Ask the Pharmacist

Q. What methods can you suggest to help me quit smoking?

A. As we discussed last week, tobacco dependence is a real thing and the cravings associated with such make it very difficult to quit a habit that we know all too well is not good for us.

The first step is to have the motivation to quit, for yourself and not just because your family, friends and health care practitioners are nagging at you to quit. When you are ready, the first step is to set a quit date, ideally within the next two weeks.

Next, tell your family and friends. This is more important than you may realize. You may wish to attempt to quit quietly on your own so that you will not be seen as a failure if you do not succeed. The flip side to this is that telling people increases your chances of quitting as the perceived pressure of disappointing others will make you more apt to stick to your agenda. If they are smokers themselves, you can ask them to not smoke in front of you for awhile, until you successfully kick the habit.

It is not uncommon to undergo multiple attempts before you are able to call yourself a non-smoker. Combining one or more smoking cessation methods may be needed to help you be successful. Regardless of which method you opt for, cognitive behavioural therapy is essential for your success. This technique focuses on changing your normal reactions for when you feel the “need” to smoke.

The first step is to avoid situations where lighting a cigarette is a part of the ritual you have become accustomed to. If smoking is the “desert” to your meal, then step away from the table immediately after you are finished eating. If it is while you enjoy a coffee, tea or alcoholic beverage, find something else to keep your hands busy. The hand to mouth action that is repeated very frequently whilst enjoying your cigarette needs to be addressed. You could try using a straw, a toothpick or a stick of celery as a way to deal with the hand to mouth action. Stress balls are good to keep nearby which will be useful to keep your hands busy when feeling fidgety.

Chewing gum can help keep your mouth engaged but for some people, constant chewing can lead to headaches or jaw pain. If you are planning to use gum, it is advised that you opt for a sugar-free version to reduce your risk of dental decay. You can also choose to use nicotine gum which will help with the cravings. Just be sure to speak to your pharmacist for the proper dose to best match your needs and the proper use.  Cutting down on the number of cigarettes you smoke each day before your quit date can also increase your success.

One of the fears of quitting smoking is the weight gain that can happen. You can reduce this effect by eating healthy and increasing your physical exercise. Choose to go for a walk every day, take the stairs instead of an elevator and begin an exercise program. This new routine will all help in your attempt to break the old habits that led to your smoking.

Some non-pharmacological tactics (non-drug) to help you quit smoking are:

· Acupuncture: There is not enough concrete evidence regarding the effectiveness in this method to say it works for most but many people have found acupuncture to be helpful for them. It is a concept developed by the Chinese to influence the energy pathways in the body by placing special needles in very specific places on the nose and/or ear. There is not much of a downside to trying this method other than cost.

· Aversion Therapy: There isn’t enough evidence to show effectiveness from this method either which tries to associate an unpleasant feeling with smoking through mild electric shock, breath-holding or rapid smoking. The excessive or rapid smoking seems to have the best result

however it is not recommended due to the potential negative effects on the heart and lungs. Not many people will support increasing the nicotine intake to help you quit smoking.

· Clove and Herbal Cigarettes: These are imitation cigarettes but don’t let that fool you into thinking that these are harmless. These may contain tar, carbon monoxide and other toxins. In fact, some clove cigarettes may have up to 70% tobacco in them.

· Electronic Cigarettes: These are battery -powered devices that heat up and provide a vapour that mimics the smoke of a real cigarette. They may include varying amounts of nicotine, propylene glycol and other chemicals or impurities. This method can help satisfy the hand to mouth habit and the inhaling of the cigarette. Because it may have nicotine, it may also help reduce the cravings and thus be used as a drug therapy. Though electronic cigarettes are available in Canada, they are not regulated and therefore the safety is unknown.

· Financial Incentives: This can be quite beneficial to help encourage people to quit smoking, especially in the short term. Along this tactic, set aside money each day you are smoke free and allow yourself to be pampered with these savings at the end of a defined period of time (week, month). According to one survey, pregnant women appear to be most successful with this method.

· Hypnosis: The power of suggestion when you allow someone to put you into a deep, relaxed state can help change your habits and attitudes towards smoking. Hypnosis does not work on everyone since you need to be able to have an open mind and allow the power of suggestion to work.

· Laser Therapy: This uses laser beams on specific points on the body to trigger endorphins to be released. This in turn relieves nicotine cravings.

None of these techniques are guaranteed to work but are, for the most part, relatively safe and have at least anecdotal evidence supporting them. They can also be combined with drug therapy for an even higher chance of achieving success. We will delve more into that topic next week.

For more information about this or any other health related topics, contact your pharmacist.