Time to quit smoking? Visit the HAWC

  • Published
  • By Kelley Suggs
  • Health Education Program Manager
MALMSTROM AIR FORCE BASE, Mont. --  Want to quit smoking? Want some help? Here is what you need to know about some of the current tobacco cessation aides (sometimes called pharmacotherapy). Many people claim that the gum/patches are expensive and don't want to purchase them. In the long run, they are a lot less expensive then a carton of cigarettes (which a box of gum/patches should last about the same amount of time). At the Health and Wellness Center, you don't have to purchase any of it. You can get if for free when you attend the Quit Program. 

Below are the tobacco cessation aides currently available at the HAWC. 

Quit Aide: Zyban was originally approved as an anti-depressant. People who took it experienced side effects that made tobacco taste bad and reduced cravings. The tobacco cessation effects are side effects and are not experienced by everyone. However, it is an easy to use pill that can be very effective when used in combination with other drug therapies (like the patch, gum or lozenge). When taking Zyban, people should be on it for a minimum of three months. Many people are not successful on Zyban because they only take it until they no longer feel cravings. Once they stop taking the Zyban, the cravings return. So anyone who starts taking Zyban should plan to use it for a minimum of three months. 
Who should take it: Those that have tried to quit several times on their own and have not been successful. If you prefer to use the taper method of quitting, this is the tobacco cessation aide for you. 
Who shouldn't take it: If you can't commit to be on Zyban for three months, you shouldn't take it. You also shouldn't take Zyban if you drink alcohol, are taking Zyban for depression, have a personal history of seizures, have had anorexia nervosa or bulimia, or are on other medications that may lower your seizure thresh hold. Teenagers and pregnant women, or those hoping to become pregnant, or breastfeeding women should not take this drug. 
A note about Zyban: All of the tobacco cessation effects are side effects and are not experienced by everyone. Other potential side effects include difficulty falling asleep and staying asleep, bizarre dreams, nausea and dry mouth. 

Quit Aide: The nicotine lozenge delivers nicotine through the lining of the mouth while the lozenge dissolves. It is easy to use. Just unwrap, pop in your mouth and then park it between your cheek and gum (and make sure that you do not chew or swallow the lozenge). The lozenge comes in two different doses, and corresponds to the amount of tobacco that is used. There is 1mg tobacco per cigarette and about 5mg of nicotine per dip (depending on the pinch size). The advantages of the lozenge are: the lozenge will deliver more nicotine than the gum (a pack a day smoker should use no more then 10 2mg lozenges per day) and the amount of nicotine in the system can be regulated on an as needed basis. The "con" list for the lozenge includes no eating or drinking 15 minutes before the lozenge is used, nausea is a frequent side effect, it has a very peppery taste and it can irritate the mouth (most people say it is less irritating then chew). The last "con" is that occasionally people replace their tobacco habit with the lozenge, and continue to use the lozenge for an extended period of time. 
Who should take it: People who should use the lozenge are those that chew and those who cannot use the patch or inhaler. 

Quit Aide: The nicotine gum. Many people use the gum incorrectly. It should be chewed slowly until you can taste the nicotine (peppery taste) or feel a slight tingling in your mouth. Then stop chewing and place (park) it between your cheek and gum. When the tingling is almost gone (about 1 minute), start chewing again. One piece of gum can be effectively used for about 30 minutes and no more then 10 pieces of gum should be used in one day. Every four to seven days, one less piece should be used until you no longer feel the need to chew the gum. The side effects of the gum are limited, but include mouth ulcers, dizziness, headache, upset stomach and jaw muscle aches. 
Who should use it: This option works the best for those who like to self-regulate their withdrawal symptoms and by those would like to quit chewing tobacco. You should not use the gum for more then three months, or if you are pregnant or breastfeeding. 

Quit Aide: The nicotine patch. The patch is a large "band-aid" that sticks on the skin to reduce the physical cravings for nicotine. It does this by releasing nicotine through the skin over a 16 hour period. You can start taking the level of patch that coordinates with the amount of smoking that you do (1 cigarette equals 1mg of nicotine) and you will gradually step down to a low level patch. After the lowest level patch, you should be prepared to be nicotine free. The patch should not be worn at night (unless you wake up in the middle of the night to smoke) and can cause a rash to occur at the site of application. Other side effects can include heartburn, nausea, dizziness and if worn at night, vivid dreams. You cannot smoke while wearing it, so those who are not ready to give up their cigarettes should not use the patch (it could result in nicotine poisoning or a nicotine overdose). The patch works for folks that don't like the taste of the gum or lozenge, or who don't want to be seen chewing gum. 

Quit Aide: Chantix is a new drug and support program. It has a very high success rate and can be used by almost anyone (nursing and pregnant women should consult their physicians before beginning use). It works at the site of the nicotine receptor to block the release of dopamine that is released when a person inhales the tobacco and nicotine. It helps in the fight against cravings and helps to calm withdrawal symptoms. Chantix is easy to use, and is usually well tolerated. Some people taking Chantix experience nausea, which can usually be avoided by taking it with food. Once you begin taking Chantix, a Target Quit Date is set for the 8th day. After that, no more tobacco products are allowed. 
Who should not use it: If you aren't ready to give up cigarettes or chew, this medication is not for you. If you are ready, the medication, along with its support program is a great choice. 

Many of these drugs can be used in combination with each other (Zyaban, the patch, the gum and the lozenge). The HAWC also offers fake chew and fake cigarettes along with the support program. Whatever you choose, it will take a lot of determination and hard work. But people can be successful with help. Call 731-4482 with questions or for more information about any of the above options. 

Additional Information: The HAWC Quit Program consists of five sessions. They are all one-on-one's and no death by PowerPoint. 
Session 1: Sit with a coach and discuss your habits (how you use tobacco products) and how you want to quit. We will set a short term goal at this time. 
Session 2: Two weeks after the first session. Discuss progress of short term goal and stress management (many people use their tobacco products for stress management) 
Session 3: One month after session two. Discuss weight management (a common concern) and how to avoid gaining extra. 
Session 4: One month after session three. Check in and support. 
Session 5: One month after session four. Check in and support. 

People who are successful are those who have two things in common - the drive/want to quit and accountability. We can't provide the want to, but we can provide the accountability. People who complete all five sessions have the best long term results.