How does nicotine affect the brain. What are the signs of tobacco addiction. Which treatment options are available for those struggling with nicotine dependence. Can lifestyle changes help in overcoming tobacco addiction.

The Impact of Tobacco and Nicotine on Human Health

Tobacco use remains a global health crisis, claiming millions of lives annually. The Centers for Disease Control and Prevention reports that tobacco is responsible for approximately 6 million deaths each year, making it the leading cause of preventable mortality worldwide. At the heart of this epidemic lies nicotine, the primary addictive compound found in tobacco products.

Nicotine’s effects on the human body are both immediate and far-reaching. Upon entering the bloodstream, whether through inhalation of cigarette smoke or absorption through oral tissues, nicotine triggers a cascade of physiological responses:

• A sudden surge of adrenaline
• Increased heart rate and blood pressure
• Enhanced dopamine release in the brain

The dopamine surge is particularly significant, as it activates the brain’s reward circuitry, creating a sense of pleasure and reinforcing the desire to continue using tobacco. This neurochemical process forms the foundation of nicotine addiction, making it extremely challenging for users to quit despite the well-documented health risks.

Identifying the Signs of Tobacco Addiction

Recognizing tobacco addiction is crucial for both users and their loved ones. While some individuals may be able to use tobacco products occasionally without developing dependence, others find themselves caught in the grip of addiction. How can one distinguish between casual use and addiction?

Key indicators of tobacco addiction include:

• Unsuccessful attempts to quit despite sincere efforts
• Experiencing withdrawal symptoms when attempting to cease use
• Needing to use tobacco immediately after meals or upon waking
• Feeling that tobacco use is necessary to function “normally”
• Avoiding social situations or events where tobacco use is prohibited
• Continuing to use tobacco despite awareness of health consequences

Are physical symptoms common in tobacco addiction? Indeed, withdrawal from nicotine can produce a range of uncomfortable physical manifestations, including:

• Trembling hands
• Excessive sweating
• Irritability and mood swings
• Rapid heartbeat
• Difficulty concentrating
• Intense cravings for tobacco

These symptoms can be severe enough to drive many users back to tobacco, even when they genuinely wish to quit. Understanding the addictive nature of nicotine and recognizing these signs is the first step toward seeking appropriate treatment and support.

Nicotine Replacement Therapy: A Stepping Stone to Quitting

For many individuals struggling with tobacco addiction, nicotine replacement therapy (NRT) offers a viable path toward cessation. NRT works by providing controlled doses of nicotine without the harmful chemicals found in tobacco smoke, helping to alleviate withdrawal symptoms and cravings.

The Nicotine Patch

How does the nicotine patch work? This small, adhesive patch is applied to the skin, typically on the upper arm or back. It delivers a steady, low dose of nicotine through the skin and into the bloodstream. The patch is designed to be used over several weeks, with the nicotine dose gradually reduced to wean the body off its dependence.

Nicotine Gum

Nicotine gum serves a dual purpose in addiction treatment. Not only does it deliver small amounts of nicotine to help manage cravings, but it also provides an oral fixation that many smokers find helpful when trying to quit. The act of chewing and the presence of something in the mouth can help alleviate the psychological aspect of the smoking habit.

Nicotine Sprays and Inhalers

For those who miss the hand-to-mouth action of smoking, nicotine inhalers can be particularly beneficial. These devices deliver a controlled dose of nicotine vapor that is absorbed through the mouth and throat. Nasal sprays offer another rapid-delivery option, providing quick relief from cravings.

While NRT products are widely available over the counter, it’s important to use them under medical guidance to ensure proper dosing and to monitor for any potential side effects.

Pharmacological Interventions for Tobacco Addiction

Beyond nicotine replacement therapies, several medications have shown promise in helping individuals overcome tobacco addiction. These pharmacological interventions work by targeting the brain’s reward system and helping to manage cravings and withdrawal symptoms.

Varenicline (Chantix)

How does varenicline aid in smoking cessation? This medication works as a partial nicotine receptor agonist. It binds to nicotine receptors in the brain, partially activating them to reduce cravings and withdrawal symptoms. Simultaneously, it blocks nicotine from fully activating these receptors, potentially reducing the pleasurable effects of smoking if a person relapses.

Bupropion (Wellbutrin)

Originally developed as an antidepressant, bupropion has found an off-label use in smoking cessation. It appears to work by altering brain chemistry related to nicotine addiction, potentially reducing cravings and withdrawal symptoms. Some studies suggest it may be particularly effective when combined with nicotine replacement therapy.

While these medications can be effective tools in the fight against tobacco addiction, they should always be used under the supervision of a healthcare provider. Each individual may respond differently to these treatments, and careful monitoring is essential to manage potential side effects and adjust dosages as needed.

