Giving up smoking - Can medicines help?

Although nicotine addiction can be a difficult habit to break, research suggests that more and more Australians are quitting successfully thanks to smoking cessation aids.

In the latest edition of Australian Prescriber, Dr Mike McDonough, Head of Addiction Medicine at Western Health, Melbourne, investigates nicotine addiction and modern treatments that are proven to be effective in helping people kick the habit.

With fewer people smoking each year, the typical 'smoker' is now someone identified with a more severe nicotine addiction who may have unsuccessfully tried to quit. They may experience chronic relapsing throughout their lives due to stressful circumstances, consuming alcohol or being with others who smoke.

Features of severe nicotine dependence include:

• smoking in the first five minutes after waking up
• smoking despite illness, such as respiratory tract infections
• waking during the night to smoke
• smoking to reduce withdrawal symptoms
• smoking more than a pack of cigarettes a day.

Dr McDonough says that nicotine replacement therapies should be considered as the first line of treatment. "Gums, lozenges, oral strips, spray, inhalers, patches and tablets are all equally effective in reducing nicotine cravings, especially when combined," says Dr McDonough. "It really just depends on individual preferences, experiences and medical conditions."

Dr McDonough compares the effectiveness of nicotine replacement therapy with other medicines for smoking cessation such as varenicline. He also provides advice about the role of e-cigarettes in smoking cessation. "They are no more effective than current medicines; in fact, there are concerns over their safety and marketing principles."

If and when smokers decide to quit, they should be taken seriously and encouraged to try the medicines available that have been proven to be effective.

For a full list of smoking cessation aids please visit www.australianprescriber.com/magazine/38/4/106/11