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DEAR MAYO CLINIC: I’m 47 years old and have been a smoker since I was 15. I’ve tried to quit more times than I can count. My wife says I should try nicotine replacement. But that doesn’t make sense to me. I want to be done with cigarettes and nicotine. How will putting more nicotine in my body help me kick this addiction?
ANSWER: When you’re trying to get rid of a cigarette habit that’s rooted in nicotine addiction, it may seem odd to look to nicotine for help. But nicotine replacement products are safe and effective aids for people trying to stop smoking. Particularly when paired with other smoking cessation techniques, nicotine replacement often serves as a bridge to a tobacco-free life.
The nicotine in cigarettes is highly addictive. Nicotine is what hooks you on smoking and keeps you smoking. However, nicotine is not the component in cigarettes that puts your health at risk. The real danger is tobacco.
Tobacco and tobacco smoke contain chemicals that cause lung cancer, as well as cancers of the mouth, throat, esophagus and larynx. Using tobacco can lead to other serious health problems, too, such as emphysema and chronic bronchitis. Two-thirds of all tobacco users eventually die of a tobacco-related illness. The sooner you stop putting tobacco into your body, the better off you will be.
Nicotine replacement products give you nicotine without tobacco. That helps relieve the withdrawal symptoms and cravings you may have if you try to quit smoking cigarettes without nicotine replacement. For many, going from tobacco to nicotine replacement is a critical and important step to a tobacco-free lifestyle.
Nicotine replacement doesn’t reinforce a cigarette habit the way tobacco does. You don’t get as much nicotine with nicotine replacement as you do with tobacco products, and nicotine replacement makes it significantly less likely that you will return to tobacco. Not using nicotine replacement reduces your chances of breaking free from tobacco.
A range of nicotine replacement products are available without a prescription. You can buy nicotine gum, patches and lozenges at most pharmacies and drug stores. Nicotine nasal spray and inhalers are available by prescription only.
Although nicotine replacement can be useful as you quit smoking, breaking a smoking habit is still hard, especially if you try to do it on your own. The best way to quit is to seek help from your doctor or a counselor trained as a tobacco treatment specialist. He or she can help you decide on the overall approach that’s best for you.
For example, along with nicotine replacement, other prescription medications may be helpful. Bupropion can help control nicotine cravings. Varenicline can reduce the pleasurable effects of smoking and lessen nicotine withdrawal symptoms.
Most health care providers also recommend behavioral therapy in addition to medication. Behavioral therapy often involves replacing old behaviors with new routines that aren’t associated with smoking.
For example, avoid places where you usually smoke. Instead, when you go out, visit places where smoking isn’t allowed. Try to spend time with people who don’t smoke or also want to stop smoking. Make it inconvenient to smoke by getting rid of your cigarettes. Chew gum while you drive, or take new routes to your usual destinations to keep your attention focused on your environment and away from smoking. If you usually have a cigarette with a cup of coffee or alcohol, drink water, soda or tea instead.
Nicotine replacement can be an integral step on the path to life without tobacco. But, to give yourself the best chance to stop smoking for good, seek help from a medical professional familiar with tobacco treatment. The effort will be well worth it, as the health benefits of not smoking are substantial, and they start accumulating almost immediately after you quit. — Dr. Jon Ebbert, Nicotine Dependence Center, Mayo Clinic, Rochester, Minnesota
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