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Smoking: Nicotine replacement therapy

Nicotine is a substance that can cause an addiction. Most people who smoke experience unpleasant withdrawal symptoms once they stop smoking. Nicotine replacement therapy can help. People particularly experience withdrawal symptoms in the first week of quitting smoking. Nicotine craving often leads to anxiety, aggression or depression. Some people also have problems concentrating or have an increased appetite. Nicotine replacement therapy can help reduce those withdrawal symptoms. The therapy provides your body with nicotine in a different way to smoking.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 25, 2013

Can nicotine vaccines help people stop smoking or help stop recent quitters from relapsing?

Nicotine is the main addictive component in tobacco. When a person smokes a cigarette, nicotine causes chemicals in the brain to be released, which gives a feeling of reward to the smoker. This reward is part of the reason why people keep smoking. Nicotine vaccines are designed to work by reducing the effects of nicotine on the brain, meaning the smoker will feel less of a reward when they smoke a cigarette. By reducing the pleasure felt when smoking, vaccines may help smokers to stop smoking or help stop recent quitters from starting to smoke again.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Can nicotine replacement therapy (NRT) help people quit smoking?

NRT aims to reduce withdrawal symptoms associated with stopping smoking by replacing the nicotine from cigarettes. NRT is available as skin patches that deliver nicotine slowly, and chewing gum, nasal and oral sprays, inhalers, and lozenges/tablets, all of which deliver nicotine to the brain more quickly than from skin patches, but less rapidly than from smoking cigarettes. This review includes 150 trials of NRT, with over 50,000 people in the main analysis. We found evidence that all forms of NRT made it more likely that a person's attempt to quit smoking would succeed. The chances of stopping smoking were increased by 50 to 70%. The evidence suggests no overall difference in effectiveness between different forms of NRT, nor a benefit for using patches beyond eight weeks. NRT works with or without additional counselling, and does not need to be prescribed by a doctor. Heavier smokers may need higher doses of NRT. People who use NRT during a quit attempt are likely to further increase their chance of success by using a combination of the nicotine patch and a faster acting form or by combining the patch with the antidepressant bupropion. Data suggest that starting to use NRT patches shortly before the planned quit date may increase the chance of success. Adverse effects from using NRT are related to the type of product, and include skin irritation from patches and irritation to the inside of the mouth from gum and tablets. There is no evidence that NRT increases the risk of heart attacks.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Can nicotine receptor partial agonists, including cytisine and varenicline, help people to stop smoking?

When people stop smoking they experience cravings to smoke and unpleasant mood changes. Nicotine receptor partial agonists aim to reduce these withdrawal symptoms and the pleasure people usually experience when they smoke. The most widely‐available treatment in this drug type is varenicline, which is available world‐wide as an aid for quitting smoking. Cytisine is a similar medication, but is only available in Central and Eastern European countries and through internet sales.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Quitting smoking: Things that can help

Most people who smoke decide to quit at some time or another. Yet it is often difficult to act on this decision. It usually takes several attempts until they are able to go without tobacco. There are a number of strategies that can help you to quit smoking.If you would like to quit smoking, there are different things you can try out to kick the habit. Around half of those who try to quit smoking don't need any extra help. Many people receive important support from their partner, friends or family. Another option is to get advice on quitting smoking from a doctor or a pharmacist. Nicotine replacement therapy (NRT) and certain medications can help you break your nicotine addiction and deal with withdrawal symptoms.Maybe it also helps to think about how much money you can save by not smoking. You can find out how much money you personally spend on cigarettes by using our cigarette calculator. Setting personal goals can also be a good motivation, for example rewarding yourself for not smoking for a month with a nice meal or some new clothes.There are lots of brochures, materials and online offers that provide support for people who want to quit smoking, for example the www.rauchfrei-info.de (in German) website from the German Federal Center for Health Education (BZgA). Stop smoking courses are also available. Some health insurers cover part of the costs of such courses.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 26, 2014

Medicines To Treat Alcohol Use Disorder: A Review of the Research for Adults

This summary will tell you about: What alcohol use disorder is Medicines to treat alcohol use disorder What research says about how well the medicines work Possible side effects of the medicines Things to talk about with your doctor

Comparative Effectiveness Review Summary Guides for Consumers [Internet] - Agency for Healthcare Research and Quality (US).

Version: February 16, 2016

Do medications used to treat depression help smokers who are trying to quit

Some medications and supplements that have been used to treat depression (antidepressants) have been tested to see whether they also help people who are trying to stop smoking. Two antidepressants, bupropion (Zyban) and nortriptyline, are sometimes prescribed to help with quitting smoking. This review set out to determine if using antidepressants increased people's likelihood of successfully quitting smoking at six months or longer and to determine the safety of using these medications to help quit smoking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Cigarette Smoking: Health Risks and How to Quit (PDQ®): Patient Version

Expert-reviewed information summary about research and guidelines focused on the prevention and cessation of cigarette smoking.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 16, 2016

Do pharmacotherapies which reduce anxiety help smokers to quit

Anxiety can contribute to increased smoking, and may be a smoking withdrawal symptom. Medications to reduce anxiety (anxiolytics) may theoretically help smokers trying to quit. There have not been many trials, and none of them showed strong evidence of an effect on quitting.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Does clonidine help smokers to quit

Clonidine is a drug used to lower blood pressure, but it may also reduce drug and alcohol withdrawal symptoms. The review of trials found that clonidine can lead to a small increase in the number of people likely to quit smoking. However, the quality of the trials was poor, which makes the evidence less reliable. Adverse effects of clonidine included a dry mouth and sedation. Clonidine may not be the best option for people trying to quit smoking, but it might be useful for people who are not helped by nicotine replacement therapy or antidepressants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Do acupuncture and related therapies help smokers who are trying to quit

We reviewed the evidence that acupuncture, acupressure, laser therapy or electrical stimulation help people who are trying to stop smoking.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Do exercise interventions help people quit smoking

We reviewed the evidence about the effect of exercise programmes in people who want to quit smoking. We looked at whether exercise programmes, either alone or combined with stop smoking programmes, helped more people to quit at six months or longer than stop smoking programmes alone or stop smoking programmes combined with health education.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Systematic Reviews in PubMed

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