Smoking Cessation in Chania

Did you ever know that smoking is the leading cause of preventable death in developed world? This means that diminishing smoking could save more lives than hypertension, diabetes and cholesterol treatment!  Worldwide, tobacco use causes nearly 6 million deaths per year, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030. On average, smokers die 10 years earlier than nonsmokers. Smoking is also a main reason for diseases that dramatically reduce the quality of our life.

The easiest way for quitting smoking is joining a smoking cessation program. Fewer than 5% of smokers succeed quitting smoking alone, whereas attending a smoking cessation clinic these percentages outweigh 80%.

What is a SMOKING CESSATION PROGRAMM/CLINIC? 

 We use the term Smoking Cessation Program to describe the most current and scientifically proven procedure to quit smoking with the help of a pulmonologist.  Doctor’s help is needed for quitting smoking, as it is considered to be a disease.  According to the World Health Organization, smoking fulfils the diagnostic criteria of an addictive disease and is included in ICD-10 diseases classification.

 Nicotine addiction is profound as a smoker has a strong desire or sense of compulsion to smoke, has difficulties in controlling this behavior and develops withdrawal symptoms in such efforts. Smokers develop tolerance (needs more and more smoking), neglect alternative pleasures or interests because of smoking and they often relapse after a successful quit attempt.

Smoking causes addiction due to nicotine, which is one of the 7000 chemicals (figure 2) that are created by cigarette burn!

Image 2. What Is In A Cigarette? Chemicals and Ingredient List Confirm How Dangerous Smoking Is 

 Nicotine is a highly addictive substance, similar to alcohol abuse or heroin as you can see in the following table.

These are the reasons why smoking cessation programs have been developed by doctors using evidence-based methods and specially created drugs for nicotine addiction.

Smoking can now be successfully treated as any other disease. 

How SMOKING CESSATION PROGRAMM/CLINIC works;

Smoking is a highly addictive habit and its quitting demands continuous and guided effort.

A smoking cessation clinic program lasts a few months, although the smoker most often quits the first few (7-14) days!

 The typical schedule of our smoking cessation clinic is as follows

*In this schedule, a basic evaluation is performed in each smoking cessation visit.  This includes evaluation of efficacy and possible adverse reactions of the prescribed treatment, dose adjustment and, if needed, treatment alteration. Moreover, we perform clinical examination, vitals measurement (blood pressure, heart rate and oxygen saturation) and pulmonary function tests such as spirometry and exhaled carbon monoxide measurement.

During smoking cessation procedure the patient is strongly encouraged to contact with his pulmonologist for any related reason and is advised to keep contact with him at least for one year following successful quit.  The doctor may call you sometimes in order to ensure maximum compliance and efficacy of the program. This “intense” follow-up is beneficial to preventing relapses of this highly addictive disease.

  Note in the schedule chart that most patients quit smoking a few days following participation in the program

Are there any specific tests for smokers that can be performed in a SMOKING CESSATION CLINIC?

During a smoking cessation procedure we can:

1. estimate the degree of your nicotine addiction using scientific questionnaires

2. measure the levels of carbon monoxide (CO) in your breath which reflects its levels in your blood. Carbon Monoxide is a colorless, odorless, and tasteless gas that combines with hemoglobin to produce carboxyhemoglobin, which usurps the space in hemoglobin that normally carries oxygen, but is ineffective for delivering oxygen to bodily tissues. Its accumulation in small rooms (such us charcoal burning) may be fatal. Carbon Monoxide level is a reliable estimate of your dependence to cigarette and, mainly, of the continuous danger of smoking to your body.

3. determine the damage that smoking has caused to your lungs by performing simple spirometry and, if necessary, complete series of pulmonary function tests (available in our surgery).

4. calculate your lung age which may be larger than your actual age, as a consequence of smoking to normal ageing process

5. measure your oxygen concentration, non-invasively with pulse oximetry or more detailed but invasively  with arterial blood gases   (if needed).

These tests can be performed in highly equipped pulmonary practices only.

Are there any drugs that may help me in smoking cessation?

Medication for smoking cessation may be offered to you by your pulmonologist. The decision for this is made taking into consideration your dependence to nicotine (questionnaires, CO levels, and spirometry), your medical history (general and smoking related) and of course your opinion and concerns.

Pharmacological treatment for smoking cessation is beneficial as it reduces the severity of withdrawal symptoms and makes nicotine detoxification a simple and highly safe procedure. Any available treatment is specially developed for smoking cessation and is administered to patient adjusted doses and schemes. Usually the treatment is given for 2-3 months.

It is advised that the smoker must not be skeptical to receiving pharmacological treatment as these drugs are really effective, highly safe, widely used and, above all, they are given by specially trained pulmonologists under close guidance and monitoring. Besides, this treatment is used for a few months in order to help you quit a potentially fatal addiction

Some of the available drugs are

1.      Nicotine replacement therapy (NRT).

This treatment acts by replacing some of the nicotine smokers would have received from their cigarettes and, in doing so, reducing the severity of withdrawal syndrome.  Various forms of NRT, such as gum, patches, inhalers, nasal spray, sublingual tablets and lozenges are available. They are given by your pulmonologist at adjusted dose (based on your dependence and medical history) and usually in combination of two different forms.

 2. Varenicline (Champix) 

Varenicline acts in nicotine receptors in brain and reduces withdrawal syndromes and cravings but also the

pleasant and rewarding sensation of smoking. It is a highly effective drug and its safety is well documented by recent studies (even when used on patient with psychiatric or cardiovascular disorders) and long-term experience (11 years). Some patients may experience mild nausea and abnormal dreams during the first week of treatment which are usually self-limiting and do not necessitate discontinuation of treatment.

2.      Bupropion

Bupropion was the first non-nicotine medication to be licensed for smoking cessation. Although it is developed and is used for smoking section, incidentally it has also mild anti-depressant action without causing any addiction to anti-depressants. It is beneficial as it helps maintaining stable body weight during cessation, although it sometimes causes mild insomnia and cannot be used to young patients (<18yo) and in case of epilepsy.