1. Smoking cessation
Felix K. Karthik

3. Why smoking is addictive?
Positive
reinforcment
Increase in
dopamine
Binds to
nACh receptors
NICOTINE

4. Tobacco Withdrawal symptoms

5. SMOKERS DIE EARLY!
Pirie et al Lancet Jan 12;381(9861):133-41

6. Making a quit attempt Tensions and triggers Tension Triggers Price
Health concerns
Triggers
Sudden illness
Price rise
Advice from a health professional

7. Remaining quit

8. Importance of brief advice
Stead et al Physician advice for smoking cessation. Cochrane Database of Systematic Reviews. CD:

9. Getting over the initial withdrawal discomfort
Behavioural support is of proven efficacy
Can be delivered in different formats
Face-to-face (individual or group)
Telephone
Internet
Pharma intervention: NRT (nicotine replacement therapy), bupropion (Zyban), nortriptyline and varenicline (Chantix) are of proven efficacy

10. Nicotine Delivery

12. Bupropion

13. Varenicline (CHANTIX)
Varenicline works by reducing craving for cigarettes making quitting smoking a little easier and increases the chances of stopping for good.
However it’s no magic cure and effort is still required.

14. SAFETY AND SIDE EFFECTS -CHANTIX
Nausea (30%) – mostly well tolerated
Strange dreams, headache, flatulence, and insomnia
Serious mood and cardiovascular adverse events

15. E-Cigarettes
How many have tried E-cigarettes?

16. Components of E-cigarettes

17. Fluid contains…..

18. “Harmless” Vapor

19. Recent FDA measures
Push tobacco industry to make cigarettes with less nicotine to make them less addictive
Banning sales of e –cigarettes to kids age <18 years
FDA carefully weighing still the opportunity for e-cigarettes as potentially low risk alternative to smokers
All e-cigarettes including the components of e-cigarettes will be regulated by FDA in the coming years to make it safe!

20. Finally……
GOOD LUCK! THANK YOU!!!!!