Combo Therapy Works Best for Smokers Looking to Quit

They need psychological, social and pharmaceutical support, experts say

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By
HealthDay Reporter

SUNDAY, Oct. 10, 2004 (HealthDayNews) -- Forget going cold turkey. If you're a smoker who's fed up with lighting up, you can improve your odds of quitting by approaching your addiction as you would a Chinese takeout menu -- by choosing one item from column A, one from column B and one from column C.

The combination that works best for snuffing out a smoking habit is A, individual or group counseling; B, medication; and C, support from family, friends or co-workers, experts say.

"Your best shot is with all three," said Cheryl G. Healton, president and chief executive officer of the American Legacy Foundation, a nonprofit organization dedicated to smoking prevention and cessation.

October is Healthy Lung Month, a great time for Americans who smoke, and the people who love them, to take a deep breath and consider the facts about smoking:

  • An estimated 440,000 Americans die each year from diseases caused by smoking. It's the leading cause of preventable death in the United States.
  • Smoking causes 87 percent of all lung cancer deaths and is responsible for most cancers of the mouth, voice box, esophagus and bladder.
  • Smoking doubles your risk of stroke.
  • Smoking causes 85 percent of all cases of chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis, making it the fourth leading cause of death in America.

Now the good news: No matter how old you are or how long you've been a smoker, you can improve your breathing and cut your risk of cancer, heart disease and stroke by quitting now.

"There's good evidence to show at any age there's a benefit to quitting smoking," said Dr. Norman H. Edelman, the American Lung Association's consultant for scientific affairs.

Studies also show that kicking the habit is harder when smokers rely on a single quit-smoking aid to break their addiction -- say a nicotine patch and nothing else. They're not as likely to succeed in their quit attempt as people who join a support group, get encouragement from a family member and use a nicotine substitute, Healton said.

"You've got to plan your quit attempt systematically," Healton insisted. A combination of counseling, medication and social support can boost a smoker's chances of quitting successfully by as much as 50 percent, she said.

Yet, the typical smoker will try to quit many times before he or she succeeds. "The reason that upping your chances becomes so important is because people become demoralized," Healton said. Better to do it right the first time.

A combination-treatment approach makes sense because it addresses the social, physical and psychological aspects of smoking. Having loved ones on your side is just as important as getting the right medicine to help you quit.

"If you smoke and your husband smokes and he says, 'I'm not quitting,' it's very, very hard," Edelman said.

On the other hand, there have never been so many tools to help people stop smoking. Smokers can join a local support group, call a stop-smoking quitline or go online to trade advice and encouragement with other would-be ex-smokers.

To beat back nicotine cravings, smokers can choose an over-the-counter nicotine substitute, such as skin patches, gum or lozenges. Nicotine replacement therapy also is available by prescription as a nasal spray or inhaler.

A prescription for bupropion (Zyban), an antidepressant approved by the U.S. Food and Drug Administration as a smoking-cessation aid, can also help. Bupropion eases nicotine cravings, which can improve a smoker's chances of kicking the habit.

But it's not for everyone. People who have seizures shouldn't take bupropion; neither should people taking the antidepressant Wellbutrin or other medications containing bupropion hydrochloride, the same active ingredient in Zyban. It's also not recommended for individuals who are abruptly discontinuing use of alcohol or sedatives or for patients with an eating disorder, according to the drug's manufacturer, GlaxoSmithKline.

Smoking-cessation advocates are anxiously awaiting a new medication that could pull double duty by blocking people's craving to smoke and keeping their weight in check. One study found quitters who used rimonabant (Acomplia) tended not to experience the weight gain associated with smoking cessation, while some even lost weight. Sanofi-Synthelabo is expected to file a new drug application with the FDA sometime in 2005.

"If it holds up, it's going to be a miracle drug," Healton said.

More information

Ready to bury the butts for good? Visit the American Lung Association for plenty of useful advice.

SOURCES: Cheryl G. Healton, Dr.P.H., president and chief executive officer, American Legacy Foundation, Washington, D.C.; Norman H. Edelman, M.D., consultant, scientific affairs, American Lung Association, New York City

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