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The need and demand for treatment to help smokers to quit

This article discusses the need for treatment to help smokers quit, highlighting the addictive nature of cigarettes and the high failure rates of quit attempts. It explores the cost of failed attempts and the effectiveness of pharmacological and psychological treatments. It also addresses the lack of awareness and utilization of these treatments among smokers and health professionals. Recommendations are provided for increasing understanding and promoting the availability and affordability of quitting treatments.

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The need and demand for treatment to help smokers to quit

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  1. The need and demand for treatment to help smokers to quit Robert West University College London April 2008

  2. Need for treatment: cigarette addiction • Cigarettes are addictive • less than 25% of serious quit attempts survive one week • less than 5% of serious quit attempts survive 6 months • smokers experience powerful compulsion to smoke when they try to stop • smokers experience unpleasant withdrawal symptoms when they are deprived of nicotine • This is because nicotine causes a disorder in the brain pathways involved in motivation • Addiction is a matter of degree and not all smokers need help but many more need it than think they do

  3. Need for treatment: cost of failure of quit attempts • Every year that quitting is postponed after the age of 40 loses and average of 3 months of life so every quit attempt is a precious resource

  4. Treatments • Treatment can improve success rates by up to 300% • Pharmacological treatments • reduce compulsion to smoke by normalising activity in brain pathways underpinning those urges that have been disordered in nicotine dependence • these include nicotine patches and gum, bupropion, nortriptyline, varenicline and probably cytisine • Psychological treatments • reduce psychological motivations to smoke, bolster motivation not to smoke and provide skills and techniques necessary to exercise self-control • these can be provided face-to-face individually or in groups, or possibly by telephone

  5. Demand for treatment • Most smokers: • do not think they need help with stopping • do not understand the benefits of treatment to aid cessation • do not use treatments to aid cessation even in the UK where it is free or very cheap and widely available (less than 50% use pharmacological treatments and less than 10% use psychological treatments • Most health professionals: • have a limited understanding of the need for, and benefits of, smoking cessation treatments

  6. Recommendations • All health professionals should: • have a basic understanding of why it is so hard for smokers to stop and the effectiveness of smoking cessation treatments • be able to explain to patients the benefits of treatments to aid cessation and encourage smokers to use those treatments • All agencies involved in communication with smokers should: • educate smokers about the benefits of psychological and pharmacological treatments to aid quit attempts • All agencies that fund healthcare provision should: • place treatments to help smokers to quit at least on a par with other life-saving treatments in terms of availability and affordability

  7. Reading • West R and Shiffman S Smoking Cessation. Oxford: Health Press (2007)

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