How Do Stop Smoking is considered a chronic disease that requires active prevention, diagnosis and treatment, according to José Luis Díaz-Maroto Muñoz, coordinator of the Smoking Group of the Spanish Society of Primary Care Physicians (Semergen).
“For the treatment of smoking we have three first-line drugs, nicotine substitute therapy (TSN), not financed and sold over the counter in pharmacies, bupropion that requires a prescription and likewise varenicline, both financed”, details.Since January 1 of this year, both bupropion and varenicline are financed by public health in Spain and can be requested at no cost provided they are prescribed by a doctor.
On how these drugs work to quit smoking, Carlos A. Jiménez Ruiz, pulmonologist and president of the Spanish Society of Pneumology and Thoracic Surgery (Separ), indicates that “varenicline acts as a partial agonist of nicotinic receptors in the central nervous system. This means that the smoker who uses this drug to quit smoking has a decrease in the symptoms of withdrawal syndrome ”.
In addition, this medicine means that when the smoker has “a specific relapse, he does not feel the effect of satisfaction and this makes his chances of having a new relapse less,” adds Jiménez.
Regarding varenicline, Luz Lewin, Technical and Quality Director of the Cofares Group, comments that this drug “reduces the effect that nicotine has on the brain and reduces the anxiety generated by the withdrawal syndrome.”
Regarding bupropion, Jiménez emphasizes that “it is an inhibitor of neuronal reuptake of dopamine in the nucleus accumbens and an inhibitor of neuronal reuptake of nor – adrenaline in the locus ceruleus”. In other words, these actions are similar to those produced by nicotine, so that smokers who use it when they are quitting do not suffer the symptoms of withdrawal syndrome so intensely.
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According to Lewin, both drugs are effective to quit smoking because varenicline produces a sufficient effect to alleviate the symptoms of craving to smoke, while bupropion mimics the nicotine substance in the brain, reducing the desire to smoke and not generating withdrawal syndrome. .
At this point, Díaz-Maroto affirms its efficacy and safety given the control of abstinence when compared with patients who do not take them: “When a smoker stops smoking on his own, without pharmacological help, abstinence can be around to 5 or 10%, whereas if it is done with psychological help plus pharmacological treatment, the percentage of abstinence results is around 30 or 40% ”.
In this regard, Jiménez highlights that the drugs to quit smoking are supported by different studies that “have shown that of ten smokers who use varenicline to quit smoking accompanied by a psychological support program, up to six of them succeed”, while Those who “use bupropion in that same context will stop smoking around three or four of them.”
The new drugs to quit smoking are indicated for all those who quit smoking, except in the cases of pregnant women and minors due to the lack of studies that confirm their safety.
In this sense, the President of Separ explains that “two studies have recently been published that have shown that these types of drugs are effective and safe to help quit healthy smokers, smokers with controlled psychiatric disease and smokers with cardiovascular disease. controlled ”.
However, experts warn that there are people who, due to previous pathologies, cannot undergo these treatments and remember that it is always necessary to consult a specialist.
According to Díaz-Maroto, he explains that “bupropion is contraindicated in smoking patients with a history of seizures, traumatic brain injury, brain tumor, bulimia, anorexia nervosa, bipolar disorder, liver cirrhosis, alcohol withdrawal and withdrawal of benzodiazepines”, while “Varenicline is only contraindicated in hypersensitivity to the active substance or to some of the excipients included in the technical data sheet.”
Regarding the side effects of both drugs, the specialists consulted warn that the main ones would be nausea, vomiting, excessive sweating, insomnia and dizziness.
“Smoking cessation, either with or without treatment, is associated with dysphoria or depression; insomnia, irritability, frustration, or anger; anxiety; difficulty concentrating; restlessness; decreased heart rate; increased appetite or increased body weight in patients who try to quit smoking ”, adds the Technical and Quality Director of the Cofares Group. In short, the three experts agree on the importance of quitting smoking for our health and the efficacy of these treatments to control abstinence and relapses.