There are an estimated 1.3 billion smokers worldwide and over 5 million deaths per year attributable to tobacco smoking. Even though smoking rates are declining, there are an estimated 7 million smokers in SA.
Almost 70% of current smokers report wanting to quit smoking, but quitting can be hard and often takes multiple attempts.
Fortunately, a variety of approved smoking cessation medications are available to help people successfully quit smoking. However, there have been some concerns around misperceptions the public may have about nicotine replacement therapies. It’s important to help patients separate fact from fiction.
THE BEST WAY TO QUIT IS “COLD TURKEY”
FICTION: There is no “right way” to quit smoking, but many smokers try to quit “cold turkey” and are not successful. The good news is that there are several proven methods to help quit smoking. There are many ways to get help and there are multiple options proven to be safe and effective when trying to quit. Over-the-counter (OTC) nicotine replacement therapy products and prescription medications can help minimise the withdrawal symptoms and cravings when trying to quit. Studies show that using cessation medicines can double the chances of successfully quitting, and behavioural support (such as counselling) can also increase the likelihood of success. In fact, according to several studies done by the National Institutes of Health, medication plus behavioural support is more effective than either alone.
ALL SMOKING CESSATION MEDICATIONS ARE THE SAME
FICTION: There are three different types of medications to help patients quit smoking — nicotine replacement therapies, bupropion, and varenicline. Nicotine replacement therapy medications are available in five different forms: inhaler, nasal spray, patch, gum, or lozenge. The medications vary in how they affect the body, how they are used, and how long they should be used. Some are available OTC, and others require a prescription from a doctor.
E-CIGARETTES ARE NOT AN APPROVED METHOD TO HELP PEOPLE QUIT SMOKING
FACT: Electronic cigarettes (e-cigarettes) are not approved by the Medicines Control Council (MCC) as an aid to quit smoking and may expose users to some of the same toxic chemicals found in combustible cigarette smoke. While there is no evidence that electronic cigarettes (e-cigarettes) are effective aids to smoking cessation, there are other proven, safe, and effective methods for quitting smoking.
NICOTINE IS NOT THE PRIMARY CAUSE OF CANCER FROM MOST TOBACCO PRODUCTS
FACT: Nicotine is the main addictive substance in cigarettes and other tobacco products, including most e-cigarettes. Nicotine is a naturally occurring addictive chemical that is found in tobacco and is what keeps people smoking. However, while nicotine has a number of toxic effects on the body, it is not the primary cause of cancer and other chronic smoking-related diseases. More than 7 000 chemicals are present in cigarette smoke, including more than 70 that can cause cancer. Examples of cancer-causing chemicals found in cigarettes include tobacco-specific nitrosamines, benzo-a-pyrene, benzene, arsenic, and more.
IT IS DANGEROUS TO USE MORE THAN ONE NICOTINE REPLACEMENT THERAPY PRODUCT AT THE SAME TIME
FICTION: Although each nicotine replacement therapy product was approved as an individual therapy, two nicotine replacement therapy products can be used safely together when you are trying to quit. For example, some smokers combine products, using a nicotine replacement therapy patch for general relief of withdrawal symptoms, then a nicotine replacement therapy gum or inhaler for sudden urges to smoke. It may take multiple tries to find out what works best to help a patient quit.
Research shows that nicotine replacement therapy is safe and effective for almost all adults, but some people should not use nicotine replacement therapy. Encourage pregnant women, teens, and people with serious health issues such as heart disease and stomach ulcers to talk to their doctor first before using nicotine replacement therapy. Patient’s considering combining nicotine replacement therapy products should talk to their doctor to determine if combination therapy is right for them.
NICOTINE REPLACEMENT THERAPY GUM IS DIFFERENT TO REGULAR GUM
FACT: Unlike regular chewing gum, nicotine replacement therapy gum is most effective when used as directed – placed between cheek and gum. Patient’s should start by placing the nicotine replacement therapy gum in their mouth and chewing slowly until there is a strong taste or tingling sensation, which indicates that the nicotine is being released. They should then stop chewing and place it between their cheek and gum to release the nicotine into the mouth lining. When the taste or tingling sensation decreases, they should repeat the chew and park process.
NICOTINE REPLACEMENT THERAPY CAN BE USED ONLY FOR THE DURATION LISTED ON THE LABEL
FICTION: Although the duration listed on the label may work for some smokers, it might not work for others. Encourage patients to talk to their doctor if they feel extending their use would help them stay smoke-free.
IF YOU’VE TRIED NICOTINE REPLACEMENT THERAPY IN THE PAST AND IT DIDN’T WORK, THERE IS STILL REASON TO TRY IT AGAIN
FACT: Research shows most smokers have to make multiple attempts to quit before being able to quit for good, even when using a proven cessation medication, like nicotine replacement therapy. The best thing to do is try again. Encourage smokers to practice quitting, because each attempt makes quitting for good more likely.
A tailored approach encompassing psychological and social support, in addition to appropriate medication to reduce nicotine withdrawal, is likely to provide the best chance of success
Knowing the facts and using proven methods to quit smoking can improve patients’ chances of success. But, if they don’t succeed on the first try, remind them every try counts.