Treatment of nicotine addiction

Introduction Nicotine dependence is recognized in the International classification of diseases the 10th version (ICD10) as Mental and behavioural disorders due to use of tobacco Its coded F17

Key facts Tobacco kills up to half of its users. Tobacco kills around 6 million people each year. More than 5 million of those deaths are the result of direct tobacco use while more than 600 000 are the result of non-smokers being exposed to second-hand smoke. Nearly 80% of the world's 1 billion smokers live in low- and middle-income countries.

Cigarettes are smoked by over 1 billion people, which is nearly 20% of the world population in 2014. About 800 million of these smokers are men. While smoking rates have leveled off or declined in developed nations, especially among men, in developing nations tobacco consumption continues to rise. More than 80% of all smokers now live in countries with low or middle incomes, and 60% in just 10 countries,

This is a list of countries by annual per capita consumption of tobacco cigarettes 1 Montenegro 4124.53 2 Belarus 3831.62 3 Lebanon 3023.15 4 Macedonia 2732.23 5 Russia 2690.33 6 Slovenia 2637.03 7 Belgium 2353.28 8 Luxembourg 2283.55 9 China 2249.79 10 Bosnia and Herzegovina 2233.4

46 Malta 1266. 14 47 Spain 1264. 74 48 Vietnam 1226. 92 49 Egypt 1215 46 Malta 1266.14 47 Spain 1264.74 48 Vietnam 1226.92 49 Egypt 1215.3 50 Iraq 1187.65 51 Albania 1177.42 52 Canada 1154.25 53 Uruguay 1135.16 54 Lithuania 1123.86 55 Portugal 1114.11

أرقام مخيفة عن التدخين في العراق      قانون مكافحة التدخين العراقي رقم 61 لسنة 2012

prevention Studies show that few people understand the specific health risks of tobacco use. For example, a 2009 survey in China revealed that only 38% of smokers knew that smoking causes coronary heart disease and only 27% knew that it causes stroke.

prevention Picture warnings work Hard-hitting anti-tobacco advertisements and graphic pack warnings – especially those that include pictures – reduce the number of children who begin smoking and increase the number of smokers who quit. Only 42 countries, representing 19% of the world's population, meet the best practice for pictorial warnings, which includes the warnings in the local language and cover an average of at least half of the front and back of cigarette packs. Most of these countries are low- or middle-income countries.

prevention Ad bans lower consumption Taxes discourage tobacco use Illicit trade of tobacco products must be stopped

In 2008, WHO introduced a practical, cost-effective way to scale up implementation of provisions of the WHO Framework Convention on the ground: MPOWER. Each MPOWER measure corresponds to at least 1 provision of the WHO Framework Convention on Tobacco Control. The 6 MPOWER measures are: Monitor tobacco use and prevention policies Protect people from tobacco use Offer help to quit tobacco use Warn about the dangers of tobacco Enforce bans on tobacco advertising, promotion and sponsorship Raise taxes on tobacco.

Treatment Many treatments, including nicotine replacement therapy and non-nicotine medications, have been approved as safe and effective in treating nicotine dependence. Using more than one medication may help you get better results. For example, combining a longer acting medication with a short-acting nicotine replacement product may be beneficial. 

Nicotine replacement therapy Nicotine replacement therapy gives nicotine without tobacco and the harmful chemicals in tobacco smoke. Nicotine replacement products help relieve withdrawal symptoms and cravings. The best time to start using nicotine replacement medication is on the date set to stop smoking. Some smokers start earlier in order to reduce smoking on their way to stopping altogether.

The following nicotine replacement products are available over-the-counter: Nicotine patch (NicoDerm CQ, Habitrol, others). The patch delivers nicotine through skin and into the bloodstream. You wear a new patch each day. typically use the patch for eight weeks or longer. Nicotine gum (Nicorette, others). This gum delivers nicotine to the blood through the lining of the mouth. Nicotine gum is often recommended to curb cravings. Chew the gum for a few times until you feel a mild tingling or peppery taste, then park the gum between your cheek and gumline for several minutes. This chewing and parking allows nicotine to be gradually absorbed in your bloodstream.

Nicotine lozenge (Commit, Nicorette mini lozenge, others) Nicotine lozenge (Commit, Nicorette mini lozenge, others). This lozenge dissolves in the mouth and, like nicotine gum, delivers nicotine through the lining of the mouth.

These nicotine replacement products are available by prescription: Nicotine nasal spray (Nicotrol NS). The nicotine in this product, sprayed directly into each nostril, is absorbed through your nasal membranes into the blood vessels. The nasal spray delivers nicotine a bit quicker than gum, lozenges or the patch, but not as rapidly as smoking a cigarette. It's usually prescribed for three-month periods for up to six months. Nicotine inhaler (Nicotrol). This device is shaped something like a cigarette holder. You puff on it, and it delivers nicotine vapor into the mouth

Non-nicotine medications Bupropion (Zyban). The antidepressant drug bupropion increases levels of dopamine and norepinephrine, brain chemicals that are also boosted by nicotine. Typically doctors will advise to start bupropion one week before stoping.  Varenicline (Chantix). This medication acts on the brain's nicotine receptors, decreasing withdrawal symptoms and reducing the feelings of pleasure got from smoking. Typically doctor will advise to start varenicline one week before stoping smoking. Nortriptyline (Pamelor). This medication may be prescribed if other medications haven't helped. 

Counseling, support groups and other Programs Telephone counseling Counseling, support groups and other Programs Telephone counseling. Individual or group counseling program

CBT Once the habit of smoking is established it is difficult to break because smokers learn that smoking is a quick, convenient way to feel good. Smoking becomes associated with daily events, like watching TV. Smoking can help you cope with uncomfortable emotions (like boredom or stress) or help you feel comfortable in social situations (like a party.) Everyone is different, smokes for different reasons, and can be more or less heavily dependent on smoking.

Tobacco use is one of the most complex and difficult habits to break Tobacco use is one of the most complex and difficult habits to break. Most people try several times (the average is 3 to 5) before they finally succeed. It can take months or even years (3 to 7) to go through the process of quitting successfully. Over 40 million Americans have quit smoking over the last 20 years, so it can be done.

CBT is an evidenced-based psychological treatment that focuses on identifying and changing maladaptive thoughts, emotions, and behaviors that trigger, worsen, and/or maintain a range of problems (such as depression, anxiety, addiction, etc.). Because changing your smoking-related behaviors – and restructuring your thoughts related to smoking urges – is essential to quitting, CBT can effectively be applied to smoking cessation.

Phase 1: Preparation During the preparation phase of a CBT smoking cessation program, there are two main goals: 1.)   Gaining awareness of your smoking behavior. 2.)   Setting a target quit date. 

Phase 2: Quitting 1.)   Managing smoking triggers. 2.)   Medication.  3.)   Coping with triggers after quitting. Phase 3: Maintenance

CBT and learning from relapse What was working when you were able to refrain from smoking? For example, what were you thinking and doing when you were not thinking about smoking? What was it that made you lapse? For example, could it have been peer pressure or boredom, or was it stress-induced? What have you learnt from this experience to make the next attempt more successful?