Treatment of withdrawal smoking

Nicotine replacement therapies

Only when necessary should be proposed with support of nicotine replacement therapies, with no more desire there is an 8% success at first, increases to 10% and to 18% in the fifth attempt. If nicotine patches or nicotine gum associate these successes can improve by 22%.

Indications:

It will only be necessary in patients with high physical dependence.

It should start the day you stop smoking, to get up, or in the previous hours.

It will continue daily, periodically reducing the dose, not to exceed 3 months of treatment.

There are several forms of administration, the most used: the skin patch and gum or chewing gum. The first offers the security of a steady release of nicotine, and prevents unsightly chewing gum. The gum is more like fluctuations in blood nicotine concentration that causes the cigarette, but must take into account contraindications and special conditions.

Sometimes it is useful to combine both methods in smokers who despite using the patch throughout the day experience episodes of intense desire to smoke, then being able to associate the gum.

Transdermal nicotine patches occurs in 16 or 24 hours of sustained release of the substance, and in different sizes of 10, 20 and 30 square cm surface, with a release of 5 or 7, 10 or 14 and 15 or 21 mgr. nicotine respectively, depending on whether the patch 16 or 24 hours.

There is not enough to opt for a kind of patch or other scientific evidence. In any case it seems logical to recommend the 24-hour patch in smokers who are already experiencing intense desire to smoke upon waking.

The patch should not be used in areas with hair because it reduces the absorption, or recently shaved areas by increasing risk.

The patch therapy usually begins with higher doses, taking into account prior consumption of snuff, to go progressively decreasing doses, approximately every 3 or 4 weeks, or even earlier, according to evolution.

Other routes of administration or alternative methods of nicotine sprays, nasal sprays, etc., are still being tested.

Price day of treatment: 2-3 € / day

Bupropion

It is an antidepressant that produces an inhibition of the neuronal uptake of norepinephrine, serotonin and dopamine, increasing their concentration in neuronal synapses. This depletion of mediators appears to be the cause of withdrawal from nicotine. So that its activity would replace this lack and wiping out or reducing the symptoms of nicotine withdrawal.

In various well-controlled studies, the percentage of patients who quit smoking was 44% at six weeks of treatment and 23% per year.

The nicotine replacement therapy associating both bupropion does not improve the success rate.

Side effects such as dry mouth in 12% of cases, and insomnia appears in 34% of cases. It is used at doses of 300 mg per day.

Price day of treatment: 2,8 € / day.