Overview: Smoking Cessation

Posted By: QuitSmoking.com Staff | Aug 13 2014

The smoking cessation guideline challenges clinicians — physicians and other health care providers — to aggressively motivate and help their patients who smoke to quit. The guideline makes specific recommendations about how clinicians can identify smokers, repeatedly encourage them to quit, and offer treatments that have been proven to work.

The guideline found three treatment elements were particularly effective, used either alone or together, in helping smokers quit. They are:

Nicotine replacement therapy — either the prescribed nicotine patch or nicotine gum, which doubles the rate of successfully quitting. [Nicotine gum has been approved for over-the-counter (OTC) use by the FDA. The nicotine patch may be approved for OTC use by the end of 1996.]

Social support — encouragement and support from the clinician.

Skills training/problem solving — practical advice and techniques from the clinician that help people adapt to life as a non-smoker.

Individual or group counseling programs are also helpful. The guideline panel found a direct relationship between the intensity of treatment and the likelihood for success. The guideline recommends that counseling programs, if chosen, be delivered over 4 to 7 sessions (20 to 30 minutes in length), for at least 2 weeks, but preferably for 8 weeks.

No conclusions were drawn about the effectiveness of the following treatments:

Acupuncture or hypnosis. There was insufficient evidence to support the effectiveness of either of these therapies.

Clonidine, antidepressants, and anxiolytics/benzodiazepines. Lack of data and/or faulty studies offered little support for their use.

The guideline panel made no recommendations regarding the use of nicotine nasal sprays and nicotine inhalers. There were limited data on these products. At the time of the panel’s deliberations, the products were not licensed for prescription in the United States. [As the guideline went to press, the FDA approved the prescription use of nicotine nasal spray.]

Recommendations for Smokers Who Want To Quit
• Be committed. Make sure you’re ready to work hard to quit.
• Talk with your doctor. Discuss nicotine replacement therapy and strategies to deal with wanting to smoke again. Do everything you can to maximize the chances for success.
• Set a quit date. Don’t try to “taper off.”
• Build on past mistakes. If you’ve tried to quit before, think about what helped and what hurt.
• Enlist support. Tell your family and friends you’re quitting. Create a network you can turn to for help.
• Learn how to avoid or cope with situations and behavior that make you want to smoke.

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