Research has demonstrated that chronic nicotine use increases the likelihood a person will become addicted to other substances. Chronic nicotine use alters the structure of the DNA’s housing in the brain cells, allowing the addiction-promoting effects of other drugs to enter the brain’s reward system and change how the brain reads its DNA instructions.
Because nicotine is legal, people often start this drug, along with alcohol, when they are teens. Those with mental illness and addictions are more likely to smoke. People who recently quit other drugs and alcohol but maintained their tobaccosmoking addiction may be more likely to relapse.
Smoking cessation treatments:
Nicotine is a very powerful and addictive drug. While quitting one drug at a time may seem easier, people who quit smoking and using other drugs or alcohol at the same time have more success with long-term abstinence.
Several medications reduce nicotine withdrawal and cravings. Nicotine replacement therapy comes in patches, lozenges, gum and inhalers. These are used for a month or more before quitting and up to a year after. Slowly tapering the daily dose of nicotine using replacement methods can make withdrawal symptoms more tolerable and allow the brain’s receptors to readjust to becoming nicotine-free. Side effects can include nausea and headache, and itching or irritation where the nicotine is applied.
Chantix (varenicline) is taken twice daily and interferes with nicotine receptors in the brain, decreasing withdrawal symptoms and the pleasure of smoking. People take Chantix for a month or more before quitting and up to a year after. Research suggests it is the most effective quit-smoking medication. Side effects can include headache, nausea, vomiting and trouble sleeping. Since depressed mood, agitated behavior and suicides have been reported among some trying to quit with Chantix, people shouldn’t use Chantix unless their mental illness is stable. WestBridge encourages participants to monitor their mood and sleep daily during smoking cessation with varenicline until acute withdrawal has passed.
Buproprion (Wellbutrin or Zyban) also reduces nicotine cravings and is taken once or twice dailyfor a month or more before quitting and up to a year after. Buproprion is more effective if used in combination with nicotine replacement therapy. Those with schizophrenia who are trying to quit smoking should start buproprion in combination with a nicotine patch and/or lozenge or gum. These medications can be used for up to a year with psychosocial support.Buproprion is also an effective antidepressant and may induce mania among people with bipolar disorder unless they are taking mood stabilizers.
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