Managing smoking cessation

doi:10.1136/bmj.39252.591806.47

BMJ 2007;335:37-41 (7 July), doi:10.1136/bmj.39252.591806.47

Clinical Review

Managing smoking cessation

Paul Aveyard, National Institute of Health research career scientist¹, Robert West, professor of health psychology and director of tobacco studies²

¹ Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT , ² Cancer Research UK Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, London WC1E 6BT

Correspondence to: P Aveyard p.n.aveyard@bham.ac.uk

The first 150 words of the full text of this article appear below.

Cross sectional studies show that most smokers in countriessuch as the United Kingdom and the United States report thatthey want to stop and intend to stop at some point.¹ The rateof attempts to stop is high—78 attempts per 100 smokersper year in the UK—with many smokers making several attemptsin a year.² Nearly half of all smokers expect not to be smokingin a year's time,³ but only 2-3% actually stop permanently eachyear.³

The most common reasons smokers give for smoking are stressrelief and enjoyment,⁴ but the main reason is nicotine dependence.Nicotine acts in the midbrain, creating impulses to smoke inthe face of stimuli associated with smoking.⁵ Consequent changesin brain chemistry also produce "nicotine hunger" when a smokergoes without nicotine. A third mechanism underlying nicotinedependence is nicotine withdrawal: unpleasant mood and physicalsymptoms that occur on abstinence and are . . . [Full text of this article]

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