Everybody knows that smoking is dangerous to health: public service advertisements and frightening illustrations on cigarette packs remind of this every now and then. Despite this, the number of smokers is declining very slowly. Even those who genuinely want to quit smoking face difficulties - all because quitting smoking is really difficult. Let's figure out which methods of quitting tobacco are the most effective from the point of view of scientists.
Once and for all: smoking cessation
You can often hear that you need to quit smoking sharply and decisively - this method is more effective than gradually reducing the number of cigarettes per day. In English-speaking countries, the practice of instant "tie-up" has even received a special name - "cold turkey". The authors of scientific studies regularly compare this method with others and most often come to the conclusion: decisively quitting tobacco does work better than consistently reducing the dose of nicotine.
In 2016, this conclusion was confirmed by Oxford scientists together with colleagues from other British universities (their article was published in the journal Annals of Internal Medicine). The experiment involved 697 adult smokers who were going to quit nicotine for two weeks. All of them received substitution therapy - they were given nicotine patches and sprays.
The volunteers were divided into groups: in one they quit smoking "once and for all," the participants in the other gradually reduced the number of cigarettes. A month after the start of the experiment, scientists summed up the first results. 49% of those who "gave up" abruptly and 39% of volunteers from the second group successfully abstained from smoking. Six months after the start, 22% of supporters of "cold turkey" and 15.5% of those who chose a gradual refusal did not return to the bad habit.
This effect has been observed by other researchers as well. A possible explanation was proposed by scientists from the University of Vermont, their work was published in 2007 by the journal Addiction. According to scientists, those who choose the gradual path are often less motivated: by reducing the number of cigarettes little by little, they try to delay the moment of complete rejection of nicotine.
To increase the chances of success with a decisive tie-up, experts recommend thinking before trying to think about how to replace habitual smoking activities: for example, drinking a glass of water instead of a morning cigarette. Psychologists at the University of Plymouth recommend another effective substitute: in 2014, they found that playing Tetris reduced the urge to smoke by an average of 24%.
Add excitement: disputes over money
Another effective method to quit a bad habit is financial incentive, while risking your own money motivates you better than the possible reward. This was confirmed by an experiment conducted at the University of Pennsylvania (its description was published in the New England Journal of Medicine in 2015).
The experiments involved 2538 smokers, their progress in quitting the habit was monitored using tests that detect the presence of nicotine in the body. Volunteers were tested two weeks, a month and six months after the official refusal of cigarettes.
Some of the volunteers received $ 200 for each successfully passed test, and those who held out for six months were paid another $ 200 bonus - in total, the participants could earn $ 800. Another (smaller) group made a deposit of $ 150 before the experiments began: after successfully completing the program, they received their money back and a bonus of $ 650.
Personal contribution turned out to be more effective: although the incomes of the second group were ultimately lower, its participants more often achieved their goals and quit smoking. One year after the start of the experiments, 17% of people from the “deposit” group and 8% of those who received only the premium abstained from smoking. It is worth clarifying that only a small part of the volunteers initially agreed to donate their money (about 13%), therefore, from the point of view of public benefit, the option with a bonus works better: it allows you to keep more people from smoking. But for those who themselves decided to quit the bad habit, a dispute over a substantial amount can be a good argument in favor of a healthy lifestyle.
Throwing Together: Supporting Loved Ones
Quitting smoking is not easy in principle, but it is even more difficult to cope with it alone. Scientists from University College London have found that if both partners in a couple give up the habit, the likelihood of success is significantly higher than if one of them continued to smoke. The work was published in the journal JAMA Internal Medicine in 2015.
The researchers looked at data on 3,722 British couples over 50 who live together. With the support of a partner, 50% of women and 48% of men succeeded in quitting tobacco. In couples where the second spouse continued to adhere to the bad habit, only 8% of men and women each successfully quit tobacco. Interestingly, attempts to lose weight together are not so successful: even with joint efforts, 36% of women and 26% of men managed to lose weight.
The support of friends on social networks also helps to say no to tobacco. In 2015, Canadian scientists compared the effectiveness of the Break It Off app, designed to support smoking cessation, with a traditional telephone hotline. The participants in the experiment were Canadians aged 19 to 29 years old: they had to survive without cigarettes for at least a month. The social media app helped 32% of the volunteers get the job done, while telephone consultations worked for only 14% of the volunteers.
