![]() ![]() This message needs to get out to patients and doctors." Rigotti emphasizes that varenicline "is our most effective agent and no riskier than any other agent, even in patients with psychiatric issues. Smokers are at significantly increased risk for CV events as it is, and it is difficult to correct for this using the methods this most recent study used. Although one 2017 study suggests a risk, the methods have been called into question. A recent, large, high-quality study helped alleviate concerns about varenicline and psychiatric or cardiovascular side effects the FDA removed that black box warning in December of 2016. Many studies have shown that 12 weeks of the prescription medications varenicline and bupropion are effective and safe in patients who want to quit smoking. Use up to one lozenge every hour or two for six weeks, with no more than five lozenges every six hours or 20 lozenges per day, and then gradually taper. Place a lozenge in the mouth for 30 minutes. ![]() Smokers who smoke within 30 minutes of awakening should use the 4-mg dose, while smokers who wait more than 30 minutes after awakening to smoke should use the 2-mg dose. Smokers with dental issues or who use dentures may do better with the nicotine lozenge. Repeat this for 30 minutes, then discard the gum, because by that time all nicotine has been released." Rigotti recommends the "chew and park" method: "Chew the gum until the nicotine taste appears, then "park" the gum between your teeth and inner cheek until the taste disappears, then chew a few more times to release more nicotine. Chew one piece of gum whenever there is an urge to smoke (up to 24 pieces of gum per day) for at least six weeks, then taper off.įor best results, Dr. Those who smoke less than that should use the 2-mg dose. For the nicotine gum, someone who is smoking more than 25 cigarettes per day should use the 4-mg dose. If the patch is removed at night and morning nicotine cravings occur, use the gum or lozenges while waiting for the new nicotine patch to take effect. If leaving the patch on overnight causes insomnia and vivid dreams, take it off and replace it the next morning (smoking quit rates are the same whether the patch is left on for 24 hours or taken off at night). Change the patch site daily to avoid skin irritation, a common side effect. How one applies the patch is also important. However, those who smoke less than 10 cigarettes per day or weigh under 99 pounds should start with the medium-dose patch (14 mg/day) for six weeks, followed by 7 mg/day for two weeks. For the long-acting patch, someone who is smoking more than 10 cigarettes per day should start with the highest-dose patch (21 mg/day) for at least six weeks. When considering NRT, smokers need to consider what dose of each product they may need. "In addition, smokers are able to adjust nicotine intake to avoid both nicotine withdrawal and nicotine overdose, as they have done this throughout their years as cigarette smokers." Combination NRT is a patch (which is long-acting) plus a short-acting agent (like gum, lozenges, inhaler, or nasal spray), and is more effective than a single form of NRT alone. Rigotti points out that it's safe to use more than one type of NRT at the same time. Nicotine replacement ("the patch" and others)įorms of nicotine replacement therapy (NRT) include patches, gum, lozenges, inhaler, and nasal spray. ![]() Medicines that can help people quit include nicotine replacement therapy and the oral medications varenicline (Chantix) and bupropion (Zyban, Wellbutrin). As far as hypnosis or acupuncture, there is not a lot of evidence showing that they work. If someone has an underlying psychological issue like depression, anxiety, alcohol, or another substance use disorder, addressing those issues at the same time makes it more likely they can successfully quit smoking. Behavior strategies can include counseling from a healthcare provider, self-help from websites or text message services, and/or social support. Two-pronged approach is bestīehavioral strategies can help, medicines can also help, but what's best is a combination of both. Research shows that even people who quit after age 65 can enjoy a longer, healthier life span. "It's never too late nor too early to quit," she emphasizes. She has extensively researched nicotine and tobacco, evaluated public policies on tobacco, contributed to US Surgeon General's Reports, and authored clinical guidelines on smoking cessation. Rigotti is director of the Massachusetts General Hospital Tobacco Research and Treatment Center. To answer this question, I spoke with my colleague Nancy Rigotti, MD. So let's get right down to the nitty-gritty: quitting smoking is tough. Okay, everyone knows smoking is bad for you, the number one cause of preventable death in the US and the world, a direct cause of lung and heart disease and cancer… et cetera. ![]()
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |