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Almost a month in.... Still stopped? This final part of our quit smoking articles looks at other help and aid to keep you going

Posted by Eamonn Brady on

Smoking Cessation Part 3

Help to give up

 

I will discuss nicotine replacement therapy like nicotine patches and gum soon in this column. This week, I discuss other options.

 

E-cigarettes

 

Electronic cigarettes (E-cigarettes) are electronic devices that mimic cigarettes and release nicotine vapour. They allow inhalation of nicotine without the negative effects of tar and carbon monoxide. There are hundreds of different types of devices and juices available. As E-cigarettes are relatively new on the market, and research is ongoing on their benefits and negative effects, the HSE still doesn’t endorse E-cigarettes as an option to help give up cigarettes and recommend nicotine replacement therapy (e.g., nicotine patches) as the first option.

The World Health Organisation’s opinion is that E cigarettes should not be recommended as a smoking cessation tool at a population level and warned they can reduce cessation by prolonging or increasing nicotine addiction. Advice from the likes of the Irish Heart Foundation and the Irish Cancer Society to an Oireachtas Committee in November 2021 was that E cigarettes need to face similar sale and advertising restrictions as tobacco products, and they are concerned at the number of teenagers and young people becoming addicted to nicotine through vaping products. Legislation will tighten on the sale and use of E-cigarettes in the coming years but while there are risks form them, they may ultimately share a more official role in aiding smoking cessation as their safety and efficacy continues to be analysed.

 

Prescription Medication

 

There are two main treatments available on prescription

 

Varenicline (Champix®)

Varenicline, whose brand name is Champix®. It is available in tablet form. The dose is titrated meaning the person smokes for the first 8–14 days while taking varenicline before quitting. The recommended course of Champix® is generally 12 weeks. It is a partial agonist that prevents nicotine reaching receptors, it also releases dopamine to help with cravings meaning it works in two ways, it reduces the enjoyment of a cigarette if a person does smoke while taking it and it reduces the craving for a cigarette.

 

Varenicline may not suit everyone and has possible side effects including:

  • Nausea and vomiting
  • Insomnia and vivid dreams
  • Dry Mouth
  • Constipation and diarrhea
  • Headaches
  • Drowsiness
  • Dizziness

 

It is not suitable for:

  • Children under 18
  • During pregnancy or breastfeeding
  • Kidney problems
  • Epilepsy

 

Varenicline has no clinically significant medicine interactions.

 

Bupropion (Zyban®)

Bupropion was originally developed as an antidepressant and way in which it works in relation to helping stop smoking is not completely understood, but it is thought to work on the brain pathways involved in addiction and withdrawal. It is available in the form of tablets. A course usually lasts 8–12 weeks.

 

Side effects can include:

  • Nausea and vomiting
  • Insomnia
  • Dry Mouth
  • Constipation and diarrhoea
  • Dizziness
  • Difficulty concentrating

 

It is not suitable for:

  • Children under 18
  • During pregnancy or breastfeeding
  • Epilepsy
  • Bipolar disorder
  • Eating disorders

 

Varenicline versus Bupropion

Bupropion has more contraindications compared to varenicline (i.e.) exacerbates more conditions. Contraindications for bupropion include increased risk of manic episodes in patients with bipolar disorder and a reduced seizure threshold for epilepsy patients. Analysis published in the Harm Reduction Journal in 2009 found varenicline to be more effective than Bupropion and NRT for smoking cessation. Varenicline is way more commonly prescribed than bupropion nowadays.

 

What is BPro Cardio Screen Service?

BPro Cardio Screen measures artery stiffness to identify risk of blockages and cardiovascular and circulatory disease. BPRo is placed like a watch on your wrist and is pain free. A pulse wave reads and calculates a wave signal that indicates the elasticity of large, small, and peripheral artery walls as well as tests for stress, central blood pressure, heart rate, and more. It is now €35 (was €50); it only takes about 15 minutes. The next clinic is Saturday February 26th (from 9am to 5pm) at Whelehans Pearse St. Book online on the Whelehans Website or by calling Whelehans at 04493 34591.

 

For comprehensive and free health advice and information call in to Whelehans, log on to www.whelehans.ie or dial 04493 34591 (Pearse St) or 04493 10266 (Clonmore). Email queries to info@whelehans.ie. Find us on Facebook.

 


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