Psychological and Behavioral Approaches to Overcoming Tobacco Addiction

Addressing the psychological aspects of tobacco addiction is crucial for long-term success in quitting. Several therapeutic approaches have shown promise in helping individuals change their thoughts and behaviors associated with tobacco use:

Cognitive-Behavioral Therapy (CBT)

CBT focuses on identifying and changing thought patterns and behaviors that contribute to tobacco use. This approach helps individuals develop coping strategies for managing cravings and stress without resorting to tobacco. CBT can be particularly effective in addressing the underlying psychological factors that maintain addiction.

Hypnotherapy

Can hypnosis help in quitting smoking? While scientific evidence is mixed, some individuals report success with hypnotherapy for smoking cessation. This approach aims to access the subconscious mind to reinforce the desire to quit and strengthen the resolve to remain tobacco-free.

Neuro-Linguistic Programming (NLP)

NLP techniques focus on changing the internal dialogue and mental imagery associated with smoking. By reframing how one thinks about tobacco use and creating new, positive associations, NLP aims to reduce the psychological pull of addiction.

These psychological interventions often work best when combined with other treatment modalities, such as nicotine replacement therapy or medication. The goal is to address both the physical and psychological aspects of addiction simultaneously, providing a comprehensive approach to recovery.

Lifestyle Modifications to Support Tobacco Cessation

Quitting tobacco often requires more than just addressing the physical addiction; it necessitates a holistic approach that includes lifestyle changes. Implementing positive habits and avoiding triggers can significantly improve the chances of long-term success.

Identifying and Avoiding Triggers

What are common triggers for tobacco use? Many individuals find that certain situations, emotions, or environments prompt the urge to use tobacco. These may include:

• Stress or anxiety
• Social gatherings where others are smoking
• Consuming alcohol
• After meals or with coffee
• During work breaks

By identifying these triggers, individuals can develop strategies to avoid or manage them effectively. This might involve finding alternative stress-relief techniques, temporarily avoiding social situations where smoking is prevalent, or changing routines associated with tobacco use.

Incorporating Physical Activity

Exercise can play a crucial role in overcoming tobacco addiction. Regular physical activity offers numerous benefits:

• Reduces stress and anxiety
• Improves mood and overall well-being
• Provides a healthy distraction from cravings
• Helps manage weight gain that may occur after quitting

Engaging in even moderate exercise, such as brisk walking for 30 minutes a day, can significantly enhance the odds of successfully quitting tobacco.

Mindfulness and Relaxation Techniques

Practicing mindfulness and relaxation can help manage the stress and anxiety often associated with quitting tobacco. Techniques such as deep breathing exercises, meditation, or yoga can provide healthy alternatives for coping with cravings and emotional triggers.

The Importance of Support Systems in Overcoming Tobacco Addiction

Quitting tobacco is often described as a journey, and like any challenging journey, having support along the way can make a significant difference. Building a strong support system can provide encouragement, accountability, and practical assistance during the quitting process.

Family and Friends

How can loved ones support someone trying to quit tobacco? Family members and friends can play a crucial role by:

• Offering encouragement and positive reinforcement
• Creating a smoke-free environment at home
• Engaging in tobacco-free activities together
• Providing a listening ear during difficult moments

It’s important for supporters to understand that quitting is a process and to remain patient and non-judgmental, even if the person experiences setbacks.

Support Groups

Joining a support group can connect individuals with others who are going through similar experiences. These groups provide a forum for sharing strategies, offering mutual support, and celebrating successes. Many communities offer in-person support groups, and online forums and virtual meetings are increasingly available for those who prefer remote options.

Professional Counseling

Working with a mental health professional or addiction specialist can provide personalized support and guidance throughout the quitting process. Counselors can help individuals develop coping strategies, address underlying emotional issues, and navigate the challenges of recovery.

The combination of professional help, peer support, and understanding from loved ones creates a comprehensive support network that can significantly enhance the chances of successfully overcoming tobacco addiction.

Managing Relapse: A Common Challenge in Tobacco Cessation

Relapse is a common occurrence in the journey to quit tobacco, with studies suggesting that approximately 75% of individuals who attempt to quit may experience a relapse within the first six months. Understanding that relapse is a normal part of the recovery process, rather than a failure, is crucial for maintaining long-term motivation and success.

Identifying Relapse Triggers

What factors commonly lead to relapse in tobacco addiction? Common triggers include:

• Stressful life events
• Social situations where tobacco use is prevalent
• Alcohol consumption
• Weight gain concerns
• Overconfidence leading to “just one” use

Recognizing these potential pitfalls can help individuals develop strategies to navigate high-risk situations more effectively.

Developing a Relapse Prevention Plan

A comprehensive relapse prevention plan might include:

• Identifying personal triggers and developing coping strategies for each
• Establishing a support network to call upon during moments of temptation
• Practicing stress-management techniques
• Setting realistic expectations and celebrating small victories
• Having a plan for immediately getting back on track if a slip occurs

Learning from Setbacks

If a relapse does occur, it’s essential to view it as a learning opportunity rather than a failure. Analyzing the circumstances that led to the relapse can provide valuable insights for strengthening one’s quit plan. Many individuals find that each quit attempt brings them closer to long-term success, as they build resilience and refine their coping strategies.

