Research: Tobacco dependence is a disease
I have read a tremendous amount of material about tobacco cessation, a term used when referring to stopping the use of tobacco products. I have taught courses to military personnel, taught prevention to middle-school students and counseled patients for years. Our best efforts seemed to only reach a few, and failed a greater number of folks who tried, but were ultimately unsuccessful at stopping tobacco use. Why is this so hard? And why have we as a medical community been unable to find a “cure” for it?
Tobacco dependence is a disease, not a personal choice. This may be the biggest breakthrough in treatment in years. The American College of Chest Physicians realized this and proposed a treatment based on our current understanding of asthma. We now treat chronic asthma with controller medications, but have “rescue” inhalers for days when the asthmatic has symptoms such as wheezing. In the same way we can use “controller” medications for tobacco users, but have “rescue” medications for the unexpected stressors that occur during our day. Since life tends to throw the heaviest stressors at us on the day when we are least able to deal, many tobacco users relapse. Another new approach to this is to realize that tobacco-dependent people are either not currently using, at risk of using, or relapsed back to using. There are treatment options available for these folks as well. If we fail to offer a course of treatment for our patients when they are non-users in a high-stress time, before they have learned behavioral techniques to handle their stress, they will relapse. The good news, however, is that there are treatment options out there, and the more times someone tries to quit, the more likely they are to succeed.