Although the major focus of pharmacological treatments of nicotine addiction has been nicotine replacement, other treatments are being developed for relief of nicotine withdrawal symptoms. For example, the first non-nicotine prescription drug, bupropion, an antidepressant marketed as Zyban®, has been approved for use as a pharmacological treatment for nicotine addiction. In December 1996, a Federal advisory committee recommended that the FDA approve bupropion to become the first drug to help people quit smoking that could be taken in pill form, and the first to contain no nicotine.
Behavioral Treatments
Behavioral interventions can play an integral role in nicotine addiction treatment. Over the past decade, this approach has spread from primarily clinic-based, formal smoking-cessation programs to application in numerous community and public health settings, and now to telephone and written formats as well. In general, behavioral methods are employed to:
(a) discover high-risk relapse situations;
(b) create an aversion to smoking;
(c) develop self-monitoring of smoking behavior;
(d) establish competing coping responses.
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Other key factors in successful treatment include avoiding smokers and smoking environments and receiving support from family and friends. The single most important factor, however, may be the learning and use of coping skills for both short- and long-term prevention of relapse. Smokers must not only learn behavioral and cognitive tools for relapse prevention but must also be ready to apply those skills in a crisis.
Although behavioral and pharmacological treatments can be extremely successful when employed alone, science has taught us that integrating both types of treatments will ultimately be the most effective approach. More than 90 percent of the people who try to quit smoking relapse or return to smoking within 1 year, with the majority relapsing within a week. There are, however, an estimated 2.5 to 5 percent who do in fact succeed on their own. It has been shown that pharmacological treatments can double the odds of their success. However, a combination of pharmacological and behavioral treatments further improves their chances. For example, when use of the nicotine patch is combined with a behavioral approach, such as group therapy or social support networks, the efficacy of treatment is significantly enhanced.
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