Tobacco use induces physical and psychic dependence on most consumers, affects the entire human body and is the leading cause of preventable morbidity and mortality, smokers have worse health indicators than non-smokers and a shorter life expectancy, on average ten years.
It is estimated that about half of regular smokers die as a result of tobacco use, 1 in 4 between 25 and 59 years of age.
The earlier you stop smoking, the greater the benefits and the resulting recovery in your life years. The act of lighting a cigarette is related to everyday situations such as eating or drinking coffee. The absence of nicotine causes anxiety, irritability, nervousness, headache, insomnia, difficulty concentrating and imperious desire to smoke.
Most smokers would like to stop smoking and attempt smoking cessation six to nine times during their lifetime, which corresponds to about 80%. Without help, those who do not smoke after one year do not exceed 7% and with medical help this figure rises to 25% to 35%. The key factors for smoking cessation are three: smoker motivation, counseling, and drug use.
To quit smoking we count on the smoker's motivation and change of habits, we ask that you set a date to quit smoking, share the decision with family and friends, and prepare that day. We also ask that you change some behaviors, exercise, healthier diet, less salt and fat, less alcohol and more water. Long-term success rates are higher with pharmacotherapy and psychological support. The use of pharmacological therapy doubles the chances of success.
Intensive support intervention should be offered to smokers who seriously consider quitting in the next 30 days, those who smoke their first cigarette within 30 minutes of waking, those who smoke more than 20 cigarettes a day, relapsing or experiencing severe deprivation syndrome. Smokers with tobacco-related pathologies such as COPD, cancer and cardiovascular disease, smokers with other addictive behaviors, and pregnant smokers should also be referred for smoking cessation consultations.
Successful smoking cessation is greatest among men, those with the highest level of schooling, and those who have been able to stop in long-term attempts.
They are factors of worse prognosis the high dependence to tobacco, depressed smokers or that integrate families of great smokers.
Pharmacotherapy for nicotine addiction aims to reduce the symptoms of deprivation, allowing them to learn to live without smoking and to provide the effects that the smoker took from tobacco: concentration, less irritable temperament, weight control, etc.
Top-line drugs are nicotine substitutes, such as varenicline, a non-nicotinic compound that reduces the symptoms of intense craving and withdrawal while reducing the payoff from the effects of smoking. The EAGLE study published in 2016 and involving more than 8000 smokers showed very interesting data: varenicline proved to be more effective than placebo. There was no significant increase in side effects attributable to varenicline over nicotine substitutes and placebo.
Relapse is part of the therapeutic process of smoking cessation and is frequent, it must be prevented, identifying high risk situations, training the approach to dealing with them.
It is also recommended that the fight against tobacco consumption should begin in schools, in our children avoiding the start of consumption and it is the task of all health professionals to address the smoking of our users and, in smokers, to propose strategies that allow stop consumption.
An article by Dr. Rui Alves, specialist in General and Family Medicine at the Sete Rios Health Center.