Long-Term Approach to Smoking Cessation May Work Best
< Nov. 30, 2011 > -- Quitting is difficult for most smokers, but treating smoking as a disease to manage may make it easier to say goodbye to tobacco.
Experts have known for a while that a combination of nicotine-replacement therapy (NRT) and counseling is more effective than either of these approaches alone to successfully quit smoking. But researchers took this tactic a step further in a study published this week in the Archives of Internal Medicine.
Instead of assuming that smokers would be able to quit on their first try, even with this combo approach, the researchers took a long-term view. They built into their program the idea that smokers would need several tries to quit.
"This approach takes a chronic disease treatment model, instead of a one-shot model," says lead researcher Anne Joseph, M.D., at the University of Minnesota. "If you want to quit smoking, you have to keep working at it and having your treatment adjusted to accommodate the possibility that it might not work the first time."
Counseling plus medication
For the study, more than 400 smokers got both phone counseling and NRT in the form of patches, gums, or lozenges for one month. Next, the participants were randomly assigned to receive two final calls, or additional calls and NRT for a total of one year.
After 18 months, 30 percent of those who received the phone calls and NRT hadn't smoked for six months, compared with 23.5 percent of those who didn't receive long-term help.
In addition, people given long-term counseling tried to stop smoking more often than those who received only a few calls. And among those given long-term counseling, even those who did not quit smoked less than the people who received only a few calls.
"The fact that long-term care, like ongoing support, results in better quit rates makes sense, as we believe that nicotine addiction is like other addictions such as heroin or alcohol, which have been clearly shown to be best managed with ongoing long-term interventions," says Norman Edelman, M.D., chief medical officer for the American Lung Association.
But Dr. Edelman notes that more research is needed to look at the cost-effectiveness of this more intensive quit strategy.
Another quit-smoking study in the same journal issue looked at the effects on NRT on people who weren't yet ready to give up cigarettes.
Researchers at the Medical University of South Carolina randomly assigned more than 800 smokers to receive both NRT and counseling, or just counseling.
At four weeks, 22 percent of those who received counseling and NRT had tried to stop smoking for a day, as did 13 percent of those who received counseling alone. After treatment was stopped, 49 percent of those who received NRT had made an attempt to quit, vs. 40 percent of those given counseling alone.
The study suggests that NRT could be marketed for people willing to give it a try, which might be attractive to a greater number of smokers, says lead researcher Matthew Carpenter, Ph.D.
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Why Quit Smoking?
Here are a few of the many reasons to snuff out that cigarette for good:
You'll have a better chance of living a longer, healthier life. As soon as you stop smoking, your body starts to recover.
Your cholesterol levels will improve, lowering your risk for heart disease.
Your smile will be brighter. With every puff, nicotine and tar coat and stain your teeth.
You'll develop fewer wrinkles. Nicotine blocks the blood supply to your skin, which can cause wrinkles. Tobacco smoke dries your skin and makes it more prone to wrinkles.
Food will taste better. Smoking interferes with your senses of taste and smell.
Always talk with your health care provider to find out more information.
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American Cancer Society - Stay Away from Tobacco
Archives of Internal Medicine - Chronic Disease Management for Tobacco Dependence
Smokefree.gov - Quit Guide