Tobacco addiction is a chronic condition that requires ongoing management. By approaching recovery as a lifelong process and remaining committed to the goal of a tobacco-free life, individuals can overcome setbacks and achieve lasting freedom from nicotine dependence.

Tobacco Addiction: Symptoms and Treatments

Tobacco and nicotine

Tobacco is one of the most widely abused substances in the world. It is highly addictive. The Centers for Disease Control and Prevention estimates that tobacco causes 6 million deaths per year. This makes tobacco the leading cause of preventable death.

Nicotine is the main addictive chemical in tobacco. It causes a rush of adrenaline when absorbed in the bloodstream or inhaled via cigarette smoke. Nicotine also triggers an increase in dopamine. This is sometimes referred to as the brain’s “happy” chemical.

Dopamine stimulates the area of the brain associated with pleasure and reward. Like any other drug, use of tobacco over time can cause a physical and psychological addiction. This is also true for smokeless forms of tobacco, such as snuff and chewing tobacco.

In 2011, about 70 percent of all adult smokers said they wanted to stop smoking.

A tobacco addiction is harder to hide than other addictions. This is largely because tobacco is legal, easily obtained, and can be consumed in public.

Some people can smoke socially or occasionally, but others become addicted. An addiction may be present if the person:

• cannot stop smoking or chewing, despite attempts to quit
• has withdrawal symptoms when they try to quit (shaky hands, sweating, irritability, or rapid heart rate)
• must smoke or chew after every meal or after long periods of time without using, such as after a movie or work meeting
• needs tobacco products to feel “normal” or turns to them during times of stress
• gives up activities or won’t attend events where smoking or tobacco use is not allowed
• continues to smoke despite health problems

There are many treatments available for tobacco addiction. However, this addiction can be very difficult to manage. Many users find that even after nicotine cravings have passed, the ritual of smoking can lead to a relapse.

There are several different treatment options for those battling a tobacco addiction:

The patch

The patch is known as a nicotine replacement therapy (NRT). It’s a small, bandage-like sticker that you apply to your arm or back. The patch delivers low levels of nicotine to the body. This helps gradually wean the body off it.

Nicotine gum

Another form of NRT, nicotine gum can help people who need the oral fixation of smoking or chewing. This is common, as people who are quitting smoking may have the urge to put something into their mouths. The gum also delivers small doses of nicotine to help the you manage cravings.

Spray or inhaler

Nicotine sprays and inhalers can help by giving low doses of nicotine without tobacco use. These are sold over the counter and are widely available. The spray is inhaled, sending nicotine into the lungs.

Medications

Some doctors recommend the use of medication to help with tobacco addictions. Certain antidepressants or high blood pressure drugs might be able to help manage cravings. One medication that’s commonly used is varenicline (Chantix). Some doctors prescribe bupropion (Wellbutrin). This is an antidepressant that’s used off-label for smoking cessation because it can decrease your desire to smoke.

Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care. Learn more about off-label drug use here.

Psychological and behavioral treatments

Some people who use tobacco have success with methods such as:

• hypnotherapy
• cognitive-behavioral therapy
• neuro-linguistic programming

These methods help the user change their thoughts about addiction. They work to alter feelings or behaviors your brain associates with tobacco use.

Treatment for a tobacco addition requires a combination of methods. Keep in mind that what works for one person won’t necessarily work for another. You should talk to you doctor about what treatments you should try.

Tobacco addiction can be managed with proper treatment. Addiction to tobacco is similar to other drug addictions in that it’s never really cured. In other words, it is something that you will have to deal with for the rest of your life.

Tobacco users tend to have high relapse rates. It’s estimated that about 75 percent of people who quit smoking relapse within the first six months. A longer treatment period or change in approach may prevent a future relapse.

Research has also shown that altering lifestyle habits, such as avoiding situations where there will be other tobacco users or implementing a positive behavior (like exercising) when cravings start can help improve chances for recovery.

How to cope with a smoking relapse »

A tobacco addiction can have fatal consequences without treatment. Tobacco use can cause:

• cancers of the lungs, throat, and mouth
• heart disease
• stroke
• chronic lung diseases such as emphysema and bronchitis

Any one of these conditions can be fatal. Quitting smoking or tobacco use can significantly reduce the risk of death due to these diseases. Even once the disease has been diagnosed, stopping tobacco use can improve treatment efforts.

Many resources are available to individuals with tobacco addiction. The following organizations can provide further information about tobacco addiction and possible treatment options:

• Nicotine Anonymous
• National Institute on Drug Abuse
• Substance Abuse and Mental Health Services Administration
• DrugFree.org
• Smokefree.gov

Tips for Coping with Nicotine Withdrawal and Triggers

What are some of the nicotine withdrawal symptoms associated with quitting tobacco?

Because the nicotine in tobacco is highly addictive, people who quit may experience nicotine withdrawal symptoms, especially if they have smoked or used other tobacco products heavily for many years. Although many of the examples in this fact sheet refer to smoking, the tips are relevant for those who are quitting the use of any tobacco product.

