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Suggest Treatment For Tobacco Addiction

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Posted on Mon, 22 Dec 2014
Question: Is getting over a smokeless tobacco addiction the same as getting over a regular cigarette smoking addiction? This person swallows the juice a good bit of the time.
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Answered by Dr. Dr. Matt Wachsman (48 minutes later)
Brief Answer:
yes....

Detailed Answer:
and in each case, it strongly depends upon how much nicotine is being taken into your system.

The usual smoker takes 20 cigarettes a day...1 to 4 mg per cigarette delivery
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/pdf/tobaccocontrol-2013-051469.pdf. The usual smoker has a constant significant amount of nicotine in the body All The Time. Nicotine addiction is driven by the withdrawal craving much more than by a positive euphoria (the cigarette doesn't feel as good as heroin or cocaine or many other drugs; the withdrawal while not as visible as heroin's, is quite intrusive and disturbing).

So, if a smoker took in 2 cigarettes a day, the addiction wouldn't be as bad as taking 20 cigarettes a day (nor would the health effects).

Smokeless tobacco products use varies hugely, with many people using them less than once a day and the addiction to it being entirely different than a typical nicotine addiction (like a pure habit without either positive reward nor huge withdrawal). The average use is 10x day with half being less than that.

Use of 10 or more a day, the addiction is going to be similar to cigarettes, less than 3x a day (a third of those who use fall into this category) is not the same addiction.

The way you'd handle the addiction changes totally in the two cases. A major feature is if you get little nicotine in your system, using nicotine to get over the addiction makes no sense, increases the nicotine you are getting, and probably makes you MORE addicted. You'd substitute gum without nicotine, you'd work on the triggers that make you want something in your mouth. You'd reward not using.
If you take in a lot of nicotine, first, mention the significant cancer risks that go with heavy use! the cost! second, you'd use a nicotine substitute and cut down, and also work on the triggers making someone to want to use smokeless tobacco.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (8 minutes later)
Thank you, I will pass this information along. I don't know what amount is being used every day but I will encourage a decrease in the amount if not willing to quit entirely.
doctor
Answered by Dr. Dr. Matt Wachsman (33 minutes later)
Brief Answer:
the amount matters.

Detailed Answer:
If a large amount of tobacco is used (10 x day), then treatment just like cigarette addction:
1) motivation by first finding how the person feels about it and then mentioning and reinforcing the bad effects of it and the positive benefits of quitting.
2) substitution of nicotine (patch, gum, lozenge).
3) identifying triggers that keep people hooked and how the trigger makes someone feel, how this triggers the addiction and alternatives to the trigger.

If small amounts are used (1-2 a day or less)... tricky:
1) how bad is it ? what are the bad effects of it?
2) you cannot easily give less nicotine
3) it's all triggers that psychologically keep someone hooked and getting someone motivated to work on them is hard.

Hope this helps! (it was a great topic to look up; I found some very useful info for my son and electronic cigarettes, thanks).
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest Treatment For Tobacco Addiction

Brief Answer: yes.... Detailed Answer: and in each case, it strongly depends upon how much nicotine is being taken into your system. The usual smoker takes 20 cigarettes a day...1 to 4 mg per cigarette delivery http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/pdf/tobaccocontrol-2013-051469.pdf. The usual smoker has a constant significant amount of nicotine in the body All The Time. Nicotine addiction is driven by the withdrawal craving much more than by a positive euphoria (the cigarette doesn't feel as good as heroin or cocaine or many other drugs; the withdrawal while not as visible as heroin's, is quite intrusive and disturbing). So, if a smoker took in 2 cigarettes a day, the addiction wouldn't be as bad as taking 20 cigarettes a day (nor would the health effects). Smokeless tobacco products use varies hugely, with many people using them less than once a day and the addiction to it being entirely different than a typical nicotine addiction (like a pure habit without either positive reward nor huge withdrawal). The average use is 10x day with half being less than that. Use of 10 or more a day, the addiction is going to be similar to cigarettes, less than 3x a day (a third of those who use fall into this category) is not the same addiction. The way you'd handle the addiction changes totally in the two cases. A major feature is if you get little nicotine in your system, using nicotine to get over the addiction makes no sense, increases the nicotine you are getting, and probably makes you MORE addicted. You'd substitute gum without nicotine, you'd work on the triggers that make you want something in your mouth. You'd reward not using. If you take in a lot of nicotine, first, mention the significant cancer risks that go with heavy use! the cost! second, you'd use a nicotine substitute and cut down, and also work on the triggers making someone to want to use smokeless tobacco.