Many former smokers swear by it: After the last cigarette, it's over! For some smokers, this works and they don't need any further help to give up smoking. For many others, there are still many "last cigarettes" before they admit to needing professional help.
There is a wide range of smoking cessation methods available. However, many of these approaches have no proven effect. In some cases, you may even experience problematic side effects.
Make sure you choose a scientifically based form of treatment. The clinic or smoking cessation specialist must be able to prove that patients are still smoke-free after six or even twelve months.
A combination of medication and behavioral/psychotherapeutic measures is recommended for smoking cessation. This addresses both the physical and psychological addiction.
The most promising approach is nicotine replacement therapy in conjunction with professionally guided individual or group therapy.
It is not the smoking itself that is addictive, but the nicotine ingested. However, it is the burnt additives in cigarettes and cigars that are responsible for the development of diseases. Nicotine replacement therapy therefore aims to supply the body with nicotine without burning tobacco. For this purpose
- Nicotine patches,
- nicotine gum and
- nicotine nasal spray
are possible.
Nicotine replacement therapy and psychological therapy can also be used independently of each other. They are then still promising.
The following always applies: A firm will is necessary when quitting smoking! You must be determined to stop smoking immediately.
Quitting smoking is unfortunately not easy, but it is certainly feasible © mbruxelle | AdobeStock
In medically supervised smoking cessation, the doctor or therapist will first take a medical history. They will ask you about your smoking history and your current smoking behavior.
The Fagerström test can be used to assess the degree of nicotine dependence. The degree of nicotine dependence provides information on the dosage and duration of drug and psychological therapies.
Concurrent mental illnesses, such as depression, can be exacerbated by nicotine addiction. You should therefore discuss these concomitant illnesses with your doctor before quitting smoking.
Make a list of the negative consequences of smoking and your personal reasons for quitting. This way you can quickly increase your motivation at any time.
The first seven to ten days of giving up smoking are the hardest. After that, the withdrawal symptoms improve significantly. The peak of withdrawal symptoms is even overcome after the first two days.
Possible withdrawal symptoms during smoking cessation include
- depressive mood,
- sleep disorders,
- irritability,
- aggressiveness,
- nervousness,
- restlessness,
- reduced ability to concentrate,
- slowed pulse,
- increased appetite or
- weight gain.
The goal of smoking cessation should primarily be permanent abstinence. This means that you no longer smoke at all.
It is true that the intake of harmful substances is also reduced if you only smoke less. However, such a reduction in cigarette consumption is not very promising because the risk of smoking more again is very high. Smoking reduction can only be an alternative in exceptional cases - if abstinence is definitely not achievable (e.g. after several therapeutic attempts).
The recommended method for quitting smoking is to stop smoking from one day to the next. You should remove any remaining cigarettes and ashtrays from sight beforehand. Only if this radical method fails should a gradual cessation be practiced as an alternative.
The aim of the temporary use of nicotine replacement is to suppress or alleviate the withdrawal symptoms.
However, smokers do not overcome their old smoking habits by taking medication. Nevertheless, the likelihood of long-term smoking cessation increases significantly with nicotine replacement therapy.
In addition to the reduced withdrawal symptoms, the cardiovascular risks are also reduced. Nicotine replacement products can therefore also be used for a longer period of time.
However, nicotine replacement therapy should be discontinued no later than twelve weeks after quitting smoking.
All forms of application are well tolerated when used as directed. The risk of developing an addiction is low.
Available nicotine replacement medication
The following over-the-counter medications are available for smoking cessation
- Nicotine gum (2 and 4 mg),
- the nicotine patch (in three strengths, over 16 or 24 hours),
- the nicotine sublingual tablet and
- the nicotine lozenge
Available on prescription are
- the nicotine nasal spray and
- the nicotine inhaler.
The nicotine patch and the nicotine nasal spray are considered to be the most effective.
The different forms of medication have different modes of action. They are more or less suitable depending on existing smoking habits.
Below you will find the characteristics of the three most recommended nicotine replacement products:
Nicotine patches
Nicotine patches ensure an even nicotine level in the blood. They are applied once a day. Nicotine patches are particularly suitable for moderate to severe nicotine dependence and regular tobacco consumption throughout the day.
After a few weeks, you should switch to a patch with a lower dosage. In this way, the nicotine patch can also be a thing of the past within two to three months.
Side effects of nicotine patches include skin irritation and patch allergies.
Nicotine gum
Nicotine gum is particularly suitable for low to moderate nicotine dependence or moderate and/or unevenly distributed cigarette consumption throughout the day.
Up to 16 chewing gums can be consumed daily. Nicotine gum can also be helpful in situations where a rapid intake of nicotine is necessary. You can use nicotine gum to prevent a relapse if necessary.
Over the weeks, you should reduce the number of chewing gums you use. Nicotine gum is the best alternative if you are allergic to nicotine patches.
Nicotine gums and tablets can
- irritate the oral mucosa, tongue, throat and oesophagus and
- lead to problems with the third teeth.
Nicotine nasal spray
Nicotine nasal spray is particularly suitable for smokers with a strong nicotine addiction and a high daily cigarette consumption.
After using the nicotine nasal spray, nicotine is available to the body particularly quickly. The maximum nicotine level is reached after ten minutes, which is why the spray also helps in situations with a strong craving.
However, there is a risk of developing an addiction to the nicotine nasal spray. It should be used regularly, but for no longer than six months and with therapeutic support.
A combination of nicotine patch and chewing gum or nicotine patch and nicotine nasal spray is possible and indicated in cases of severe dependence. However, you should discuss this with your doctor beforehand.
Other medications for smoking cessation
It is generally not advisable to use other smoking cessation medications in addition to these nicotine replacement products. Although the antidepressant bupropion can be helpful in quitting smoking, more serious side effects are possible.
Nicotine replacement therapy can counteract physical withdrawal symptoms. However, as part of the smoking cessation process, it is also important to
- to break habits,
- practice new behaviors (e.g. in stressful situations) and learn
- learn mechanisms of self-control.
Behavioral and psychotherapeutic measures can help here. They can take place within structured treatment concepts or independently.
Contact points include
- the online quit program of the Federal Centre for Health Education (BZgA)
- the German Cancer Research Center's (DKFZ) smoking helpline (06221 42 42 00).
The positive effect of social support on smoking cessation has been scientifically proven. This can be a doctor, but support from your private environment is even better. If possible, involve someone close to you in your smoking cessation activities.
On the other hand
- the introduction of "contracts" about rewards for achieving goals and/or punishments for not achieving them,
- relaxation techniques/breathing exercises and
- hypnosis
do not (permanently) increase success according to current knowledge.
Acupuncture does not appear to be more effective for smoking cessation than placebo treatment. There is also no scientific evidence of effectiveness for smoking cessation treatments from the field of homeopathy and herbal medicine.