Common nicotine withdrawal symptoms include:

• nicotine cravings 
• anger, frustration, and irritability
• difficulty concentrating
• insomnia
• restlessness
• anxiety
• depression
• hunger or increased appetite

Other, less common nicotine withdrawal symptoms include headaches, fatigue, dizziness, coughing, mouth ulcers, and constipation (1, 2).

The good news is that there is much you can do to reduce nicotine cravings and manage common withdrawal symptoms. Also, it may help to know that nicotine withdrawal symptoms do subside over time. They are usually worst during the first week after quitting, peaking during the first 3 days. From that point on, the intensity of symptoms usually drops over the first month. However, everyone is different, and some people have withdrawal symptoms for several months after quitting (3, 4).

What can I do about nicotine cravings after I quit?

People who use tobacco products get used to having a certain level of nicotine in their body. After you quit, cravings develop when your body wants nicotine. This may occur long after your body is no longer addicted to nicotine. In addition to this physical craving, you may experience a psychological craving to use a tobacco product when you see people smoking or are around other triggers. Your mood may change when you have cravings, and your heart rate and blood pressure may go up.

The urge to smoke will come and go. You may start experiencing cravings within an hour or two after your last use of tobacco, and you may have them frequently for the next few days or weeks. As time passes, the cravings will get farther apart. However, you may have occasional mild cravings months or years after you quit.

Here are some tips for managing cravings:

• Try nicotine replacement products or ask your doctor about other medications.
• Remind yourself that cravings will pass.
• Avoid situations and activities that you used to associate with using tobacco products.
• As a substitute for smoking, try chewing on carrots, pickles, apples, celery, sugarless gum, or hard candy. Keeping your mouth busy may stop the psychological need to smoke.
• Try this exercise: Take a deep breath through your nose and blow out slowly through your mouth. Repeat 10 times.

Go online to Smokefree.gov, a website created by NCI’s Tobacco Control Research Branch, and use the step-by-step personalized quit plan to learn about other tips for managing cravings.

What can I do about anger, frustration, and irritability after I quit?

After you quit smoking or using other tobacco products, you may feel edgy and short-tempered, and you may want to give up on tasks more quickly than usual. You may be less tolerant of others and get into more arguments.

Studies have found that the most common negative feelings associated with quitting are feelings of anger, frustration, and irritability. These negative feelings peak within 1 week of quitting and may last 2 to 4 weeks (1).

Here are some tips for managing these negative feelings:

• Remind yourself that these feelings are temporary.
• Engage in an enjoyable physical activity, such as taking a walk.
• Reduce caffeine by limiting or avoiding coffee, soda, and tea.
• Try meditation or other relaxation techniques, such as getting a massage, soaking in a hot bath, or breathing deeply through your nose and out through your mouth for 10 breaths.
• Try nicotine replacement products or ask your doctor about other medications.

What can I do about anxiety after I quit?

Within 24 hours of quitting smoking or other tobacco products, you may feel tense and agitated. You may feel a tightness in your muscles—especially around the neck and shoulders. Studies have found that anxiety is one of the most common negative feelings associated with quitting. If anxiety occurs, it usually builds over the first 3 days after quitting and may last several weeks (1).

Here are some tips for managing anxiety:

• Remind yourself that anxiety will pass with time.
• Set aside some quiet time every morning and evening—a time when you can be alone in a quiet environment.
• Engage in an enjoyable physical activity, such as taking a walk.
• Reduce caffeine by limiting or avoiding coffee, soda, and tea.
• Try meditation or other relaxation techniques, such as getting a massage, soaking in a hot bath, or breathing deeply through your nose and out through your mouth for 10 breaths.
• Try nicotine replacement products or ask your doctor about other medications.

What can I do about depression after I quit?

It is common to feel sad for a period of time soon after you quit smoking or using other tobacco products. If mild depression occurs, it will usually begin within the first day, continue for a couple of weeks, and go away within a month.

People who have a history of depression often have more-severe withdrawal symptoms, including more-severe depression. Some studies have found that many people with a history of major depression will have a new major depressive episode after quitting (5, 6). However, in those with no history of depression, major depression after quitting is rare.

Many former smokers and people who are quitting have a strong urge to smoke when they feel depressed. Here are some tips for managing feelings of depression:

• Get together with a friend.
• Identify your specific feelings at the time that you seem depressed. Are you actually feeling tired, lonely, bored, or hungry? Focus on and address these specific needs.
• Participate in physical activities that you find enjoyable. This will help to improve your mood, decrease your fatigue, and reduce your depression.
• Breathe deeply.
• Make a list of things that are upsetting to you and write down solutions for them.
• Ask your doctor about prescription medications that may help you with depression. Studies show that bupropion and nortriptyline can help people with a past history of depression who try to quit smoking. Nicotine replacement products may also help (7).

Learn about the signs of depression and where to go for help at the National Institute of Mental Health’s page on depression.

What can I do about weight gain after I quit?

