Smoking is a disease, the cure is to quit smoking! Tobacco addiction treatment
Smoking is an addiction disease!
Smoking is a disease called tobacco addiction.
When cigarettes were first introduced, they were perceived as an item of personal preference and spread widely, but the perception changed as they became known as a cause of various cancers, including lung cancer, and cardiovascular and cerebrovascular diseases.
According to the International Classification of Diseases (ICD-11) published by the World Health Organization (WHO), diagnosis code 6C4A.2 is defined as a disease called “nicotine dependence,” and according to the manual of diagnosis and statistics of mental disorders (DSM-5) published by the American Psychiatric Association (APA), “tobacco use disorder” is classified as a disease belonging to addiction disorders.
In other words, tobacco addiction is a disease with clear diagnostic criteria.
Among the many harmful substances contained in cigarettes, nicotine is an addictive substance that makes smokers unable to quit smoking and continue to smoke.
One-third of adults around the world smoke, and most people start smoking during adolescence.
It is rare for people to start smoking after age 21.
Among daily smokers, the prevalence of nicotine dependence is known to be approximately 50%. More than 80% of smokers try to quit at some point, but 60% start smoking again within a week and less than 5% quit for life.
However, most smokers make several attempts to quit smoking, and about half of them eventually quit.
Self-diagnosis of tobacco addiction!
| Questions | Answers | Points |
| How soon after waking up in the morning do you smoke your first cigarette? | Within 5 min. | 3 |
| Within 6~30 min. | 2 | |
| Within 31~60 min. | 1 | |
| After 60 min. | 0 | |
| Is it difficult to refrain from smoking in non-smoking areas (subway, bus, hospital, theater, etc.)? | Yes | 1 |
| No | 0 | |
| When is it most difficult to stop smoking? | First cigarette in the morning | 1 |
| Others | 0 | |
| How many cigarettes do you smoke per day? | Less than 10 cigarettes | 0 |
| 11~20 cigarettes | 1 | |
| 21~30 cigarettes | 2 | |
| More than 31 cigarettes | 3 | |
| Do you smoke more in the first few hours after waking than at other times of the day? | Yes | 1 |
| No | 0 | |
| Do you smoke even when you are sick and lying in bed all day? | Yes | 1 |
| No | 0 |
A tool to assess dependence on nicotine is the Fagerstrom test.
The higher the score, the more severe the withdrawal symptoms and the more difficult it may be to quit smoking.
A total score of 0-3 points indicates low dependency, 4-6 points indicates medium dependency, and 7-10 points indicates high dependency.
In a simpler way, if the combined scores of questions 1 and 4 of the Fagerstrom test are 4 or higher, it can be judged that nicotine dependence is high. Through this, you can predict your success in quitting smoking.
Smoking Cessation Treatment
Because continuing to smoke is a behavior caused by an addiction disease, quitting smoking is possible through smoking cessation treatment, not through willpower.
The rate of smokers successfully quitting smoking through individual will alone is very low, but systematic treatment can increase the success rate of quitting smoking by more than 2-5 times.
According to actual research results, the probability of quitting smoking alone is 5%, while drug treatment can increase the success probability of quitting smoking to 40%.
Smoking cessation treatment can be divided into psychosocial treatment and pharmacological treatment.
Psychosocial treatments include “short-term intervention,” which effectively induces smoking cessation in a very short period of time, “motivation enhancement therapy,” which approaches change in stages by considering the level of motivation to quit smoking, and “cognitive behavioral therapy” that uses techniques such as self-monitoring, coping skills training, and stimulus control and relapse prevention training. Other treatments include group psychotherapy and hypnotherapy.
The reason drug treatment is needed to treat tobacco addiction is because nicotine is as addictive as heroin or cocaine. Drug treatment can reduce dependence on nicotine and reduce the desire for nicotine even after quitting smoking.
To date, primary drug treatments that have been proven effective for nicotine dependence include nicotine replacement therapy (nicotine patches, gum, candies, etc.) and oral medications such as bupropion and varenicline.
Nicotine replacement therapy aims to reduce withdrawal symptoms during smoking cessation and gradually recover from nicotine dependence by supplying nicotine ingredients and reducing cravings.
Bupropion is known as a treatment for depression, but it is an effective treatment for smoking cessation regardless of the presence or absence of depressive symptoms.
Varenicline helps with smoking cessation through its dual effect of alleviating withdrawal symptoms caused by smoking cessation and at the same time reducing the rewarding effect of nicotine.
Drug treatment is usually maintained for 12 weeks, but it is more effective to extend treatment beyond that to prevent recurrence.
Long-term smoking due to tobacco addiction continues to worsen the health of smokers. For example, smoking is involved in 85% of lung cancer deaths, and smoking is also the main cause of chronic cardiovascular disease.
The positive side is that quitting smoking benefits people at all ages. Immediately after quitting smoking, blood coagulation decreases, oxygen supply to human tissues increases, and the risk of cardiovascular disease decreases. In addition, if you keep quitting smoking for 10 to 15 years, your mortality rate will decrease to the same level as that of someone who has never smoked, so the importance of maintaining a smoking cessation cannot be overemphasized.
Tobacco addiction is often not resolved in a short period of time. If you succeed in quitting smoking through long-term treatment with a spirit of challenge without giving up, the gift of good health will surely come to you.
Hanyang University Medical Centre
Professor of Psychiatry Roh Sung-won
Click here to go to the website of Hanyang University Medical Centre.
