The success of nicotine replacement
Posted on August 17, 2008
Filed Under Smoking |
The nicotine replacement can afford to bear the lack of nicotine caused by smoking cessation. The success of smoking cessation depends on the strength and number of weeks of use of nicotine replacement. Sales of treatments aid to smoking cessation of the first quarter of 2007 increased by 44.9% over the first half of 2006, according to data released by the french Observatory for Drugs and Drug Addiction (Ofdt) .More than 1, 6 million French have consumed nicotine substitutes.
The substitutes are medicines containing nicotine.
They are sold in pharmacies without a prescription.
Substitutes increase by 2 chances to quit after 6 months to 1 year.
Surrogates broadcast of nicotine so slow and prolonged.
Alternatives allow nicotine to spread very slowly through blood through the skin with patches, or the lining of the mouth and gums, tablets and inhaler.
Their duration of use varies from 6 weeks to 6 months depending on smokers.
The alternatives are not hazardous to health because they can absorb only nicotine unlike the tobacco which contains the recall, 4000 toxic substances.
The lead substitutes few side effects.
There is no cardiovascular contrindication the use of nicotine replacement.
The use of nicotine replacement rarely sufficient to allow the total cessation of tobacco: The vast majority of smokers begin smoking. A psychological help can increase the chances of success.
The nicotine replacement, especially gum, inhaler or pills can cause addiction. But this risk is lower than that caused by tobacco.
The alternatives are not prohibited from pregnant woman: it is better to take nicotine substitutes that are not contrindiques rather than continuing to smoke. The aid to smoking cessation should be made with the advice of a doctor.
AFSSAPS, the French agency for safety of health products, recommends that pregnant women who smoke try to quit being supported by psychological or behavioral therapy. The substitutes are advised in case of failure of a psychological supports.
The patch
Colle on the skin, gradually diffuse patch of nicotine in the body. The effect begins after 30 minutes and then continues throughout the day.
There are different dosages that adapts based on the number of cigarettes that the smoker consumes each day, thus deliver a dose of nicotine equivalent to that received by compensating the usual daily intake.
The various patches:
small patch 24 hours 10 cm2, 7 mg, issuing 7 milligrams of nicotines during the day
Stamp 24 hours average 20 cm2, 14 mg (14 mg of nicotine are issued)
Stamp 24 hours 30 cm2 large, 21 mg (21mg of nicotine are issued)
Stamp 16 hours small 5 mg (5 mg of nicotine delivered)
Stamp 16 hours average 10 mg (10 mg of nicotine delivered)
Stamp 16 hours 15 mg high (15 mg of nicotine delivered)
The body may thus be gradually deshabituer the lack of cigarette.
The size of the patch determines the prescribed dose of nicotine.
The dissemination of the amount of nicotine depends on the size of the patch and the exposure time stamp left on the skin.
Using a patch is possible only when total cessation of tobacco.
The widest patches are used in early treatment and the smaller end of weaning, reducing gradually overcome over a period of 8 to 12 weeks.
The nicotine patches must be posed in the morning to replace the patch installed the day before.
Avoid touching the adhesive side of the patch.
The patches are removed 16 hours to 16 hours and are not kept overnight.
The risk of skin allergies are rare, but may nevertheless occur. When they appear, it is necessary to change the place where the patch is installed. If this attitude does not change, we must switch brands, as it happens that this reaction does not occur with another manufacturer. If the demonstrations continue, using patch must be abandoned. Before the emergence of these events, we should not hesitate to take the advice of her doctor or pharmacist.
The patches do not cause addiction.
The cost of a 6-month treatment varies from one to two or more according to the pharmacies.
Smoking with a patch can result in risks of nicotine overdose.
Some smokers think qu’enlever patch allows them immediately after smoking a cigarette. However, the nicotine delivered by the patch remains in the surface layers of the skin and continues to spread over 2heures after removing the patch.
It is formally contrindique smoking with a patch.
Allergy patchDes allergic reactions can occur with patches
These reactions are caused by the dispostif adhesive.
They cause local skin reactions at the site of the patch. In this case, we must remove the patch and change places.
If these events persist, it is necessary to switch brands or no longer use patch.
The gums
The oral forms can immediately address the lack of nicotine.
adjusting doses with greater precision, they cause peaks of nicotine that can maintain dependence.
The gum containing 2 to 4 mg of nicotine, suck for a few minutes and then chew slowly in order to liberate some of which contain nicotine.
The gum will consume according to the cravings that occur during the day and can manage its deficiencies.
8 to 12 gums are usually used in early weaning.
Put gum in mouth, chew slowly and chew inside several times.
Using a rubber takes about 30 minutes.
A gum chewed too quickly can cause unpleasant sensations of heartburn, sore throat or hoquets.
The inhaler
The inhaler is a plastic mouthpiece that opens in 2 to receive a cartridge or a swab containing nicotine.
The smoking aspires several times a tip.
Several cartridges can be used in early weaning.
The tablets
The tablets can melt under the tongue or suck without bite.
The urge to smoke disappears rapidly a few minutes by taking a pill.
The number of tablets used daily varies depending on the length of smoking between 8 and 12 per day at the beginning of treatment and decreases thereafter.
consumption of coffee or fruit juice is not recommended 15minutes before taking the pill because these substances alter the absorption of nicotine level buccal.
Association of several types of substitutes
The associations of various types of alternatives, are recommended for smokers with a high dependence on nicotine accompanied by cravings at any time of day.
