage form for your needs. 

All dosage forms are available in two strengths:  2mg and 4mg. They are used as part of a 12-week program, best supported by a behavioral support program.

12-week program at a glance.

  • Choose the day you wish to quit smoking and begin treatment on that day
  • It is recommended that someone smoking in excess of 25 cigarettes per day, should use a higher strength.  
  • No food or drink must be taken 15 minutes before or during the introduction of a dose to ensure maximum drug enters the system.
  • Chew one lozenge or dissolve one lozenge in the mouth every 1 – 2 hours up to a max of 9 pieces per day for the first 6 weeks. 
  • Week 7 – 9, use 1 gum or lozenge every 2 – 4 hours
  • Week 10 – 12, use 1 gum or lozenge every 4 – 8 hours.

Possible Side Effects of Nicorette. 

  • Increased blood pressure
  • Tachycardia Dizziness
  • Insomnia Irritability   
  • Anorexia
  • Dyspepsia Hiccups
  • Increased salivation
  • Indigestion Nausea Vomiting
  • Cough May loosen inlays/fillings                          
  • Sticks to dentures
  • Damage and irritation to oral mucosa & teeth

Chantix (varenicline)

Unlike Nicorette, Chantix is a nicotine-free pill, which decreases the urge to stop smoking even while you still may be smoking.  It gives you the flexibility to stop smoking when you think you can.  Like Nicorette, it is best used as a part of a behavioral support program.

Chantix Starter has instructions on how to start this product and gradually increases the dose of varenicline to the level required to help you stop smoking. 

Chantix dosage forms

Chantix presents as a 0.5mg and 1mg pill.

Dosing schedule for the Chantix Starter package

Days 1 – 3 0.5mg daily

Days 4 – 7 0.5mg twice daily

Days 8 – end of treatment 1mg twice daily 

For patients who have been successful at quitting after 12 weeks, continue to take 1mg twice daily for another 12 weeks.

How to use Chantix at a glance 

Chantix provides three flexible methods for quitting. In conjunction with your physician, you can decide the best plan for you. 

  1. If you wish to quit within a week:
  • Start taking Chantix and continue smoking for that 1 week while you prepare to quit. 
  • Quit smoking after that week, then continue Chantix for 11 more weeks. 
  1. If you wish to quit within a month:
  • Start taking Chantix, then choose a day to quit within 30 days from the date you started Chantix. 
  • You can continue to smoke until your quit date.
  • Continue taking Chantix for 11 more weeks.
  1. If you wish to quit within 12 weeks
  • This method is for those who aren’t sure they are ready to or can quit right away
  • Start taking Chantix, gradually reducing smoking to quit within 12 weeks.
  • Reduce smoking in half in first 4 weeks of treatment, in half again during the next 4 weeks, reducing in half again in the last 4 weeks.
  • This treatment plan is for 24 weeks.

Possible Side Effects of Chantix

Seizures Sleep problems Heart/blood vessel problems

Nausea Constipation Gas and/or vomiting

Can Chantix and Nicorette be used together?

While some clinical studies conducted have shown benefit in this combination therapy, further studies need to be conducted to determine the safety and efficacy of this evidence conclusively.  Using these 2 drugs together can cause an increase in side effects. If you are planning to use the two medications together, speak to your physician, pharmacist, or health care provider about the risks and benefits.

Disclaimer: This article is sponsored by Canada OnlineHealth and is for medical information purposes only and is not designed to approve the use of these drugs in your treatment in smoking cessation or guarantee that it will work for you. Always remember to consult your medical doctor to determine if any of these treatment plans are recommended for your unique situation.  

Useful links:
www.chantix.com
www.nicorette.com

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