One of our favourite morning television hosts said in late December that he was going to stop smoking and I suspect that he did ... for a few days. But, by early January he was sporting his 20-pack sidekick in his breast pocket. One guest later explained the host's inability to stop smoking by saying, "He's just not ready to stop as yet. When he's ready, he will stop." His response, "I just love to smoke".

All this is understandable for the smoker who's trying to quit, since smoking tobacco is an addiction which is very difficult to shelve. Having a few slips does not mean that we've already blown our chances of quitting but it sometimes predicts a full relapse shortly afterwards.

Thank you for smoking

Cigarette companies may thank us for smoking since they benefit from this activity. However, there is no benefit for the smoker. Smoking has been called the single most health-damaging activity that an individual can undertake. It is the leading preventable cause of premature death in most countries.

Health benefits of stopping

The single most important thing a smoker can do to live longer is to stop smoking. Stopping reduces the risk of cancers, coronary heart disease, stroke, and respiratory symptoms like coughing, wheezing and shortness of breath. Women who stop smoking before or during pregnancy reduce their risk for infertility and low-birthweight babies.

Products to help you quit

Smoking cessation aids cannot stop you from smoking, make you want to stop or make quitting easy, but they can ease the symptoms of withdrawal, boost your confidence and reduce the urge to smoke. The doctor or pharmacist may advise you about products which are safe for you. Health insurance does not subsidise nicotine replacement nor varenicline, but they subsidise bupropion.

Nicotine Replacement Products

These products replace some of the nicotine that you used to get from smoking, to ease the withdrawal symptoms. You must stop smoking completely while taking nicotine replacement. If you have a heart problem you will need special guidance on using these products.

There are six forms of nicotine replacement available worldwide - patches to be worn on the skin, chewing gum, lozenges, tablets taken under the tongue, nasal sprays, and inhalers. However, in Jamaica, we only have the nicotine chewing gum (Nicorette) available in few pharmacies. It comes in two strengths - 2mg for those who used to smoke less than 25 tobacco cigarettes per day, and 4mg for those who used to smoke more. The gum delivers a higher dose of nicotine more quickly than the other forms of replacement, so the user gets a 'quick fix' for cravings. It is normally used for 8 to 12 weeks.

Cost works out to about $100 per piece of chewing gum (about $5,000 per pack of 50 pieces). The nicotine in the chewing gum is delivered to the bloodstream through the tissues in the mouth. It is available without a prescription but under the control of the pharmacist. Indigestion, headache, gum irritation and disease are possible side effects.

Bupropion Tablets

Bupropion (Wellbutrin) was first used to treat depression but was eventually found to help smokers quit. It reduces the desire to smoke and helps to relieve some unpleasant symptoms experienced when we stop smoking. It is available only with a prescription. One tablet is usually taken every morning for the first six days, then one tablet is taken twice daily for the rest of the course (about eight weeks). Bupropion, when used with nicotine replacement products, can cause high blood pressure. However, you can smoke cigarettes for the first week of treatment while the tablets start to work. Dry mouth, difficulty sleeping and headache are possible side effects.

The Quitting Power of Varenicline

Varenicline (Champix) tablets are now available here. The marketers of Champix say that it puts smokers on a path to success. It blocks the effects of nicotine on the brain - nicotine usually stimulates the 'pleasure centre' of the brain.

Dahlia McDaniel is a pharmacist and final year doctoral candidate in public health at the University of London; email: yourhealth@gleanerjm.com.

Steps to stop smoking

We need willpower to help break the addictive hold of nicotine, so preparing for the attempt to quit is advisable. Think about it long and hard before stopping.

If you need help to give up smoking, consult your medical doctor or pharmacist who may recommend a product to help you to stop. Consult close friends or family for help and support, or start a non-smoking group with your smoking friends.

Set a stress-free date and stick to it.

Throw away cigarettes, ashtrays and lighters.

Drink plenty of fluids.

Keep busy and get more active with exercise.

Be aware of urges to snack on sweet, fatty comfort foods, and try to avoid them.

Be prepared for withdrawal symptoms like irritability, craving for nicotine and experiencing poor concentration.

If you relapse, work out why you felt the urge to smoke, revisit your reasons for quitting and try again.