For these smokers, the beginnings of judgement are more difficult and some situations pose risks for ex-smokers. The smoker can more easily resist the need to smoke.
Taking occasional nicotine in gum or inhaler, in addition to the patch can help smokers to level the irresistible impulse to smoke.
It is now possible to use at the same time several types of substitutes, patch or gum and patches and inhalers,
This association allows a better adaptation of smoking cessation and a more appropriate.
A combination of several alternatives must be done under medical supervision in order to adapt the proper dosage.
The area supports best moments of the day when his desires are very important and the risks of refumer greatest.
The smoker feels reassured to manage its lack of nicotine by taking a substitute whenever he wants to smoke a cigarette.
A medical advice is recommended when taking several types of nicotine replacement.
Take nicotine substitutes and continue smoking is possible
Continue to smoke a cigarette while maintaining continuous rate of nicotine with nicotine replacement is now a measure recommended for all heavily dependent smokers who can not even imagine “life without a cigarette.”
This helps to reassure the smoker who is unable to imagine that it can no longer smoke.
The knowledge that they can continue to allow smoking in some smokers have more time to deconditionner and be done gradually to the idea that they smoke more.
This method is more flexible and reduces the risk of failure.
A smoker who smokes 10 cigarettes can and try not to smoke cigarettes 3 or 4 will replace it by 3 or 4 oral forms of substitutes in the form of gum or tablets.
The use of patches is incompatible with concurrent consumption of cigarettes.
Budget using nicotine replacement
The prices of substitutes may vary from simple to double or even more depending on the pharmacies. Please, you can make savings. The average cost is about 2 euros a day.
health insurance supports ER since 1 February 2007 a lump sum of 50 euros per year for the purchase of nicotine replacement on medical prescription. It is thus possible to obtain an assumption of 50 euros each calendar year.
Some substitutes may be used as young as 15 years. Ask the advice of your doctor or pharmacist.
The use of nicotine replacement in a pregnant woman or a woman breastfeeding, is possible but the advice of a doctor is essential, especially after the sixth month of grossesse.Il is nevertheless advised pregnant women to begin by trying to wean without substitute.
The nicotine substitutes are dangerous for children.
Know the signs of nicotine overdose
The occurrence of these events must fear the occurrence of an overdose of nicotine replacement and may require the advice of a doctor.
Feeling degout tobacco
Headaches
Dizziness
Acceleration cardiac rhythm
Nausea
Diarrhoea
Bouche pasty
The cessation of substitutes in all its forms, remains the first step to be taken immediately. In the vast majority of cases, events disappear.
How to adjust the doses substitutes based on dependency?
The choice of dose is an important factor for success in stopping smoking
The success of smoking cessation depends on the strength of nicotine replacement and their duration of use, which usually varies from 6 weeks to 6 months.
insufficient dosage may lead to failure: Alternatives must provide a dose of nicotine equivalent to that received the smoker with cigarettes.
doses substitutes adapts depending on the degree of dependence evaluated with the test Fagerström and the existence of events related overdose.
If after 7 days, feelings of lack and needs compulsive smoking are always present, it means that the mix of substitutes is insufficient.
A person taking substitutes and who needs to smoke, should review and determination of his deputies.
The dose of nicotine prescribed depends on the daily consumption of tobacco and the level of dependency.
High doses are proposed at the beginning of treatment. Then they are gradually reduced.
The dependent smokers are more likely to agree with an eraser determined to 4 mg as measured by the 2 mg.
For low-dependent smokers, the decision to use substitutes depends on the ability to stop alone.
Smokers moderately dependent use most of the time of nicotine replacement.
For highly dependent smokers, medical opinion remains indispensable
The combination of markers of smoking can assess the degree of dependence
The best scorer of the tobacco dependence is the cotinine, a derivative of nicotine that can be measured in saliva or urine and reflected the degree of exposure to active and passive smoking. A high rate indicates a significant dependence.
Even little used, this technique can become a valuable tool for assessing the degree of dependence and adjust the dosage of nicotine replacement.
Tips according to the degree of dependence obtained after the test Fagenstrom
Score of 0 to 2: I do not care
It is possible to quit without using nicotine substitutes. We must be vigilant and quickly get rid of these first smoking habits when the urge to smoke arises: drink a glass of water, eating an apple, have a sporting activity …
Score of 3 to 4: low dependence
It is possible to quit without using nicotine substitutes, but we must remain vigilant and nicotine replacement can be advised if smoking cessation is impossible alone.
Score 5 to 6: dependence average
The use of nicotine replacement is recommended.
Score 7 to 10: dependence strong or very strong
consulting a tobaccologist is strongly recommended. The committee will advise substitutes or nicotine as a drug dependence.
Attempts stops tobacco must not demotivate
“I’m fed up,” it is 3 times that I try to stop and each time I resume… ”
This sentence, many smokers have often pronounced.
must cling yet, because every attempt to quit smoking, provides experience.
What you need to know:
several attempts are necessary before finalizing.
4 trials on average are needed before coming to stop smoking.
Each relapse represents a step towards stopping smoking.
Do not demotivate
Do not blame
Do not dramatize
Know quarreter few months is possible and important.
In opportunity to understand why it has relapsed in order not to repeat the same mistakes.
Do not take a cigarette from time to time when the judgement began as the risk of relapse is very important.
A heavy smoker dependent remains a smoker who may recur 6 months, 1 year or several years later.
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