Stop smoking

Once you have started it soon becomes a habit, a habit that is actually an addiction and now you want to get rid of it. And we would encourage that. For some it is easy, for others it is difficult or very difficult and for others it seems (almost) impossible. Whatever group you are in, you have already taken an important step with the desire to stop smoking.

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What is smoking? 

Smoking is the consumption of smouldering tobacco. Tobacco is found in cigarettes, tobacco and pipe tobacco, among other things*. The method of smoking can be inhaling, where smoke is sucked into the lungs, or non inhaling, where the smoke remains in the mouth. Tobacco contains the addictive substance nicotine. In addition to nicotine, cigarettes contain many other substances and additives. The substances are added to make and keep a cigarette even more attractive. Many of these substances are carcinogenic when burned. Some common harmful substances are: 

  • Ammonia: nicotine reaches the brain even faster through ammonia and thus strengthens the addiction. 
  • Tar: this substance is released during combustion of the added substances and is carcinogenic. Tar accumulates in many organs. 
  • Flavourings (menthol, sugars, cocoa, anise, etc.): they are added to give a pleasant taste to the cigarette, but when burned they are carcinogenic. 

Carbon monoxide, this substance is not in the cigarette, but is released when the cigarette is burned. Carbon monoxide binds to the red blood cells in the body, so oxygen has no chance to bind to it. Carbon monoxide is also harmful to the environment 'passive smoking'.   

Smoking diseases 

Smoking is harmful to health. There are many diseases caused by smoking. The most famous is lung cancer. But other cancers can also be caused by smoking. Other diseases and conditions that can be caused by smoking are chronic respiratory and pulmonary diseases (COPD), cardiovascular diseases, hypertension, cerebral infarction and haemorrhage, eye diseases, metabolic diseases, diabetes, rheumatism and Crohn's disease. In addition, smokers often suffer from a smokers cough and a hoarse voice, poor skin that can become pale, yellow and grey, more likely to have wrinkles. Chance of bad breath and teeth. Chance of yellow, even brown teeth. Risk of reduced smell and taste. Women who smoke may have problems getting pregnant, it is also bad for the fetus (smaller babies, more frequent miscarriages, premature birth), men are more likely to suffer from erectile dysfunction and their sperm is often worse. 

Reasons why people start smoking 

There are many reasons why people start to smoke. The reasons are: 

  • Curiosity about the product. Others seem to enjoy it, which can stimulate curiosity. 
  • A contagious effect, almost everyone in your environment smokes.  
  • Group pressure, this is a familiar phenomenon among young people. Not wanting to be inferior to others, wanting to be part of it. 
  • Wanting to stand up to rules from adults.  
  • Advertising, although there has been a complete ban on tobacco advertising in the Netherlands since 2002 for example, there is still a lot of smoking in TV series and films. The smoking characters can be a role model for someone.  
  • Socially accepted, in the past, people even smoked in television programmes, doctors smoked, smoking was still a socially accepted phenomenon at that time. 

 

What makes stopping smoking difficult? 

Smoking is linked to a situation or an action. This makes it so hard to stop. We see the following mechanisms associated with smoking: 

  • Psychological effect: there is a slight intoxication that can last several minutes. It is always sought after.  
  • Familiarisation, you need more and more to achieve the same effect. 
  • Physical dependence: the body asks for more and protests when no nicotine is supplied.  
  • Habituation: having rituals is part of this: the cigarette when you get up, with your coffee, after dinner, with a drink, etc. Smoking is linked to certain situations.  
  • Reward or consolation: you feel that you have earned a cigarette after a certain task and/or you first take a cigarette to relax or unwind. In this way, smoking is linked to emotions. 
  • Concentration: you need the cigarette to concentrate. Here, too, smoking is linked to a particular situation. 
  • Withdrawal symptoms when you stop: you really do not feel well. When you light a cigarette, that nasty feeling stops.  
  • Denial: everyone knows the story of 'the one family member who was a chain smoker and who turned 80' to 'I can stop whenever I want' and 'I will be okay, I play sport a lot and eat healthily'. 

 

What are the forms of treatment? 

With your doctor you can see which treatment or a combination of treatments suits you best. Counselling together with nicotine substitutes or medications has the greatest chance of success. There are different types of support. 

  • Telephone coaching: the coach will give you advice on how to stop by phone. 
  • Personal coaching: you will then have a number of conversations with a care provider, which can also be the general practitioner himself. Some of the calls can also be made by e-mail or by telephone.  
  • Group training: in a group, all participants stop at the same time. There will be a number of meetings. The participants can help to support each other. 
  • Lifestyle training: this form is used when all other forms did not help with stopping. The training is more intensive than the other forms of support and can take place individually or in a group.  

 

Medication 

There are various types of medicines that can help to stop smoking. They can be used in combination with a non-medical treatment.  

  • Before starting medication, read the package leaflet.  
  • In pregnancy, nicotine is bad for the fetus.  
  • When breastfeeding, take the nicotine medication just after breastfeeding and do not breastfeed in the 2 to 3 hours that you have taken it. 
  • It is important that insulin dependent persons are properly monitored when they stop smoking. Stopping smoking may require a lower dose of insulin. 

The following medications are possible: 

  • Nicotine substitutes (NVM), which are available in the form of mouth spray, patches, medicines for under the tongue, sugar-free chewing gum and lozenges. A combination of administration forms is possible. If you use nicotine substitutes, you must stop smoking otherwise you may consume too much nicotine.  

The following medications may help to reduce the withdrawal symptoms and reduce your need to smoke, they can be prescribed in combination with nicotine.  

