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    Smoking? Butt out!

    Most smokers don’t quit smoking on a whim. Some planning is usually necessary for the project to be successful.
    Most smokers don’t quit smoking on a whim. Some planning is usually necessary for the project to be successful.

    WAIT UNTIL YOU’RE READY

    Whether they are aware of it or not, smokers go through several stages before they quit smoking for good. Some experts say there are five smoking cessation stages: precontemplation, contemplation, preparation, action and maintenance.

    1. In the precontemplation stage, smokers are not considering quitting and they even reject the idea that smoking may be detrimental to their health.
    2. Contemplation refers to the stage when smokers are thinking about quitting but do not yet know how to do it.
    3. Next is the preparation stage: smokers are getting ready to quit smoking and are looking into the various programs and treatments available.
    4. Smokers then take action: they smoke their last cigarette and initiate their withdrawal. This is the stage where they need the most help and support.
    5. The last stage is the maintenance stage. This is when ex-smokers are usually better able to foresee and manage the temptation to smoke, but they must remain vigilant in order to avoid a relapse.

    AN ACTION PLAN FOR SUCCESS

    Before you quit smoking, you must prepare an action plan to help you overcome the obstacles you will be facing. The idea is to identify the habits that are connected with tobacco consumption and to plan how to avoid them or react when faced with them. Examples of activities to avoid during the first few weeks of smoking cessation might include going out to pubs, social drinking and seeing friends with whom you used to smoke. Bear in mind that powerful urges to smoke, which occur more frequently during the first two or three weeks of withdrawal, are short-lived. If you make an effort to think of something else, they quickly pass.

    There are many support measures for people who wish to quit smoking, including support groups, personal therapy with a healthcare professional, acupuncture and even hypnosis. These measures can also be associated with a pharmacological treatment, which increases their efficacy. No studies have yet scientifically proven that acupuncture and hypnosis are effective, but this does not mean that these methods will not suit certain individuals who would like some help to quit smoking.

    There are many pharmacological options to support smoking cessation efforts. One approach is nicotine replacement therapies (NRTs), which come in the form of chewing gum, skin patches, lozenges and inhalers. Another approach involves two prescription drugs indicated for smoking cessation: bupropion and varenicline.

    Skin patches are long-acting drugs that allow us to maintain a relatively constant level of nicotine in the blood. This helps control withdrawal symptoms better. The dose selection is based on the number of cigarettes smoked per day and on the way they are smoked. Patches are available in three nicotine contents designed for the dose to be gradually reduced.

    Nicotine gum, lozenges and inhalers are short-acting products often used in combination with nicotine patches or bupropion to overcome any powerful urges to smoke that may arise. They can also be used on their own by establishing a regular intake schedule in the first few weeks. It is extremely important to use these products as recommended, since improper use is the leading cause of adverse effects reported for these products. The choice of product should be based on the individual’s smoking habits and personal preferences.

    Smokers can also choose to use bupropion or varenicline to help them quit smoking. With these two agents, smokers begin the pharmacological treatment one to two weeks prior to quitting. Bupropion may be combined with an NRT, but not varenicline. As with any other medication, these products are not suitable for everyone and may produce adverse effects.

    THE EFFECTS OF SMOKING CESSATION

    People may experience unpleasant effects when they quit smoking, but thankfully these effects are transitory. Gaining weight is one of these dreaded effects, as individuals who quit smoking put on an average of 2.5 kg, for a variety of reasons. Most ex-smokers manage to lose that extra weight, however, by avoiding replacing cigarettes with food and by becoming a bit more physically active. Why not walk for a few minutes to replace the usual “cigarette break”?

    In the first few weeks of smoking cessation, some people cough much more than they used to, which may seem paradoxical. The lungs are actually performing a big cleanup in order to get rid of the toxins with which they were previously clogged. The lack of nicotine may also make individuals more nervous or irritable; these transitory effects may be alleviated by the use of NRTs.

    On the other hand, the positive effects of quitting smoking quickly appear and will always be there. For example, in the first few days and weeks of smoking cessation, individuals notice improvements in their energy level, breathing quality and sense of smell and taste. Positive effects are also soon observed on heart health: after one year, the risk of heart disease is cut by half, and it becomes the same as that of a non-smoker after approximately 15 years of abstinence.

    TO SUCCEED OR NOT TO SUCCEED

    Four out of ten smokers successfully quit smoking on their first try if they are properly prepared and supported. Relapses usually occur in the first three months and commonly give rise to a strong sense of guilt, decreased self-esteem and loss of motivation. It is important, however, to consider a relapse as part of the smoking cessation process, rather than as a failure.

    The risk of relapsing decreases after three months of withdrawal. The maintenance phase continues for several years and the cigarette cravings decrease considerably as time passes. Ex-smokers must remain vigilant, however, especially during times of intense stress.

    Smoking cessation is therefore a process that involves preparation and willpower, but also support. When these three elements come together, most smokers manage to free themselves from tobacco. Don’t forget that pharmacists can offer much support during this process, through both their professional knowledge and their great availability. Don’t hesitate to consult your pharmacist if you need advice or even just some encouragement. The Quebec government’s www.jarrete.qc.ca/en website is also an excellent source of tips and advice.

    Do you want to quit smoking? Great idea! Take the time to get ready and you will have excellent odds of succeeding!

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