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Doctors' Answers to "Frequently Asked Questions" - Smoking
Answer: Clonidine is an central alpha blocker first used intreating hypertension. Subsequently, it became clear of it's advantages in blocking symptoms of different kinds of drug withdrawals. First used in narcotic addiction, it is often used with different drug withdrawals to block the symptoms. It will not particularly affect the craving like Zyban can. But, can be helpful. Side effects are sedation, constipation, dry mouth. Start with 0.1 mg at bedtime. If that works it does come in a patch which lasts a week, and some start with the patch increasing it as you can tolerate the side effects. I have not been impressed with mecamylamine(Inversine) but worth a try if clonidine is not helpful.
Answer: No connection that I am aware of.
Answer: I assume you have tried to replace the nicotine while you stop? You can do this with the patch, gum etc. There are two parts of smoking addiction. One is the social aspect(I always smoke when I drink or with coffee, office break etc.) The other is nicotine. Try breaking one at a time. That is use nicotine to break the social aspect and then go for the nicotine. Clonidine a blood pressure pill is sometimes helpful in withdrawal and won't cause weight gain, (drowsiness is it's problem). Focus on your emotional needs and keep at it.
Smoking Tree Leaves [posted
Answer: It always amazes me that people will voluntarily put things into their bodies from a recreational perspective that they would sue any polluter or drug manufacturer that did it. Every inhaled smoke damages lung function. However, the exact risk depends on the type of tree.
Nicotine & Haldol [posted
Answer: It does change the metabolism;but not necessary to change the dosing a great deal with each cigarette. This is micromanaging.
Nicotine Patch Doses [posted
Answer: Usually higher;but, I'd start with the 21 mg and see the result.
Is Zyban Suggested for One Pack per
Day Smoker [posted 10/28/98]
Answer: Start with the Zyban, if you fail try the combo.
Zyban [posted 10/9/98]
Answer: Zyban does have increased risk of seizure and is relatively contraindicated in patients with a seizure disorder. I know of no reaction between Zyban and Dilantin,but, you need to watch your dilantin levels closely when starting an additional drug. However, I would not recommend Zyban for you.
Wellbutrin and Prozac [posted
Answer: About one week should be sufficient.
Smoking Cessation Medication
Answer: Completely different class of drug, so it is hard to know if you would have troubles stopping it. Usually, you can use somewhat lower doses with nicotine stoppage than in depression.
Smoking Cessation Medication
Answer: Must be an OTC, as Im not aware of it. Do you have a generic name?
Answer: That study has been done with cigarettes as the source of the nicotine. The nicotine patch or nicotine gum may have slightly less effects, but probably similar. The addition of nicotine will decrease the placental size and oxygen carrying capacity of the blood. Consequently, the babies of smokers are about 1/2 to 1 pound lighter and tend to have earlier onset of labor by two weeks or so on average. The birth scores of nicotine babies are slightly less than non-nicotine babies. One does not apparently see the developmental problems that alcohol causes, but further research is in progress.
Answer: Whether to use a drug has little with its availability. The cessation rate for stopping smoking is about 10-15%. This rises about 5% or so with the use of nicotine patches. This is particularly true of those patients who are truly nicotine addicted versus socially addicted. That is, some patients smoke at predictable times dictated by social parameters.(Breaks, parties, first cup of coffee, etc.). Others are climbing the walls with any cessation of nicotine intake. This is the best group to use patches, although both groups will benefit.
Nicotine In Blood
Answer: Nicotine will be out of your system in 48 hours or so. It is usually detectable in urine for 3-4 days depending on the sensitivity of the test.
Second Hand Smoke
Answer: A lot of debate here. There are two potential effects. The first is the immediate effect. It is clear that children exposed to smoking parents will have higher rates of respiratory illness. Also, the susceptibility of the non-smoker to asthma in particular will vary widely. Some patients will have severe asthma triggered by minimal smoking -others with no trigger with heavy smokers. Long term there appears to be a higher risk of lung cancer and heart disease in spouses of smokers; but, there is heavy debate here.
Answer: I recommend to patients to follow certain steps. First, decide if you really want to stop. This should be an emotional decision not an intellectual one. Second, find something in your emotional inventory that you prefer/fear more than smoking. For example, losing control of your life with a stroke or seeing your children suffer after your death. Then use the emotional focus to help the decision to stop. Set a date known only to yourself-make it an emotional memory that is important to you. Finally, try to break the habits associated with smoking in the six weeks leading to the stop date. For example, if you habitually smoke with coffee-don't smoke for one week with coffee to break the associative habit. Finally, when you stop throw the cigarettes away-if you need nicotine supplements use them they help 20% or so of patients. Finally, reward yourself with something you would not do with the proceeds of not smoking. That is save it in a jar with a picture of Hawaii or whatever on the jar where you can see it. Focus on the emotions of your life that are stronger than your need to smoke. They will break the habit with you.
Answer: Smoking cessation can be one the most difficult tasks you will ever
choose to undertake. However, should you succeed, the rewards are many. Improved
cardiovascular function, improved energy level, as well as a lower risk of heart and lung
disease, cancer, stroke, are all amongst the benefits obtained down the road, in those who
quit smoking tobacco. Quitting is not easy, and the majority of those who do quit
successfully require more than one attempt. As a physician, I am pleased to see that you
have taken the first and most important step- to decide to quit. The next important step
is to find an ally- a friend, spouse, co-worker, or any person in your life that you can
count on to be there when the cravings hit, when you start to think about smoking again,
and to keep you away from tobacco when things get difficult. Your physician should not
only be involved in this process, but if you choose, can be depended on to serve as your
coach or ally, until you break the habit. There are many different options
available to aid in smoking cessation. Each has its advantages and drawbacks, and the
final option you choose should be the result of a discussion with your physician, so that
the regimen is tailored to your specific needs, and will maximize the possibility of
success. The first thing I tell my patients to do is to first get rid of the tobacco -
from the house, the car, the workplace- all of it. I encourage them to put the daily cash
that would have gone towards tobacco purchases, into a jar in the kitchen, so they can
find some motivation from the fact that this money can be put towards something they may
really want. The first and oldest quitting technique is the so called cold
turkey approach, in which you just simply stop entirely- no weaning or slow
reductions in the amount you smoke. In people who are well motivated this technique has a
surprisingly high rate of success, but relies heavily on outside support. The medication
options currently available include nicotine patches or gum (both of which simply replace
nicotine, and then require slow weaning of these agents) as well as non-nicotine pills.
These pills are designed to do what you asked about- they take away the craving, or that
rush, or intense need for smoking. These are fairly new medications and the
long term success studies are not as numerous, but early data suggests some success. You
should know that all of these drugs, like all medications, have side effects, which can be
serious depending on whether you have any other medical problems. These pills are
available through your physician (one of them goes by the generic name
bupropion, and is also used in different doses to treat depression), who can
discuss a plan for quitting with you, and provide you with additional information to help
you make the right medication choice. Good luck!
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