  • Bupropion, this medicine only works after a week, so it is best to start this medicine one week before you stop smoking. 
  • Nortriptyline, only works after a week, so it is best to start this medicine a week before you stop smoking. 
  • Cytisin, this medicine is started at least 5 days before the date of smoking cessation. 

Another process has the following effect: 

  • Varenicline, it blocks the action of nicotine in the brain, it can therefore not be used with nicotine substitutes. The medication is started 1 to 2 weeks before you stop smoking. And lasts 12 weeks.  

 

Alternative treatments 

  • Acupuncture, homeopathy, hypnotherapy and laser therapy: alternative treatments for smoking include acupuncture, homeopathy, hypnotherapy and laser therapy: although these therapies have not been sufficiently proven to help, there are some people who say that they have benefited from them. The search for the right method to quit smoking is the responsibility of each individual.  
  • Apps: there are several apps on the market that can help you quit smoking. They will give you tips on how stop smoking again and how to keep it up. Some allow you to set up guides. They indicate how long you have not smoked for and the benefits of not smoking. 
  • Other online: there are also games and courses online that provide support. There are also programs to stop independently. 
  • E-cigarette: there is no scientific evidence yet as to whether the e-cigarette is good or bad for your health. The e-cigarette is electronic and mimics a real cigarette, it also contains nicotine. The advantage is that you can slowly reduce the nicotine, the disadvantage may be that with the e-cigarette you maintain the mechanisms associated with smoking. 

 

Lifestyle changes 

Changes in lifestyle for people who quit smoking or have stopped, is very personal and depends on the patterns you have developed over time when you (still) smoked. These patterns have to be broken. It is also advisable to maintain a healthy lifestyle. A healthy lifestyle means that you should live as healthily and regularly as possible with a varied diet and drink enough water. Get enough sleep, avoid stress and exercise regularly. Moderate the consumption of alcohol and coffee. Get sufficient relaxation. 

Additional risks and side effects 

When you stop smoking, you may experience the following withdrawal symptoms: 

  • Tension
  • Unrest
  • Irritable
  • Insomnia
  • Concentration problems
  • Sweating
  • Mood swings
  • Depression 
  • Headache
  • Coughing fits
  • Stomach complaints
  • Delayed bowel movements
  • Increase in appetite, possibly with weight gain

Do not be discouraged by these phenomena. They are transient. If they are very bad, discuss them with your doctor, you may be able to get medication for them, or your medication may need to be adjusted or changed. After a few weeks, they will become less and you will be able to reap the benefits of having stopped smoking.  

The benefits of quitting smoking 

Not smoking has a significant positive effect on all diseases and conditions that may be caused or aggravated by smoking. Some of the advantages when you have stopped smoking are: 

Physical effects: 

  • Better breathing
  • More energy
  • Better smell and taste
  • Whiter teeth, healthier teeth and fresher breath
  • Your skin and hair will look better
  • More fertile again

Less chance of illness: 

  • The risk of lung cancer and all other cancers that can be caused by smoking decreases with the years you do not smoke. 
  • Reduces the risk of heart disease, cerebral haemorrhage and infarction. After 4 years of non-smoking, you are as likely to suffer from these diseases as a non-smoker. 
  • Fewer colds due to improved resistance. 
  • Reduces the risk of miscarriage and premature birth.  

Other benefits: 

  • You stop 'passive smoking'. You are an example to others. 
  • You have more money left. 
  • And you can and should be proud of yourself.  

 

How can you prevent smoking? 

Do not be tempted by the reasons why people start smoking and think about the benefits of not smoking.  

 

 

References

Rokeninfo.nl. (z.d.). Operation & risks / operation / addiction. Consulted on 5 May 2019 at https://www.rokeninfo.nl/publiek 

Jellinek.nl. (September 2018). Substances in tobacco. Consulted on 5 May 2019 at https://www.jellinek.nl/vraag-antwoord/welke-stoffen-zitten-in-tabaksrook/ 

Sickofsmoking.nl. (z.d.). What is really in a cigarette? Consulted on 5 May 2019 at https://sickofsmoking.nl/feiten/wat-zit-er-echt-in-een-sigaret-2/ 

Prostop.nl. (z.d.). Why are we smoking, anyway? Consulted on 5 May 2019 at https://www.prostop.nl/waarom-roken-mensen-eigenlijk/ 

Stichtingstopbewust.nl. (z.d.). Diseases. Consulted on 5 May 2019 at https://www.stichtingstopbewust.nl/informatie/stoppen-met-roken-gezondheid/ 

ikstopnu.nl. (z.d.). What is the best way to quit smoking? Consulted on 5 May 2019 at https://www.ikstopnu.nl/vraag-en-antwoord/wat-is-de-beste-manier-om-te-stoppen-met-roken/ 

ikstopnu.nl. (z.d.). Apps for stopping. Consulted on 5 May 2019 at https://www.ikstopnu.nl/vraag-en-antwoord/online-hulp/de-5-beste-stoppen-met-roken-apps/ 

farmacotherapeutischkompas.nl. (z.d.). Medication. Consulted on 5 May 2019 at .https://www.farmacotherapeutischkompas.nl/bladeren/indicatieteksten/stoppen_met_roken 

van der Putten.N. (09-02-2017). Alternative treatments. Consulted on 5 May 2019 at https://www.rokeninfo.nl/publiek/blog/post/?bericht=13 

Brijder.nl. (z.d.). Smoking addiction / Stopping smoking / Withdrawal symptoms. Consulted on 5 May 2019 at https://www.brijder.nl/probleem/rookverslaving 

 

* Whenever cigarette is used in this text, it includes cigarette tobacco and pipe tobacco.