Nicotine is one of the most addictive substances known to man. Individuals who have been addicted to heroin and nicotine have confessed to finding it much more difficult to give up nicotine, giving us an idea of what an average tobacco consumer goes through when trying to quit.
The first step towards giving up tobacco is, therefore, being more forgiving of oneself for having failed at giving it up, and starting afresh, possibly with a different strategy.
Most individuals who smoke, or chew tobacco, know that it is harmful, and wish to give it up. Their continued consumption is a reflection of how addictive the substance is (quitting can be associated with a lack of concentration, irritability, severe cravings, all of which make it very challenging), and how low a person’s confidence is, as multiple attempts to quit have not succeeded.
What are the behavioral strategies that might help? Breaking associations can help. If one smokes when having coffee, switch to tea. If one smokes in the balcony, make it difficult to enter the balcony (consider locking it, for example). Consider quitting with a smoking buddy so you can support each other. Have a written action plan which changes smoking to something else (“If I have a strong desire to smoke , I will listen to the playlist of my favorite songs instead”).
Medicines to help individuals give up smoking are more effective than behavioral strategies alone. They form the backbone of most scientific cessation programs worldwide. Medicines work by tricking the brain into receiving the same feeling of being stimulated by nicotine, without exposing the body to the hundreds of cancer-causing, mouth and lung irritating substances that chewing and smoking tobacco exposes the body to, respectively. The strategy that I use in my smoking cessation therapy is a combination of a nicotine patch (a steady level of nicotine prevents severe cravings) along with nicotine lozenges to be used as and when needed. In addition, certain drugs such as bupropion and varenicline are used, depending on the severity of addiction. One needs to address concerns such as weight gain, constipation that some individuals might face after giving up tobacco, but these are often easy to work on.
A note of caution. Addictions have a much higher prevalence among those with mental health issues than those without. A person who is addicted to multiple substances (for example, alcohol and tobacco) is likely to have underlying depression or anxiety, and this must be addressed, often with the help of a psychiatrist. However, this is a minor subset of those who consume tobacco, and most individuals will benefit with a combination of behavioral strategies and pharmacotherapy (medications) alone.
“If You Always Do What You’ve Always Done, You Always Get What You’ve Always Gotten”is a popular saying attributed to Henry Ford. Giving up tobacco is an investment with the highest returns in health. However, it isn’t easy, and can sometimes take multiple attempts. The key is to persevere, and to try something different when one starts afresh.
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