Giving up Smoking

In 1561, Jean Nicot introduced Europe to a herb that very quickly became fashionable in aristocratic circles. Soon noblemen were regularly taking snuff and smoking pipes. This habit remained the privilege of the few until the 19th century, when cigars and cigarettes appeared on the scene - now it seems nothing can stop the spread of the habit worldwide. We now know beyond any doubt that smoking poses enormous health risks, since two-thirds of all deaths that occur in middle age can be attributed to smoking. Smoking 20 cigarettes per day reduces life expectancy by seven years, by increasing the risk of heart disease and cancer.

Giving up smoking will benefit your health, no matter how old you are but nicotine causes such a powerful addiction that giving up can cause significant withdrawal symptoms. These may include mood and behavioural disorders, a lump in the throat, spasms, cramps, acute hunger pangs, and often a gain in weight. The intensity of these withdrawal symptoms is not necessarily in direct proportion to the amount smoked.

The role played by cigarettes is a complex one - we may smoke as a way of asserting ourselves, to rebel, or to fit in with our friends, to increase our alertness, or calm our nerves, or simply to enjoy the cigarette. There is, therefore, no one purely pharmacological reason, attributable only to the chemical ingredients of the smoke or the nicotine content of the cigarette, to explain why giving up smoking is so difficult. Behavioural and psychological elements enter into the equation, too, and unless they are clearly understood, they will help sabotage your efforts to give up.

Let us examine the most effective support methods available to try to cope with the very difficult challenge of giving up cigarettes without too much pain.

The most effective method for stopping smoking is willpower, but the factor essential to success is motivation. Here are some examples:
- perhaps you have met someone who does not smoke
- you may have decided to have a baby, or you may already be pregnant
- you might want to take up physical exercise again, or train for a competition;
- you find you have a persistent cough in the mornings
- someone close to you may be affected by a serious illness caused by smoking
- you want to save money

In 1998, 27 per cent of adults aged 16 and over smoked cigarettes in England; 28 per cent of men and 26 per cent of women. In the same year, 69 per cent of smokers wanted to give up smoking. In 1999, 9 per cent of children aged 11-15 smoked cigarettes regularly - 8 per cent of boys and 10 per cent of girls. In the UK in 1995,over 120,000 deaths were caused by smoking; that is, one in five of all deaths.

Why do we smoke?

There are two types of addiction:

- psychological addiction, which is the most prevalent. We light up a cigarette when we are with friends, to make a phone call, while we watch television, or to go with a cup of coffee

- physical addiction, which is less common, but which goes deeper, and is related to the ingredients in nicotine. Nicotine reaches the brain in less time than it takes a sprinter to run 100 metres (after one inhalation, less than seven seconds). Once in the brain, nicotine stimulates the production of psychotropic or tranquillizing substances.

Smokers have a sort of counter in the brain, a 'nicostat' that orders them to light another cigarette as soon as the level of nicotine drops below a certain threshold. Light or ultra-light cigarettes are smoked differently: smokers draw on them more deeply, for longer, more often - precisely in order to keep up the nicotine levels in the blood. In such cases, smoking stops being a pleasure and becomes an obligation, as going without a cigarette leaves the smoker feeling ill, irritable, and unable to concentrate. For everyone cigarette smoked with genuine pleasure, several are smoked from pure addiction.

Essential general advice

The list of these tips is somewhat long, but must be followed if you are to give yourself the best possible chance of success. As soon as you decide not to smoke:

