Smoking

A lit cigarette. Source: NIH

Smoking is the purposeful inhalation of smoke, one of the products of combustion. Here it refers to inhalation of smoke from burning tobacco supplied in cigarettes, pipes, and cigars. Smoking can be physically addictive because it rapidly delivers nicotine to the body; the practice can also be psychologically addictive. Smoking's causal relationship to lung cancer (and a host of other diseases) makes it the leading cause of preventable death in the United States.

Treatment

Cigarette smoking is a major preventable cause of illness and death, and many different options for treatment are currently available.

Medications

Nicotine replacement therapy

Nicotine replacement therapy (NRT) is available in several different forms: chewing gum, oral inhalers, nasal sprays, as well as in patch form, which is placed on the skin. The latest evidence suggests using a combination of these products. ^[1]

Bupropion (Zyban)

Bupropion is a type of antidepressant drug that has proven to be effective in aiding smoking cessation.

Varenicline (Chantix)

Varenicline is a relatively new drug developed specifically for smoking cessation. The drug binds to nicotine receptors in the brain, exerting two different effects: Since the drug occupies the same receptors normally bound by nicotine from smoking, the normal positive feelings stimulated by smoking are not elicited. Thus, the normal cycle of satisfaction from smoking is broken. In addition, binding of the varenicline to the nicotine receptors results in partial stimulation of the receptors, which leads to a reduction in withdrawal symptoms.

Therapies

Psychosocial counselling is an extremely important part of Smoking cessation therapy and should accompany pharmacotherapy at all stages.

Holistic and alternative treatments

Hypnosis and Acupuncture are both used to aid in smoking cessation although the evidence for their effectiveness is lacking.

Prevention

Cigarette Smoking is a "disease" which starts as early as adolescence, in rare cases - even earlier. Studies show the importance of targetting parents and siblings as well as peer environments in specific Smoking prevention programs. ^[2]

Complications

The ramifications of cigarette smoking are vast, as smoking contributes to diseases involving a number of the major systems of the body.

Cancer

Smoking increases the risk for many types of cancers, including cancers of the lip, oral cavity, pharynx, esophagus, pancreas, larynx (voice box), lung, uterine cervix, urinary bladder, and kidney.

Cardiovascular effects

Smoking has been associated with increased risk of high blood pressure, peripheral vascular disease, heart attack and stroke,

Respiratory disorders

Chronic Obstructive Pulmonary Disease (COPD) is more common and more severe in smokers.

Reproductive complications

Some complications of smoking may include increased risk of pregnancy complications, premature birth, low-birth-weight infants, and the indicence of stillbirth.

Notable Experts

Organizations

Centers for Disease Control and Prevention

References

1. ↑ Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD000146.Abstract
2. ↑ Mercken L, Candel M, Willems P, de Vries H. Social influence and selection effects in the context of smoking behavior: changes during early and mid adolescence. Health Psychol. 2009 Jan;28(1):73-82. Abstract