Are you trying to quit smoking? Follow the Four Ds rule!


23. 05. 2024

Smoking is a very risky form of behaviour that damages not only smokers’ health, but the health of the people around them. This involves a disease with potentially deadly consequences, causing the deaths of 16,000 to 18,000 people every year in the Czech Republic alone. Furthermore, the average lifespan of smokers is 10-11 years shorter than that of non-smokers. Quitting smoking is a long process, but it doesn’t have to be as difficult as it may seem at first glance.

Cigarette smoke contains more than 4,000 different chemicals that are hazardous to human health. These include carcinogens (substances that promote the formation of malignant tumours) and mutagens (substances that damage cell DNA), allergens and toxic substances, including carbon monoxide. The impact that these chemicals have on the body leads to the development of serious illnesses including lung, larynx and urinary-bladder cancer, heart, vascular and brain diseases, stomach ulcers, premature bone thinning and chronic obstructive pulmonary disease, as well as erectile dysfunction in men and infertility in both sexes.

Passive smoking can be similarly hazardous over the long term, exposure to cigarette smoke poses a nearly comparable risk to non-smokers as it does to smokers. As a result, we may encounter the same illnesses in non-smokers. With respect to passive smoking, children also comprise a group at significant risk. We often see various pulmonary illnesses, a weakened immune system and, for example, recurring middle-ear infections in children who have been exposed to cigarette smoke. 

The effects of toxic substances are not the only risk that users of tobacco products face. Whether users of tobacco or other products containing nicotine smoke regular or electronic cigarettes or use nicotine pouches, for example, they are exposed to nicotine and the risk of becoming dependent on it. The addictiveness of nicotine is comparable to that of heroin – that is why it is so difficult to stop using cigarettes and other products containing nicotine. Though electronic cigarettes and other alternatives usually do not contain tobacco, such products are most commonly based on “pure” nicotine. It’s thus no wonder that these products will not help us break our addiction in most cases. The decision of when and how to break the habit is up to each smoker individually. Health insurers provide a financial contribution for medications used in smoking cessation treatment.

It is necessary to cope with withdrawal symptoms – a pharmacist can help

Pharmacists can help smokers in their effort to quit and contribute to the successful treatment of nicotine addiction. They provide those who want to quit smoking with valuable support and motivation through specialised consultations. During the initial consultation, which usually takes up to sixty minutes, they assess the character and degree of addiction, discuss with the patient various strategies on how to approach smoking cessation and, together with the patient, formulate an individualised plan so that the whole process is not only effective, but also safe. Pharmacists also familiarise patients with the possibilities of pharmacological treatment and regimen-based measure that help to overcome the desire for cigarettes and to cope with withdrawal symptoms. Though withdrawal symptoms are unpleasant, it is necessary for the patient to overcome them in order to succeed in quitting. The craving for cigarettes can persist for up to ten weeks. In addition to that, the following problems may also occur.

  • Anger and irritability or, conversely, anxiety and depression may persist for up to four weeks. This is due to a lack of dopamine – the “happiness and reward hormone” – the release of which in the brain is stimulated by nicotine.
  • Problems with concentration and impatience can persist for up to four weeks and are often caused by headaches.
  • Insomnia persisting for up to four weeks. Conversely, fatigue may also occur. Patients’ sleep is often interrupted and accompanied by unpleasant dreams.
  • Constipation, hunger and nausea to the point of vomiting may occur over a period of ten weeks.
  • Other possible withdrawal symptoms are slowing of intestinal peristalsis and metabolism, which can lead to weight gain. Patients gain an average of four kilograms in the first year of abstinence.
  • Withdrawal symptoms may also include tremors.

When quitting, it is necessary to follow the Four Ds rule

Even though the success rate of treating nicotine addiction rises significantly with the intervention of healthcare professionals, the smoker’s will to quit and to not prematurely terminate treatment is crucially important. Therefore, it is necessary to follow the Four Ds, which have been proven in practice and help to ward off the craving for cigarettes:

  • Drink – slowly drink water and hold it in your mouth to diminish the craving
  • Deep Breathe – breathe deeply
  • Do – engage in some physical/mental activity to keep your mind off of smoking
  • Delay – don’t give in to the desire to smoke

The good news is that the craving for cigarettes weakens in as little as three to five minutes. One of the pieces of the puzzle of the smoking cessation process is thus already in place. However, the process of quitting smoking, or rather treating nicotine addiction can take a significantly longer time, at least three to six months.

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