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Thread: deaddiction of smoking

  1. #1
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    Question deaddiction of smoking

    smoking- a chronic relapsing desease is the definition now.. its nt just a habit...
    nicotine is nt the dangerous substance in cigars.. problem is vt benzopyrenes.... but nicotine causes addiction so more exposure to pyrenes..
    deaddiction nicotine chewing gums- they act by preventing the peak rise in nicotine levels which cause addiction as associated vt smoking....
    plz post more details reg this...
    Last edited by rupu; 09-02-2008 at 09:04 PM. Reason: correct

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    Nicotine Replacement therapy helps in quittin smoking by relieving the withdrawal symptoms and cigarette cravings experienced by an addict when he quits smoking.NRT can be in the form of Nicotine transdermal patches or nicotine chewing gums both of which provide a source of low levels of nicotine to the body.
    The nicotine released from chewing Nicorette gum is absorbed into the bloodstream from the oral mucosa.It is chewed whenever there is an urge to smoke.
    Bupropion hydrochloride,an anti-depressant,has been found effective in bringing about de-addiction.It is nicotine-free.Reduces cravings, irritability, restlessness,anxiety,depression.MOA unclear,though it is inependent of its anti-depressant action.
    O you who believe! Seek help in patience and As-Salât (the prayer). Truly! Allâh is with As-Sâbirin (the patient ones). (Al-Baqarah 2:153)

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    i quit smoking in january 2008 after almost 10 years of smoking more than a pack (marlboro regulars) a day..... it's been 10 months now....and it was tough in the beginning....now i am a non-smoker with 0 chances of relapsing.....
    i went cold turkey....all that nicotine replacement is baloney.... u can quit smoking only if u really really want to, and no amount of nicotine gum is going to help..... initially, when i got the urge (usually i was at home in these times) i just dropped down and did push ups till i couldn't breathe and all my muscles ached.... all that lasted about 2 months.... now i don't even get the urge to smoke and all my senses (smell, taste) work a lot better.....
    if u r a smoker, quit today, before it's too late.

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    Default Nicotine replacement therapy (NRT) increases your chance of quitting smoking.

    Clinical News & Knowledge: Nicotine Replacement Therapy (NRT)


    Nicotine replacement therapy (NRT) increases your chance of quitting smoking.



    1.


    What is nicotine addiction?


    Nicotine is a drug that is inhaled from the tobacco in cigarettes. It gets into the bloodstream and stimulates the brain. Most regular smokers are addicted to nicotine.

    If you are a regular smoker, when the blood level of nicotine falls, you usually develop withdrawal symptoms such as restlessness, increased appetite, inability to concentrate, irritability, dizziness, constipation, nicotine craving, or just feeling awful. These symptoms begin within a few hours after having the last cigarette. If they are not relieved by the next cigarette, withdrawal symptoms get worse. If you do not smoke any more, the withdrawal symptoms peak after about 24 hours, and then gradually ease over about 2-4 weeks.

    So, most smokers smoke regularly to feel 'normal', and to prevent withdrawal symptoms.

    About 2 in 3 smokers want to stop smoking but, without help, many fail to succeed. The main reason why so few smokers succeed, even though they want to stop smoking, is because nicotine addiction is strong and difficult to break. This is where NRT can help.


    What is nicotine replacement therapy (NRT)?


    NRT is a way of getting nicotine into the bloodstream without smoking. There are nicotine gums, patches, inhalers, tablets, lozenges, and sprays. You can buy most of these from pharmacies and other retail outlets. They are also available on prescription.


    How does NRT work?


    NRT stops, or reduces, the symptoms of nicotine withdrawal. This helps you to stop smoking, but without having unpleasant withdrawal symptoms. NRT does not 'make' you stop smoking. You still need determination to succeed in breaking the smoking habit.


    How do I use NRT?


    •Take advice from a GP, practice nurse, pharmacist or Stop Smoking Clinic.

    •Decide on which type of NRT will suit you best (see below).

    •Set a date to start. Stop smoking, and start NRT straight away. Some people prefer to stop smoking at the end of one day, and start NRT when they wake the following day.

