Published On: Thu, May 31st, 2018

CRUSH THE CRAVE WITH NICOTINE REPLACEMENT THERAPY

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QUIT Smoking! This world Tobacco Day

 

Bengaluru, May 31, 2018: Tobacco smoking is one of the biggest public health threats the world has ever faced. The 3 billion smokers worldwide are not only putting themselves at risk, but also the non-smokers. Tobacco use is the leading cause of preventable disease and preventable death in India. Yet millions continue to smoke, leading to the most rapid rise in morbidity and mortality in India, killing nearly 6 million people each year with more than 6, 00,000 people dying due to exposure to second-hand smoke. Tobacco smoking is the most important risk factor for developing COPD2.  At least 1 amongst 4 smokers are at risk of developing COPD3. In both asthma and COPD, cigarette smoking is associated with an accelerated decline of lung function, increased mortality and worsening of symptoms4.  Lifelong smokers have a 50% probability of developing COPD during their lifetime7. An estimated 12 crore Indian adults smoke.

Smoking is the leading modifiable risk factor for chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), and lung cancer. Smoking cessation is the only proven way of modifying the natural course of COPD. It is also the most effective way of reducing the risk of myocardial infarction and lung cancer. The risk of total mortality and rate of recurrence of lung cancer is substantially lower in smokers who manage to quit smoking following the diagnosis of early stage lung cancer or small cell lung cancer. The risk is nearly 50%9. The prevalence of smoking tobacco use among current tobacco users is 35.1%. Smoking tobacco exposes the smoker to more than 7,000 chemicals, of which nearly 250 are harmful and nearly 69 chemicals are carcinogenic. Oral and Lung cancers account to more than 30% of all the cancers in India. In India, about a quarter of oral cancers are attributable to tobacco use.

 

More than 40 chemicals in tobacco smoke have been identified to cause cancer. (Again “more than 40” in this sentence and “nearly 69” in a previous sentence) Smoking also damages the lungs and other parts of the respiratory system, raises the blood pressure, and robs the body of oxygen, just to name a few of its harmful effects1. The average smoker is at a risk: 14x higher risk of dying from cancer of the lung, throat, or mouth, 4x higher risk of dying from cancer of the esophagus, 2xhigher risk of dying from a heart attack and 2x higher risk of dying from cancer of the bladder.

According to Dr. Murali Mohan B V, Chest Physician, Narayana Mazumdar Shaw Medical Centre, Bengaluru, Quitting the habit is made more difficult by the physical addiction to nicotine (the chemical stimulant in tobacco). Nicotine is a highly addictive drug that causes strong physical cravings and withdrawal symptoms like other drugs that stimulate the nervous system. Fortunately, medical treatments are now available that can help you control the withdrawal symptoms and cravings. With the treatment significant improvements in the quality of life, daytime symptoms, and bronchial hyper-reactivity can be witnessed.” 

Interestingly, female smokers experienced a faster decline in lung function compared with male smokers for the amount of cigarettes they smoked10. However, female smokers experienced larger gains in lung function when they stopped smoking early when compared with male quitters8.

Nicotine Replacement Therapy (NRT) is recognized globally as an effective form of treatment to help smokers to quit smoking.

Cigarettes are an effective means of delivering nicotine quickly to the brainstem where it stimulates the release of dopamine via the nicotinic receptors. NRT aims to take away the cravings for cigarettes and mitigate nicotine withdrawal symptoms by providing steady stimulation to the nicotinic receptors and preventing the rapid fluctuations in the release of dopamine in the forebrain12, 13.

Further Dr. Murali Mohan B V, mentioned, “When a tobacco user tries to quit, the drop in nicotine level in the blood can cause withdrawal symptoms and intense craving, which causes failure of the smoker’s attempt to quit. Nicotine replacement therapy (NRT) helps reduce nicotine withdrawal and craving by supplying nicotine, and maintaining the nicotine level. It contains about one-third to one-half the amount of nicotine found in most cigarettes. NRT is a way of getting nicotine into the bloodstream without smoking, thus avoiding withdrawal symptoms while avoiding exposure to all the other harmful chemical in tobacco. There are nicotine gums, patches, inhalers, tablets, lozenges, and sprays. Many clinical trials show NRT can increase the chances of quitting smoking by 50-70% compared to unassisted quitting. Combining NRT with other smoking cessation strategies like bupropion and varenicline and also counselling techniques like cognitive behavioral therapy, all increase quit rates safely and effectively”

Tobacco is linked with many health problems in addition to lung disease and cancer. As our knowledge about the health consequences of smoking grows, these health concerns have also been extended to the innocent bystanders (those who regularly encounter second-hand smoke). If you are ready to quit, talk to your physician. Your doctor can help you successfully quit smoking by treating your addiction to nicotine and by giving you information on how to change your behavior.

It is necessary to create awareness about the NRT and its benefits. Tobacco issue is an important issue and needs to be addressed and awareness around it needs to be created on regular intervals. It’s time to emerge stronger than addition. Let us say NO to tobacco and CRUSH THE CRAVE!

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