Smoking Cessation-from "Healthnotes"

Dietary Modification

A high-carbohydrate diet, combined with a tryptophan supplement (50 mg/kg body weight per day) lessened withdrawal symptoms and helped participants smoke fewer cigarettes in one controlled study,1 but no research has investigated the effect of dietary changes alone on smoking cessation.

Lifestyle Modification

Smoking cessation often leads to weight gain, which can dissuade smokers from trying to quit or cause them to resume smoking.2 3 Increasing physical activity after quitting smoking can minimize weight gain, and a controlled trial found that adding exercise to a smoking cessation behavioral counseling program improved abstinence rates.4 5 However, other, smaller studies have not shown that exercise either alone or added to a comprehensive program helps to maintain abstinence.6 7 Adding weight control through dieting to smoking-cessation programs has resulted in either an increase in smoking relapses or no effect.8 9 Changing the diet at the same time as quitting smoking may require more discipline than most people can achieve.
Other therapies

Individuals who want to quit smoking cigarettes will have better success if they decide on a quit date and change their routines around typical smoking cues, such as coffee breaks, meals, boredom, and sexual activity. Absolute stopping, known as quitting "cold turkey," is generally considered a better method than weaning off.

Nutritional Supplement Treatment Options

Nicotine addiction is thought to be caused by increased stimulation of nerve receptors for various brain chemicals, including serotonin.10 Withdrawal symptoms that accompany smoking cessation could be related to the sudden drop in nerve receptor stimulation. However, a double-blind study found that depleting blood levels of tryptophan, the precursor to serotonin, had no effect on withdrawal symptoms after five hours of smoking abstinence.11 In a controlled study, a daily tryptophan supplement (50 mg/kg body weight) along with a high-carbohydrate diet (which increases brain uptake of tryptophan) was added to a smoking-cessation program. While rates of complete abstinence were not significantly affected, tryptophan plus a high-carbohydrate diet lessened withdrawal symptoms and helped participants smoke fewer cigarettes.12 More research is needed to clarify whether supplementing with tryptophan or other serotonin precursors might help support smoking cessation.

Botanical Treatment Options

Lobelia (Lobelia inflata), also known as Indian tobacco, contains a substance (lobeline) that has some effects on the nervous system that are similar to the effects of nicotine, and preliminary reports suggested that pure lobeline or lobelia herb could be used to support smoking cessation.13 14 15 However, results in preliminary human trials with lobeline have been mixed and generally negative, and no long-term controlled studies of lobeline or lobelia for smoking cessation have been done.16 17

Other herbs used to treat anxiety are sometimes recommended as part of a smoking cessation program, including oat straw (Avena sativa), scullcap (Scutellaria lateriflora), valerian (Valeriana officinalis), lemon balm (Melissa officinalis), and vervain (Verbena officinalis). Of these herbs, only oat straw has been investigated in human research for smoking cessation. At least three trials have reported no effect of oat straw on smoking cessation, but one controlled study in India found that taking 1 ml of an alcohol extract of oat straw QID significantly reduced the number of cigarettes smoked per day.18 19 20 21


Integrative Options

In the year 2000, the United States Public Health Service published updated smoking-cessation guidelines for doctors.22 This report identified counseling and behavioral therapies as proven effective components of a smoking-cessation program. Effective components include providing basic information about successful quitting, identifying factors that will increase the risk of relapse, and teaching problem-solving and coping skills. Also effective is social support provided either in a healthcare setting (for example, being able to talk about the quitting process with a doctor) or by strategies that teach the quitter to build a support network among friends, family, and the community. Guidelines issued in other countries have reached similar conclusions about the effectiveness of counseling and behavioral therapies.23 Government-sponsored, free counseling resources in North America include Quitline [800-QUIT-NOW] and SmokeFree (www.smokefree.gov). Group or individual counseling is often a component of successful smoking cessation programs offered in schools and the workplace.24 25

People tend to smoke more often under conditions of stress. Those who achieve long-term success in quitting smoking have been shown to have more social support and less stress than people who eventually relapse.26 Stress-reduction techniques that have been shown in controlled trials to be effective for assisting smoking cessation include self-massage, guided relaxation imagery, and exercise.27 28 29

Some research indicates that the effectiveness of acupuncture on abstinence from smoking is similar to that reported for nicotine chewing gum and behavioral therapy, and that these methods can complement each other.30 One controlled trial showed that daily cigarette consumption decreased more significantly during acupuncture treatment to points associated with smoking cessation than in fake acupuncture treatment (i.e., acupuncture applied to points not associated with smoking cessation). Altogether, 31% of subjects in the treatment group had quit smoking completely at the end of the treatment, compared with none in the control group.31 Electroacupuncture treatment to points on the ear has also been shown to aid in smoking cessation compared with fake ear acupuncture in a controlled trial.32 However, most clinical trials have not achieved comparable results. An analysis of 22 studies found that while acupuncture is often as effective as other smoking cessation techniques, its effectiveness does not last very long. Moreover, in most studies the overall effect of real acupuncture was no better on average than fake acupuncture for smoking cessation.33

A controlled clinical trial showed that people undergoing single hypnosis sessions smoked significantly fewer cigarettes and had a higher frequency of abstinence than a placebo control group.34 However, most clinical trials have not corroborated these results.35 A review of 59 studies of hypnosis and smoking cessation concluded that hypnosis "cannot be considered a specific and efficacious treatment for smoking cessation."36
Interactions with Foods and Other Compounds

Food
Absorption of nicotine from nicotine gum requires mildly alkaline saliva.3 Acidic foods and beverages (coffee, colas, fruit, fruit juices, and others) may reduce nicotine absorption. This potential interaction may be avoided by chewing nicotine gum one hour before or after consuming acidic food and beverages.



Dr. Celeste Ruland
www.naturallyvital.net