|
If you are thinking about the possibility of quitting smoking, there is good news for you! Both non-pharmacological and pharmacological approaches to quitting smoking are available. Examples of non-pharmacological methods include individual or group counseling, behavioral programs, and support groups. Pharmacological methods include over-the-counter (OTC) as well as prescription-only medications. Here at Campus Health Pharmacy, we carry several OTC and prescription medications that are useful to help smokers quit. Perhaps you have heard of the term nicotine replacement therapy (NRT). NRT uses medications that supply nicotine to the body. Although these medications contain nicotine, they do not contain the tars and carcinogens found in regular cigarette smoke; therefore, nicotine replacement products can be thought of as “clean” or “pure” nicotine. The goal of NRT is to replace “dirty” nicotine in cigarette smoke by the “clean” nicotine present in these medications so that the individual attempting to quit smoking will still be exposed to nicotine but not other substances that could further compromise the smoker’s health. However, NRT is used in a “step down” approach in that the quitter is exposed to diminishing amount of nicotine over a period of time as the body adjusts to lesser nicotine. This tapering method helps to reduce uncomfortable withdrawal symptoms. Finally, the quitter reaches the lowest dose of nicotine and the transition to total abstinence becomes much easier to accomplish. OTC nicotine replacement products available at Campus Health Pharmacy include Nicorette gums and Nicoderm CQ patches. Nicorette gums are available in 2 mg and 4 mg strengths, but Campus Health Pharmacy carries only the 2 mg strength. Nicorette gums release about 50% of its nicotine content once it is chewed and “parked” between the cheek and gum, and the nicotine is absorbed through the oral mucosa. The gum should be chewed every 1-2 hours or whenever the urge to smoke arises, for at least 1-3 months without exceeding 30 2-mg gums per day. Nicoderm CQ patches release nicotine through the skin and are available in three strengths: 21 mg (Step 1), 14 mg (Step 2), and 7 mg (Step 3). For individuals who smoke more than 10 cigarettes per day, they should start with Step 1 for 6 weeks, then switch to Step 2 for 2 weeks, and finally Step 3 for another 2 weeks. For individuals who smoke 10 cigarettes per day or less, begin with Step 2 for 6 weeks and then switch to Step 3 for an additional 2 weeks. The patches should be applied daily for 16 or 24 hours. Choose a site of application that is clean, hairless, and dry. Irritation can be avoided by alternating the site of application and changing the patch every 16 or 24 hours. As far as prescription medications Campus Health Pharmacy carries
Zyban. Zyban is actually an antidepressant indicated for smoking
cessation that does not contain any nicotine. It works by reducing
nicotine withdrawal symptoms and the urge to smoke. It is available
in 150 mg sustained-release tablets and is dosed 150 mg once a day for
three days, then increased to twice a day for 7-12 weeks.
Adverse effects of nicotine replacement products include increased heart rate, increased blood pressure, increased blood sugar, increased respiration, reduced appetite, and cardiac arrhythmias. Special adverse effects associated with Nicorette gums are jaw muscle fatigue and oral sores. Nicoderm patches may cause skin rash and irritation. Zyban may cause dry mouth, difficulty sleeping/vivid dreams, shakiness, rash, and increased chance of seizure due to reduction in seizure threshold. Therefore, it is important for quitters taking Zyban to avoid drinking alcohol. Besides the above smoking cessation products carried by the Campus
Health Pharmacy, there are additional OTC and prescription medications
on the market. The following table provides a basic overview of all
the OTC and prescription medications used in smoking cessation including
strength, dosage, and major side effects. If you have any questions
about smoking cessation or NRT, please stop by the Campus Health Pharmacy
and ask a pharmacist. Good luck in your effort to become an ex-smoker!
|