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Smoking cessation

Pale smooth lung contrasted with stained and crumpled lung
A healthy lung compared to a smoker's lung

Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking.[1] Tobacco smoke contains nicotine, which is addictive and can cause dependence.[2][3] As a result, nicotine withdrawal often makes the process of quitting difficult.

Smoking is the leading cause of preventable death and a global public health concern.[4] Tobacco use leads most commonly to diseases affecting the heart and lungs, with smoking being a major risk factor for heart attacks,[5][6] strokes,[7] chronic obstructive pulmonary disease (COPD),[8] idiopathic pulmonary fibrosis (IPF),[9] emphysema,[8] and various types and subtypes of cancers[10] (particularly lung cancer, cancers of the oropharynx,[11] larynx,[11] and mouth,[11] esophageal and pancreatic cancer).[12] Smoking cessation significantly reduces the risk of dying from smoking-related diseases.[13][14] The risk of heart attack in a smoker decreases by 50% after one year of cessation. Similarly, the risk of lung cancer decreases by 50% in 10 years of cessation [15]

From 2001 to 2010, about 70% of smokers in the United States expressed a desire to quit smoking, and 50% reported having attempted to do so in the past year.[16] Many strategies can be used for smoking cessation, including abruptly quitting without assistance ("cold turkey"), cutting down then quitting, behavioral counseling, and medications such as bupropion, cytisine, nicotine replacement therapy, or varenicline. In recent years, especially in Canada and the United Kingdom, many smokers have switched to using electronic cigarettes to quit smoking tobacco.[16][17][18] However, a 2022 study found that 20% of smokers who tried to use e-cigarettes to quit smoking succeeded but 66% of them ended as dual users of cigarettes and vape products one year out.[19]

Most smokers who try to quit do so without assistance. However, only 3–6% of quit attempts without assistance are successful long-term.[20] Behavioral counseling and medications each increase the rate of successfully quitting smoking, and a combination of behavioral counseling with a medication such as bupropion is more effective than either intervention alone.[21] A meta-analysis from 2018, conducted on 61 randomized controlled trials, showed that among people who quit smoking with a cessation medication (and some behavioral help), approximately 20% were still nonsmokers a year later, as compared to 12% who did not take medication.[22]

In nicotine-dependent smokers, quitting smoking can lead to nicotine withdrawal symptoms such as nicotine cravings, anxiety, irritability, depression, and weight gain.[23]: 2298  Professional smoking cessation support methods generally attempt to address nicotine withdrawal symptoms to help the person break free of nicotine addiction.

