Quit smoking in a scientific way
Methods that really work
Everyone knows that smoking is dangerous for health: social advertising and frightening illustrations on cigarette packs remind us of this every now and then. Despite this, the number of smokers is declining very slowly. Even those who sincerely want to quit smoking face difficulties – all because quitting smoking is really not easy. Let's figure out which methods of giving up tobacco are most effective from the point of view of scientists.
Once and for all: abrupt quitting smoking
It is often possible to hear that you need to quit smoking abruptly and decisively – this method is more effective than a gradual decrease in 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: a decisive refusal from tobacco really works better than a consistent reduction in 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 give up 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 of the other reduced the number of cigarettes gradually. A month after the start of the experiment, the scientists summed up the first results. 49% of those who "quit" abruptly and 39% of volunteers from the second group successfully abstained from smoking. Six months after the start, 22% of cold turkey supporters and 15.5% of those who chose gradual withdrawal did not return to the bad habit.
This effect has been observed by other researchers. A possible explanation was offered by scientists from the University of Vermont, their work was published in the journal Addiction in 2007. According to scientists, those who choose a 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.
In order to increase the chances of success with a decisive "tie", experts recommend even before trying to think through what to replace the usual actions associated with smoking: for example, drinking a glass of water instead of a morning cigarette. Another effective replacement is recommended by psychologists from the University of Plymouth: in 2014, they found out that a game of Tetris reduces the desire to smoke by an average of 24%.
Add excitement: disputes for money
Another effective method to give up a bad habit is a financial incentive, while the risk of 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).
2538 smokers participated in the experiments, their success in quitting the habit was monitored using tests that detect the presence of nicotine in the body. The 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 lasted six months were paid another $ 200 bonus – in total, participants could earn $ 800. Another (smaller) group made a $150 deposit before starting the experiments: after successfully completing the program, they received their money back and a $650 bonus.
Personal contribution turned out to be more effective: although the incomes of the second group were lower in the end, its participants more often achieved their goals and quit smoking. A year after the start of the experiments, 17% of people from the "deposit" group and 8% of those who received only a premium abstained from smoking. It is worth clarifying that only a small part of the volunteers (about 13%) initially agreed to donate their money, so from the point of view of public benefit, the premium option works better: it allows you to keep more people from smoking. But for those who have decided to quit a bad habit themselves, a dispute for a substantial amount can be a good argument in favor of a healthy lifestyle.
Throwing together: support for 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 found out that if both partners in a couple give up the habit, the probability of success is much higher than if one of them continued to smoke. The work was published in the journal JAMA Internal Medicine in 2015.
The researchers examined data on 3,722 British couples over the age of 50 who live together. With the support of a partner, 50% of women and 48% of men managed to give up tobacco. In couples where the second spouse continued to adhere to the bad habit, only 8% of men and women successfully gave up 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 application, designed to support quitting smoking, and a traditional telephone hotline. The participants of the experiment were Canadians aged 19 to 29 years: they had to go without cigarettes for at least a month. An application working with social networks helped 32% of volunteers to cope with the task, and telephone consultations worked only for 14% of volunteers.
Magic Pill: substitution therapy and drugs
Not only behavioral, but also "chemical" methods allow to overcome the craving for tobacco. The most studied of them is nicotine replacement therapy. This name combines all the ways that help to supply the body with small doses of nicotine in order to weaken the manifestations of the "withdrawal syndrome" and facilitate the rejection of cigarettes.
Today, there are many means for delivering small doses of nicotine to the body: special patches, chewing gum, lollipops, inhalers, sprays for the nose and mouth. Research shows that these methods work equally effectively – you can choose any convenient form. In 2015, nicotine patches and chewing gums were included in the list of essential medicines of the World Health Organization.
Methods of the future: enzyme-constructor and sleep training
Today, scientists are also working on fundamentally new experimental methods to combat smoking. One of them may be a "vaccine" against a bad habit: scientists from the Scripps Research Institute in the USA create such a drug.
According to the plans of scientists, this tool will be able to destroy nicotine in the blood of a smoker even before the dangerous substance reaches the brain. To do this, the researchers proposed using the NicA2 enzyme: it accelerates the oxidation of nicotine, turning it into a safe compound for the body. This enzyme is produced by Pseudomonas putida bacteria found in the soil, but the "natural" NicA2 is rapidly excreted from the human body.
Scientists have improved the enzyme by adding to it a sequence of amino acids that allows NicA2 to bind to albumin, a protein that is constantly present in the blood and is destroyed 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 extend the "life" of the drug in the blood to administer the drug to patients as rarely as possible.
Another unexpected method is the fight against smoking with the help of unpleasant stimuli in a dream. This method was tested in 2014 at the Weizmann Institute of Israel, 66 smokers participated in the experiments. They spent the night in the Institute's somnological laboratory: in a dream, volunteers from the experimental group simultaneously inhaled the smells of tobacco smoke and spoiled fish. Volunteers from the control groups were exposed to two odors in a dream, but not in parallel, or inhaled unpleasant odors together, but in a state of wakefulness.
The therapy worked only for the experimental group: the morning after the experiment, its participants did not remember the smells, but smoked fewer cigarettes. Those who smelled smoke and fish at the second stage of the slow sleep phase managed to reduce nicotine consumption as much as possible: they started smoking 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 the combination therapy of addiction.
Which probably won't help
While some methods successfully pass more and more experimental tests, others regularly become a cause for controversy. One of the most heated discussions is around electronic cigarettes: vaporizers "charged" with flavored liquid. The filling of electronic cigarettes may contain nicotine or do without it.
In 2013, scientists from the University of Auckland conducted an experiment involving 657 smokers who want to give up tobacco. One group used electronic cigarettes with nicotine, the second – nicotine patches, the third – vaporizers-"pacifiers" 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 patch users and 4.1% of volunteers who used "empty" electronic cigarettes got rid of the habit.
However, in recent years, most researchers believe that vapes are rather useless for quitting smoking. Moreover, they can complicate the rejection of nicotine. This conclusion was reached by the authors of a meta-analysis of 38 studies published in 2016 in The Lancet. Twenty of the papers studied included descriptions of experiments involving control groups: scientists found that the use of 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. According to the results of the studies described above, it is easy to notice 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 decrease to normal levels, and within 12 weeks blood circulation will improve and lung functions will begin to recover. After a year without tobacco, the risk of developing coronary heart disease will drop by half compared to the risk for a smoker. Do not forget about the danger of passive smoking: the tobacco consumer harms not only himself, but also the health of others.
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