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Wednesday, May 22, 2013
Smoking and Tobacco
I`ve tried many times to quit smoking. After about 24 hours I get very bad urges to smoke. I also have strong urges to smoke the first thing in morning when I wake up. Please help.
It is important that you have tried to quit smoking as you learn something about yourself and nicotine addiction each time that you try. This can be addressed on the next quit attempt. Early morning cravings are related to the fact that nicotine levels in your blood are low since you probably have not smoked during the night. The shorter time to the first cigarette of the day - for example 5 minutes - indicates a greater level of nicotine addiction. This seems to be true in your situation. The new guidelines on treating tobacco use recommend that every person have nicotine replacement (patch, gum or inhaler). For example, the patch will keep your nicotine blood levels at a low consistent level and reduce the intensity of your cravings. In addition, support of a friend or family member is recommended, as well as developing specific skills to deal with craving. Another medication that you can discuss with your health care provider is bupropion (Zyban) which does not contain nicotine, but changes some of the chemicals in the brain to reduce the urge to smoke. Bupropion needs to be taken for 7 days while you continue to smoke and at that time the medication levels will be high enough in your system to be effective. It is recommended to continue Zyban for 7 more weeks when you are not smoking. Website for the clinical guideline is below.
Karen L Ahijevych, PhD, RN, FAAN
Professor at The College of Nursing
Professor at The College of Public Health
Associate Dean for Academic Affairs
College of Nursing
The Ohio State University