People who quit may gain weight due to increased appetite. Although the weight gain is usually less than 10 pounds, it can be troublesome for some people (8, 9). However, the health benefits of quitting far outweigh the health risks of a small amount of extra weight.

Here are some tips for managing weight gain after quitting:

• Balance your physical activity with your calorie intake. This will help you achieve and maintain a desired weight.
• Ask your doctor about the medication bupropion. Studies show that it helps counteract weight gain (7).
• Studies also show that nicotine replacement products, especially nicotine gum and lozenges, can help counteract weight gain (7).
• A nutritionist or diet counselor can be helpful.

Although the prospect of weight gain may be unwelcome, it is important to remember that quitting smoking is one of the most important things you can do to improve your health overall. Do not let fear of gaining weight discourage you from quitting.

What are some of the triggers for tobacco use?

Reminders in your daily life of situations when you used to use tobacco products may trigger your desire to do so again. 

Triggers may include:

• social triggers, such as being around others who use tobacco or in a social gathering or event
• emotional triggers, such as feeling stressed or anxious; bored, lonely, sad, or frustrated or upset after an argument; or happy, excited, or relieved
• pattern or activity triggers, such as starting the day, being in a car, drinking coffee or tea, enjoying a meal or an alcoholic beverage

Knowing your triggers for using tobacco helps you stay in control because you can choose to avoid those triggers or keep your mind distracted and busy when you cannot avoid them. More specific information on different types of triggers is on Smokefree.gov.

How can I resist the urge to smoke when I’m around smokers?

You may want to analyze situations in which watching others smoke triggers an urge in you to smoke. Figure out what it is about those situations that makes you want to smoke. Is it because you associate feeling happy with being around other smokers? Or is there something special about the situations, such as being around the people you usually smoked with? Is it tempting to join others for routine smoke breaks?

Here are some tips:

• Limit your contact with smokers, especially in the early weeks of quitting.
• Do not buy, carry, light, or hold cigarettes for others.
• If you are in a group and others light up, excuse yourself and don’t return until they have finished.
• Do not let people smoke in your home. Post a “No Smoking” sign by your front door.
• Ask others to help you stay quit. Give them specific examples of things that are helpful (such as not smoking around you) and things that are not helpful (like asking you to buy cigarettes for them).
• Focus on what you’ve gained by quitting. For example, think of how healthy you will be when all smoking effects are gone from your body and you can call yourself smokefree. Also, add up how much money you have saved already by not purchasing cigarettes and imagine (in detail) how you will spend your savings in 6 months.

How can I resist the urge to smoke if I live with a smoker?

Living with someone who smokes can present additional challenges for a person who wants to quit. Here are some tips for people in such a situation:

• Make your home a no-smoking environment. Remove all cigarettes, ashtrays, and lighters and don’t allow friends or family to smoke anywhere inside your home.
• If the smokers you live with will not go outside to smoke, consider making one room of the home smokefree so you have a nonsmoking indoor area available to you.
• Ask the smokers you live with not to offer you any tobacco products or purchase them for you, even if you ask for them. Enlist their help in keeping you smokefree.

How can I start the day without smoking?

Many smokers light up a cigarette right after they wake up. After 6 to 8 hours of sleep, a smoker’s nicotine level drops and they need a boost of nicotine to start the day. After you quit, you must be ready to overcome the physical need and routine of waking up and smoking a cigarette. Instead of reaching for your cigarettes in the morning, here are some tips:

• The morning can set the tone for the rest of the day. Plan a different wake-up routine to divert your attention from smoking.
• Be sure no cigarettes are available. Instead, keep sugar-free gum, mints, or nuts in the locations where you previously kept your cigarettes so when you automatically reach for cigarettes a healthy alternative is at hand.
• Before you go to sleep, make a list of things you need to avoid in the morning that will make you want to smoke. Place this list where you used to place your cigarettes.
• Begin each day with a planned activity that will keep you busy for an hour or more. Keeping your mind and body busy will distract you from thinking about smoking.
• Begin each day with deep breathing and by drinking one or more glasses of water.

How can I resist the urge to smoke when I’m feeling stressed?

Most smokers report that one reason they smoke is to handle stress. Smoking cigarettes causes temporary changes in your brain chemistry that can cause you to experience decreased anxiety, enhanced pleasure, and alert relaxation. Once you stop smoking and your brain chemistry returns to normal, you may become more aware of stress.

Everyday worries, responsibilities, and annoyances can all contribute to stress. As you go longer without smoking, you will get better at handling stress, especially if you learn stress reduction and relaxation techniques.

Here are some tips:

• Know the causes of stress in your life (your job, traffic, your children, money) and identify the stress signals (headaches, nervousness, or trouble sleeping). Once you pinpoint high-risk trigger situations, you can start to develop new ways to handle them.
• Create peaceful times in your schedule. For example, set aside an hour where you can get away from other people and your usual environment. Or try visualizing yourself in a peaceful setting.
• Try relaxation techniques, such as progressive muscle relaxation or yoga, and stick with the one that works best for you.
• Try this breathing exercise: Take a deep breath through your nose and blow out slowly through your mouth. Repeat 10 times.
• Try meditation involving focused breathing or repetition of words or phrases to quiet your mind. 
• Rehearse and visualize your relaxation plan. Put your plan into action. Change your plan as needed.
• You may find it helpful to read a book about how to handle stress.

