Around 25 million Americans have tried to quit smoking in the past year, but more than half restart smoking within 2 months. About 70% of smokers quit without help, a strategy that can be successful in smoking cessation.
Tobacco dependence is a complicated disorder of repeated exposure to tobacco that is associated mainly with substance use disorders and social problems. Long-term nicotine use may alter brain circuitry critical for motivation and reinforcement, while acute or sustained use affects the prefrontal cortex, hypothalamus, limbic system, mesocorticolimbic dopamine system, and mesolimbic glutamate system. These changes may have important implications for treatment of tobacco dependence.
Results from a recent clinical trial shows for the first time that there is a positive association between the development of tobacco dependence and the occurrence of depression, while, conversely, tobacco dependence is associated with a higher risk of developing depression.
Tobacco use has the potential to cause significant distress to the tobacco user, family member, and family system, and to negatively affect a wide range of other psychological attributes in both smokers and non-smokers. These adverse effects may have substantial long-term consequences to the health of tobacco users; therefore, smokers may experience increased morbidity and medical management cost through their use of tobacco.
Medications are used to treat tobacco dependence, but behavioral changes are paramount in its treatment. Self-help programs and counseling are also used to treat tobacco dependence. A combination of these approaches seem to be especially successful.
Individuals are not able to be cured from tobacco dependence. If you have it or if you are dependent on it, there are few options around. If your dependence can be reduced, then you can get a bit of better lifestyle and enjoy the life. But if unfortunately, your dependence on cigarettes and tobacco will increase, then there is no chance that you can control it.
A good deal of information is known about the pharmacokinetics of tokacin in smokers. Its effect on the CNS in non-smokers is unknown, as are its cardiovascular side effects in this special patient.
Patients' smoking status, in particular their cravings, has important effects on the response to NRT. When this was explored, craving had a significant effect on the success rate of NRT. Thus, clinicians should inform smokers with a great deal of urgency not to quit.
Researchers at different institutions have made new discoveries. For instance, one study reported a breakthrough in understanding brain development in tobacco dependent rats. More recent research has shown the potential of new treatments, such as neurophysiology, and the role that hormones play in the development of tobacco dependence. Other areas of recent discovery include how smokers manage the devastating effects of tobacco dependence as well as the interaction of nicotine with specific types of neurons, all within the context of neural networks and the brain's ventral tegmental area. More information on the latest studies in addiction research can be found in the “Tobacco dependence – Current research” section.
Most smokers(2-4) are willing to seek out medical help such as medication to help them with quitting, and they are still able to quit or lessen the effects of their addiction for the duration of the study (e.g. up to 12 weeks)?. Of those who participated in a quit trial, >50% reported being healthier or feeling better (e.g. 'being in better shape and having healthier thoughts and habits') and the likelihood of achieving their quitting goals was also greater.
While dependence is often an indicator of more serious illness, the symptoms of tobacco dependence may not always be debilitating. Patients who present with severe and disabling symptoms should be evaluated with respect to the possibility of [alcohol dependence or co-occurring non-adherence disorders and/or co-occurring health conditions that could be causing symptoms] and encouraged to seek further help or seek treatment. In general, clinicians and patients need to be aware that the severity of tobacco dependence is not synonymous with the severity of illness. Clinicians should work together and communicate to assure the best care for their patients. Patients who are struggling with serious and debilitating symptomatology do not always consult their physicians for help.
The average age of smokers getting diagnostically diagnosed with tobacco dependence is around 54 years (5 years younger than what was reported in early reports).