Smoking cessation Felix K. Karthik
Why smoking is addictive? Positive reinforcment Increase in dopamine Binds to nACh receptors NICOTINE
SMOKERS DIE EARLY! Pirie et al Lancet. 2013 Jan 12;381(9861):133-41
Making a quit attempt Tensions and triggers • Tension • Price • Health concerns • Triggers • Sudden illness • Price rise • Advice from a health professional
Importance of brief advice Stead et al 2013. Physician advice for smoking cessation. Cochrane Database of Systematic Reviews. CD: 000165
Getting over the initial withdrawal discomfort • Behavioural support is of proven efficacy • Can be delivered in different formats • Face-to-face (individual or group) • Telephone • Internet • Pharma intervention: NRT (nicotine replacement therapy), bupropion (Zyban), nortriptyline and varenicline (Chantix) are of proven efficacy
Varenicline (CHANTIX) • Varenicline works by reducing craving for cigarettes making quitting smoking a little easier and increases the chances of stopping for good. • However it’s no magic cure and effort is still required.
SAFETY AND SIDE EFFECTS -CHANTIX • Side effects • Nausea (30%) – mostly well tolerated • Strange dreams, headache, flatulence, and insomnia • Serious mood and cardiovascular adverse events
E-Cigarettes How many have tried E-cigarettes?
Recent FDA measures • Push tobacco industry to make cigarettes with less nicotine to make them less addictive • Banning sales of e –cigarettes to kids age <18 years • FDA carefully weighing still the opportunity for e-cigarettes as potentially low risk alternative to smokers • All e-cigarettes including the components of e-cigarettes will be regulated by FDA in the coming years to make it safe!
Finally…… GOOD LUCK! THANK YOU!!!!!