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Stop Smoking: A mission that requires more than Determination
In this Report:
– Data on Tobacco Dependence
– Harmful effects of smoking
– Dependency Concept
– Methods To Stop Smoking
– Factors that Interfere in Abandon Attempt the cigarette
– View Other Articles Related to the Theme
"Quitting smoking is perhaps one of the hardest tasks that anyone may have to face. According to experts, the most serious difficulty is not in substance abuse, how they could assume many smokers, but in compensatory pleasure relationship that smoking takes on their lives . Overcoming this is a task that should have psychological help, as well as make use of chemical devices that replace tobacco, such as chewing gum and adhesives. "
Data from the Tobacco Dependence
Much of those who smoke (80 percent) want to quit smoking but can not. They use the drug in larger amounts or for longer than they would like, and maintains its use despite knowing the physical and psychological harm that comes from it. Although most smokers have already faced some physical problem due to the cigarette, put a stop to this habit is the most difficult tasks that a human being can face, which shows that the manifestations of nicotine addiction are very similar to other drugs with the difference of not producing psychic manifestations with its use. Although smoking does not make a person more aggressive or euphoric, their consumption pattern is typical of a drug that produces dependence.
According to data from the World Health Organization (WHO) currently die three million people per year due to the cigarette. If the trend remains the same, in 2020 this number will jump to ten million annual deaths. Also according to the WHO, it is estimated that in the coming decades 500 million people will die because of this addiction. In Brazil, always poor in statistics, it is difficult to assess the social cost of smoking, but we know that 35% of men are smokers.
Despite numerous anti-smoking campaigns and increasing restrictions on tobacco industry advertising, the number of new follow-smoking growing: in Brazil, a survey conducted by IBGE in 1989 accused the existence of 30 million smokers older than 5 years, corresponding in time, 24% of the population.
In the United States today there are about 50 million smokers. A forecast for today indicates the existence of 36 million tobacco users in Brazil. Also according to the IBGE, these 30 million in 1989, about 60 percent were men, and the proportion of smokers in rural areas was higher than in urban areas. The consumption reveals the IBGE, is higher among individuals 30-49 years in both sexes, and is reduced to 50 years. Among men, the average consumption varies from 11 to 20 cigarettes a day, while among women, it is between 5 and 10 cigarettes daily.
These data, collected by psychiatrists Ronaldo Laranjeira, coordinator of UNIAD (Research Unit on Alcohol and Drugs), Maria Teresa Cruz Lawrence, director of the Department of Psychiatry and Psychology of Cancer Hospital A. C. Camargo and also coordinator of the Support Group for Smoking Cessation (GAT) and Helena B. Samaia, a graduate student in the Department of Psychiatry, EPM – UNIFESP, and published in an article on the web are quite significant from the will of many smokers quit smoking. However, according to experts, the information is still the first step towards the final decision that only the smoker can take. For this, we explain here some basic concepts about tobacco addiction and its harmful effects, basing this decision.
Dangers of smoking
According to the SBC-FUNCOR (Brazilian Society of Cardiology and the Heart Foundation), the dangers of smoking outweigh the action of nicotine and relate to various toxic substances resulting from tobacco combustion. The SBC 43 identifies these substances as carcinogenic. It is related to smoking 90 percent of cases of lung cancer, 80 percent of cases of chronic bronchitis and between 20 and 25 percent of angina or myocardial infarction. Smoking is also related to the occurrence of the mouth and esophagus cancer and it is possible to promote the development of pancreatic cancer, bladder, kidney and stomach. In addition, children of smoking mothers show delayed intrauterine growth and low birth weight.
The SBC does not stop there to list the damage to health caused by smoking. According to the institution, smoking also damages blood circulation and ultimately providing strokes, better known as 'strokes'. In some cases, the 'plugging' of the vessels supplying the legs can lead to gangrene, leaving no alternative to amputation.