    •Do not smoke at the same time as taking NRT.

    •You should use NRT regularly at first, and not 'now and then'.

    •Use an adequate dose of NRT. The higher doses are used if you smoked more than 18-20 per day.

    •Use NRT for at least 8-12 weeks for the best chance of stopping smoking long-term.

    •The dose of NRT is typically reduced in the later part of the course, and then stopped.


    You are more likely to stop smoking if you receive counselling or support whilst taking NRT. A doctor, nurse, pharmacist, or Stop Smoking Clinic may give this support. Also, the manufacturers of NRT often offer support such as telephone counselling, tapes, internet sites, personalised written programmes, etc. The details come on the packets of the various NRT products. It is strongly advised that you take up any offer of support whilst going through the difficult time of giving up smoking.


    How effective is NRT?

    NRT does increase the chance of quitting smoking. Various studies have looked at this issue. The studies compared NRT to a similar dummy (placebo) product in people who were keen to stop smoking. The results from the studies showed that, on average, about 17 in 100 people who took NRT stopped smoking successfully.


    This compared to about 10 in 100 who took the dummy (placebo) product rather than NRT. In other words, it increased the rate of success by about 70%. A combination of NRT with support or counselling may give the best chance of success.


    Which form of NRT is best?


    There is not much difference in how well the different types of NRT work. Personal preference usually determines which one to use. Below are listed some points about each form of NRT. Please note, this is just a brief overview. Read the manufacturer's instructions on the packet for detailed advice on each type of NRT, or seek advice from a pharmacist, doctor or nurse.



    Nicotine gum

    Two strengths are available - 2mg and 4mg. You should use the 4mg strength if you smoke 18 or more cigarettes a day. You need about 12-15 pieces of gum per day to start with (about one per hour). To release the nicotine, chew the gum slowly until the taste is strong.

    Then rest it between the cheek and the gum to allow absorption of nicotine into the bloodstream. Chew the gum again when the taste fades, and rest it again when the taste is strong, etc. Use a fresh piece of gum after about an hour.


    After 2-3 months you should use the gum less and less. For example, reduce the chewing time, cut the gum into smaller pieces, or alternate the nicotine gum with sugar-free gum. Gradually stop the gum completely.


    The disadvantage of gum is that some people do not like the taste, or always having something in their mouth. Gum is not suitable if you wear dentures.


    Nicotine Gum:- One of the most used and well-researched NRTs is nicotine gum (e.g., Nicorette). The AHCPR, after reviewing three meta-analytic studies concerning the efficacy of nicotine gum, concluded that nicotine gum improves cessation rates by 40 to 60% at a 1-year follow-up, compared with control interventions; abstinence rates are highest when the gum is paired with a behavioral therapy (e.g., skills training), compared to the gum only; and there is a dose-response effect for heavy smokers, with the 4-mg dose being more effective than the 2-mg dose. However, the efficacy of nicotine gum decreases over time and is largely dependent on the contribution of adjuvant behavioral therapies.65 Indeed, the efficacy of this NRT has been shown to be related to the intensity (i.e., duration) of accompanying behavioral therapy. Moreover, the gum’s efficacy is limited by low compliance due to such factors as inconvenience, side effects (e.g., burning, nausea), and bad taste. Consequently, although nicotine gum has been shown to be an effective NRT (versus placebo or a nogum control), it should be viewed as only one dimension of a comprehensive cessation program.




    Nicotine patches


    A patch that is stuck onto the skin releases nicotine into the bloodstream. Some patches last 16 hours, which you wear only when you are awake. Other types last 24 hours, and you wear these the whole time. The 24 hour patch may disturb sleep, but is thought to help with early morning craving for nicotine. Patches are discreet, and easy to apply.


    The patches come in different strengths. The manufacturers normally recommend that you gradually reduce the strength of the patch over time before stopping completely. However, some research studies suggest that stopping abruptly is probably just as good without the need to gradually reduce the dose.


    The disadvantage of patches is that a steady amount of nicotine is delivered. This does not mimic the alternate high and low levels of nicotine when you smoke, or with chewing nicotine gum. Skin irritation beneath the patch occurs in some users.

