Smoking dependence is a very hard habit to quit, due to the extreme addictiveness that nicotine induces. The adverse reactions caused during its withdrawal process have generated a number of smoking cessation therapy options. Learn about the different available treatments and which one could best meet your needs.
Nicotine dependence, is defined as the compulsive and repetitive need to inhale nicotine, a stimulating component found in large quantities in the tobacco plant and tobacco products, such as cigarettes and cigars. Inhaling nicotine releases a pleasurable sensation, driving the smoker to repeat the process. Due to the highly addictive nature of nicotine, this quickly becomes a full-blown addiction.
Nicotine works by binding with the brain’s nicotinic cholinergic receptors, causing the release of acetylcholine, a mood-elevating neurotransmitter.
In addition to nicotine being a universally addictive substance, smoking addiction can be caused by several other coinciding factors. Among them is a genetic tendency, which increases their probability of developing this addiction. Social pressure also frequently influences smoking beginners to stick with the habit until it becomes hard for them to quit.
13.7% of all adults are considered smokers. Men smoke slightly more than women (15.6% vs. 12.0%), with 45 million Americans found to be smokers.
Due to tobacco’s addictiveness, one third of those who smoke even once become daily users, with only 7% managing to quit. Many of those who have tried quitting, speak about the adverse withdrawal process, with symptoms that include irritable mood, insomnia, anxiety, and increased appetite.
Tobacco use causes about 8 million deaths a year, from both direct and passive smoking. Illnesses such as cancer, cardiovascular diseases, diabetes, lung disorders, and other life-threatening conditions have been linked to exposure to tobacco smoke.
The importance of finding the right treatment can be a deciding factor regarding one’s ability to achieve and maintain smoking cessation over time. There are several options currently available on the market, each with their own advantages and drawbacks. As with other forms of health treatments, it is important to consult with your primary care physician before deciding on a course of action.
Approved by the U.S. Food and Drug Administration (FDA), two medications have been found to offer significant benefit in facilitating smoking cessation, and both can be obtained with a doctor’s prescription. Before deciding on this course of action, it is recommended one consults with their primary physician.
Chantix (or its generic version, varenicline tartrate) lowers the rewarding effects caused by nicotine inhalation by binding to nicotinergic sites in the brain, thereby preventing the nicotine from forming its own bonds. Among other possible side effects, Chantix can cause constipation, vomiting, and sleep disturbance, in addition to causing an adverse reaction when taken with alcohol. It is not recommended for patients under 18.
Zyban (generic name: bupropion hydrochloride) has also been FDA-approved for smoking cessation, though its mechanism remains unclear. The active ingredient in Zyban is the same as in the antidepressant Wellbutrin, which is why both can induce the same side effects, such as insomnia or dry mouth.
Who Could Benefit from this: Though as stated, the exact method with which Zyban works is not yet understood, both medications have received FDA approval thanks to their proven safety and efficacy. If they are found to be tolerable enough to maintain treatment, those open to receiving medicinal support during their attempt to quit smoking should suggest this option to their doctor as they formulate a treatment course that can facilitate their cessation.
Deep Transcranial magnetic stimulation (also known as Deep TMS) is a non-invasive, FDA-cleared medical device treatment that has been shown to ease the nicotine withdrawal process by reducing the severity of its symptoms.
Deep TMS is one of two kinds of TMS devices currently available on the market. Both offer their own variation on the same TMS process, which utilizes electromagnetic fields to safely and effectively regulate the neural activity of brain structures empirically found to participate in the brain’s smoking addiction process.
Of the two currently available types of TMS—traditional TMS and Deep TMS— only Deep TMS has been FDA-cleared to treat smoking addiction. Compared to traditional TMS, Deep TMS uses its own, patented H-Coil technology to simultaneously reach wider areas of the brain, and directly regulate the activity of structures located in its deeper, hard to reach areas. This allows Deep TMS to both avoid targeting issues that are sometimes found in traditional TMS procedures, while also safely regulating key brain structures involved in the smoking process. Together, these attributes have been shown to enhance Deep TMS’s response rate.
TMS also offers the advantage of being a well-tolerated treatment option, which normally does not cause any adverse or long-lasting side effects. The most common side effect of this treatment is a local, passing, and generally tolerable headache that sometimes occurs during the first few sessions.
TMS is also usually easy to add to existing treatment regimens, as patients undergoing psychopharmacological treatment do not usually experience any complications due to the addiction of TMS.
Who Could Benefit from this: Since Deep TMS does not cause significant side effects and can be incorporated with other forms of treatment, patients who have tried medications for smoking cessation and found them either ineffective on their own, or have suffered adverse side effects, could greatly benefit from this non-invasive treatment. As Deep TMS does not require anesthesia or any prolonged recovery period, those looking to incorporate it into their daily schedule should also consider this option.
The FDA has also recognized three types of nicotine replacement therapy (NRT) as a secure way to ease the withdrawal process as one quits smoking. These products provide the brain smaller nicotine doses, aimed to curb the adverse withdrawal side effects.
The three types of NRT products are skin patches, tobacco chewing gum, and lozenges. All three have a slow-release mechanism of nicotine that enables the body to gradually become accustomed to smaller and smaller doses.
Who Could Benefit from this: Nicotine replacement therapy products are seen as more of a short-term solution, and normally are not considered a fully effective course of treatment for smoking cessation. Additionally, certain over the counter NRT products should not be used by individuals under the age of 18.
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