The specialty of the SBC, however, is, as you can imagine, the heart. This vital organ is especially harmed by smoking. "Nicotine becomes harmful to the cardiovascular system as it promotes the release of substances – catecholamines -.. That normally would only be released in the body in times of stress These chemicals prepare the body to deal with situations of imminent danger as a consequence increase heart rate, blood pressure (and therefore the need for oxygen) and the resistance that the vessels opposing the passage of blood, "said the organization in an article about it. In the case of the heart, all these effects are multiplied, yet alert SBC.
"The harmful effects of smoking on the heart and vessels are due not only to nicotine, but also the resulting carbon monoxide from burning paper and tobacco itself," says the Brazilian Society of Cardiology, which explains that the combination monoxide carbon with hemoglobin – the protein pigment of red blood cells to carry oxygen function – form carboxyhemoglobin a 250 times stronger bond than that of oxygen to hemoglobin.
"Thus, the oxygen content of red blood cells of smokers is reduced by 15-20%, compromising the supply to the organs," he explains. According to the institution, this oxygen deficit, always harmful, it becomes even more serious because of the increased demand caused by nicotine. "As if it was not already enough damage, carbon monoxide is toxic action, attacking the inner wall of the arteries, creates an injury, which will deposit fat circulating in the blood," he adds. To complete "smoke also has the property of enhancing the fractionation of fats inside the vessels, thereby increasing the concentration of LDL cholesterol" bad ", and reducing the HDL, the" good "cholesterol." For all that, it is estimated that smokers lose an average of ten years of life.
According to cardiologist Jaqueline Issa of the Heart Institute (Incor), in São Paulo, the main weapons of the institution Smoking Clinic is a free information and samples of prescription free drugs, such as chewing gum and nicotine patches used as adjunctive therapy in the treatment against cigarette. "These mechanisms function as an anesthetic when taking tooth. They decrease the disorders, but only fulfill their function if they were used in the right way," said the doctor.
Dependency Concepts
Be dependent on a substance basically means no more control of their use, and symptoms such as tolerance (the need for increasing amounts of the drug to get the same effect) and withdrawal syndrome (lower concentration and attention, anxiety, urge to smoke: the body's responses to the absence of nicotine, leading the smoker to reset it in ever shorter periods). Currently, no longer entitled to a person dependent or non-dependent, but as more or less dependent on, or addiction is related to the intensity of these symptoms.
According to psychiatrists before mentioned, many smokers who try to quit smoking alone can not reach his intention to present the withdrawal symptoms and not know recognize them as such. In fact, say the experts led by Dr. Laranjeira, not all smokers who have withdrawal symptoms, but it can be said that about 70 percent of them have some discomfort associated with the absence of smoking. They explain that the symptoms usually appear hours after the last cigarette smoked and may extend for a period which may range up to two months.
The withdrawal symptoms are reported as anxiety, restlessness, irritability, aggression, depression, poor concentration and attention and increased appetite. "It can be observed EEG changes (EEG), decreased heart rate and BP (blood pressure), peripheral vasodilation, sleep disorders, weight gain and decreased performance in surveillance and memory tests. The most typical symptom is 'craving', ie a desire to smoke intense and inexplicable, "experts say.
Methods To Stop Smoking
Nicotine replacement of
Method that aims at replacement of nicotine to ease withdrawal symptoms. Studies show that nicotine replacement doubles the success rate, if there is a simultaneous advice of the doctor. The group that benefits from the replacement therapy is that of heavy smokers who smoke more than fifteen cigarettes a day; smoke up to an hour after waking up; and who have had withdrawal syndrome symptoms in other attempts to stop smoking.
The replacement may be by means of an adhesive or chewing gum. The first method allows the absorption of nicotine through the skin and the second, at the mouth. The reported results have proved promising, although further studies, the long term to establish real effectiveness and usefulness of nicotine replacement of the smoke.
Abrupt stop
Allow to smoking at once, forgoing the use of cigarettes from one time to another.
Gradual stop
You have two ways to quit smoking gradually way:
1) The first is to reduce the number of cigarettes. For example, a smoker of 30 cigarettes per day for the first day smoke 30 cigarettes usual, the second day will smoke 25 and taking five cigarettes a day, until the seventh day without smoking.