    Nicotine inhaler


    This resembles a cigarette. Nicotine cartridges are inserted into it, and inhaled in an action similar to smoking. Each cartridge provides up to three 20 minute sessions. You should use about 6-12 cartridges a day for eight weeks, and then gradually reduce over four further weeks. It is particularly suitable if you miss the hand-to-mouth movements of smoking.


    Nicotine tablets / lozenges

    You dissolve these under the tongue (they are not swallowed). Nicotine is absorbed through the mouth into the bloodstream. They are easy to use.


    Nicotine nasal spray

    The nicotine in the spray is rapidly absorbed into the bloodstream from the nose. This form of NRT most closely mimics the rapid increase in nicotine level that you get from smoking cigarettes. This may help to relieve sudden surges of craving. Side-effects such as nose and throat irritation, coughing, and watering eyes occur in about 1 in 3 users. As the nasal spray may cause sneezing and watering eyes for a short time after use, do not use it whilst driving.


    Can different methods of NRT be combined?

    This is an option, especially if you have particularly bad withdrawal symptoms. The common combination is to use an NRT patch (which gives a regular background level of nicotine) with gum or a nasal spray (taken now and then to top up the level of nicotine to ease sudden cravings). Evidence from research studies suggests that this kind of combination provides a small but significant increase in success rates compared with a single product. It is also thought that it is safe to combine NRT in this way.


    NRT and other diseases and situations



    As a rule, getting nicotine from NRT is much safer than from cigarettes. (NRT does not contain the harmful chemicals that cigarettes have.) But the following points may be relevant to some people.


    •Pregnancy. NRT is likely to be safer than continued smoking and so its use can be justified in pregnant women who are finding it difficult to stop smoking. NRT products that are taken intermittently (such as gum, lozenge, spray, inhalator) are preferred to patches. This is to minimise the exposure of nicotine to the unborn baby. Avoid liquorice-flavoured NRT products.


    •Breastfeeding. The amount of nicotine that gets into breastmilk is probably similar whether the mother smokes or uses NRT. Breastfeeding within one hour of smoking or taking an NRT product can significantly increase the levels of nicotine in breast milk. Therefore, NRT products that are taken intermittently are probably best if NRT is used during breastfeeding. Avoid using the NRT for at least one hour before breastfeeding.


    •If you are taking a theophylline medicine (used for some lung conditions) and stop smoking, the blood level of theophylline will increase. (The chemicals in cigarette smoke interfere with this medicine.) It is likely that the dose you need to take will need to be reduced, typically by about a third.


    Some other points about NRT

    •Apart from causing addiction, nicotine is not thought to cause disease. The health problems from cigarettes, such as lung and heart diseases, are due to the tar and other chemicals in cigarettes. So, taking NRT instead of smoking is one step towards a healthier life.

    •The dose of nicotine in NRT is not as high as in cigarettes. Also, the nicotine from smoking is absorbed quickly, and has a quicker effect than NRT. So, NRT is not a perfect replacement. Withdrawal symptoms are reduced with NRT, but may not go completely.


    •Always read the product label before starting NRT for full instructions and cautions.

    •Cost - a week's supply of NRT can vary, depending on the one you chose. NRT is also available on prescription. However, your doctor will follow guidelines when prescribing NRT. For example, a first prescription should only be issued if you are committed to giving up smoking, and further prescriptions should only be issued if you have stayed off cigarettes.

    •The risk of becoming addicted (dependent) on NRT is small. About 1 in 20 people who stop smoking with the help of NRT continue to use NRT in the longer term.

    .----------------------------------------------------------------


    2.

    Nicotine replacement therapy for quitting tobacco



    Examples


    Generic Name :
    Nicotine

    Brand Name:
    Habitrol, Nicoderm, Nicorette Inhaler, Nicotrol, Prostep, Transdermal Nicotine Patch


    Nicotine polacrilex:
    Nicorette Gum


    Nicotine gum releases nicotine slowly into the mouth.

    Nicotine patches stick to your skin and slowly release nicotine through the skin into your bloodstream.

