NICOTINE DEPENDENCE
Description
Nicotine dependence is a major public health problem. Nicotine is abused in the form of tobacco, smoked in bidis, cigarettes and hooka, and chewed as such or in pan masala.
Symptoms
1. Most tobacco users smoke or use smokeless tobacco on a daily basis.
2. Indicators of dependence include the time from waking to first use. About 15% of the dependent smokers light up within 5 minutes of waking, while almost half of smoke within the first half hour of the day.
3. Typical physical symptoms following cessation or reduction of nicotine intake include craving for nicotine, irritability, anxiety, difficulty concentrating, restlessness, sleep disturbances, decreased heart rate, and increased appetite or weight gain.
Treatment
1. Nicotine gum, one …show more content…
Advise the patient that starting from the quit date, total abstinence is essential.
6. Help the patient identify each of the environmental conditions that most likely lead to tobacco use and then develop a course of behaviour that avoids those conditions or prevents them from occurring.
7. Suggest that the patient develop an alternate plan to having a cigarette during the morning toilet, smoking after a meal, and smoking to manage stress at work or in traffic, being in an argument, and so on.
8. The five Ds to handle urges:
• Delay until the urge passes. It usually takes 3-5 minutes
• Distract yourself. Call a friend or go for a walk.
• Drink a glass of water
• Deep breaths—Relax! Close your eyes and take 10 slow, deep breaths
• Discuss your feelings with someone close to you.
9. The patient should be sensitized to the ill effects of tobacco use.
References
1. Sadock BJ, Sadock VA. Kaplan and Sadock’s Synopsis of Psychiatry, 10th Edition, Lippincott Wlilliams and Wilkins: Philadelphia 2007; pp. 438-442.
2. Lal R (Ed). Substance Use Disorder: Manual for Physicians. National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, 2005; pp.
Description
Nicotine dependence is a major public health problem. Nicotine is abused in the form of tobacco, smoked in bidis, cigarettes and hooka, and chewed as such or in pan masala.
Symptoms
1. Most tobacco users smoke or use smokeless tobacco on a daily basis.
2. Indicators of dependence include the time from waking to first use. About 15% of the dependent smokers light up within 5 minutes of waking, while almost half of smoke within the first half hour of the day.
3. Typical physical symptoms following cessation or reduction of nicotine intake include craving for nicotine, irritability, anxiety, difficulty concentrating, restlessness, sleep disturbances, decreased heart rate, and increased appetite or weight gain.
Treatment
1. Nicotine gum, one …show more content…
Advise the patient that starting from the quit date, total abstinence is essential.
6. Help the patient identify each of the environmental conditions that most likely lead to tobacco use and then develop a course of behaviour that avoids those conditions or prevents them from occurring.
7. Suggest that the patient develop an alternate plan to having a cigarette during the morning toilet, smoking after a meal, and smoking to manage stress at work or in traffic, being in an argument, and so on.
8. The five Ds to handle urges:
• Delay until the urge passes. It usually takes 3-5 minutes
• Distract yourself. Call a friend or go for a walk.
• Drink a glass of water
• Deep breaths—Relax! Close your eyes and take 10 slow, deep breaths
• Discuss your feelings with someone close to you.
9. The patient should be sensitized to the ill effects of tobacco use.
References
1. Sadock BJ, Sadock VA. Kaplan and Sadock’s Synopsis of Psychiatry, 10th Edition, Lippincott Wlilliams and Wilkins: Philadelphia 2007; pp. 438-442.
2. Lal R (Ed). Substance Use Disorder: Manual for Physicians. National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, 2005; pp.