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How To Quit Smoking (For Good!)

As many people are starting to make new year’s resolutions, stopping smoking is one that comes up regularly! Smoking is the leading cause of avoidable death in Ireland with 6000 deaths a year from the effects of smoking. Every cigarette takes 5 and a half minutes off your life so the sooner you quit the better!

There are many health benefits to stopping smoking;

  • After eight hours nicotine and carbon monoxide levels in your blood decrease and oxygen levels increase.
  • After 48 hours nicotine and carbon monoxide have left your body and your sense of smell and taste have improved
  • After one month skin will be clearer, brighter and more hydrated.
  • After three to nine months breathing will have improved, and you will no longer have a cough or wheeze. Lung capacity can have improved by up to 30%.
  • After one year the risk of heart attack and heart disease will have fallen to about half that of a smoker.
  • After 10 years the risk of lung cancer will have fallen by half.
  • After 15 years the risk of heart attack and heart disease will be the same as someone who has never smoked.


In order to successfully stop smoking it can be helpful to identify potential barriers and ways to overcome these. Some tips include;

  • Tell friends that you are trying to stop
  • Don’t go on smoking breaks with friends who are smokers for the first few weeks
  • Don’t go out to smoking areas on nights out for the first few weeks
  • If you normally smoke in morning try to break habit. You can try having a shower as soon as you wake or put on the radio or have a cup of tea or coffee.
  • If you always smoke after a meal you could get up and go for a walk to distract yourself.
  • Have a money box and put the money you would normally spend on smoking into it. You could then set a date to use this money to buy a treat for yourself.
  • Have a friend who you can call when you get cravings to distract yourself.


Nicotine Replacement Therapy (NRT)

Nicotine Replacement Therapy (NRT) an be a very useful way to control cravings while quitting smoking. You are twice as likely to quit smoking for good if you use NRT. There are many types available on the market so you can try a few and see what suits you best.

GUM 

For someone who smokes less than 20 cigarettes per day the 2mg gum is recommended. For someone who smokes more than 20 cigarettes per day the 4mg gum is usually more suitable.

Unlike regular chewing gum, you should use the “Park and chew” method with nicotine gums. This means chew the gum until taste becomes strong, ‘Park’ in cheek until taste fades, then rechew. Repeat cycle for 30 mins.

Coffee, acidic drinks and soft drinks may decrease the absorption of nicotine and should be avoided for 15 minutes before gum or lozenge.

Nicorettemax 15 gums day (normally 8-12 per day are enough)
Nicotinelmax 25 gum per day


LOZENGE

There are three main brands of lozenges available, Nicorette, Nicotinell and NiQuitin. 

For smokers of less than 20 cigarettes per day the lower strength lozenges are suitable. Smokers of more than 20 cigarettes per day would use the higher strength lozenges.

Place lozenge in mouth and allow to dissolve. It should be moved from one side of the mouth to the other for 20-30 minutes until dissolved. Do not eat or drink while lozenge is in mouth. Do not chew the lozenge.

Step 1:1 lozenge every 1-2 hours. Normally at least 9 per dayWEEK 1-6
Step 2:Reduce to 1 lozenge every 2-4 hoursWEEK 7-9
Step 3:Reduce to 1 lozenge every 4-8 hoursWEEK10-12


PATCH

If smoking less than 20 cigarettes per day start with the middle dose patch but still follow a twelve week course.

One main difference to take into account is Nicorette patches are left on for 16 hours compared to 24 hours for NiQuinin and Nicotinell. Some people prefer the overnight patch if they are prone to craving immediately when they wake up in the morning. Sleep disturbances or vivid dreams can occur when using the 24 hours overnights. In this case the 16 hour Nicorette patch is more suitable.

  • When first use patch may cause mild skin reaction. Usually redness or itching of skin where the patch has been. This will usually disappear after a few days.
  • Apply patch to dry, hairless, clean skin that is oil & product free. Apply to front or side of chest (not breasts), back or upper arms or, if necessary, outer thighs/buttocks.
  • You can shower, swim etc with no problems once the patch is applied right. If the patch does fall off, which is unlikely, discard it and apply a new patch.
  • Dispose of patch by folding it in half to cover the side attached to skin and placing it in an empty sachet or by wrapping it in aluminium foil.

Nicotinell

21mg

Then 14mg

Then 7mg

3-4 Weeks

3-4 weeks

3-4 weeks

Nicorette

25mg

Then 15mg

Then 10mg

8 Weeks

2 weeks

2 weeks

NiQuitin

21mg (step 1 patch)

Then 14mg (step 2 patch)

Then 7mg (step 3 patch)

6 weeks

2 weeks

2 weeks


QUICKMIST

Quickmist is very quick acting with just 60 seconds until onset of action. It is normally used for 3 months and can be used for up to a maximum of 6 months. When starting to use Quickmist, spray once into your mouth. If cravings don’t disappear within a few minutes, use a second spray. If two sprays were needed use two consecutive sprays from then on. Do not close mouth immediately after spraying as hiccups can occur.

Step 1:

1-2 sprays. Max 4 perhour, max 64 per day


WEEK 1-6

Step 2:

Reduce number of sprays per day. Should be using half the amount of sprays by week 9

WEEK 7-9


Step 3:

Continue reducing until using not more than 2-4 sprays per day by week 12. Stop using once reach 2-4 sprays per day

WEEK10-12


INHALER

Nicorette inhaler can be very useful for people who would like to mimic the feel of a cigarette in their hand. Most people use between 3-6 cartridges per day when beginning to quit smoking. After 8 weeks, start to decrease the number of cartridges used per day. Aim to halve the amount within 2 weeks. Do not use more than 6 cartridges per day. Each cartridge lasts the equivalent to 40 minutes of smoking.

Combination therapy

You can use a combination of long-acting form of NRT such as the patch in combination with a short acting form such as gum or spray to control any additional cravings.

Pregnancy

Smoking can increase the risk of miscarriage, pregnancy complications and premature delivery.

Nicotine Replacement Therapy is less harmful to the baby than smoking. Preferably the options should be discussed with your doctor. A reduced period of 2-3 months NRT is most acceptable in pregnancy. Lozenges/gums are preferred to patches as they are not continuous. However, patches may be necessary if nausea is a problem.

Breastfeeding

NRT is less harmful during breastfeeding than second hand smoke. Gums or lozenges should be used and taken immediately after breast feeding so the baby gets the smallest amount of nicotine in the milk.

Prescription Medication

In some cases, prescription medication such as Champix or Zyban are necessary to help you to quit smoking. You can speak to your GP about these medicines.

For any support on quitting smoking visit quit.ie or call into any McGorisks pharmacy for helpful advice.

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Philip McGorisk

Supervising Pharmacy

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