Help for smokers who want to quit

 

Most smokers know that quitting is the single best thing they can do for their health. But they may not be aware of all the options available to help them start living a smoke-free life.

Support and encouragement from family, friends and healthcare providers can be a big help on the road to becoming smoke-free.

Tools and assistance are available through workshops and programs, and by phone, online, via texts and through phone apps from organizations like the Smokers’ Helpline Canadian Lung Association’s QuitNow.ca, and the Centre for Addiction and Mental Health. Your family doctor, pharmacist and other healthcare professionals can offer help and guidance.

It may help to know that the benefits of quitting begin immediately, and multiply over the days, weeks, years and decades of your smoke-free life. The Canadian Lung Association notes that:

• blood oxygen levels climb back to normal within hours of quitting, and carbon monoxide levels drop
• within days, lung capacity begins to increase
• risk of heart attack is already starting to drop within days of quitting, and it keeps on dropping: after a smoke-free year, heart attack risk is half that of a smoker’s, and after 15 years the risk of dying from heart attack is the same as if you never smoked
• someone who quits today will cut their risk of lung cancer in half in 10 years – and throughout that decade, they’ll have enjoy improved sense of taste and smell as well as easier breathing, starting just a few days from now

Even with support, many smokers are concerned that withdrawal symptoms will be challenging. The good news is that there are more options than ever to ease those symptoms and help people make the journey to quitting. Research has shown all of these aids to be effective.

“Any intervention – whether prescription or non-prescription – can double the odds of success,” says Marko Tomas, a registered pharmacist at Women’s College Hospital.

Nicotine replacement options

Nicotine replacement therapy is currently the most commonly used option, Tomas says. It’s available in different formats, including patches, gum, lozenges and inhalers, and you don’t need a prescription for it.

Patches are a convenient choice. Applied daily, the patch provides a constant release of nicotine throughout the day.

“This is really good for smokers who are smoking about a pack a day or more,” Tomas says. “It gives them that baseline level that they need to control symptoms.”

Using nicotine gum or lozenges in addition to a patch can help with cravings.

“It offers that baseline level of nicotine, and then something for craving control on top of it,” Tomas says.

People who smoke less than a pack a day may find that using gum or lozenges alone is enough to help them quit. Smokers who have their first cigarette of the day within 30 minutes of waking up may find the higher-dose (four milligram) gum more helpful than the two-milligram.

Nicotine replacement inhalers are also available, and provide rapid delivery of nicotine.

“Patients sometimes like it because it mimics that hand to mouth motion of smoking actual cigarettes,” Tomas says. However, nicotine inhalers are the most expensive form of quick-delivery nicotine replacement, which may be one reason why they are aren’t used as often.

In terms of effectiveness, research has shown that different forms of nicotine replacement are equally effective. Tomas notes that whatever format a quitter prefers, or whatever is most available to them, is their best option.

Prescription options

There are also two prescription medications available to help people stop smoking: bupropion (sold under the trade name Zyban) and varenicline (sold under the trade name Champix).

Bupropion is a norepinephrine-dopamine reuptake inhibitor. It is believed to work by easing the symptoms of withdrawal. Patients usually start taking bupropion a week before their quit date, and continue taking it for 12 weeks.

Varenicline is a different type of drug. It both blocks the effects of nicotine, while also easing withdrawal.

“It’s a partial agonist of the nicotine receptor,” Tomas explains. “What that means is it sits there in that binding pocket and it doesn’t let nicotine bind, which takes away some of the pleasure of smoking. But being a partial agonist, it’s also able to stimulate that nicotine receptor to ease the withdrawal symptoms.”

Varenicline is usually started one or two weeks before the quit date.

Trying again

Many people make several attempts to quit before successfully becoming smoke-free. Unsuccessful attempts to quit can help people know more about their quitting journey: they can identify triggers and be better prepared the next time.

“The good news is that the chance of quitting increases with subsequent attempts, as long as they make a conscious decision to make that attempt,” Tomas says. “The reason for that is people learn what works for them, what doesn’t, and what things they need to watch out for.”