Despite the well-known benefits of smoking cessation, quitting can be difficult. Nicotine is a highly addictive substance.
However, research has shown that a combination of medication, counselling and/or nicotine replacement therapy can be very successful in helping smokers to kick the habit for good.
Commonly used pharmacological therapies include:
• Treatment with bupropion hydrochloride (Zyban or Nicolift), an antidepressant
• Treatment with varenicline (Champix), a nicotine receptor agonist
• Nicotine replacement therapy in the form of patches, lozenges, gum or nasal spray
Nicotine replacement therapy reduces withdrawal symptoms by substituting some of the nicotine absorbed from tobacco.
Bupropion hydrochloride reduces cravings and other symptoms experienced when smokers cut back or stop smoking.
Varenicline attaches to nicotine receptors in the brain to prevent the release of dopamine. In this way, it blocks the sensations of pleasure that smokers experience when they light a cigarette.
Nicotine replacement therapy is usually available over the counter, whereas bupropion and varenicline require a doctor’s prescription.
Counselling forms an important part of the smoking-cessation process, and is best applied in combination with some of the pharmacological therapies described above.
Your doctor is likely to:
• Talk to you about your readiness to quit.
• Ask you about your current smoking habits, your history of quit attempts and your social stressors – and how to manage them while you’re trying to quit.
• Help you set a quit date.
• Arrange a follow-up appointment.
A psychologist or trained counsellor could be of great assistance, especially in helping you to find healthier ways to cope with stress and to manage your mood while you’re trying to quit. Ask your doctor to refer you if you don’t already have a relationship with a psychologist or counsellor.
Ready to quit smoking?
Speak to your doctor about the combination of treatments that is best for you. Also note that the following resources are available free of charge:
• The National Council Against Smoking’s Quitline: 011 720 3145
• The Cancer Association of South Africa’s (CANSA) Call Centre: 0800 22 66 22
• The CANSA eKick Butt Programme: www.ekickbutt.org.za
• Information supplied by the US Government: https://smokefree.gov
Reviewed by Cape Town-based general practitioner, Dr Dalia Hack. October 2018.