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Medication combination is latest approach to quit smoking

2014-01-08 21:18
Medication combination may be the best approach to quit smoking

A new study, published in the Jan. 8 2014 issue of the Journal of the American Medical Association, found that when Chantix and Wellbutrin were taken in combination, more quitters didn't take up the habit again. This may be good news for heavy smokers that find it nearly impossible to quit.

Should auld acquaintance be forgot, and never brought to mind? According to Thomas Glynn, a director at the American Cancer Society, New Years Day is the most popular quit day for smokers. To me, I feel the proverbial New Years song may be very close to the truth when it comes to quitting smoking. You try to forget and never bring it back to your mind. Good luck on that. Like the smoke from a cigarette itself, the memories and cravings linger.

Perhaps the French poet and novelist (Orpheus) Jean Cocteau said it best. “If an addict who has been completely cured starts smoking again he no longer experiences the discomfort of his first addiction. There exists, therefore, outside alkaloids and habit, a sense for opium, an intangible habit which lives on, despite the recasting of the organism. The dead drug leaves a ghost behind. At certain hours it haunts the house.” The addiction remains, however the form may change. It is therefore important to find whatever tools you need to kick the habit.

According to this latest study, Chantrix and Wellbutrin when taken together increased the rate of quitting over 12 weeks in comparison to taking Chantrix alone. However, relapse rates after 12 months were similar.

"We believe this evidence strongly supports the idea that varenicline (Chantrix) helps everybody quit," said lead researcher Dr. Jon Ebbert, a professor of medicine at the Mayo Clinic in Rochester, Minn. "But for heavier smokers and more dependent smokers, combination therapy with varenicline plus bupropion (Wellbutrin) will increase quit rates more than varenicline alone."

Therefore he indicated that at Mayo Clinic they would be using combination therapy because the two medications work synergistically but in different ways. The medications have been found to target different areas of the brain and therefore may be crucial in the successful treatment of the nicotine addiction.

During the 12 week study, 315 smokers were given either Chantix and Wellbutrin or Chantix and a placebo. Dr Ebbert discovered that 53 percent of those taking the combination of both drugs had successfully quit smoking after 12 weeks. This was in comparison to 43 percent of those taking Chantix alone. In six months, 37% of individuals with the drug combination remained smoke free, while those who took Chantrix alone, only 28% where still successful quitters.

As time progressed the difference became less and less apparent with 31% in the combination and 25% taking Chantrix alone were still not smoking.

Despite the wealth of information, and amount of tools that are available, quitting smoking is notoriously difficult.

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Strategies to quit include medications,support groups,,acupuncture and hypnosis. The best idea says Bill Blatt, director of tobacco programs at the American Lung Association is to have a plan. Trying to quit on your own, without a plan, won’t work well. In fact, only 5% of people, who don’t have a plan, are able to quit long-term and smoke-free at least six months, Blatt says. In addition, he indicated that the most successful quitters, combine medications with counseling with 40% to 50% success rate.

How to increase your odds

  • Write down the reasons to quit.
  • Set a quit date
  • Inform your friends, coworkers and family
  • Change daily routines that revolve around smoking
  • Build support either via meetings, on the phone or online
  • Begin an exercise program
  • Cut back on cigarettes gradually
  • Drink lots of water
  • Find something to hold in your hand and mouth
  • Keep a picture of your family or someone very important to you with you at all times.


Take home message

It does not matter whether you take one medication, a combination, use hypnosis or acupuncture. The important thing is that you find support through whatever avenue will best meet your needs. Start imagining yourself as a non-smoker who is on the journey of a lifetime….one that will be healthier and hopefully much longer.

Resources:
The lung association's "Quitter in You" program offers guidance both for smokers and those who want to help a loved one quit.

Telephone counseling is also effective, however, and people can access this help easily by calling 1-800-QUIT-NOW.

People can sign up for a "SmokefreeTXT," at from the Department of Health and Human Services.

People can chat live online at cancer.gov run by the National Cancer Institute, which is available 8 a.m. to 11 p.m. ET Monday through Friday.

For more information on quitting smoking, visit the American Cancer Society

SOURCES:
Jon Ebbert, M.D., professor of medicine, Mayo Clinic, Rochester, Minn.; Sidney Braman, M.D., senior faculty, pulmonary, critical care and sleep medicine, Mount Sinai Hospital, New York City; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Jan. 8, 2014, Journal of the American Medical Association

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Comments

To quit smoking, you need to withdraw from it by the same determination,dedication and strength of desire to the reasons that caused you to start in the first place. One returns to the place of origin. Therein lies the strength to overcome the emotional trauma from withdrawl. The desire for long term gain and personal freedom from addiction must become stronger than the desire for immediate gratification. A metaphor; you eat a chicken, the same way you eat an elephant...one bite at a time.