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Combination therapy may work better to help smokers quit
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I've heard it over and over again--"I tried The Patch (or the gum, the pills or any other quitting medication) and it didn't work". There is a new study that shows that a combination of medications may work better for some smokers than using one one type of product alone. Patients with medical conditions used a combination of the nicotine inhaler, the patch and bupropion (Zyban) and had higher quit rates at 6 months than smokers who used the patch alone (35% vs 19%).
Other ways to increase the effectiveness of medications:
1. Use enough nicotine replacement product. Often smokers will under dose themselves and not get the relief they should. The guidelines for the use of nicotine replacement products may not provide sufficient nicotine. If a smoker is smoking two packs a day that is the equivalent to two-21mg patches. If they were only using one patch, they are not getting anywhere close to the level of nicotine that they are used to and they can suffer from withdrawal symptoms.
2. Use the product correctly. Nicotine gum is not to be chewed like gum but chewed long enough to soften it and then park in between the cheek and gum so the nicotine is absorbed through the mucosa of the mouth instead of being swallowed into the stomach, which can cause indigestion.
3. Don't expect too much. Medications are not a magic wand. Often a smoker will "try" medications with a "show me" attitude. Medications are used to help with the physical symptoms while the smoker learns to deal the behavioral, social and psychological aspects. If nothing is done to address this issues, after discontinuing the use of the medication, the smoker will relapse. Successful quitters need a variety of tools in their toolbox to be successful. If the only tool you have is a hammer, then every problem looks like a nail but sometimes you need a saw or a screwdriver or a wrench. Medications won't help you learn how to deal with beng around other smokers. Build up a full toolbox of different coping methods.
4. Use the product for as long as you need it. Often smokers will stop using a product too soon. In a short period of time, most smokers have released their "habit" cigarettes and feel like a non-smoker but they are still at high risk for relapse but they will discontinue their medication because they think they've got smoking beat. Or the individual may experience side effects and stop the medication instead of changing the regiment to lower the risk of side effects. Any smoker should have two full weeks of no cravings, no slips and no strong urges before tapering down.
5. Have a strong motivation to quit. Quitting can be one of the hardest things a smoker ever accomplished and it takes the right kind of motivation for the smoker to stick it out when the going gets tough instead of caving in and reaching for a smoke.
6. Assuming that because one kind of medication didn't work, the others won't either. Often it takes someone that is familiar with the medications to make adjustments to fit a particular individual's situation. For some smokers, a combination of several medications is needed to increase the effectiveness.
7. Give medications a chance. Some individuals are concerned about the long term effects of medications or that they may become addicted. Discuss these concerns with your physician. Long term use of nicotine replacement products has been shown to be much safer than smoking where besides nicotine, you are inhaling 4000 other chemicals. Inhaling nicotine is the faster way to get the highest of nicotine to the brain. None of the over the counter nicotine replacement products can match the speed and level of smoking which is why there is little risk of becoming addicted to OTC nicotine replacement products. Nicotine spray which is by prescription only is an exception and should be monitored by a physician because it is closest to inhalation, in delivering the rapid dose of nicotine
I believe that the physical addiction to nicotine is over estimated when individuals are trying to quit and there are effective medications to help with these withdrawal symptoms BUT I believe that the physical addiction is UNDER rated when it comes to relapse prevention. Inhaling nicotine causes structural brain changes that are still there even after a smoker quits and having even one cigarette is risking a full relapse. Instead, use FDA approved medications while you increase your coping strategies instead of reaching for that smoke. Remember, you're a puff away from a pack a day.
