Smoking is one of the major causes of preventable death worldwide. Despite the well documented health risks of smoking, millions of people continue struggling with nicotine addiction. Quitting smoking isn't easy but it is one of the best things one can do for their health. In this article, we discuss some of the options available to help people quit smoking and overcome nicotine addiction.

Why is it Difficult to Quit Smoking?
Nicotine, the active ingredient in cigarettes, is highly addictive in nature. When someone smokes, nicotine reaches the brain within seconds and triggers the release of dopamine which leads to pleasurable feelings. Over time, the brain adjusts to the extra nicotine and dopamine, which makes one physically and psychologically dependent on cigarettes to feel normal. When a person tries to quit, withdrawal symptoms like cravings, irritability, anxiety, difficulty concentrating occur due to sudden drop in nicotine levels in the brain. These withdrawal symptoms make it difficult to quit without assistance. Understanding this nicotine dependence is key to fighting the addiction.

Available Smoking Cessation Products and Therapies
There are several FDA approved medications and therapies available today to help people cope with nicotine withdrawal symptoms and break the addiction cycle.

Smoking Cessation and Nicotine De-addiction

NRTs such as nicotine gum, patches, lozenges, inhalers and nasal sprays provide controlled doses of nicotine without the other harmful chemicals present in cigarette smoke. Using these products as per prescription helps satisfy nicotine cravings and control withdrawal symptoms while tapering off the dosage gradually. Multiple studies have found NRTs to be around twice as effective as placebo in helping people quit long term.

Bupropion (Zyban) and Varenicline (Chantix)
Bupropion and Varenicline are non-nicotine prescription medications approved as smoking cessation aids. Bupropion is a common antidepressant also used to reduce cravings and negative effects of nicotine withdrawal. Varenicline is newer medication that acts as partial nicotine receptor agonist to relieve cravings but also blocks the rewarding effects of smoking. Both drugs have shown high rates of long term smoking abstinence when used along with counseling support.

Digital Cessation Therapies
With growing popularity of smartphones and internet, digital smoking cessation programs are becoming convenient alternatives. Apps provide real-time support through tracking of cravings and slips, connecting with coaches/mentors, mini lessons about triggers and managing withdrawal symptoms. Some examples include National Cancer Institute's QuitPal app, smokefree.gov mobile program and tobacco/nicotine cessation communities on social media platforms. Preliminary studies show that use of smoking cessation apps along with counseling increases treatment success.

Group/Individual Counseling
Seeking counseling support from trained professionals either in person or through telephone quitlines is highly recommended when trying to quit smoking. In cognitive behavioral therapy sessions, people learn strategies to change thoughts, behaviors and routines associated with smoking. Counselors also address emotional or stress triggers that lead to relapse. Joining group cessation programs run by hospitals or health centers provides benefit of shared experiences, accountability and motivation from others on similar quit journeys. Multiple studies have found counseling to at least double a person's chance of quitting long term.

Integrated Treatment Approach
Experts recommend using a combination of pharmacological and non-pharmacological treatments for maximum results. For example, using nicotine patches or gum along with mobile apps, counseling and support groups gives people multiple tools to fight cravings through various withdrawal phases. Tailoring the treatment protocol based on someone's smoking history, triggers, support system also improves success rates. Monitoring progress and periodic counseling increases long term abstinence rates from smoking.

Benefits of Quitting Smoking
While nicotine withdrawal can feel challenging initially, within weeks and months of quitting numerous health benefits follow. Within 20 minutes of last cigarette the heartrate and blood pressure drops rapidly. After a year risk of heart disease is half of a smoker. Within 10 years lung cancer death rate halves and risk of stroke also reduces. Not only a person saves thousands of dollars spent on cigarettes each year, their skin, hair, clothes do not smell of smoke anymore. Quitting at any age significantly improves health and longevity. Understanding these benefits and having strong support system keeps one motivated to keep trying until finally being able overcome nicotine addiction.

In Summary
Quitting smoking is a challenging yet worthy battle against nicotine dependence that needs strong willpower and utilizing available evidence-based resources. While withdrawal symptoms cannot be avoided, appropriate combination of medications, digital programs, counseling and behavioral support makes it much more achievable. Having understanding from family and friends also plays a huge role in successful de-addiction. With growing risk awareness and options for pharmacological and non-pharmacological support, more individuals than ever are overcoming nicotine addiction each day.

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