Yes, there is extensive research that has shown that treatments for tobacco addiction do work. Although some people can break the habit by themselves, many people need help to stop smoking. This is particularly important because quitting smoking can have immediate health benefits. For example, within 24 hours of quitting, blood pressure and the likelihood of a heart attack decrease. The long-term benefits of stopping smoking include lower risk of a stroke, lung cancer and other types of cancer and coronary heart disease. A 35-year-old man who quits smoking increases his life expectancy by an average of 5 years.
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Nicotine replacement treatments
Nicotine replacement therapies (NRTs), such as nicotine gum or chewing gum and the nicotine transdermal patch, were the first drug treatments approved by the Food and Drug Administration (FDA). by its acronym in English) of the United States to be used in treatments to stop smoking. These nicotine replacement therapies (in conjunction with behavioral support) are used to relieve the symptoms of withdrawal syndrome, because they produce less severe physiological alterations than tobacco-based systems and generally provide the user with lower nicotine levels than those of tobacco. An additional benefit is that these forms of nicotine have little potential to be abused as they do not produce the pleasurable effects of tobacco products. They also do not contain the carcinogens and gases associated with tobacco smoke. It has been shown that behavioral treatments are an essential complement to nicotine replacement therapies, improving their efficacy and long-term results.
The transdermal nicotine patch
The approval by the FDA of nicotine gum in 1984 marked the availability (by prescription) of the first nicotine replacement therapy in the United States market. In 1996, the FDA approved Nicorette® chewing gum for sale without a prescription. While nicotine gum gives some smokers the control that to alleviate the craving for tobacco, others can not tolerate the taste or the fact that they have to be chewing it. In 1991 and 1992, the FDA approved four transdermal nicotine patches, two of which have been sold over the counter since 1996. The nicotine nasal spray was released in 1996 and the nicotine inhaler in 1998, both requiring a prescription. These products met the needs of many other tobacco consumers. All nicotine replacement products, both chewing gum, patch, spray and inhaler, appear to be equally effective.
Additional medications
A bottle of pills
Although the main focus of pharmacological treatments for tobacco addiction has been the replacement of nicotine, other treatments are also being studied. For example, bupropion, an antidepressant sold on the market as Zyban®, was approved by the FDA in 1997 to help break the habit of smoking. Varenicline tartrate (Chantix®) is a new drug recently approved by the FDA as a treatment to stop smoking. This medication acts on the sites of the brain affected by nicotine and can help people to break the smoking habit by relieving the symptoms of withdrawal syndrome and blocking the effects of nicotine if people try to smoke.
Other medications that do not contain nicotine are being investigated for use in the treatment for tobacco addiction. These include, among others, some antidepressants and a medication for high blood pressure. Scientists are also studying the potential of a vaccine that would act on nicotine to prevent relapse. This nicotine vaccine is designed to stimulate the production of antibodies that would block nicotine access to the brain, preventing its reinforcing effects.
Behavioral treatments
Behavioral interventions can play an integral role in tobacco treatment, either in conjunction with medications or on their own. They use a variety of methods to help smokers break the habit, ranging from self-help materials to individual cognitive-behavioral therapy. These interventions teach people to recognize high-risk situations that encourage smoking, to develop alternative strategies to avoid smoking, to manage stress, to improve their ability to solve problems as well as to increase social support. Research has shown that the more therapy adjusts to each person's case, the greater the likelihood of success.
A man sitting on the couch
Traditionally, behavioral approaches were developed and carried out in formal settings such as smoking cessation clinics and numerous community and public health settings. However, in the last decade researchers have been adapting these approaches to telephone, mail and Internet formats, which may be more acceptable and accessible to smokers who want to break the habit. In 2004, the United States Department of Health and Human Services (HHS) established a toll-free national telephone hotline, 1-800-784-8669 (1-800-QUITNOW), to serve as a only access point for smokers seeking information and help to stop smoking. The calls of the people who dial this number are transferred to the telephone help lines to stop smoking that correspond to the state where they reside. In the case of those people who live in states where these helplines have not been established, they are transferred to the telephone line maintained by the National Cancer Institute (NCI). In addition, HHS has a new website ( www.smokefree.gov ) that offers advice and information that can be downloaded on how to facilitate the process of breaking the smoking habit.
Breaking the habit of smoking can be difficult. While the intervention may be useful at the time participants receive it, most intervention programs are short term (1 to 3 months). Within a period of 6 months, 75 to 80 percent of people trying to quit suffer a relapse. Research has shown that extending treatment beyond the typical period of a smoking cessation program can achieve success rates of up to 50 percent a year after quitting.