How can I resist the urge to smoke when I’m driving or riding in a car?

You may have become used to smoking while driving—to relax in a traffic jam or to stay alert on a long drive. Like many smokers, you may like to light up when driving to and from work to relieve stress, stay alert, relax, or just pass the time. 

Tips for short trips:

• Remove the ashtray, lighter, and cigarettes from your car.
• Keep healthy substitutions, such as sugar-free gum, mints, or nuts, in your car.
• Turn on your favorite music and sing along.
• Take an alternate route to work or try carpooling.
• Clean your car and use deodorizers to reduce the tobacco smell.
• Tell yourself:
  • “This urge will go away in a few minutes.”
  • “So, I’m not enjoying this car ride. Big deal! It won’t last forever!”
  • “My car smells clean and fresh!”
  • “I’m a better driver now that I’m not smoking while driving. ”

When you are driving or riding with other people:

• Do not allow passengers to smoke in your car.
• If you’re not driving, find something to do with your hands.

Your desire to smoke may be stronger and more frequent on longer trips. On long trips:

• Take stretch breaks.
• Take healthy snacks along.
• Plan rest stops.

How can I resist the urge to smoke when I’m having coffee or tea?

You may be used to smoking when drinking coffee or tea (for example, during or after meals or during work breaks), and you may associate good feelings with drinking a hot beverage. When you give up smoking, expect to feel a strong urge to reach for a cigarette while drinking coffee or tea. Some people quit drinking coffee or tea temporarily while they’re quitting cigarettes to avoid the urge to smoke. Although you do not have to give up coffee or tea to quit smoking, you should expect that coffee or tea will not taste the same without a cigarette.

Here are some tips:

• If you used to smoke while drinking coffee or tea, tell people you have quit, so they won’t offer you a cigarette.
• Between sips of coffee or tea, take deep breaths to inhale the aroma. Breathe in deeply and slowly while you count to five, and then breathe out slowly, counting to five again.
• Try changing your routine around drinking coffee or tea. For example, try switching what drink you consume or try having your coffee or tea in a different location than when you were smoking to help change the routine.
• Keep your hands busy by nibbling on healthy foods, doodling, playing games on your phone, or making a list of tasks for the day.
• If the urge to smoke is very strong, drink your coffee or tea more quickly than usual and then change activities or rooms.
• When you quit smoking, drinking coffee or tea without smoking may make you feel sad. Focus on what you’ve gained by quitting.

How can I resist the urge to smoke when I’m enjoying a meal?

Food often tastes better after you quit smoking, and you may have a bigger appetite. Expect to want to smoke after meals. Your desire to smoke after meals may depend on whether you are alone, with other smokers, or with nonsmokers.

Your urge to smoke may be stronger with certain foods, such as spicy or sweet foods. Also, the urge to smoke may be stronger at different mealtimes.

Here are some tips:

• Know what kinds of foods increase your urge to smoke and stay away from them.
• If you are alone, call a friend or take a walk as soon as you’ve finished eating.
• Brush your teeth or use mouthwash right after meals.
• Wash the dishes by hand after eating—you can’t smoke with wet hands!

How can I resist the urge to smoke when I’m drinking an alcoholic beverage?

You may be used to smoking when drinking beer, wine, liquor, or mixed drinks. When you quit smoking, you may feel a strong urge to smoke when you drink alcohol. Know this up front if you are going to drink because your ability to resist triggers to smoke may be impaired under the influence of alcohol.  

Here are some tips for the first few weeks after quitting smoking:

• Many people find it helpful to drink less alcohol or avoid it completely.
• If you do drink, choose different alcoholic beverages than you used to have when smoking.
• Stay away from the places you usually drink alcohol.

How can I resist the urge to smoke when I’m feeling bored?

When you quit smoking, you may miss the increased excitement and good feeling that nicotine gave you. This may be particularly true when you are feeling bored.

Here are some tips:

• Plan more activities than you have time for.
• Make a list of things to do when confronted with free time.
• Move! Do not stay in the same place too long.
• If you feel bored when waiting for something or someone (a bus, your friend, your kids), distract yourself with a book, magazine, puzzle, or your phone.
• Look at and listen to what is going on around you.
• Carry something to keep your hands busy.
• Listen to a favorite song.
• Go outdoors, if you can, but not to places you associate with smoking.

Do nicotine replacement products relieve nicotine cravings and withdrawal symptoms?

Yes. Nicotine replacement products deliver measured doses of nicotine into the body, which helps to relieve the cravings and withdrawal symptoms often felt by people trying to quit tobacco use. Nicotine replacement products are effective treatments that can increase the likelihood that someone will quit successfully (7, 10).

