Definition
The term "smoking" refers to a toxic syndrome of addiction to tobacco smoke: we are talking about one of the most felt modern health problems, which involves a good portion of the world population. Everyone knows that tobacco addiction, or addiction to smoking if you prefer, is an "unintelligent habit and very harmful to health; however, despite this assumption, it seems that abstention from this vice is not one of the good intentions of heavy smokers.
Causes
We cannot speak of a real cause that induces the subject to smoke; we often start 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 full-fledged addiction, which often cannot be controlled (a real drug addiction). Tobacco smoke, in fact, contains a well-known alkaloid, nicotine, responsible for addiction, which must be understood both in chemical and psychological terms.
Symptoms
Smokers do not realize the consequences that can follow from smoking (or when they understand it they can no longer quit 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, pancreatic cancer, bladder cancer
- it is a risk factor for cardiovascular disease
- promotes weight gain
- increases the risk of anxiety and depression
- seems to reduce life expectancy
The information on Smoking - Quit Smoking Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Smoking - Drugs to Quit Smoking.
Medicines
It is understandable how abstention from smoking is the smartest thing to do to safeguard the health of oneself and of others: it should not be forgotten, in fact, that passive smoking - involuntarily and inevitably breathed by non-smokers in contact with people who smoke - it is very dangerous, as it promotes the development of many diseases, including cancer and even death.
Drugs to stop smoking can only exercise their therapeutic activity if the subject is convinced of it: it is in fact useless to take drugs if there is no intention to really do it. Before following a therapeutic process to give up the habit, it is also advisable to to turn to assistance centers for behavioral treatment: not surprisingly, it seems that quitting smoking, for a heavy smoker, 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 neurotransmitter dopamine; according to this, it is understood that quitting smoking is difficult precisely because a withdrawal syndrome is established, characterized by anxiety, depression, memory difficulties and worsening of mood.
When the willpower is not sufficient to quit smoking, it is possible to make use of the help of specific drugs: in general, drugs with a very low dose of nicotine are introduced, useful for avoiding the triggering of the withdrawal syndrome.
Let us remember once again that the habit of smoking is also a form of drug addiction.
The following are the classes of drugs most used in smoking cessation therapy, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Nicotine and nicotine substitutes: nicotine-based drug therapy (nicotine replacement) consists in the administration of this alkaloid in the form of chewable gums or transdermal patches that release nicotine. Drugs belonging to this category are prescribed when the patient is strongly convinced that he is giving up the habit, but good intentions and willpower are not enough. Before starting therapy it is essential to abstain 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. As a guideline, take 2mg / hour of the drug. 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. Generally, the duration of the entire therapy is 3 months (12 weeks).
- Nicotine chewable tablets (eg Niquitin Mini, Nicorette): take 4 mg gum every 1-2 hours for 6 weeks. Over the next three weeks, it is recommended to take a 2-4 mg gum every 2-4 hours. Continue from the tenth week with a 4 mg gum every 4-8 hours. Do not take more than 24 gums 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 patches for quitting smoking (eg Nicopatch): generally, apply one patch a day, on dry, cleansed skin; the patch should be applied to the arm, or to an upper part of the body, always trying to place it in a different place, to avoid local irritation.
- Bupropion hydrochloride (eg Elontril, Wellbutrin, Zyban): start the treatment by taking 150 mg of active orally, 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 earlier than three days after the start of therapy. The drug is not indicated for patients with a previous history of epilepsy and eating disorders.
Other smoking cessation medications:
- Varenicline (eg Chapmix, 25-28-56 tablets): it is a partial agonist drug of nicotinic receptors, able to bind to nicotine receptors (nicotinic acetylcholine α4β2 receptors), mimicking their action and relieving symptoms the compulsive desire to smoke. To quit smoking, it is recommended to take 0.5 mg of active orally 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 onwards, 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 drug for smoking cessation.
- Nortriptyline (eg Dominans, Noritren): tricyclic antidepressant drug, used in therapy to quit smoking and to counteract the secondary symptoms that result 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 for the treatment of hypertension in pregnancy. It is also sometimes indicated for smoking cessation. Indicatively, administer the drug orally at a dosage of 0.1 mg, twice a day; alternatively, to quit smoking, apply a clonidine-based patch once a week. Consult your doctor for more information.
