A REVIEW OF MEDICINES USED IN SMOKING CESSATION PROGRAMS

A REVIEW OF MEDICINES USED IN SMOKING CESSATION PROGRAMS

By NZERIBE CHISOM EMMANUELLA

 

Over the years, Cigarette Smoking remains the largest preventable cause of premature death; thereby reducing life expectancy. Tobacco is estimated to kill up to one of every two users.  However the challenging aspect of smoking is its addiction which is as a result of the nicotine as well as its withdrawal symptoms making it difficult to quit. As the use of tobacco has declined in high-income countries, the tobacco industry has increasingly turned to low- and middle-income countries, particularly in Africa, Asia, and Eastern Europe, to recruit new users.

According to WHO, Worldwide, tobacco use causes 12 percent of all deaths and 3 percent of deaths in Africa. Smoking is estimated to cause 71 percent of all lung cancer deaths, 42 percent of chronic respiratory disease, and nearly 10 percent of cardiovascular disease.  Therefore Researches which has been done were geared into making substances which could gradually stop the physical smoking and help in that way stop the nicotine addiction. Usually; patients are hardly aware of the fact that there are therapies to help them quit smoking. This makes them want to quit on their own and more than 90 percent of them go back.

The popularly used therapy is the Nicotine Replacement Therapy (NRT). This virtually comes in different formulations like the skin patches, gums, inhalers as well as lozenges. Studies have shown that this therapy can double the chance of quitting smoking because it aims at reducing the nicotine withdrawal symptoms. The Nicotine replacement therapy is as effective as cognitive behavioral therapy especially in pregnant women and does not seem to increase perinatal adverse outcomes. Guidelines generally recommend behavioral therapy first with the drug therapies as second line options.

Another option which is being used is Bupropion. Bupropion, discovered as an antidepressant in the year 1989, is the first non-nicotine based drug for smoking cessation which was licensed in 1997 by the United States and in 2000 by UK. It exerts its effects primarily by the inhibition of dopamine reuptake into the neuronal synaptic vesicles and hence has proven efficacious in clinical trials. Insomnia and Xerostomia are the common side effects. Pharmacoeconomically, it is a cost effective in that a systematic review of clinical and cost effectiveness of bupropion concludes that it is superior to NRT, giving incremental cost per quality adjusted life years gained(QALY) for bupropion of approximately one third less than that of NRT.

Varenicline is the newest agent made for just smoking cessation. And it is believed to account for reduction of craving and withdrawal as well as blocking the rewarding effects of smoking. Studies have shown that it has a better efficacy and tolerability. This also comes with certain side effects such as general body swellings, shortness of breath, slow speech and so on.

Currently, Aromatherapy and essential oils with emphasis on black pepper oil in 2017 has been said to be one of the most effective quitting smoking oils because inhaling it stimulates the respiratory system in a certain way that decreases cravings and anxiety. To help reduce smoking, most countries introduce smoking bans in public places and this is where these therapies also play a big role. Meanwhile Pharmacotherapies alone cannot confer successful smoking cessation but also psychological support as well as personal motivation and modifying environmental factors are very paramount. It is very important to facilitate smoking cessation better in order to reduce health consequences in tobacco use.

Even as we channel our resources and researches into the management and treatment of cancer, we ought to be mindful of the fact that most of these cancers and many other non-communicable diseases one way or the other can be prevented.

REFERENCES:

  1. Pharmacologic- based Strategies for smoking cessation {Internet}, Ottawa CADTH; 2010 Sep.21 {cited 2016 Feb3}. {CADTG health Technology Assessment}; Available from: https://www.cadth,ca?pharmacologic-based-strategies-smoking-cessation.
  2. Preventing a tobacco epidemic in Africa; A call for effective action to support health, social and economic development.

NZERIBE CHISOM EMMANUELLA is from Nigeria and a PharmD student of Kwame Nkrumah University of Science and Technology, Ghana. A Health Enthusiast, enjoys reading and travelling.

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