We know that cigarette smoking is a bad habit and it starts early age in our life, mostly in adolescence. To act smart(!), follow the code of friends group, break the set rules, etc. can be the reason behind jumping into the trap of nicotine addiction. Nicotine addiction may become a big problem in a smoker’s life after a few years.

 

After a few years, a smoker starts realizing that smoking causes health problems, social problems, family problems, and sometimes even financial problems. Now he or she starts thinking of quitting smoking cigarettes. But a smoker’s nicotine dependence makes the process of giving up smoking difficult, many a time impossible.

How Big is the Problem?

The seriousness of the problem can be understood from WHO’s statement[1] on tobacco that

Nicotine addiction kills up to half of its users.

Tobacco kills more than 8 million people each year.

More than 7 million of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke.

Over 80% of the world’s 1.3 billion tobacco users live in low- and middle-income countries.

WHO identified nicotine addiction as a big health threat for the future world population, WHO act to control the use of tobacco, recommended several measures like the introduction of stringent acts and rules to restrict the marketing of tobacco products, imposition of stiff tax on the cigarette to discourage cigarette purchase, etc.

They identified that primarily a smoker remains unaware of his or her nicotine dependence.  But, once they realize it, many of them try to quit smoking. Without any support, only 4% of smokers successfully quit smoking.  Professional support and proper medication increase the chance to quit becomes double.

There are more than a hundred crores cigarette smokers worldwide. If even a mere one percent of smokers starts thinking of quitting smoking the group size becomes more than one crore. Numerous numbers of organizations come forward to help smokers to get out of their problems, educate them about the cause of tobacco addiction and advise how to quit smoking cigarettes on the contents of their websites.  One thing that is very common in those articles is that after a few lines they start suggesting accepting their product as Nicotine Replacement Therapy (NRT).  Let me discuss, what is NRT.

Is There Any solution:

Nicotine is a very highly addictive chemical that remains in tobacco and that’s the reason for the nicotine dependence of a smoker. That’s why it becomes hard to stop smoking once start. We know that Nicotine affects the brain and without it, the smoker feels uneasy called cravings or withdrawal symptoms. Nicotine Replacement Therapy or NRT supplies a small amount of nicotine to the user’s body through any of the therapeutic products viz. Nicotine Gum, Nicotine patch, Nasal spray, Nicotine Inhalers, or Lozenge. This gives the user relief from withdrawal symptoms for some time. While smoking tobacco smokers inhale 70 carcinogenic harmful chemical substances with tobacco smoke. NRT ensures users eliminate those harmful chemicals.

While NRT has a proven record of success in reducing cravings and the cause of tobacco addiction when used by a smoker, it has some side effects too.

Nicotine Patch: Side effects: Irritation or redness of the skin, dizziness, headache, nausea, high heart bits, muscle pain, sleeping problem

Nicotine Gum: Side effects: Irritation to your mouth or throat, bad aftertaste, nausea, jaw pain, high heart bits.

Nicotine Nasal Spray: Side effects: Irritation to your nose or throat, coughing, watery eyes, sneezing. These side effects usually get better after 1-2 weeks of treatment. Other side effects that can occur include headache, nervousness, and a high heart bit.

Nicotine lozenges: Side effects: Coughing, gas, heartburn, sleeping problem,  nausea, hiccups, high heart bits.

Nicotine Inhaler: Side effects: irritation to your mouth or throat, nausea, headache, nervousness, and a high heart bit.

Though NRT products  introduced nearly 14 years back, their popularity is still in question.  Failure to quit rate is too high which influenced the popularity. It may be possible that Indian middle-income and low-income group smokers find it difficult to continue with the treatment for the long period it required. In affluent countries, NRT is fairly successful.

Recent Developments:

World Health Organization (WHO), approves two medicines in 2021 that work in a different way than NRT. Bupropion and varenicline are those two medicines. The new medicines manage cravings for nicotine without supplying a nicotine substitute. Thus the medicines  supporting smokers to gradually reduce nicotine dependence and finally quitting nicotine addiction.

Side effects of Champix are sleeplessness, difficulty concentrating, decreased heart rate, increased appetite, weight gain, nausea. Other common side effects include headaches and abnormal dreams and thoughts. Champix may produce dizziness.

According to a report, varenicline produced in India under the trade name Champix, by Pfizer Ltd, the Indian unit of the US pharmaceutical giant, sold for Rs. 9600/- for three months of treatment with a 44% success rate.

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