Five forms of nicotine replacement therapy have been approved by the US Food and Drug Administration (FDA):

• The nicotine patch is available over the counter (without a prescription). A new patch is worn on the skin each day, supplying a small but steady amount of nicotine to the body. The nicotine patch is sold in varying strengths, usually as an 8- to 10-week quit-smoking treatment. Typically, the nicotine doses are gradually lowered as treatment progresses. The nicotine patch may not be a good choice for people with skin problems or allergies to adhesive tape. Also, some people experience the side effect of having vivid dreams when they wear the patch at night. These people may decide to wear the patch only during the daytime.
• Nicotine gum is available over the counter in two strengths (2 and 4 milligrams). When a person chews nicotine gum and then places the chewed product between the cheek and gum tissue, nicotine is released into the bloodstream through the lining of the mouth. To keep a steady amount of nicotine in the body, a new piece of gum can be chewed every 1 or 2 hours. The 4-milligram dose appears to be more effective among highly dependent smokers (those who smoked 20 or more cigarettes per day) (11, 12). Nicotine gum might not be appropriate for people with temporomandibular joint disease or for those with dentures or other dental work, such as bridges. The gum releases nicotine more effectively when coffee, juice, or other acidic beverages are not consumed at the same time.
• The nicotine lozenge is also available over the counter in 2 and 4 milligram strengths. The lozenge is used similarly to nicotine gum; it is placed between the cheek and the gums and allowed to dissolve. Nicotine is released into the bloodstream through the lining of the mouth. The lozenge works best when used every 1 or 2 hours and when coffee, juice, or other acidic beverages are not consumed at the same time.
• Nicotine nasal spray is available by prescription only. The spray comes in a pump bottle containing nicotine that tobacco users can inhale when they have an urge to smoke. Nicotine is absorbed more quickly via the spray than with other nicotine replacement products. Nicotine nasal spray is not recommended for people with nasal or sinus conditions, allergies, or asthma or for young tobacco users. Side effects from the spray may include sneezing, coughing, and watering eyes, but these problems usually go away with continued use of the spray.
• A nicotine inhaler, also available by prescription only, delivers a vaporized form of nicotine to the mouth through a mouthpiece attached to a plastic cartridge. Even though it is called an inhaler, the device does not deliver nicotine to the lungs the way a cigarette does. Most of the nicotine travels only to the mouth and throat, where it is absorbed through the mucous membranes. Common side effects include throat and mouth irritation and coughing. Anyone with a breathing problem such as asthma should use the nicotine inhaler with caution.

Using a long-acting form of nicotine replacement therapy (like the patch) along with a short-acting form (like the gum or the lozenge) can be especially helpful for managing nicotine withdrawal (10). Nicotine replacement therapy is more effective when combined with advice or counseling from a doctor, dentist, pharmacist, or other health care provider.

Are nicotine replacement products safe?

It is far less harmful for a person to get nicotine from a nicotine replacement product than from cigarettes because tobacco smoke contains many toxic and cancer-causing substances. Long-term use of nicotine replacement products has not been associated with any serious harmful effects (12). However, nicotine replacement products are not recommended for use by people who are pregnant or trying to become pregnant.

Are there products to help people quit that do not contain nicotine?

Yes, two medicines that help people quit but do not contain nicotine are available by prescription:

• Varenicline, a prescription medicine marketed as Chantix, was approved by FDA in 2006 to help cigarette smokers stop smoking. This drug may help those who wish to quit by easing their nicotine cravings and by blocking the pleasurable effects of nicotine if they do resume smoking. Several side effects are associated with this product. Discuss with your doctor if this medicine is right for you.
   
• Bupropion, a prescription antidepressant, was approved by FDA in 1997 to treat nicotine addiction (under the trade name Zyban). This drug can help reduce nicotine withdrawal symptoms and the urge to smoke and can be used safely with nicotine replacement products. Several side effects are associated with this product. Discuss with your doctor if this medicine is right for you.

Are there alternative methods to help people deal with nicotine withdrawal?

Some people claim that alternative approaches such as hypnosis, acupuncture, acupressure, laser therapy (laser stimulation of acupuncture points on the body), or electrostimulation may help reduce the symptoms associated with nicotine withdrawal. However, in clinical studies these alternative therapies have not been found to help people quit using tobacco (13). There is no evidence that these alternative approaches help tobacco users who are trying to quit.

Can e-cigarettes help people quit?

The evidence to date is inconclusive about whether e-cigarettes can help with smoking cessation (10). In addition, FDA has not approved any e-cigarette as a smoking cessation therapy. Currently, people who smoke are advised to use evidence-based quit strategies, including FDA-approved cessation medication and smoking cessation counseling.

How can I get help if I’m having trouble dealing with nicotine withdrawal or triggers?

NCI can help smokers deal with nicotine withdrawal:

• Go online to Smokefree.gov, a website created by NCI’s Tobacco Control Research Branch, and learn how to prepare for withdrawal symptoms.
• Call NCI’s Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848) for individualized counseling, printed information, and referrals to other sources.

