Stating that nicotine addiction starts with the first cigarette, experts point out that craving symptoms start when smoking is stopped after 1 month of chronic use.
Emphasizing that smoking tobacco in the form of cigarettes is the easiest way to deliver nicotine to the receptors in the brain quickly and to get maximum pleasure, experts state that in addition to nicotine, Transmanyetic Stimulation Therapy-TTMU is also effective in treatment.
Üsküdar University NPISTANBUL Hospital AMATEM Coordinator Psychiatrist Prof. Dr. Nesrin Dilbaz, in a statement on February 9, World Stop Smoking Day, pointed out that cigarette consumption, which decreased in developed countries, increased in developing countries.
A smoker who smokes 100 cigarettes in a lifetime is considered a smoker
Stating that the World Health Organization (WHO) defines smoking as smokers and non-smokers, Prof. Dr. Nesrin Dilbaz said, "These are also classified in various ways among themselves. Regular smokers are defined as people who smoke at least one cigarette every day in the last 30 days; people who smoke but less frequently than every day in the last 30 days and occasional smokers. Non-smokers are defined as lifelong never smokers who have quit smoking, and former smokers who have quit smoking. In addition to these definitions, WHO provides a clearer definition for the distinction between smokers and non-smokers. Accordingly, a person who has smoked a total of 100 cigarettes throughout his/her life is considered a lifelong smoker."
Usage decreased with the regulation in 2008
Stating that the use of tobacco products, which are widely used in all countries, has undergone significant changes in terms of the frequency of use in countries in the last 50-60 years, in which its negative effects on health have emerged, Prof. Dr. Nesrin Dilbaz said, "During this period, the use of tobacco products has been decreasing especially in developed countries, while the use of tobacco products has been increasing in developing countries. For example, while more than half of the people in the adult age group in the UK were smokers 50-60 years ago, this figure has decreased to around 20 percent today. Although a similar trend is observed in most of the developed countries, for example, in our country, there has been an 80 percent increase in cigarette use in the 1980s and 1990s."
Prof. Dr. Dilbaz stated that the Law on the Prevention of Harms of Tobacco Products is a turning point in terms of the fight against tobacco in Turkey and said that tobacco use has decreased significantly thanks to the legal regulation made in 2008.
Cigarettes deliver nicotine easily and quickly
Stating that smoking tobacco in the form of cigarettes is the easiest way to deliver nicotine to the receptors in the brain quickly and to get maximum pleasure, Prof. Dr. Nesrin Dilbaz said, "Taking nicotine in this way increases the risk of nicotine addiction due to its effects on the reward system in the brain. Nicotine shows its pleasurable effect by directly binding to nicotinic cholinergic receptors in the brain reward system. It can also produce other effects by binding to nicotinic sub-receptors in many other areas of the brain. For example, it binds to receptors in the frontal region of the brain (prefrontal cortex) and shows its mentally stimulating effect. After nicotine binds to nicotinic receptors in the reward system, it activates the dopamine pathways and releases dopamine in the Ventral Tegmental area of the brain and reveals its pleasurable effect."
Nicotine in a cigarette provides enough pleasure
Stating that nicotine receptors at rest are hypersensitive to nicotine, Prof. Dr. Nesrin Dilbaz explained why there are 20 cigarettes in a pack, stating that the nicotine taken in one cigarette is enough to fill all nicotine receptors in the reward system:
"After the nicotine from cigarette smoke combines with these receptors, they become insensitive to nicotine. If all nicotine receptors in the reward system are saturated with nicotine, further nicotine intake does not produce a pleasurable effect. The nicotine ingested during the smoking of one cigarette is sufficient to fill all nicotine receptors in the reward system. This is why the cigarette branch is of standard length. In other words, a longer cigarette branch cannot have a more pleasurable effect.
It takes a certain amount of time before a person can enjoy cigarettes again. Nicotine receptors are sensitized in about 45 minutes. Assuming that a person who smokes a pack of cigarettes a day stays awake for an average of 16 hours, if he or she smokes one cigarette every 45 minutes, he or she will need a total of 20 cigarettes. This is probably why there are 20 cigarette branches in cigarette packs. A smoker does not experience cravings for cigarettes because the nicotine receptors in the brain are constantly saturated and desensitized to nicotine throughout the day. However, as chronic smoking continues, the number of nicotine receptors in the brain increases and the smoker starts to need to increase the dose to avoid cravings."
Addiction starts with the first cigarette
Stating that nicotine addiction starts with the first cigarette and is not easy to treat, Prof. Dr. Nesrin Dilbaz said: "It has been shown by experiments on animals that nicotine addiction starts with the first cigarette. After 1 month of chronic use, craving symptoms begin when smoking is stopped. Thanks to molecular memory, the craving continues for a lifetime after quitting, but its intensity shows a gradually decreasing trend."
Prof. Dr. Nesrin Dilbaz stated that the two best proven treatment methods in studies on smoking cessation are behavioral counseling and drug therapy and said, "The most effective results are achieved by applying these two methods together.
There are no evidence-based studies showing that other methods such as hypnosis and acupuncture are effective. The results of the meta-analysis show that the physician's suggestion to quit causes an increase in the cessation rate in adults; it has even been shown that counseling for a short period of time such as three minutes is very effective. The longer the duration of counseling, including telephone counseling, the greater the effectiveness. Effective psychotherapy and pharmacological treatments for smoking cessation have been defined and these treatment options can be offered to all smokers."
Nicotine is used in treatment
Stating that nicotine itself is one of the leading psychopharmacological agents shown to be effective in the treatment of nicotine addiction, Prof. Dr. Dilbaz said, "Nicotine gum, nasal spray or nicotine patches adhered to the skin are available. The psychopharmacological agent varenicline, which acts through nicotine receptors (partial agonist), has been shown to be 30-40% effective in nicotine addiction."
Stating that smoking and related health problems are still the most common cause of premature deaths all over the world, Prof. Dr. Nesrin Dilbaz said, "Despite the pharmacotherapy and psychotherapy programs applied, the smoking cessation rate is around 35%. Studies are being conducted on whether brain stimulation techniques are useful in treatment-resistant cases."
tTMU treatment is effective
Stating that in studies on nicotine addicts, the effects of Transmagnetic Stimulation Therapy-tTMU applied in single or repeated sessions on nicotine craving and the amount of cigarettes consumed were examined, Prof. Dr. Nesrin Dilbaz said, "The first study on the application of tTMU in Repetitive Tobacco Use Disorders (tTMU) was conducted in 2003 and this application has attracted a lot of attention in recent years and gives positive results. Some studies have reported that it reduces cravings and some have reported that it reduces consumption. Unlike TMU used in depression, it has been reported that both craving and cigarette consumption decrease together in treatments that stimulate the deep regions of the brain, especially Insula, using H coil, and the success rate continues to be 33% after 6 months."