What is the Single Best Thing You Can Do to Quit Smoking?
How to Quit Smoking – A Guide to Kicking the Habit for Good
Guide to Quitting Smoking – American Cancer Society
What are the success rates of the non-NRT therapies?
The success rates of the various non-NRT Therapies
Non-nrt medication – success rates
Bupropion SR – 24.2%
Varenicline 1 mg/d – 25.4%
Varenicline 2 mg/d – 33.2%
Nortriptyline – 22.5%
Clonidine – 25.0%
SSRIs – 13.7%
Naltrexone – 7.3%
Placebo -13.8%
What is cognitive behavioral therapy and how is it helpful?
Cognitive behavioral therapy (CBT) involves talking interventions that focus on both thoughts and behaviors. CBT has been shown to be effective with or without the use of medication in smoking cessation. It is a goal-oriented problem-solving approach to overcome distortions resulting from ingrained or automatic thinking that lead to maladaptive behaviors.
Cognitive behavioral therapy is helpful because all smokers develop not only physiological dependency to cigarettes but also psychological and behavioral addictions. The physiological dependency can be dealt with by taking one of the medications for smoking cessation. However, medication cannot take care of the psychological or behavioral addiction. Thoughts and behaviors or addictive habits that people have developed over time are difficult to change. Many people have integrated cigarette smoking into their daily lives (wake up in the morning, smoke; drink coffee, smoke; read the paper, smoke; feed the dog, smoke). Smokers view cigarettes as a friend and a support. There is the “good morning” cigarette, the “pat myself on the back” cigarette, the “stress relief” cigarette, and my “after dinner” cigarette. Consequently, some people need more than just medication. Cognitive behavioral therapy is a great adjunct to pharmacological therapies to ensure a person’s success at quitting.
Sykes and Marks from the
Smokers may choose the quit methods that are most comfortable for them. A textbook includes a cassette tape, which summarizes the various behavioral and cognitive strategies that participants can select. Handouts for participants include a combination of 30 CBT methods and other materials. A self-help package is provided, which includes:
- A handbook
- Reduction cards
- Behavioral strategies include:
- Identifying triggers (that is, cues to smoke) and risky situations
- Keeping a smoking diary
- Delaying tactics
- Fading techniques (tapering the nicotine content in NRT medications)
- Behavior substitutes (chewing gum or eating carrot sticks versus smoking cigarettes)
- Positive reinforcements (setting goals and self rewards)
- Self-esteem enhancement
- Coping skills training
- The cognitive techniques include:
- Personal responsibility for one’s own thoughts
- Learning to change beliefs that prove to be barriers to Success
- Disputing irrational thoughts and then replacing them with more positive thoughts
- Homework assignments
- Learning mastery and control
- Cognitive rehearsal (that is, practicing how to deal with risky relapse situations)
- Identifying barriers to successful quitting and how to cope with them
Styles and Marks’ studies have shown that Quit for Life has quit rates that are five to six times higher than quitting using willpower alone. CBT is another effective method to add to the smoking cessation repertoire of quit programs.
Cognitive behavioral therapy is helpful because all smokers develop not only physiological dependency to cigarettes but also psychological and behavioral addictions.
Are there 12-step programs for cigarette smokers, like Alcoholics Anonymous (AA)?
Nicotine Anonymous is a form of group therapy. It began in
Believing in oneself and in a higher power is strongly encouraged.
The concept of a higher power is not faith-based but rather an acceptance of one’s own limitations regarding one’s ability to change on one’s own, thus allowing group members to interpret a stronger outside force that helps to guide them and give them the strength to change according to their own personal beliefs. That outside strength can be the group itself or the extended community. It does not necessarily have to be an abstract being such as God. During the recovery process, group members are encouraged to believe in the power of healing within the group. The 12 steps and 12 traditions for Nicotine Anonymous are similar to Alcoholics Anonymous.
They are as follows:
The Twelve Steps of Nicotine Anonymous
1. We admitted we were powerless over nicotine-that our lives had become unmanageable.
2. We came to believe that a Power greater than ourselves could restore us to sanity.
3. We made a decision to turn our will and our lives over to the care of God as we understand Him.
4. We made a searching and fearless moral inventory of ourselves.
5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. We were entirely ready to have God remove all of these defects of character.
7. We humbly asked Him to remove our shortcomings.
8. We made a list of all persons we had harmed, and became willing to make amends to them all.
9. We made direct amends to these people wherever possible, except when to do so would injure them or others.
10. We continued to take a personal inventory and when we were wrong promptly admitted it.
11. We sought through prayer and meditation to improve our conscious contact with God, as we understand Him, praying only for the knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to nicotine users and to practice these principles in all our affairs.
The Twelve Traditions
1. Our common welfare should come first; personal recovery depends upon Nicotine Anonymous unity.
2. For our group purpose, there is but one ultimate authority-a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.
3. The only requirement of Nicotine Anonymous membership is the desire to stop using nicotine.
4. Each group should be autonomous except in matters affecting other groups or Nicotine Anonymous as a whole.
5. Each group has but one primary purpose-to carry its message to the nicotine addict who still suffers.
7. Every Nicotine Anonymous group ought to be self-supporting, declining outside contributions.
8. Nicotine Anonymous should remain forever non-professional, but our service centers may employ special workers.
9. Nicotine Anonymous, as such, ought never to be organized; but we may create service boards or committees, directly responsible to those they serve.
10. Nicotine Anonymous has no opinion on outside issues; hence the Nicotine Anonymous name ought never to be drawn into public controversy.
11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of the press, radio, TV, and films.
12. Anonymity is the spiritual foundation of all of our traditions, ever reminding us to place principles before personalities.
Self-help groups and psychosocial aftercare groups are highly recommended long-term for people who are at risk for a relapse. Belonging to a group may prevent this common phenomenon.
The success rate of Nicotine Anonymous has not been well documented because Nicotine Anonymous is a self-help group, which is not run by professionals. Some of the data collected to evaluate the effectiveness of a 12-step approach to smoking cessation was conducted at an inpatient program run by the
