hey all -
just wanted to offer a few observations and a bit of advice. I do nicotine research, and see patients in a county medical center's Tobacco Dependence Clinic.
- Nicotine is incredibly addictive. With drugs of abuse the speed with which they enter the brain is often the key determinant to how addictive they are. Chewing on coca leaves isn't very addictive, but snorting or smoking cocaine sure is. Nicotine from a cigarette gets to the brain incredibly quickly - 3-5 seconds is the estimate I hear thrown around a lot. And there's some evidence now (the tobacco industry new about this for a while, but non-industry scientists are just figuring this out now) that aldehyde in cigarettes (produced from burning sugar) makes nicotine more addictive in juveniles.
- Nicotine is harder to give up than other drugs. In the clinic I've seen a handfull of people, and have been told about dozens of others, who have been addicted to many drugs (crack, methamphetamine, alcohol, marijuana, heroine, and nicotine), and they consistently say that giving up cigarettes is the hardest drug to give up.
-Effective treatments are available. There are many forms of nicotine replacement therapy (NRT) available now, in addition to buproprion (AKA Zyban, AKA Wellbutrin). Generally, each type doubles your chance of quitting. For those whom NRT and buproprion is not appropriate, there are second line medications as well.
-A comprehensive tobacco dependence program is the most effective. Seeing a health care provider (usually a doctor or a nurse supervised by a doc in a tobacco dependence clinic) who specializes in treating smokers is best. These people know how to best use the medications and can offer the best advice. What is listed in the package insert or smoking meds or said on TV is often not the whole truth. For example, the typical dosages of NRT given usually produces nicotine levels way below average venous plasma concentrations, thus requiring more intense use than often typically recommended in package inserts (for example, you'd need to chew more gum or use much more of the inhaler), or use multiple forms of NRT , and often a continuous med combined with an as needed med, such as the patch or buproprion combined with the gum/inhaler/nasal spray/lozenge. Also, the "step down" programs generally don't work very well from what I've seen, people who are put on relatively high levels of NRT naturally taper themselves off. Other than a few individuals with severe schizophrenia, I've never seen anyone have trouble quitting NRT.
-Behavioral things are way more effective than any sort of medication or counseling. People who live with annother smoker who smokes inside, people who go to smoky bars, people who hang around others who are smoking, etc, are at a great disadvantage. I wouldn't want a cocaine addict hanging around people who are using and smelling their cocaine, just as I wouldn't want an ex-smoker around smoke. If you want to quit, it helps greatly to avoid smoke. Unfortunately, you may have to avoid certain situations and ask friends to not smoke around you, though in my experience this isn't nearly as hard as it seems.
I hope I didn't sound too preachy.
If anybody wants more of my opinion, feel free to ask here if you're comfortable doing so, otherwise you can always PM me.