• Choose an appropriate time to give up
• Try to stop abruptly and completely, not gradually
• Do not try 'cutting down' first
• Avoid the temporary use of light or ultra-light cigarettes, which do not change the fact that smoking is still part of your daily routine - this is an important factor in the inability to give up
• Do not light up even one more cigarette
• Avoid the circumstances in which you usually smoke more, such as long meals, banquets, dinners with friends, card games, nightclubs, and bars
• Make sure you have a healthy, light, well-balanced diet, and that you eat regularly throughout the day. Be aware that you will most likely want to eat more during the first few days
• Watch out for the tendency to nibble constantly, which may cause you to replace 20 cigarettes with 20 sweets instead
• Eat plenty of cereals, nuts, brewer's yeast (for its vitamin B content), fresh fruit and green vegetables for their vitaminC
• Cut back on stimulants such as coffee and tea, that only increase the craving for a cigarette
• Get up from the table before coffee, because the smell of coffee often causes the smoker to feel an irresistible desire for a cigarette
• Drink plenty of water at regular intervals. This will fill the stomach and suppress the urge to eat
• Take up physical exercise without delay, as this will prevent or reduce weight gain, and above all allow you to see the objective benefits of not smoking for your fitness and breathing

Some consequences of giving up smoking

In order to measure the undesirable effects of nicotine deprivation on weight, 9,000 Americans were followed over a ten-year period. On average, they gained between seven and nine pounds, but 13 per cent of the women and almost 10 per cent of the men gained two stone or more. Men generally find it easier to go back to their original weight than women. This very common tendency to gain weight only adds to the difficulties involved in giving up smoking.

According to the experts, it takes several years for the risk of cancer in an ex­smoker to drop down to that of someone who has never smoked. This is another reason to stop sooner rather than later.

Some conventional therapies

• Nicotine replacement consists of delivering nicotine to the body in the form of gum or a patch applied to the skin, which maintains a steady supply. The main disadvantage is that these nicotine replacement methods often cause side-effects, such as hiccups, nausea, stomach upset, and the risk of heart complications, including increased heart rhythm or high blood pressure. And while nicotine may well be one of the factors in cigarette addiction, it is far from being the only one. Nicotine replacement continues over a period of two or three months, with the dose of nicotine being gradually reduced.
• The Venturi Method gradually weans the body off nicotine by means of a series of cigarette filters, changed every week, that gradually filter out more and more of the tar and nicotine. After a period of about four weeks, it should be much easier to stop smoking altogether
• The FiveDay Plan, which has been in existence for 30 years, is a classic stop-smoking method. It brings people together in groups, and raises their awareness about what cigarettes do to the body through films and presentations. This method addresses the smokers' psychological needs, teaching them to avoid the pitfalls of certain situations, offering them dietary advice (vitamin and mineral supplementation) and relaxation sessions, in an effort to eliminate the dependency, so that people are less likely to relapse. Those who have tried this method find it to be hard going, but effective
• Mental strategies, such as hypnosis, relaxation, sophrology, and neuro­lingistic programming, help the smoker to reduce, eliminate, or channel the effects of the stress brought on by going without cigarettes, as well as reinforcing his or her motivation. These approaches help the person avoid taking up some other compensatory habit, particularly overeating

Acupuncture

This is the most widely used method to help give up smoking. Acupuncture helps the would-be nonsmoker by calming and balancing the nervous system, reducing the desire to smoke by inducing an aversion to tobacco. It produces a feeling of satiety that is most needed in the first few days when people are likely to turn to food instead, and lessens the craving, making this phase generally much easier to bear.

Treatment Schedule: Sessions should initially be set up on a biweekly basis for the first three weeks of nicotine withdrawal. After that, maintenance sessions should be arranged depending on the subject's needs and any possible difficulties he or she encounters.

Auriculotherapy

This is acupuncture's little sister, and is also regularly used to bring about a successful cure.

Technique: Auriculotherapy consists of piercing the earlobe with tiny needles the size of a pinhead, and leaving them in place for up to a week or more at a time. They are generally removed by the acupuncturist to avoid any septic problems but they may fall out of their own accord at some point anywhere from two days to two weeks later.

Remarks: These 'semi-permanent needles' establish a longer-term readjustment that seems to be more effective than a single session of acupuncture. It is worth noting that these small needles can hardly be seen, and that they always fall towards the outside, rather than inwards, so there is no risk to the eardrum. While the needle treatment to the ears is not exactly pleasant, it is by no means really painful, and this therapy is not dangerous at all.

