Introduction
Health professionals’ guidance and support are important ways of a broad strategy to tobacco control. Health professionals can contribute significantly to tobacco control in Australia and the health of the community by providing opportunities for smoking patients to quit smoking.
Health professionals take a crucial role in educating and motivating smoking patients and also diagnosing their dependence on nicotine and providing medical assistance to stop. Health professionals should thoroughly examine smoking patients, assess their smoking status, and provide them guidance and cessation therapy at all opportunities. When a patient comes with a problem caused or worsened by smoking, the health professional must raise the issue of quitting smoking (Robyn and Boyle, 2004).
Health professionals can work together with other parties to make possible accessibility and affordability for treatment of tobacco dependence including pharmaceutical products and their constituents (these include medicines, and products used to administer medicines and diagnostics) in pursuit of Article 22 of the FCTC (Australian Institute of Health and Welfare, 2008).
Three cognitive-behavioral approaches to quitting smoking
- Delay – this involves taking a much longer time than usual before taking the cigarette. This is an intentional delay by the smoker so that at the end of the day, the smoker reduces the number of cigarettes taken and reduces together smoking.
- Doing something else – this involves preoccupying oneself with something else that could be done besides smoking. One distracts the mind from the usual smoking.
- Drinking water – this is rather unconventional but in a way, can assist to ease the craving for a cigarette for at least in the short term.
Medications used for stopping smoking. How does each work?
Nicotine replacement therapy (NRT)
Nicotine is the element in tobacco that makes smokers addicted and dependent on cigarettes. The goal of this mode of treatment is to reduce withdrawal symptoms by giving some of the nicotine that would usually be got from cigarettes, without giving the harmful factors of tobacco smoke. The available forms of NRT are transdermal patch, gum, inhaler, lozenge, and sublingual tablet.
Varenicline
Varenicline is a “nicotinic acetylcholine-receptor partial agonist to alleviate symptoms of craving and withdrawal.” It was developed purposely for smoke quitting by targeting the nicotinic acetylcholine (ACh) receptor in the reward centers in the brain. Consequently, when a person smokes, the drug stops the inhaled nicotine from stimulating the α4β2 receptor adequately to cause the satisfaction and reward response. This mechanism explains why this mode of treatment is more long-term (The RACGP, 2011).
Bupropion
Bupropion is a non-nicotine oral therapy that reduces the urge to smoke reduces symptoms from nicotine withdrawal and considerably increases the long-term cessation rate. Bupropion is effective in several patient populations including smokers with depression, cardiac disease, and respiratory diseases including COPD.
Nortriptyline
Nortriptyline is a tricyclic antidepressant used in smoking cessation. It has been shown that it prolongs abstinence rates up to at least 6 months. However, the efficacy of this drug is limited in its application by its potential side effects including dry mouth, constipation, nausea, sedation, and headaches (Benowitz, 2008).
Six specific high-risk groups for smoking
Children and adolescents, pregnant and lactating women, people with mental illnesses, people with substance use disorders, people with smoking-related diseases, and prisoners.
What can be done to assist two of these groups to quit smoking?
- Adolescents and young people – In this age group, counseling can be important in helping them quit smoking. Also, health professionals should ask about smoking and give a proactive anti-smoking message. NRT can be used with the health professional first assessing the nicotine dependence, motivation to stop and enthusiasm to accept counseling.
- Pregnant and lactating women – This group should be offered intense advice and strong counseling and also, they should be provided with self-help material to supplement advice and support. NRT can also be administered by a health professional, but the smoker should first understand the risks because of the uncertainty of the safety of NRT (Einarson 2009).
Smoking is a vice that should be avoided at all costs. Smokers should seek advice and support to assist them in quitting smoking sooner before it is already too late, and the side effects of smoking have taken a toll on them. Health professionals can play a significant role in smoking cessation and smoking patients should seek help from these professionals.
References
Australian Institute of Health and Welfare, 2008. Australia’s health 2008. Cat. no. AUS 99. Canberra: AIHW.
Benowitz, N.L., 2008. Neurobiology of nicotine addiction: implications for smoking cessation treatment. Am J Med 121(4 Suppl 1), p. S3–10.
Einarson, A, 2009. Riordan S. Smoking in pregnancy and lactation: a review of risks and cessation strategies. Eur J Clin Pharmacol, 65, p. 325–30.
Robyn, L. and Boyle, R., 2004. Treatment of tobacco dependence. Oxford: Oxford University Press.
The RACGP, 2011. Supporting smoking cessation: a guide for health professionals. South Melbourne VIC 3205: The Royal Australian College of General Practitioners.