addiction

The 4 D's: Steps for Coping With Withdrawal

Description: 
Details withdrawal symptoms from tobacco cessation and how to manage them.

Coping with Withdrawal Symptoms

Withdrawal symptoms are no fun, yet most people feel them when they quit smoking. Most people feel withdrawal symptoms when they quit smoking. There are 2 types of addiction: the physical and the psychological.

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Nicotine Nasal Spray

Description: 
See FDA package insert for more complete information

The nasal spray is available by prescription only. Each spray delivers 0.5 mg of nicotine. One dose consists of 2 sprays, one in each nostril, for a total of 1.0 mg of nicotine. A minimum of 8 doses is recommended per day, with the initial dose being 1 to 2 doses per hour, increasing dose as needed. Eight (16 sprays) to 40 (80 sprays) doses per day is the recommended range. Therapy duration is 3 to 6 months.


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Nicotine Gum

Description: 
See FDA package insert for more complete information

Nicotine gum is currently available as an over-the-counter medication in 2-mg and 4-mg dosages. If you smoke 25 or more cigarettes a day, it is recommended that you use the 4-mg gum. Use one piece every 1 to 2 hours for the first 6 weeks; use up to 12 weeks. Do not exceed 24 pieces per day. The gum should be used for up to 12 weeks.


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Nicotine Patch

Description: 
See FDA package insert for more complete information

The nicotine patch is available over the counter and in prescription form. Find out if your insurance will reimburse you for the prescription patch. Doses and how long they are worn vary in the different brands and your doctor may help select the right one for you. Generic patches are also available, often at lower costs. The recommended duration of usage is 8 weeks, which is as effective as longer treatment.


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Nicotine Inhaler

Description: 
See FDA package insert for more complete information

Nicotine inhaler is available through prescription only. It consists of a mouthpiece and a cartridge. The cartridge contains 10 mg of nicotine. A dose is a puff or inhalation. The initial dosage is typically 1-2 doses per hour. Recommended dosage is a minimum of 8 doses and maximum of 40 doses per day. Recommended duration of use is up to 6 months, tapering during the final 3 months.



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Avoiding Triggers

Description: 
Situations in which patients may find they desire to smoke. Includes possible solutions to these situations.

What triggers you to smoke? The table below lists what a lot of smokers say. Do some of these sound familiar to you? Take a look at the suggestions for how to overcome each trigger. Try to think of some other changes you can make.

And don't underestimate your possible physical addiction to nicotine. If, for example, you feel a need to smoke within 20 minutes after waking up, it's most likely a need for a nicotine hit.


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Patient Handout: Varenicline (Chantix®)

Description: 
See FDA package insert for more complete information.

Warnings and side effects of Varenicline (Chantix) are included in the table below. For more information, you can refer to the FDA package insert.

 

Description

Varenicline is a quit-smoking medication approved by the Food and Drug Administration. It does not contain any nicotine. It is available as Chantix® and only by prescription. You can use it for up to 12 weeks. An additional 12 weeks may be recommended by your physician after successful cessation to help maintain abstinence.

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Patient Handout: Bupropion Hydrochloride SR (Zyban®)

Description: 
See FDA package insert for more complete information.

Description, side effects, and instructions for the medicine Bupropion Hydrochloride SR (Zyban®) are presented below. For more complete information, you can refer to the FDA package insert for the medication.

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Patient Handout: Physical Activity

Description: 
Details how ex-smokers are successful at quitting by getting involved in some kind of regular physical activity.

Do you find it hard to believe that exercise (something that is active) can help you quit smoking (something that is passive)? It's true. A lot of ex-smokers are successful at quitting by getting involved in some kind of regular physical activity.

Question: How do I know what kind of exercise to do?

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The 5 R's of Motivation

Description: 
Details how to increase a patient's motivation to quit using tobacco products.

For patients not willing to make an attempt at quitting, clinicians should provide a brief intervention to promote the motivation to quit. Motivation is also important for patients who do express interest in quitting. Ask patients to state their reasons for wanting to quit. Hearing their own answers helps strengthen their commitment, and you can provide positive reinforcement by supporting their reasons. Motivational interventions can be divided into 5 basic types, or the 5 R's: Relevance, Risks, Rewards, Roadblocks, and Repetition (Fiore et al. 2008).


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