    The nicotine inhaler has a holder that contains nicotine. The inhaler delivers a puff of nicotine vapour into your mouth and throat.

    You can buy nicotine gum, patches, and inhalers without a prescription.

    Note: Non-prescription nicotine replacement therapy products cannot be sold legally to people younger than age 18. A doctor may prescribe one of these products if a person younger than 18 is dependent on nicotine.


    How It Works

    Nicotine replacement therapy (NRT) helps reduce nicotine withdrawal and craving by supplying your body with nicotine. It contains about one-third to one-half the amount of nicotine found in most cigarettes.

    People become dependent on the nicotine in cigarettes because it increases the levels of certain chemicals, such as dopamine and norepinephrine, in their brains. When people quit smoking, the levels of those chemicals drop, and their bodies react by having nicotine withdrawal symptoms such as grouchiness and hunger. Nicotine from medicines increases the levels of dopamine and norepinephrine just like nicotine from cigarettes does. Chemical levels in the brain are kept level so withdrawal symptoms are reduced.


    When you inhale tobacco smoke, the nicotine in the smoke moves quickly from your lungs into your bloodstream. The nicotine in replacement products takes much longer to get into your system. This is why nicotine replacement medications are much less likely to cause dependence on nicotine than are cigarettes and other tobacco products.


    Nicotine replacement therapy is safe when used properly. Nicotine by itself is not nearly as harmful as smoking. Tars, carbon monoxide, and other toxic chemicals in tobacco cause harmful effects, not the nicotine.


    Why It Is Used

    Nicotine replacement therapy is useful for most people who are trying to quit smoking.

    Nicotine replacement therapy may not be right for you if you are pregnant or have heart disease.


    Pregnancy. Using nicotine replacement products during pregnancy has been linked to low birth weight . But smoking is more dangerous to you and your baby than nicotine replacement is.1 If you are pregnant or planning to become pregnant and want to stop smoking, talk to your doctor before you decide how to do it. During pregnancy, most doctors will recommend that you try other means to stop before they will suggest a nicotine replacement product.


    Heart disease. Nicotine replacement therapy has been shown to be safe in most people with heart disease. But if you recently had a heart attack or if you have serious heart problems, such as an irregular or rapid heartbeat (arrhythmia) or chest pain (angina), consult your doctor before you use nicotine replacement products.


    Doctors do not often recommend nicotine replacement therapy for people younger than 18, largely because the products have been tested only on adults. The side effects of nicotine replacement therapy for young people are unknown.


    How Well It Works


    Using some form of nicotine replacement therapy doubles your chances of quitting smoking.2 All forms of nicotine replacement products appear to be about equally effective when used properly.

    Combining the use of the nicotine patch with another form of nicotine replacement therapy or bupropion may increase your chances of success. Talk to your doctor before you combine NRTs.

    Your chances of quitting are best when you combine nicotine replacement therapy with a complete smoking cessation program that includes setting a quit date, having a plan in place for dealing with smoking triggers, and getting support from a doctor, counsellor, or support group.


    Side Effects

    Since all NRTs appear to work equally well, many smokers choose a treatment based on how easy it is to use and what possible side effects it may cause. All forms of nicotine replacement have side effects, but the types of side effects differ across NRTs. Very few people (less than 5%) have to stop using a nicotine replacement product because of side effects.

    Stopping nicotine replacement therapy abruptly may cause some of the same withdrawal symptoms that occur when you stop smoking cigarettes. You are less likely to have withdrawal symptoms if you gradually decrease the dose or number of uses of the specific therapy per day.

    It is possible for a person to become dependent on a nicotine replacement product, although this is rare.



    Gum


    Side effects of nicotine gum may include:

    A bad taste from the gum. A mint and a citrus flavour are available, and most people find they taste much better.


    A tingling feeling on the tongue while chewing the gum.
    Hiccups.


    Upset stomach (nausea) or heartburn. This is sometimes caused by improper use, such as chewing the gum without "parking" it between your cheek and gum.


