Smoking Cessation Should Follow Scientific Methods

The survey results show that among the respondents, 53% of smoking men have attempted to quit smoking, with over 70% having tried to quit 1-2 times, and even 10% having quit more than 5 times. The data clearly indicates that more than half of smokers have tried to quit, but why is quitting so difficult? The primary reason is their insufficient understanding of tobacco addiction. Most people do not realize that smoking addiction is actually a disease.
 
Smoking addiction is a chronic disease, classified under the International Classification of Diseases (ICD-11) as 6C4A, referred to as tobacco dependence, which often manifests as both physical and psychological dependence. Physical dependence is characterized by a series of intolerable withdrawal symptoms that occur after stopping or reducing smoking, including cravings for smoking, anxiety, depression, restlessness, increased salivation, difficulty concentrating, sleep disturbances, and some quitters may also experience weight gain. Research shows that the primary substance causing tobacco dependence is nicotine, whose pharmacological and behavioral processes are similar to other addictive substances such as heroin and cocaine. When nicotine is inhaled, it prompts the brain to release dopamine, which induces pleasure, and over time, this leads to tobacco dependence and addiction.

The addictive nature of tobacco is second only to heroin and cocaine; relying on willpower to quit results in 95%-97% of people relapsing. Generally, withdrawal symptoms can begin within hours of quitting and are most intense during the first 14 days, gradually diminishing thereafter. Most withdrawal symptoms last about a month, while some patients may experience psychological dependence on smoking for over a year. Psychological dependence, also known as mental dependence or 'heart addiction', is characterized by a strong subjective craving to smoke. Many quitters fail because they cannot escape the torment of this mental addiction. Therefore, quitting smoking should follow scientific methods.

All versions of smoking cessation guidelines mention that for tobacco dependents, the rational use of cessation medications can effectively improve long-term quit rates. Currently, several authoritative guidelines recommend first-line cessation medications, including nicotine replacement therapy, bupropion hydrochloride, and varenicline. Nicotine patches are indicated for patients in a stable disease state, without insomnia, and who have not experienced cardiovascular events in the past three months or month, and who do not have allergic reactions to the patches. Bupropion hydrochloride sustained-release tablets are psychiatric medications that interact with many drugs, requiring scientific selection based on individual circumstances. Varenicline is also a primary cessation medication currently available, with a relatively broad range of indications and fewer contraindications. For example, patients with acute cardiovascular diseases who need to quit smoking can consider using it. When patients experience reduced pain after a stent is placed due to a heart attack, they are at risk of relapse, and these medications can help manage complex acute patients to some extent.