Mesotherapy

• Mesotherapy helps soothe and readjust the nervous system, helps develop an aversion to cigarettes that is most helpful, and can also be used to treat weight gain in specific parts of the body. It is this last area of application that has helped make mesotherapy better known in France. It is rarely practised in Britain other than by some GPs who have trained in homeopathic medicine

- The therapy consists of minute intradermic or subcutaneous injections of dilute classic medicines, that are applied to the face or body

The so-called 'Versailles treatment' is often used by therapists who deal with smokers in the process of giving up. This consists of micro-injections of solutions based on trace minerals and vitamins, delivered to the ear and nose areas, to help patients through the critical period of cigarette withdrawal.

Homeopathy

Tabacum

- Four 5c tablets to be sucked slowly three or four times a day during the first two weeks, then as needed after that

Tabacum

- Vegetable origin: the leaves of the tobacco plant
- The homeopathic remedy for nicotine-withdrawal symptoms

There are also the three great 'nervous tension' remedies: Ignatia, Nux vomica, and Staphysagria.

• Ignatia: for when giving up cigarettes is felt to be an enormous imposition, even when it is the individual's choice
• Nux vomica: for the heavy smoker who gives up completely and is worried about the effects on his or her mood
• Staphysagria: when the withdrawal period brings feelings of frustration and deprivation

- Four 7c tablets of one, two, or all three of these remedies to be sucked slowly between meals, twice a day for a fortnight

• You could also try Arteria-Heel@ (Heel), which contains Tabacum D8, Secale comutum D4, Phosphorus D8, Viscum album D4
  - Available in drop bottles containing 30 and 100ml
  - 10 drops 3 times daily
• In France, one original homeopathic prescription involves the use of 'isotherapy', consisting of a remedy tailored to the individual based on his or her favourite brand of cigarettes. In Britain, a general remedy such as tobacco smoke in 30 potency is usually given for a few weeks followed by constitutional prescribing. Additional remedies such as Plantago or Caladium seguinum are often used in support .

Herbal remedies

Hawthorn and passionflower for their calming effect.

Bladderwrack, fennel. and pink sage can help in the struggle against weight gain.

These plants can be made up singly or in combination, as fluid extracts, mother tinctures, powder capsules, or dried extracts, for example. Ask your herbalist to prepare and package them for you.

Possible Prescription: Ask your herbalist to prepare a 60ml bottle of hawthorn in whole fresh plant suspension (this formulation's cold stabilization process restores the full natural therapeutic effect of the plant). Take one teaspoonful in a little water two or three times a day.

Hawthorn

This tree has been in use since Greek and Roman times, and for a variety of purposes. It was only in the 19th century, however, that it gained recognition when its cardiosedative benefits were discovered. Hawthorn can slow down a racing heart, reduce or eliminate palpitations, act as a heart tonic, and a vasodilator for those who have suffered a heart attack, thus improving heart function. It also brings down high blood pressure, and calms anxiety, both in children and adults, without inducing drowsiness or memory lapses. It has the added advantage of being nontoxic.

Passionflower

This vine or liana originally came from Brazil and Mexico, and was used by the Aztecs for its calming properties. It was introduced to Europe in the 17th century, and has been shown to be very effective against anxiety, nervous symptoms, and sleep disturbances.

• You could also try a mild tranquillizing remedy such as Passiflora Complex (Bioforce), which is a combination of tinctures of passionflower and oats:
  - Available in bottles of 50ml
  - 20 drops twice daily in a little water

I could suggest various other methods and remedies, but while it is encouraging that such a choice exists, it also goes to show that no one method stands out from the others as a miracle treatment. The ultimate success of any treatment finally depends on whether the subject genuinely wishes to stop smoking, and that is often the heart of the matter.