Psychology of smoking cessation – stratergies to stop.

25 03 2012

Recently, I failed in an attempt to quit smoking. This attempt lasted all of 3 weeks and 3 days. The phrase ‘the best way to quit smoking is to never start’ is something that as a non-smoker, I could not empathise with. However, the reality of the statement dawned upon me as nicotine cravings painfully engulfed most of my mornings. I intend to attempt to quit again. In my next endeavour I aim to be armed with preventative strategies based on empirical evidence researched in this current blog, whilst appealing to commenter’s to suggest alternative novel solutions which I can also implement.

 

An assessment of nicotine addiction by the University of Minnesota* demonstrates the complexity of smoking behaviour which makes smoking cessation problematic. Physiological dependence, psychological dependence and socio-cultural factors contribute towards maintaining a tobacco addiction. Furthermore, they suggest human genetics, early family experiences, environmental factors and societal influences combine to set an addictive cycle in motion. This implies that smoking cessation would be most successful if accompanied with a life style change.

 

Christakis (2008) demonstrated that whilst the proportion of the population smoking is gradually decreasing in the United States, the cluster size of smokers has remained consistent. Christakis suggested that this is due to smokers tending to quit in groups. Furthermore, concordance rates of smoking cessation were assessed between two individuals whom chose to do so together. Smoking cessation by a spouse decreased individual’s chances of smoking by 67%, whilst smoking cessation by a sibling decreased an individual’s chances of smoking by 25%. A spouse is not applicable to my situation; however I do have a brother whom also shares my desire quit smoking (eventually). Therefore, our chances of smoking cessation would be boosted if we attempted to do so together.

 

Hughes (2007) investigated the effectiveness of antidepressants for smoking cessation. Three logical deductions led Hughes to believe that antidepressants may help smoking cessation. Nicotine withdrawal may present with depressive symptoms or contribute towards a major depressive episode. Nicotine may have antidepressant effects that maintain smoking, and antidepressants may substitute for this effect. Finally, certain antidepressants may have a specific effect on neural pathways or receptors underlying nicotine addiction. Results suggested that antidepressants Bupropion and Nortiptyline aid long-term smoking cessation, whereas SSRI’s did not. The author then suggests that these drugs should be prescribed to any individual seeking to quit smoking. However, under current regulation these drugs are only prescribed to individual’s cessing smoking with a history of depression. I have no history of depression; therefore it is unlikely that any GP would prescribe these drugs to me.

 

Stead (2008) researched nicotine replacement therapy (NRT) for smoking cessation. NRT seeks to replace nicotine from smoking with nicotine gained through an alternative method, thus reducing the motivation to smoke and easing the transition from smoking to complete abstinence. NRT includes nasal spray, patches, inhalers, gum and lozenges. Results suggest that all commercially available forms of NRT can increase rates of quitting by 50-70%. Therefore, in the weeks preceding my next cessation attempt, I shall purchase patches to replace the medium in which nicotine enters my body in order to increase chances of success.

 

Due to practical medicinal restraints I will be unable to use antidepressants for smoking cessation. However, from reviewing the literature I have devised a quit smoking strategy which should increase my chances of cessation. I will collaborate with my brother and set a date to quit smoking, whilst ensuring adequate NRT resources are available to us in the weeks preceding the date.

 

* http://www1.umn.edu/perio/tobacco/nicaddct.html

 

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5 responses

27 03 2012
kmusial

An interesting blog! Some good tips on how to stop smoking! One thing you have not coverd is quitting by hypnosis and self suggestion (http://www.buzzle.com/articles/self-hypnosis-stop-smoking-using-self-hypnosis.html).By the look of it is not a bad technique sice 48% reported abstinence 12 months post treatment Elkins & Rajab (2010) (http://www.tandfonline.com/doi/abs/10.1076/iceh.52.1.73.23921).
(PS. wish you luck in the future).

16 04 2012
smmitch

Great blog! As a now ex-smoker of 28 years i decided when we did out Self Management project, i would use this time to quite the disgusting and unhealthy past-time that is smoking! I didn’t bother to set a date to quit as personally I find that doesn’t work. The week before I quit though, I kept a diary of every time I had a cigarette, then on that Sunday evening I graphed my findings. It was really interesting to see that after meals, boredom and visiting my friend’s house, caused an increase in nicotine intake. So the following week I planned to stay away from my friend’s house and have her come to mine where she couldn’t smoke. I listed lots of jobs and activities to keep me busy and visited my doctor to get free patches, inhalators and gum (as prescriptions are free in Wales). I am now 3+ months on and have not touched one cigarette since. I feel great, I smell great and thanks to my-self management project have no nicotine cravings.

18 04 2012
stach22

Looking at research into this I came across a research paper by Guillsepie, Stanton, Lowe & Hunter, 2009. It looked at fesible ways in which to get students to stop smoking. It found that those that intended to stop or had tried and previously failed to stop were more likely to eventually quit smoking- a point they raised though was that it had to take will-power- they concluded that it was this that was the most important factor in actual attempts at stopping. It took me 3 or 4 attempts to stop and I know have been a non-smoker for 12months. It will come eventually if you want it enough- like anything-it’s all about mind over matter- we’re stronger than we initially believe.

18 04 2012
anthonyshock

Looking at Hughes’ (2007) study there, into how anti-depressants are used for treatment of nicotine addiction and associative depression, brings some worries tied with anti-depressant use. Tamam & Ozpoyraz, 2002, described something called ‘SSRI Discontinuation Syndrome’, a series of symptoms which present when somebody is taken off an SSRi antidepressant. The way to avoid this is to gradually titrate the drug from the system, to slowly wean the patient off. This is known to take months, which sound familiar eh? Giving up smoking takes a similar commitment to stop. My argument being, anti-depressents don’t seem very suitable. They appear to replace one problem with another, which is just dislocation that isn’t making our lives easier!

But you did mention something very interesting, about how a behaviour is easily changed when accompanied with a lifestyle change. Perhaps overhauling your diet or some new hobby might make it a bit easier! 😀 Good luck!

3 04 2013
Byron Heldt

The way most people tackle the task of quitting smoking is by simply going cold turkey. They stop smoking and try to remain strong and determined enough to fight the craving and desire for cigarettes. Many people have succeeded in this way and I guess if you are astrong willed person this may work for you. I am not so sure this is the way for me to give up cigarettes as I suspect I would just start all over again.`

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