  1. ^ "Take steps NOW to stop smoking". www.nhs.uk. London: National Health Service. 2022. Archived from the original on 29 May 2022. Retrieved 31 May 2022.
  2. ^ "How to Quit Smoking or Smokeless Tobacco". www.cancer.org. Atlanta, Georgia: American Cancer Society. 2022. Archived from the original on 25 May 2022. Retrieved 31 May 2022.
  3. ^ Cite error: The named reference nicotine dependence was invoked but never defined (see the help page).
  4. ^ Kalkhoran S, Benowitz NL, Rigotti NA (August 2018). "Prevention and Treatment of Tobacco Use: JACC Health Promotion Series". Journal of the American College of Cardiology. 72 (9). Elsevier for the American College of Cardiology: 1030–1045. doi:10.1016/j.jacc.2018.06.036. PMC 6261256. PMID 30139432. S2CID 52077567.
  5. ^ Rodu B, Plurphanswat N (January 2021). "Mortality among male cigar and cigarette smokers in the USA" (PDF). Harm Reduction Journal. 18 (1). BioMed Central: 7. doi:10.1186/s12954-020-00446-4. LCCN 2004243422. PMC 7789747. PMID 33413424. S2CID 230800394. Archived (PDF) from the original on 26 August 2021. Retrieved 28 August 2021.
  6. ^ Nonnemaker J, Rostron B, Hall P, MacMonegle A, Apelberg B (September 2014). Morabia A (ed.). "Mortality and economic costs from regular cigar use in the United States, 2010". American Journal of Public Health. 104 (9). American Public Health Association: e86–e91. doi:10.2105/AJPH.2014.301991. eISSN 1541-0048. PMC 4151956. PMID 25033140. S2CID 207276270.
  7. ^ Shah RS, Cole JW (July 2010). "Smoking and stroke: the more you smoke the more you stroke". Expert Review of Cardiovascular Therapy. 8 (7). Informa: 917–932. doi:10.1586/erc.10.56. PMC 2928253. PMID 20602553. S2CID 207215548.
  8. ^ a b Laniado-Laborín R (January 2009). "Smoking and chronic obstructive pulmonary disease (COPD). Parallel epidemics of the 21 century". International Journal of Environmental Research and Public Health. 6 (1). MDPI: 209–224. doi:10.3390/ijerph6010209. PMC 2672326. PMID 19440278. S2CID 19615031.
  9. ^ Oh CK, Murray LA, Molfino NA (February 2012). "Smoking and idiopathic pulmonary fibrosis". Pulmonary Medicine. 2012. Hindawi Publishing Corporation: 808260. doi:10.1155/2012/808260. PMC 3289849. PMID 22448328. S2CID 14090263.
  10. ^ Shapiro JA, Jacobs EJ, Thun MJ (February 2000). Ganz PA N (ed.). "Cigar smoking in men and risk of death from tobacco-related cancers". Journal of the National Cancer Institute. 92 (4). Oxford University Press: 333–337. doi:10.1093/jnci/92.4.333. eISSN 1460-2105. PMID 10675383. S2CID 7772405. Archived from the original on 21 April 2021. Retrieved 28 August 2021.
  11. ^ a b c Anjum F, Zohaib J (4 December 2020). "Oropharyngeal Squamous Cell Carcinoma". Definitions (Updated ed.). Treasure Island (FL): StatPearls Publishing. doi:10.32388/G6TG1L. PMID 33085415. S2CID 229252540. Bookshelf ID: NBK563268. Retrieved 7 February 2021 – via NCBI. {{cite book}}: |work= ignored (help)[clarification needed]
  12. ^ Chandrupatla SG, Tavares M, Natto ZS (July 2017). "Tobacco Use and Effects of Professional Advice on Smoking Cessation among Youth in India". Asian Pacific Journal of Cancer Prevention. 18 (7): 1861–1867. doi:10.22034/APJCP.2017.18.7.1861. PMC 5648391. PMID 28749122.
  13. ^ Temitayo Orisasami I, Ojo O (July 2016). "Evaluating the effectiveness of smoking cessation in the management of COPD". British Journal of Nursing. 25 (14): 786–791. doi:10.12968/bjon.2016.25.14.786. PMID 27467642.
  14. ^ "WHO Report on the global tobacco epidemic". World Health Organization. 2015. Archived from the original on July 8, 2015.
  15. ^ "Tobacco". www.who.int. Retrieved 2024-02-24.
  16. ^ a b "Vaping and quitting smoking". www.canada.ca. Ottawa: Government of Canada. 31 March 2022. Archived from the original on 8 May 2022. Retrieved 31 May 2022.
  17. ^ "Using e-cigarettes to stop smoking". www.nhs.uk. London: National Health Service. 29 March 2022. Archived from the original on 11 May 2022. Retrieved 31 May 2022.
  18. ^ Wilson E, ed. (15 November 2019). "Long-term smokers who start vaping see health benefits within a month". New Scientist. London. ISSN 0262-4079. Archived from the original on 5 March 2022. Retrieved 31 May 2022.
  19. ^ Heiden BT, Baker TB, Smock N, Pham G, Chen J, Bierut LJ, et al. (2022). "Assessment of formal tobacco treatment and smoking cessation in dual users of cigarettes and e-cigarettes". Thorax. 78 (3): 267–273. doi:10.1136/thorax-2022-218680. PMC 9852353. PMID 35863765.
  20. ^ Rigotti NA (October 2012). "Strategies to help a smoker who is struggling to quit". JAMA. 308 (15): 1573–1580. doi:10.1001/jama.2012.13043. PMC 4562427. PMID 23073954.
  21. ^ Stead LF, Koilpillai P, Fanshawe TR, Lancaster T (March 2016). "Combined pharmacotherapy and behavioural interventions for smoking cessation". The Cochrane Database of Systematic Reviews. 2016 (3): CD008286. doi:10.1002/14651858.CD008286.pub3. PMC 10042551. PMID 27009521. S2CID 29033457.
  22. ^ Rosen LJ, Galili T, Kott J, Goodman M, Freedman LS (May 2018). "Diminishing benefit of smoking cessation medications during the first year: a meta-analysis of randomized controlled trials". Addiction. 113 (5). Wiley-Blackwell on behalf of the Society for the Study of Addiction: 805–816. doi:10.1111/add.14134. PMC 5947828. PMID 29377409. S2CID 4764039.
  23. ^ Benowitz NL (June 2010). "Nicotine addiction". The New England Journal of Medicine. 362 (24): 2295–2303. doi:10.1056/NEJMra0809890. PMC 2928221. PMID 20554984.

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