TRADITIONAL: CHRISTINA TUNZI, family doctor at the Spadina Health Centre in Toronto
I prescribe drugs because, for me, it’s a no-brainer: Quitting smoking is hard, and drugs can significantly increase your chances of success. Every quitter could use moral support, so I also refer them to the Canadian Cancer Society quit line at 1-877-513-5333 or Smokershelpline.ca.
Champix, the new drug on the block, disrupts the nicotine receptors, but it also stimulates them, acting like a weak version of nicotine. There have been reports that one side effect of Champix is that it may worsen psychiatric illness, but the incidence is very low. (I follow up with patients two weeks in, and then don’t see them again unless they’re having problems. If the patient has a history of psychiatric illness, I’ll follow up every two weeks.)
The other prescription drug, Zyban, works like Champix by partially blocking the brain’s nicotine receptors, eliminating the high you get from smoking. Patients take it orally for 12 weeks; by the second week, there’s enough of the drug in a patient’s body for her to quit. Zyban doubles a patient’s success rate.
When nicotine replacements, such as the patch or chewing gum, are used along with Zyban, the success rate is even higher. Even though they contain nicotine, they’re safer than smoking. Side effects may include skin irritations from the patch or vomiting from the gum, although that’s usually because patients are using it wrongly.
I usually recommend Champix over Zyban, because the drug has been shown to triple a patient’s chances of quitting. Why not use what works best?
ALTERATIVE: SUSAN BARKER, hypnotherapist at the OnTrack Options clinic in Ottawa
To start off, I tell my clients this simple motivational truth: You will never perform consistently in a way that is inconsistent with how you define yourself. Hypnotism changes how you see yourself, so it helps smokers make the shift to becoming non-smokers.
In the first appointment, I assess a client’s motivation, support and self-esteem. After all, hypnotism isn’t a magic wand. Generally, I want to see her for three sessions: The client will quit smoking after the first one; the second and third appointments are for reinforcement.
When a client comes in for her first session, she’s craving a cigarette. So I do neurolinguistic programming: I ask her to picture the craving, give it a size and shape, shrink it down, put it in a lead box, duct-tape it and send it to the moon.
Then I use different methods to put her into a trance. Once she’s hypnotized, I speak to the part of her that reminds her to smoke: “Reminder,” I say, “you’ve done a good job over the years, but part of this woman has chosen to stop this habit.” I list the reasons why the client wants to be a non-smoker. Then I negotiate with the parts of the client that are associated with smoking and get them to agree that it’s time to stop.
I also use direct suggestion, where I guide the client into a hypnotized state and remind her that she’s been successful at many things. I repeat the reasons she wants to quit and what smoking does to her lungs, teeth and heart. I affirm those ideas again and again, repeating, “You are now a non-smoker. You will never again have the urge to smoke.”