Smoking is the graetest single cause of illness and premature death allover the world.Half of all regular smokers will die as a result of smoking. We will discuss in this article Smoking Cessation Medication
?Firstly : What is the risk of smoking
Risks Of Smoking :
- Cancers : common include : Lung; Lip; Mouth; Stomach; Colon; Bladder
- Cardiovascular disease : CHD, CVA, Peripheral Vascular Disease
- Chronic Lung disease : COPD, recurrent chest infection, exacerbation of asthma
- Problems in Pregnancy : PET, IUGR, Preterm delivery, neonatal and late fetal death
- DM
- Thrombosis
- Osteoporosis
- Dyspepsia and Gastric Ulcer
Smoking Cessation Medication
Smoking Cessation:
- Nicotine Replacement therapy (NRT) :
All preparation are equally effective. Start with higher doses for patients highly dependent. Continue treatment for 3 months, tailing of dose gradually over 2 weeks before stopping (except gum which can be stopped abruptly).
Contraindications:
- Post-MI
- Stroke
- TIA
- Arrhythmia
- Bupropion (Zyban):
Smokers older than 18 y start taking the tablets 1-2wk before intended quit day (150mg od for 3 days, then 150mg bd for 7-9wk)
Contraindications :
- Epilepsy
- Eating Disorders
- Bipolar disorders
- High risk of seizures
- Varenicline (Champix):
Smokers older than 18y start taking tablets 1wk before intended quit day (0.5mg od for 3d, 0.5 bd for 4d then 1mg bd for 11wk)
Decrease dose to 1mg od if renal impairment or elderly.
Contraindications:
- Caution in psychiatric patient
- Alternative therapy : Hypnotherapy may be helpful in some cases
Sources :
Oxford Hand Book of GB 4th Edition