Stopping smoking represents a major public health challenge, with notable repercussions both on an individual and collective level. General practitioners (GPs) and smoking cessation specialists, such as Dr Alex Bobak and Louise Ross (smoking cessation specialists in England), play a crucial role in supporting patients who want to quit smoking. Through this article, we explore the different approaches and therapies available, as well as their effectiveness.
The opportunistic approach in consultation: a first-line strategy
Adopting an opportunistic approach during consultations is strongly recommended. Known by the acronym VBA (“Very Brief Advice”), this method is divided into three key steps: asking the patient's smoking status, advising on the best cessation strategies including support and pharmacological treatment, and referring to the local resources available. This strategy can be implemented in less than 30 seconds, providing a quick and efficient way to engage patients.
Therapeutic options available
Scientifically validated smoking cessation aids mainly include:
- Nicotine Replacement Therapy (NRT) : Available by prescription or over the counter, it offers controlled doses of nicotine without the toxins present in tobacco smoke, helping to reduce withdrawal symptoms and cravings. Formats vary: patches, gums, lozenges, inhalers, and nasal or oral sprays.
- Varenicline : Available only by prescription, this molecule acts as a partial agonist of nicotinic cholinergic receptors in the brain, reducing cravings and withdrawal symptoms, while blocking the rewarding effects of nicotine.
- Bupropion : Antidepressant misused for its action on nicotine withdrawal, it is also prescribed to help quit smoking, thanks to its action on the recovery of dopamine and norepinephrine.
- Cytisine : Similar to varenicline, it also helps reduce cravings and withdrawal symptoms related to quitting smoking.
The role of electronic cigarettes
E-cigarettes, or vapes, are another alternative to quitting smoking. By heating a nicotine liquid, they simulate the act of smoking without burning tobacco, which considerably reduces exposure to harmful combustion products. They are particularly effective when combined with behavioral support.
Behavioral support
Behavioral support tailored to individual needs is essential to maximize the chances of success. This support may include assessing tobacco dependence, planning a quit date, managing triggers, and ongoing motivational support.
This set of strategies and treatments offers smokers various pathways to overcome their tobacco addiction, highlighting the critical importance of a personalized and sustained approach in the smoking cessation journey.
source: pulsetoday.co.uk
