Friday, March 28, 2014

Stop Smoking Effortlessly

Quit Smoking

Quitting smoking is a very difficult task though it is a wise decision. Nicotine is perhaps one of the most addictive substances on Earth and the addiction is reinforced so often due to the frequency with which smokers light up. There are ways for even the most addicted smoker to quit.


1. Believe it or not all smokers are not created equal. Recently when I was with a friend who has taken up smoking in her adulthood, unlike most people who are going the other way, I realized she was not inhaling which infuriated me as I was forced to inhale her second hand smoke as were other patrons of the cafe we were sitting outside of. It is shocking to me the number of people who "faux smoke" for the affectation. Then there are also those who smoke a very controlled limited amount of cigarettes such as my own father who smokes a cigarette a day. This too infuriates me as I see no purpose to smoking at all if you do not have a legitimate addiction to nicotine as otherwise you are simply putting poison in you and passing it to the rest of us.

The advice in this article is not for the light smoker or faux smoker. These people do not need advice they need to merely get a grip as they suffer no actual addiction. In fact it would surprise many smokers who are highly addicted just how many smokers do not have a physical addiction. For many smokers minimal effort and some willpower is all that is needed to give up the habit. For others the story is not quite as simple.

To determine a level of addiction I always ask a person when they have their first cigarette of the day and to describe their smoking pattern. A highly addicted smoker who will invariably have a hard time quitting almost always is a heavy morning smoker. I call this recovering as they are recovering the nicotine lull in their body from their night's sleep. Heavily addicted smokers tend to smoke immediately upon waking and subsequently smoke heavily in the morning gradually evening out and pacing themselves with a steady nicotine hit throughout the day culminating in a cigarette or two before bed. Those who do not fit this pattern and smoke more later in the day or not before eating, noon, or other times they designate have a much easier time quitting.

2. There are many medications out there such as Zyban, Chantix and nicotine replacements ranging from fake cigarettes to patches and gum. Nicotine is not dangerous for you and in fact is used in medicine to treat ailments such as Parkinson's Disease. The danger of smoking is more from the other substances found in tobacco and in cigarettes specifically.

For lighter smokers or not heavily addicted smokers I recommend using a patch step down if needed or perhaps one of the two approved medications for nicotine withdrawal such as Chantix or Zyban. For heavy smokers I do NOT recommend these. Instead I believe that you need to consult a very sympathetic doctor and discuss a chemical detox using alprazolam (****) and diazepam (Valium).

To understand why I recommend these I want to walk through the symptoms of nicotine withdrawal. Nicotine withdrawal causes a multitude of symptoms throughout the body and most specifically in the first 72 hours which slowly subside over a 7-10 day period. The symptoms can range from physical to psychological.

The physical symptoms of nicotine withdrawal in the first three days include cravings, a chest tightness, heart palpitations, sore throat, constipation, flu-like symptoms, headache, dizzy spells, feeling faint, coughing, mouth ulcers (canker sores caused by the body detoxing), anxiety and feelings of depersonalization and derealization (time is distorted and you feel like you are not yourself but all is in slow motion or surreal).

Due to the range of severe physical symptoms I find the following regimen to be the best aid in smoking cessation: Under a doctor's supervision you should be given 15 .05mg alprazolam pills (****). You should take enough to calm you when your first withdrawal symptoms occur. Typically this would be about 1.5-2mg maximum. After this you should take .05mg every 4 hours for the first 24 hours. You should also be given 30 5mg diazepam tablets (Valium). Alprazolam is a fast acting benzodiazepine and best for the instant relief but Diazepam is better for sleep and also has a longer half-life therefore it is better to maintain steady dosing of benzodiazepines. Your first diazepam should be taken with your last alprazolam in the first evening. The second day you should take one .05mg alprazolam along with one 5mg diazepam every 4 hours as needed. After 48 hours you should then take a 5mg diazepam as needed for the remaining week. This should successfully avoid most withdrawal symptoms.

3. Finally you need to deal with the psychological ramifications of quitting. Typically people are very attached to the smoking habit. When you think of how often you smoke you can clearly see you are reinforcing this habit far more often than most drug addicts or alcoholics are reinforcing their habits and therefore will naturally have a longer mourning period. You also will tend to go through a period of depression for which an antidepressant may be prescribed, SSRI's or selective serotonin reuptake inhibitors, are the best antidepressants for nicotine related withdrawal.

You will need a period of adjustment and need to learn to do things that you associate smoking to without smoking. It is not an easy adjustment period but it can be done.

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