chapter  31
11 Pages

Smoking cessation

Health interventions
WithG. Hussein Rassool

In DSM-V (APA 2013) there is no nicotine dependence diagnosis, but rather Tobacco Use Disorder. Nicotine dependence defining features include failed attempts to abstain, powerful urges to use nicotine and withdrawal symptoms on cessation. An important element of the strategy on smoking is the establishment of smoking cessation services in recognition that many smokers want to stop, but find it hard to do so. A Cochrane review of the evidence on Nicotine Replacement Therapy found that it roughly doubles the chances of a smoker successfully quitting compared to someone using no therapy. A systematic review of studies published between 1990 and 2007 suggests that intensive treatments for smoking cessation are effective in helping smokers to quit. The findings from this study also showed that group treatment may be more effective than one-to-one treatment, and the impact of ‘buddy support’ varies based on treatment type. A smoking cessation service should include both psychological (motivational) and pharmacological treatment interventions. That is the combination of psychological and behavioural support, delivered in a group or individual setting, with pharmacotherapy (nicotine replacement therapy or Bupropion).