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Dear patients!
Multidisciplinary Clinic and Maternity Hospital “Paracelsus” informs you, according to the Letter of the Ministry of Finance of the Russian Federation to the Federal Tax Service dated March 25, 2022. N BS-4-11 / 3605, that subparagraph 3 of paragraph 1 of Article 219 of the Tax Code of the Russian Federation provides for the taxpayer’s right to receive a social tax deduction in the amount paid by him in the tax period for medical services provided by medical organizations engaged in medical activities , him, his spouse, parents, children (including adopted children) under the age of 18, wards under the age of 18 (in accordance with the list of medical services approved by the Government of the Russian Federation).

Joint order of the Ministry of Taxation of Russia and the Ministry of Health of Russia of July 25, 2001 N 289 / BG-3-04 / 256 (hereinafter – the order of July 25, 2001) approved the form of the Certificate of payment for medical services for submission to the tax authorities of the Russian Federation (hereinafter – the Certificate payment for medical services).

This certificate certifies the fact of receiving a medical service and its payment through the cash desk of a healthcare institution at the expense of the taxpayer.

Thus, if the taxpayer submits to the tax authority a Certificate of payment for medical services, the taxpayer’s failure to submit the relevant contract for the provision of medical services and (or) documents confirming payment cannot be grounds for refusing to provide such a deduction.

The amounts are based on payment data. Therefore, checks, an agreement and a clinic license are not needed to make a deduction.

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Deputy Director for Medical Activities of the Multidisciplinary Clinic “Paracelsus”

Makeev Alexander Anatolyevich

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Allergy to tobacco smoke: allergy to tobacco smoke in children

Even if a person is not an active smoker, nowadays he has to come into contact with cigarette smoke constantly. In some cases, he may be allergic to tobacco smoke.

It is worth mentioning the fact that nicotine itself is not able to become an irritant and provoke an allergic disease. But allergies can be provoked by other substances that are part of cigarettes or cigarette smoke. And these include radioactive substances, hydrocyanic acid, and a huge number of chemical compounds that negatively affect the body, and formaldehyde.

In most cases, smokers are the most susceptible to this allergic disease. This is due not only to the fact that they constantly come into contact with the allergen, but also to the fact that their body systems, which could neutralize and remove allergen substances, are quite badly damaged by the negative effects of nicotine on them. By the way, for the same reason, most patients also suffer from very serious symptoms of this disease.

Causes of allergy to tobacco smoke

In addition, the causes of such an allergic disease include the following:

The presence of such a component as flavoring additives in cigarettes. And flavors very often act as an allergen that provokes the development of allergies in a person.

The lungs suffer due to external influences when a person has been ill with pneumonia

If a person has an increased level of smell sensitivity, then tobacco smoke affects the human nervous system and the person tolerates such substances extremely poorly.

Allergy symptoms

It should be noted that the allergy to tobacco smoke does not appear immediately, but such serious symptoms appear later:

• The patient has difficulty breathing through the nose
• Some areas of the skin begin to itch, especially around the eyes, mouth and nose
• Sore throat, tickle
• The patient constantly sneezes
• Anaphylactic shock is sometimes possible
• The patient begins to cough
• Shortness of breath appears
• Voice becomes hoarse
• Swelling in areas of the body such as the neck, head, mouth and sometimes even the mucous membrane of the throat
• If the patient is also asthmatic, then the allergy provokes additional attacks of bronchial asthma in him. This is due to the fact that the respiratory organs of an asthmatic react very subtly to coming into contact with any irritants, and tobacco smoke can cause them to spasm in the bronchial area. In connection with this reason, in no case should you smoke where there are asthmatics.

If the above symptoms are not addressed as soon as they begin to appear, it may be fraught with the need for urgent medical attention. Since the patient does not immediately establish the symptoms and their connection with the allergen, he does not limit contact with him. This means that tobacco smoke continues to enhance the reaction of the human body and leads to a serious threat to human health.

Tobacco smoke allergy in children

It is even worse when children are allergic to tobacco smoke. The situation in this case is complicated by the fact that the symptoms of allergies in children are almost identical to the symptoms of SARS. Accordingly, it is not possible to cure a child when he has a sore throat, cough and runny nose. To do this, you should show it to an allergist, who will prescribe the correct treatment.

Allergy treatment

It is recommended to treat allergies to tobacco smoke only after consultation with a specialist. Most often, it includes the use of antihistamine drugs, sometimes they are added, if necessary, to those medications that remove inflammation. You can use the methods of traditional medicine in the treatment. But at the same time, it is still recommended to first consult with a specialist in this matter. Also, for the purpose of prevention, it is recommended to strengthen the body’s immune system with the help of vitamins.

If a smoker is allergic to tobacco smoke, they will have to stop smoking. If the patient is not a smoker, then it will be more difficult for him, because it will be necessary to shun a large number of people (after all, there will definitely be those who will smoke). It should be remembered that if you try to simply use an air conditioner or a fan, and also try to eliminate the allergen in the air with aromatic oils or sticks, this will not have any effect in achieving the goal of eliminating cigarette smoke from the room.