Question

Give an explaination on the technique of Tobacco Cessition "Cold Turkey" and include: 1. Pharmacology 2. Modes of Action (how it works) 3. Pros and Cons 4. Inditications and Contraindications 5. Prices 6. How effective it is

Answer 1

Smoking cessation (also known as quitting smoking or simply quitting) is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is addictive. Nicotine withdrawal makes the process of quitting often very prolonged and difficult.

Many different strategies can be used for smoking cessation, including abruptly quitting without assistance ("cold turkey"), cutting down then quitting, behavioral counseling, and medications such as bupropion, cytisine, nicotine replacement therapy, or varenicline.

Like the phrase itself, the “cold turkey” method of quitting smoking can be confusing. The most accepted meaning of quitting cold turkey is “to quit abruptly with no treatment support or replacement medications”.

Though challenging, many smokers have used the cold-turkey strategy to quit smoking.

Quitting cold turkey means giving up smoking all at once, without the aid of any nicotine replacement therapy (NRT) products or stop-smoking drugs.

A lot of people think that the common sense way to give up smoking is to reduce the amount they smoke before quitting. But the results suggested just the opposite: quitting cold turkey is best.

Only the most disciplined among us can quit without any help. Studies show only about 4-7% can do it without any additional help.
If you want to try this method, what works best is to be mentally prepared, the experts say, and really commit to it. Also, get ready for the symptoms of withdrawal.
The folks at QuitSmokingCommunity.org suggest you drink water when the cravings start. Distract yourself with something else. Maybe go for a walk or go talk to someone. Try breathing deeply and slowly and think it though. It'll be tough, but the feelings will pass.
One other thing that could help is to ask for support. Let your friends and family know that you are trying to quit. They can help keep you honest.

PHARMACOLOGY:

• Nicotine replacement therapy: There are several types, including nicotine gum, patches, inhalers, sprays, and lozenges. They work by giving you nicotine without the use of tobacco. You may be more likely to quit with nicotine replacement therapy, but it works best when you use it with behavioral therapy and lots of support from friends and family. And remember that the goal is to end your addiction to nicotine, not simply to quit using tobacco.
• Bupropion and varenicline (Chantix) are prescription medicines that can help with your cravings and withdrawal symptoms.
• Other helpful combinations include behavioral therapy and nicotine replacement therapy; prescription medication with a nicotine replacement therapy patch; and a nicotine replacement therapy patch and nicotine spray.

Modes of Action :

Nicotine replacement therapy (NRT):

The main mode of action of Nicotine replacement therapy (NRT) is thought to be the stimulation of nicotinic receptors in the ventral tegmental area of the brain and the consequent release of dopamine in the nucleus accumbens. This and other peripheral actions of nicotine lead to a reduction in nicotine withdrawal symptoms in regular smokers who abstain from smoking.

NRT may also provide a coping mechanism, making cigarettes less rewarding to smoke. It does not completely eliminate the symptoms of withdrawal, however, possibly because none of the available nicotine delivery systems reproduce the rapid and high levels of arterial nicotine achieved when cigarette smoke is inhaled.

All the available medicinal nicotine products rely on systemic venous absorption and do not therefore achieve such rapid systemic arterial delivery. It takes a few seconds for high doses of nicotine from a cigarette to reach the brain; medicinal products achieve lower levels over a period of minutes (for nasal spray or oral products such as gum, inhalator, sublingual tablet, or lozenge) and hours (for transdermal patches).

Bupropion :

Bupropion is an atypical antidepressant structurally similar to diethylpropion, an appetite suppressant. The mechanism of the antidepressant effect of bupropion is not fully understood, but bupropion inhibits reuptake of dopamine, noradrenaline, and serotonin in the central nervous system, is a non-competitive nicotine receptor antagonist, and at high concentrations inhibits the firing of noradrenergic neurons in the locus caeruleus.

It is not clear which of these effects accounts for the antismoking activity of the drug, but inhibition of the reductions in levels of dopamine and noradrenaline levels in the central nervous system that occur in nicotine withdrawal is likely to be important. The antismoking effect of bupropion does not seem to be related to the antidepressant effect as bupropion is equally effective as a smoking cessation therapy in smokers with and without depression.​depression.

Varenicline (trade name Chantix and Champix):

It is a prescription medication used to treat nicotine addiction. It reduces both craving for and decreases the pleasurable effects of cigarettes and other tobacco products.
Varenicline binds with high affinity and selectivity at α4β2 neuronal nicotinic acetylcholine
receptors. The efficacy of CHANTIX in smoking cessation is believed to be the result of
varenicline’s activity at a sub-type of the nicotinic receptor where its binding produces agonist
activity, while simultaneously preventing nicotine binding to α4β2 receptors.
Electrophysiology studies in vitro and neurochemical studies in vivo have shown that varenicline
binds to α4β2 neuronal nicotinic acetylcholine receptors and stimulates receptor-mediated
activity, but at a significantly lower level than nicotine. Varenicline blocks the ability of nicotine
to activate α4β2 receptors and thus to stimulate the central nervous mesolimbic dopamine system,
believed to be the neuronal mechanism underlying reinforcement and reward experienced upon
smoking. Varenicline is highly selective and binds more potently to α4β2 receptors than to other
common nicotinic receptors.

The Pros of Cold Turkey Quitting

Those who quit cold turkey may have a harder time or be unsuccessful but there are some advantages including:

• You won’t have to spend money on smoking cessation products, which can be expensive.
• Nicotine patches and gum may seem attractive, but you are still introducing nicotine into your body.
• You immediately reap the reward of cleaner breath and teeth and are able to gain a stronger sense of smell. Your clothing and locations where you smoke will also smell cleaner.
• There are many support groups including SmokeFree.gov where members support each other during craving times.
• Withdrawal symptoms -- if you go cold turkey -- will only last approximately three months.
• Food will taste better once your body is nicotine free.

The Cons of Cold Turkey :

Along with the advantage of simply quitting nicotine altogether, there are some disadvantages including:

• Withdrawal symptoms that can include irritability, depression and insomnia. Others may experience physical symptoms such as tremors, headaches and weight gain due to increased appetite.
• The use of smoking cessation aids has a variety of side effects. Those in pill form are in antidepressant category and many experience unusual dreams, mood changes and even suicidal thoughts. Doctors and pharmacists recommend seeking out an urgent care center if you experience symptoms from these medications.
• Nicotine patches and gum -- even electronic cigarettes with nicotine are still introducing the substance into your body so you aren’t really nicotine free.
• People who use stop smoking aids have a higher chance of quitting permanently than those choosing the cold turkey route.