2) The second method is to postpone the time of first cigarette. For example: on the first day starts smoking at 9 am, the second at 11 and so on, until the seventh day, when the first cigarette was smoked at night. Thus, it would be easy to give up on the seventh day.
Experts suggest a few tips to make the process easier. First, note that if you must believe in the method and also that the "desire to smoke" is something surmountable. Later, indicate that drink plenty of water, that used chewing gum and candy, which is carried out exercises and walking, as to avoid alcoholic beverages, which is brush your teeth after meals, etc.
Other methods such as acupuncture (from a surgical point method), drugs (antioxidants kits) and mind control as the method M.A.M.C. – Method for mental self-control on the cigarette, which sells a booklet on the Internet, has also been widely reported. Whatever the method used, however, it is recommended to be done under medical supervision.
Factors that Interfere in Abandon Attempt the cigarette
According to the psychologist and psychoanalyst Fernando Falabella Tavares de Lima, clinical director of Netpsi – Studies and Issues in Psychology and expert in drugs, quit smoking may be more difficult due to the psychological motivations that keeps using that due the biological aspect. "From an organic point of view, there are several methods of nicotine replacement, what decreases the difficulty of the effects of withdrawal. The psychological dependence on a drug, and it should be clarified that nicotine is a stimulant psychotropic drug in the central nervous system, is related to the habit and attitudes of preparation and use of substances. There is a psychological meaning to the use of cigarettes, "he said.
According to the expert, to let the smoke initially must overcome the withdrawal period. For this, various methods such as the nicotine patch may be used, chewing gums, etc., he finds valid although insist that the great difficulty to leave the smoke is not in organic matter. "The difficult thing is to kick the habit and their psychological structural components of use. Therefore, I consider quite valid that is used a method to decrease the physiological effects of the lack of nicotine, however it is essential that there is a psychological support." This support can be obtained, according to Fernando, both in psychotherapy and in self-help groups.
Since psychoanalysis, psychologist's specialty, it is a method of understanding and treating the unconscious psychic causes that motivated and keeps the need for the drug. "You could say that, in general, the cigarette is for the person who uses it as a 'remedy', often used to reduce anxiety and this fact is paradoxical, since nicotine is a stimulant drug, logo should generate anxiety. I mention this to make the case that the most important in the treatment of tobacco dependence are the emotional components and not the biological aspect, "reaffirms.
This conviction that cigarette addiction is stronger emotional and psychological point of view results from observation of examples such as MT, 40, who after two years free cigarette (she used the patches to stop smoking while traveling when she was happy and relaxed), he returned to smoking gradually. Currently, smoking six cigarettes a day and can not give up the pleasure that smoking gives you, justifying the return to dependence because of the many 'concessions' that already do in life. "I will not deprive myself of this pleasure more, because I have to deprive a lot," says M. T., who declined to be identified. Fernando explains that "of course, at a time of life when one returns to need the 'crutch' of the use of a drug, it comes back to get the pleasure derived from smoking. Again, it is undeniable the importance of the psychological aspects of the return to use even after all these years. "
Many smokers family are true 'campaigns' at home so that they stop the habit that can lead them to death. The anguish of the family, however, has little effect on the smoker if this is not really convinced of the need to stop. "Initially, when we think of helping someone, we must have a clear need to respect the individuality of the other. You can not make a cigarette usage treating a forced manner without the smoker wishes," he explains Fernando.
"When it comes to the use of other drugs, I quote the crack, cocaine, heroin, for instance, you can even think about the need to remove the person from a vicious and destructive cycle. But the cigarette does not make a violent person or confused psychologically, its consequences are physical, "he compares. According to the expert on drugs in general, smokers have the information necessary to judge the severity of the consequences of his addiction. "While it is an important first step, information, pure and simple, everyone knows, is insufficient both to prevent and to determine the end of a dependency."
Copyright © 2001 eHealth Latin America May 4, 2001
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