Anyone who has tried knows that giving up cigarettes is not easy. But there is always the opportunity to achieve a better life without tobacco . In fact, effective treatment involves addressing three aspects: physical, psychological and behavioral. In addition to circumventing (physical) abstinence, one must separate the cigarette from emotions such as joy or sadness (psychological) and habits such as drinking coffee or driving (behavioral). Only a careful medical evaluation is able to indicate which treatment is optimal for each patient. Are you interested and want to know more about the methods available?
Nicotine gum
Nicotine chewing gum should be used when the patient has symptoms of withdrawal or an intense urge to smoke. When chewed, chewing gum gradually releases nicotine, and it is absorbed by the oral mucosa, with a peak in 20 minutes. In this case, the action of nicotine in the body is different from when it is inhaled with cigarette smoke, because it will be deposited in the bloodstream in small doses with the purpose of controlling addiction. An important factor in making chewing gum use effective is its technique of use. They should not be chewed like ordinary chewing gum, but chewed a few times until the taste of nicotine is apparent, and after that you should deposit the chewing gum between the gum and the cheek until the taste disappears. The same cycle of chewing and depositing chewing gum should be repeated until 30 minutes of use is completed, when it should be discarded.
The nicotine gums are contraindicated for patients with mandibular joint disorders, poor dentition or gingivitis and pregnant women. In the case of future mothers, it is known that nicotine is associated with the birth of low birth weight babies, and all nicotine from pregnancy should be excluded. However, the use of nicotine replacement therapies, such as patches and chewing gum, is still safer than continuing to smoke. Side effects may include nausea, vomiting, abdominal pain, headache, coughing, excessive salivation and irritation of the oropharyngeal mucosa. In addition, ingesting liquids while chewing the gum may "wash" the oral nicotine, making the product ineffective.
Nicotine lozenges
Similar to chewing gum, nicotine lozenges also release the substance gradually and should be used below the tongue. The pills require a higher dose for patients who smoke the first cigarette in less than 30 minutes after waking. Because it does not require chewing, it can be used in patients with mandibular joint disorders or poor dentition, but the other contraindications are the same as chewing gum. Nicotine lozenges can be used for up to three months and the side effects are similar to gum. Ideally, the tablet should be moved from side to side of the mouth until it dissolves completely, and is used when the patient feels like smoking, not exceeding the daily amount indicated in the package insert.
Nicotine adhesives
In order to further increase abstinence rates to tobacco, transdermal nicotine patches have been developed. They should be used constantly and changed every 24 hours, without interfering in the activities of the individual. They are indicated for all the people who want to stop smoking, not having any formal contraindication, with the proviso for pregnant women. The use of the replacement adhesives should be done during 45 to 90 days, and the dosage depends on how many cigarettes the person smoked per day. Among the side effects are the presence of skin irritations, which may prevent the continuation of treatment. Most common side effects due to nighttime use are insomnia and nightmares, in which case the patch should be removed before bedtime.
Nicotine nasal spray
The nasal spray releases an aqueous nicotine solution into the nasal mucosa with rapid absorption and peak of 10 minutes when compared to chewing gum. Its use is recommended for up to three months. It should be given at one or two doses per hour, without exceeding the number of five doses per hour or 40 doses per day. Its most common side effects are nasal and oropharyngeal irritation, rhinitis and tearing, with 94% of users showing some signs of nasal irritation in the first two days. However, none of these effects warrant discontinuation of treatment. The product may be used in conjunction with other forms of replacement, as directed by a physician. Most patients use on average 15 doses per day, decreasing the number of doses over time.
Electronic cigarette
The commercialization of electronic cigarettes is prohibited in some countries. The internal cartridge of these products contains nicotine, the same substance as the common cigarettes that causes addiction, although manufacturers claim that the smoke is just water vapor. There is no evidence that the device has any use in the smoking cessation process. As it is an unregulated product, there is no way of knowing in fact what the substances are in these cigarettes or whether they can cause harm. There are researches on the electronic cigarette that did not show benefit in the long term, but problems and respiratory difficulties in the users.
Bupropion
Originally an antidepressant, this medication has been approved by the Food and Drug Administration (FDA) for the treatment of smoking. Its effect on tobacco control has been discovered in studies to check its effects against depression, in which participants reported decreasing their desire to smoke. Unlike the nicotine replacement therapies cited above, smokers should start using bupropion one week prior to withdrawal. The most common side effects are insomnia, restlessness, dry mouth and headache. Experts point out that bupropion can be used in conjunction with other over-the-counter therapies, such as nicotine chewing gum, but regardless of whether it is administered individually or not, it asks for medical follow-up.
Hopefully the information above is useful for those of you who want to be free from dependence on tobacco.
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