The magic pill: replacement therapy and drugs
Not only behavioral methods, but also “chemical” methods can help you to overcome cravings for tobacco. The most studied of these is nicotine replacement therapy. This name brings together all the ways that help supply the body with small doses of nicotine to ease the symptoms of "withdrawal syndrome" and make it easier to quit cigarettes.
Today there are many means for delivering small doses of nicotine to the body: special patches, chewing gums, lozenges, inhalers, nasal and oral sprays. Research shows that these methods work equally well - you can choose any form that suits you. In 2015, nicotine patches and chewing gums were included in the list of essential medicines of the World Health Organization.
Future Techniques: Constructor Enzyme and Sleep Learning
Today, scientists are also working on fundamentally new experimental methods to combat smoking. One of them could be a "vaccine" against a bad habit: such a drug is being created by scientists from the Scripps Research Institute in the United States.
According to the plans of scientists, this tool will be able to destroy nicotine in the smoker's blood even before the dangerous substance reaches the brain. For this, the researchers suggested using the NicA2 enzyme: it accelerates the oxidation of nicotine, turning it into a compound that is safe for the body. This enzyme is produced by the bacteria Pseudomonas putida found in the soil, but the "natural" NicA2 is quickly eliminated from the human body.
Scientists have improved the enzyme by adding an amino acid sequence to it that allows NicA2 to bind to albumin, a protein that is constantly present in the blood and degrades much more slowly. The drug has been successfully tested on laboratory rats, but people will not be able to use it soon: researchers are looking for ways to further extend the "life" of the drug in the blood so that the drug is administered to patients as rarely as possible.
Another unexpected method is fighting smoking with unpleasant sleep stimuli. This method was tested in 2014 at the Israeli Weizmann Institute, 66 smokers participated in the experiments. They spent the night in the institute's sleep laboratory: in their sleep, the volunteers from the experimental group simultaneously inhaled the smells of tobacco smoke and spoiled fish. Volunteers from control groups were exposed to two odors in their sleep, but not in parallel, or inhaled unpleasant odors together, but while awake.
The therapy worked only for the experimental group: the next morning after the experiment, the participants did not remember about the smells, but smoked fewer cigarettes. Those who smelled smoke and fish in the second stage of slow wave sleep succeeded in minimizing their nicotine intake: they began to smoke 30% less. In the control groups, the number of cigarettes did not change.
These methods are still at the testing stage, and it has not yet been possible to achieve truly high efficiency. According to scientists, if such methods can be improved, they can become part of combination therapy for addiction.
Which most likely won't help
While some methods are successfully passing more and more experimental tests, others regularly become the subject of controversy. One of the hottest debates is around electronic cigarettes: vaporizers “charged” with a flavored liquid. E-cigarette fillings may or may not contain nicotine.
In 2013, scientists from the University of Auckland conducted an experiment involving 657 smokers who wanted to quit tobacco. One group used e-cigarettes with nicotine, the second - nicotine patches, and the third - “dummy” vaporizers containing only flavors. Nicotine vaporizers turned out to be not much, but still more effective than other methods: after six months, 7, 3% of their supporters, 5, 8% of band-aid users, and 4.1% of volunteers who used "empty" electronic cigarettes got rid of the habit.
However, in recent years, most researchers believe that vaping is rather useless for quitting smoking. Moreover, they can make it difficult to quit nicotine. This is the conclusion reached by the authors of a meta-analysis of 38 studies published in 2016 in The Lancet. Twenty of the studies studied included descriptions of experiments involving control groups: scientists found that using vaporizers reduced the chances of success by an average of 28%.
Why quitting smoking is still worth it
Smoking is regularly included in the lists of bad habits, which are the most difficult to give up. Based on the results of the studies described above, it is easy to see that most of the volunteers returned to tobacco, even if the first months after the start of the experiment were successful.
But if a person still managed to quit smoking, the health benefits will not be long in coming. According to the World Health Organization, after 12 hours without cigarettes, the concentration of carbon monoxide in the blood will drop to normal levels, and within 12 weeks, blood circulation will improve and lung function will begin to recover. After a year without tobacco, the risk of coronary heart disease will drop in half compared to the risk for a smoker. Do not forget about the danger of secondhand smoke: the tobacco user harms not only himself, but also the health of others.