About one in three Germans regularly reaches for cigarettes. Therapies, nicotine patches or hypnosis promise a simple way out of addiction. But even the best method can only help if the smoker really wants to quit.
Smoking costs money and a lot of life. A recent overview study shows that people who stop smoking in time are given up to ten years as a gift. However, it is easier said than done to banish the smokers forever. There are a number of ways in which smoking abstinence can be achieved.
Some people put the cigarette out of their hand overnight, others try to gradually give up smoking. The meanwhile deceased non-smoker activist Allen Carr helped some smokers to quit with his bestseller “Finally non-smokers”. But also hypnotists and acupuncturists promise to make the withdrawal suffering bearable.
According to the Eurobarometer 2012, 66 percent of smokers try to get rid of cigarettes alone. However, they rarely succeed in doing so at the first attempt. “Nevertheless, the will to quit is the decisive prerequisite,” says Martina Pötschke-Langer from the German Cancer Research Centre (DKFZ). “Without him, no aid can be used.
According to Eurobarometer, about 30 percent of Germans currently smoke. 47 percent of 15- to 24-year-olds have already tried to quit smoking. In the group of 40- to 54-year-olds, the figure was 66 percent. Smoking can make you physically and mentally dependent. For this reason, the Association of Scientific Medical Societies (AWMF) recommends combining methods for psychological and physiological weaning in a guideline for a safe stop of smoking.
SPIEGEL ONLINE presents the four best known ways to quit smoking and explains how they work.
Stopping alone – it’s all about preparation
If you quit smoking, you will be struggling with withdrawal symptoms such as restlessness, irritability and discomfort. “That’s why you have to prepare for quitting,” says Pötschke-Langer. In the first few hours of withdrawal, thirst and hunger attack the body. “For the first day without a cigarette you should buy fresh fruit.” Sugar-free chewing gum, tea and water also help to overcome the first withdrawal symptoms.
“Before you quit, think about what you want to do instead of smoking and avoid situations that might tempt you during the first two weeks,” the expert advises. It would help to set a date for the exit and throw away all smoking utensils. Occupation – for example through sport – is also a good way to distract yourself from withdrawal. The DKFZ has put together ten tips to help you quit.
How difficult withdrawal is also depends on the degree of physical and psychological dependence. The internationally recognised Fagerström test reveals the severity of the addiction. According to Pötschke-Langer, only about three to six percent of the attempts to quit are successful without help.
Ex-smokers should deal with short-term relapses in a relaxed manner. “Do not give up your goal, but continue smoking directly,” the expert recommends.
Counselling and behavioural therapy – Only with the right therapist
The most important part of weaning is counselling: smokers are supposed to give up their bad behaviour and replace it with other positive experiences. Addicts integrate cigarettes into their everyday lives as a matter of course. They often subconsciously combine positive characteristics with their habits – such as recognition or better opportunities to make new contacts.
Review articles – including those by the AWMF and the Medicines Commission of the German Medical Association – come to the conclusion that behavioural therapy is an effective way of giving up smoking. “Counselling and therapy can increase the chances of success to 20 to 30 percent,” says Pötschke-Langer.
Behavioural therapy attempts to use conversations, role-plays or group sessions to show new ways of dealing with situations in which those affected would otherwise have to resort to cigarettes.
Nevertheless, one should not rely on the success rates of a therapy. “The interpersonal aspect plays a particularly important role in personal care,” says Pötschke-Langer. If the mood in a group or at the individual consultation is bad, the therapy shows considerably less success.
Nicotine replacement therapy – best in combination with advice
When quitting smoking, the body asks for nicotine, which it otherwise ingested through cigarettes. Withdrawal symptoms are the result. Plasters, tablets, chewing gum or inhalers with nicotine are supposed to help alleviate the physical symptoms. In this way, the smoker can initially concentrate more on his psychological dependence.
Especially heavy smokers can use plasters and the like to ease the initial withdrawal period. However, the nicotine replacement products carry the risk of becoming addicted. Acute withdrawal symptoms and acute cravings relieve them reliably. Whether the chance of giving up smoking actually increases with the products alone is controversial. “Combined with a consultation, however, they can noticeably increase the success rate,” says Pötschke-Langer.
During withdrawal, depressive affect disorders such as depression or exaggerated emotional reactions sometimes occur. The antidepressant bupropion, which is sold in Germany under the name Zyban, and the drug varenicline counteract negative feelings during withdrawal, but not without side effects.
Bupropion, for example, can cause insomnia, tremors, difficulty concentrating or restlessness. “These prescription drugs can only be considered if several attempts at counselling and nicotine replacement therapy have failed,” says Pötschke-Langer.
