The Asthma Center

Smoking cessation

There are two distinct approaches to discontinuing smoking: behavioral therapy and pharmacological approaches.

Behavioral Therapy
Behavioral therapy can include education, individual and group counseling, hypnosis, psychotherapy, conditioning, desensitization, sensory deprivation and transcendental meditation. Although some have benefited from this approach, it has not met with great success and is associated with a high long term failure rate. Of these methods, group or individual counseling is best when used in conjunction with pharmacological treatment as listed below.

Pharmacological Approaches
There are many pharmacological antismoking aids available today. Some of these include: nicotine replacement therapy, tranquilizers, antidepressants, anti-anxiety medications, anticholinergics and clonidine. The use of Zyban® or Wellbutrin® in combination with nicotine replacement therapy offers the best results for smoking cessation.

Nicotine Replacement Therapy
Nicotine has been incorporated in tablets, lozenges, chewing gum, nasal sprays, aerosols and skin patches for use as smoking cessation aids.

Nicotine Polacrilex
This consists of chewing gum or lozenges in which nicotine is bound to a resin that allows for better absorption through the mucosal tissues of the mouth. Significant nicotine blood levels can be achieved with chewing this compound, reducing symptoms of tobacco withdrawal. Chewing gum with Nicotine Polacrilex (2 - 4mg/tab) has improved quitting rates. Using nicotine lozenges, in addition to the patch, may help lessen failure rates. This treatment is available without a prescription.

Transdermal Nicotine
This patch delivery system allows nicotine to be absorbed through the skin. It helps reduce tobacco withdrawal symptoms. This method has consistently improved quitting rates. Plasma nicotine concentrations using the 21mg per day patch typically provides up to half the nicotine levels achieved by smoking. In general, a minimum of 4 weeks of therapy is necessary to be effective for long term cessation of smoking. While using the patch, you may experience some withdrawal symptoms following the first day of quitting. The first few weeks of wearing the patch are critical. Continuation of smoking during the first few weeks of patch use usually ends in failure and is also dangerous since overload of nicotine can lead to acute heart disease. This treatment is available without a prescription.

If you do not succeed on the first attempt at tobacco cessation, you often will meet with success if you persist. There is no one best approach for smoking cessation. The great majority of individuals who stop smoking use no smoking cessation aids. Motivation is the key factor in smoking cessation. You simply need to totally commit to the belief that discontinuing smoking is a major life issue and be determined to succeed.