IV.

Quitting Smoking

Studies of former smokers show that their risk of dying from smoking-related disease decreases with each year of abstinence. According to the World Health Organization (WHO), smokers who quit smoking before the age of 50 reduce their risk of life-threatening disease by half after just one year, compared with those who continue smoking.

Other benefits of quitting smoking include more disposable income, admission to social activities and institutions that ban smoking, and often, lower health insurance premiums. Nonetheless, to quit smoking is difficult, most likely because smokers crave the effect of the nicotine in the smoke. The U.S. surgeon general declared nicotine an addictive drug comparable to other addictive substances, including cocaine, heroin, and alcohol, in its ability to induce dependence. Overall, tobacco smoking causes about 20 times the number of deaths in the United States than all other addictive drugs combined.

Smoking cessation methods are plentiful, and many books and products are available to help an individual stop smoking. Many smokers turn to group help because of the support and understanding provided by other former smokers or people trying to quit. Most successful group-help techniques involve a challenge and reward system that also bolsters the self-discipline of the former smoker. One study found that smokers are more likely to quit within social networks. These networks are not necessarily organized support groups; they may consist of friends or co-workers.

A number of nicotine replacement products are available to help a person quit smoking. Nicotine patches are small, nicotine-containing adhesive disks that must be applied to the skin. The nicotine is slowly absorbed through the skin and enters the bloodstream. Over time, a smoker uses nicotine patches containing smaller and smaller doses of nicotine until eventually the craving for nicotine ends. Nicotine gum works in a similar manner, providing small doses of nicotine when chewed. A nicotine nasal spray is a physician-prescribed spray that relieves cravings for a cigarette by delivering nicotine to the nasal membranes. Also available by prescription, the nicotine inhaler looks like a cigarette; when puffed, the inhaler releases nicotine into the mouth.

An approach combining three different smoking cessation therapies has found remarkable success. This approach combines an antidepressant drug called bupropin, marketed under the brand name Zyban, with a nicotine replacement product and counseling. While less than 25 percent of smokers who use nicotine replacement products alone remain smoke-free for more than a year, 40 to 60 percent of smokers using this combination approach achieved this milestone.