Definition
Anti-smoking products are aids designed to help people who wish to stop smoking tobacco.
Description
Most people who smoke become addicted to the nicotine content in tobacco. When you try to quit you will experience a craving for nicotine which causes withdrawal symptoms. There are products available to help you give up smoking and they are designed to help with this problem. NOTE: Anti-smoking Products are most effective when combined with behaviour therapy or counselling.
Treatment options
PRESCRIPTION PRODUCTS
A prescription medication that contains the active ingredient Bupropion hydrochloride, acts in the brain to block the reuptake of the neurotransmitters noradrenaline and dopamine in nerve cells. These chemicals are thought to be involved in the process of psychological addiction. The medication reduces withdrawal symptoms and cravings following smoking cessation.
This medication is usually taken while you are still smoking with a target date set for quitting within approximately two weeks. The starting dose is generally 150 mg, which is taken daily for three days then increased to 150 mg twice daily, with at least 8 hours between doses.
– This medication is NOT suitable for people with: Seizure disorders (or history of); CNS tumour; abrupt alcohol or benzodiazepine withdrawal; bulimia, anorexia nervosa (or history of); concurrent MAOIs (or use within 14 days of ceasing MAOIs). Ask your Doctor for more information about side effects and interactions.
NICOTINE REPLACEMENT THERAPY (NRT)
This form of therapy does not require a medical prescription and provides smaller doses of nicotine to help reduce withdrawal symptoms while you learn to live without cigarettes. Nicotine is delivered to the blood stream more slowly, at lower doses and in more constant concentrations than cigarettes.
When using NRT it is important that you replace cigarettes with the NRT and do not continue to smoke. Usually once the physical, psychological and social aspects of smoking have been overcome, you should not find it difficult to give up the NRT. If you really want to stop smoking, you are twice as likely to succeed in giving up with the help of NRT. This means that up to 1 in 5 smokers who want to stop will do it with the help of NRT. A combination of NRT with support or counselling gives the best chance of success.
TYPES OF NRT
– CHEWING GUM
Doses of 2mg and 4mg are available – the dose of nicotine gum to be used depends on the smoking habits of the person concerned. The gum is used when the urge to smoke is felt.
The gum is chewed slowly until a strong taste or a slight tingling sensation is felt and then placed under the tongue or between the cheek and gums until the taste or tingling sensation disappears. This process is then repeated until the nicotine effect is no longer experienced – usually around 30 minutes.
No more than 40mg (2mg x 20 pieces or 4mg x 10 pieces) should be used in one day. The dose is gradually reduced over time. The gum should not be used continually for a period of more than one year. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for these products.
– NICOTINE PATCHES
These are also called nicotine transdermal devices and are available in differing strengths of high, medium and low nicotine. The treatment period varies depending on the brand of patch chosen and lasts between 8 and 16 weeks.
The patch should be applied to a hairless area of the upper body or to the upper arm. It should be replaced daily or at bedtime if a 16-hour patch is chosen and skin sites should not be reused for a week.
If symptoms of overdose develop, the patch should be removed from the skin and the area washed with water. (Soap will increase nicotine absorption). Because nicotine can be readily lost from the patch by evaporation, patches must not be removed from their protective pouches until immediately prior to their use. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for these products.
– NICOTINE LOZENGES
Doses of 2mg and 4mg are available. The ‘Time to First Cigarette’ (TTFC) test is used to determine a smoker’s level of dependence and corresponding dosage selection. Smokers who have their first cigarette within 30 minutes of waking up are considered to be highly dependent and the 4mg lozenge is recommended for them. The 2mg lozenge is recommended for smokers who wait more than 30 minutes after waking before having a cigarette.
Lozenges are put in the mouth and are sucked like any other lozenge and moved around the mouth periodically, until completely dissolved. The lozenge should not be chewed. The dose is reduced gradually by reducing the number of lozenges taken each day. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for this product.
– NICOTINE INHALERS
These plastic smokeless devices, in the shape of a cigarette, are designed to provide the hand-to-mouth action you may miss, when giving up smoking. The device has a cartridge impregnated with nicotine and menthol and is inhaled in the same way a cigarette is inhaled. The nicotine runs out when there is no taste of menthol in the mouth when inhaling. The cartridge may be replaced after this time.
It is recommended that 6-12 cartridges be used per day over a 3-month treatment period. This is followed by dosage reduction over 6-8 weeks. Ask your Doctor or Pharmacist about contraindications/precautions/interactions information for this product.
Organisations & support groups
See the Australian Cancer Society topic on the Healthpoint for information about the Quit Programme.
What is the Quitline?
Quitline is a telephone information and advice or counselling service for people who want to quit smoking.
You can phone the Quitline on 131 848 confidentially from anywhere in Australia for the cost of a local call only.
Pharmacist’s advice
Ask your Pharmacist for advice.
- If you want to give up smoking ask your Pharmacist for suggestions. Your Pharmacist may suggest a nicotine replacement product and advise you about stop smoking services available locally.
- If after a week or two you are still suffering cravings or withdrawal symptoms, your Pharmacist might suggest you see your Doctor for advice on increasing the dosage of the nicotine replacement product or changing the product you are using.
- If the diet is inadequate, consider some supplements. Smoking is a leading cause of ‘oxidative stress’ in the body. This is an imbalance between the production of unhealthy free radical molecules and healthy antioxidant substances. Antioxidant supplements that my be advisable for smokers to take include vitamin C, co-enzyme Q10, vitamin E and grapeseed extract. See the antioxidants topic for more information.