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Smoking cessation (quit smoking)

What are effective interventions to quit smoking?

  • counseling and psychotherapy
    • brief advice to quit from health professionals
    • individual or group counseling
    • behavioural support/therapy
    • motivational interviewing
    • clinical hypnosis
  • pharmakotherapy/medication
    • nicotine replacement therapy
      • gums, patches, sprays, tablets, lozenges
    • Bupropion
    • Varenicline

 

What are the most effective counseling methods?

 

The longer the counseling intervention, the better are the smoking cessation rates. Self-help interventions without personal support have a very small effect size (1%). Individual and group counseling have an estimated cessation rate of 13 - 17%. Counseling should include: provision of information, coping skills, and recognition of danger situations (risk of relapse).

 

What kind of medication is being used for smoking cessation?

 

Nicotine replacement therapy comes in different applications: transdermal patches, nasal sprays, gums, sublingual tablets, and inhalators. The effect size (difference in abstinence rates between intervention and placebo) is about 7-8%. 

Bupropion has a similar effect size (about 7%), and is contra-indicated in patients with epilepsy, brain tumors, anorexia nervosa, bulimia, bipolar disorder, and severe liver disease.

Varenicline has the best effect size (about 15%), and is contra-indicated in pregnancy.

 

How can clinical hypnosis be helpful in smoking cessation?

 

Clinical hypnosis is used to increase the motivation to stop and to support behavioural change, and to cope with withdrawal symptoms. For example, hypnotherapists use visualisation in order to help the patient to imagine how he looks/feels like in one year after quitting smoking. Or the patients visualize in a hypnotic state how the cope with danger or risk situations (these are situations in which the patient used to smoke, e.g. smoking after dinner or after a coffee).

 

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© Dr. med. Roger Bühler