Many people who use tobacco develop a tobacco addiction. They develop a biological need for nicotine that arises because of physiological adaptation to the presence of the drug. The body becomes dependent on the drug and requires it in order to function normally. If a person stops using the drug, they can experience withdrawal and cravings. Withdrawal can be very unpleasant and is one of the most common reasons that people relapse to using tobacco (West & Shiffman, 2007).
Medications can play a key role in helping to manage withdrawal and cravings and increase the success in quitting. Medications can help people by:
Note: Medications are not recommended for everyone. Generally, people who smoke less than 10 cigarettes per day will not require medications and should be supported through counselling and behavioural interventions.
Medications used to treat tobacco addiction can be roughly divided into those that contain nicotine and those that do not. Some guidelines list medications as first line if they have several well-conducted randomized control trials (RCTs) with at least 6 months of follow up and biochemical confirmation of quit status AND the medication has official indication for the treatment of tobacco addiction. These first-line options include nicotine replacement therapies as well as prescription medications, such as varenicline and bupropion. Second line medications meet all the above criteria but do not have official indications to treat tobacco addiction.
What are some of the common concerns that you have heard from your clients regarding pharmacotherapy for tobacco cessation? What steps have you taken to address those fears/dispel those myths?