    Jaw pain caused by chewing. Nicotine gum is not recommended for people who have problems with the jaw joint (temporomandibular, or TM, disorders).
    Patch


    Side effects of nicotine patches may include:

    A skin rash at the location of the patch. This may be a reaction either to the sticky backing on the patch or to the nicotine. People with sensitive skin or allergies to adhesive should not use the patch. Moving the patch to a different part of your body or using a non-prescription antihistamine cream, ointment, or gel (such as Benadryl) may relieve some of the discomfort.
    Sleep problems when using a 24-hour patch, such as having trouble sleeping or having especially vivid dreams. This is because your brain isn't used to getting nicotine when you are sleeping. Removing the patch after 8 p.m. may help decrease this side effect. If the sleep problem is a nicotine withdrawal symptom, not a side effect, removing the patch may not help. Talk with your doctor if you have sleep problems.
    Inhaler


    Side effects of nicotine inhalers may include:

    A cough.
    A scratchy throat.
    An upset stomach.


    The nicotine inhaler may not be a good choice if you have a breathing problem, such as asthma, allergies, or a sinus condition.

    See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

    What To Think About

    Do not continue to smoke while you are using nicotine replacement therapy. You may overdose on nicotine if you smoke regularly and use nicotine replacement products at the same time. An overdose of nicotine can cause headaches, nausea, confusion, and vomiting. If you think you have overdosed, call your doctor right away.

    Regardless of the method you use to quit smoking, you may cough more or start coughing for the first week after you quit. This is not a symptom of withdrawal from nicotine—it is the result of your body trying to clear your lungs. This happens whether you use nicotine replacement therapy or not.

    With nicotine gum and the inhaler, not taking enough is a common cause of relapse. Avoid drinking beverages, especially acidic beverages (such as coffee, juices, and soda pop) for 15 minutes before and after you use these products. Your body may not absorb the nicotine well because of the acid in these drinks.

    Choosing a form of nicotine replacement therapy is usually a matter of personal choice. People who smoke heavily are more successful when they use the strongest forms of the product (gum with 4 mg of nicotine or patches with 21 mg or more nicotine in each patch).2

    You will begin using a nicotine replacement product on your quit date, not before as with other forms of treatment.

    If you find you cannot continue to use one form of nicotine replacement because of its side effects, stop using that form and try a different one. Remember, using nicotine replacement products doubles your chances of quitting smoking.

    Long-term use of nicotine gum has not been found to be harmful.

    Nicotine replacement therapy will reduce most but not all of the nicotine withdrawal and other symptoms associated with quitting smoking.

    By the time you finish nicotine replacement therapy, you will have greatly decreased your dependence on nicotine. You also will have started to get used to not smoking at the usual times. This will take longer for people who have smoked for many years and may mean using nicotine replacement products for several weeks or months. Stopping nicotine replacement therapy too early is a common cause of relapse. When you finally reduce your nicotine intake to zero, you still may have some symptoms of nicotine withdrawal. But these symptoms won't last. Using nicotine replacement products makes symptoms less severe.

    Talk to your doctor before you use two forms of nicotine replacement (such as a nicotine patch and nicotine gum) at the same time.

    Using bupropion and nicotine replacement products together may work well for some people who smoke, but it should be tried only under a doctor's care. Your doctor may recommend bupropion alone instead of using two medicines.

    .

    For Key Messages for Healthcare Professionals:

    [HIDE]


    http://www.trdrp.org/publications/co...M00program.PDF

    [/HIDE]


    [HIDE]

    http://www.ashaust.org.au/pdfs/NRTguide0702.pdf

    [/HIDE]



    [HIDE]

    http://www.cancer.org/downloads/pub/...ECTION6/25.pdf

    [/HIDE]


    [HIDE]

    WHO says Electronic cigarette not nicotine replacement therapy _English_Xinhua

    [/HIDE]

    .
    Last edited by trimurtulu; 11-10-2008 at 06:15 PM.

  5. #5
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    Default

    Over all this new drug VARENICLINE is doing great..it will make smokers hate cigarettes just after 1 week...its taken upto 3 months with side effect of headache and sleeplessness only...
    Used very much by pychiatrists..

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