Articles

By Janice Boafo

The truth is that use of FDA approved smoking cessation medications doubles the long term success rates for quitting. Many of us know of a client or a peer who used “the patch” and ended up so miserable that they were tearing it off and heading for a smoke break within the first two hours.

The truth is that most of the time the user is not getting enough nicotine from the product to prevent or reduce withdrawal. Using medication to help with quit attempts is not as simple as it may seem. There are several factors to consider when helping a client or peer, or making a quit attempt ourselves, including ensuring sufficient dosing.

WHO?

According to the Clinical Practice Guideline, clinicians should encourage all patients to use effective pharmacotherapy for tobacco dependence treatment except where contraindicated, or where there is insufficient evidence of effectiveness. That means you can and should recommend medication for all smokers. The exceptions to the rule are pregnant smokers, those who smoke less than 10 cigarettes per day and adolescents. There are other options for those special populations, however. All patients should see a medical professional when planning to use any sort of smoking cessation medication to rule out other concerns.

WHAT?

There are three classes of FDA approved drugs for smoking cessation:

• Nicotine Replacement Therapy (NRT), including nicotine gum, lozenge, patch, nasal spray & inhaler.
• A psychotropic medication called Bupropion SR (commonly known as Zyban). This is a non-nicotine smoking cessation aid that is taken in pill form twice per day. The brand name Wellbutrin is prescribed to treat depression.
• A partial nicotinic receptor agonist, Varenicline (commonly known as Chantix). This tablet is taken twice per day

The truth is, the most effective use of smoking cessation medication is in the form of combination therapy. Combo- therapy involves using a short acting formula with a long acting formula such as the patch with gum, lozenge, nasal spray or inhaler as needed. Another option is Bupropion SR with the patch.

WHEN?

The truth is, the best time to start using smoking cessation medication is before you quit. For example putting on the patch the night before your quit date ensures that enough time will pass for the long-acting medication to be released and absorbed in your system. The key is to follow the directions for use. Use medications according to dosing schedules. Don’t wait until you need it. By then you are already suffering withdrawal symptoms, and there is no reason for you or your client to feel that way while using a smoking cessation medication.

WHERE?

The truth is that this is a trick question. It is however, necessary for those using the patch to move the patch to a different location each day to avoid skin sensitivity. It is also important to apply in an area with as little hair as possible to allow for full skin contact.

WHY?

Why not? These medications reduce physical withdrawal from nicotine and allow the patient to focus on behavioral and psychological aspects of tobacco dependence. That means you can avoid or greatly reduce the irritability, anxiety, depression, insomnia, cravings and increased appetite that are often some of the greatest triggers for relapse. There are advantages and disadvantages to each type of medication, so explore your options and, most importantly, make sure you or your clients are getting enough to be able to focus on recovery.

Long-Term (6 month) Quit Rates for Available Smoking Cessation Medications