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Group Therapy and Willpower can Help Smokers to Quit

Smoking bans in public places have recently come into effect in several European countries, and Germany is set to join their ranks next month .

There has never been a better time to kick the habit, but smokers should be warned - without professional help the task is likely to be much harder. Statistics show that only 1-2 percent of smokers manage to quit on their own.

In Germany at least, smokers are vanishing fast, mainly because hardly anyone actually takes up the habit.

The number of young people who smoke fell this spring to a historic low, according to officials at Germany's Federal Centre for Health Awareness in Cologne. The number of 12- to 17-year-olds who regularly light up has dropped to 18 percent, the figures show.

Failure to quit smoking by relying on sheer willpower alone usually means that the smoker is physically addicted.

"Nicotine is a very strong stimulant and one of the most dependency-inducing drugs," said Karin Joder, a health scientist and psychologist from the northern city of Kiel. "Addiction occurs faster than with heroin or other drugs since nicotine influences the brain's metabolism."

The substance activates the brain's reward mechanisms and releases "feel-good" chemicals. As a result, smokers who do not light up just feel bad.

Studies show that most habitual smokers only need to smoke one cigarette to find their emotional equilibrium. They have become so used to the kick unleashed by the substance that they are no longer consciously aware of its effect.

Smokers usually associate smoking a cigarette with a pleasant experience such as taking a break from work. Before long the brain learns to associate the two actions, telling the person "a pause for a cigarette feels good".

The brain is unfortunately not adequately aware that the positive feedback is not a direct result of nicotine being inhaled.

Group t herapy sessions with such promising titles as "How to finally quit smoking" are seen to be the most effective method of cessation. The group of smokers meets with a counsellor who guides the session. Initially, the aim is to analyse the smoking habits of those taking part.

"The idea is to make it clear to people that they are actually addicted," said Karin Joder. In many cases this means destroying the illusions associated with the smoking habit.

The counsellor has little time for nicotine substitutes such as patches, sprays and other medicines.

These substances can reduce the craving and headaches, which usually occur as part of the nerve- wracking withdrawal symptoms although the smoker does realize that he no longer needs cigarettes and becomes more amenable to therapy.

Such substitute products are however ineffective in the long-term since they cannot diminish physical dependence and continue to provide the body with the nicotine it so craves.

The same applies to nicotine replacement therapy (NRT) medicines that are usually only available on prescription. Zyban (buspronion and Champix (varenicline) reduce the burning desire for nicotine but their side effects are undesirable.

Those observed in clinical trials include insomnia, panic attacks and dizziness. Vareniclin reduces the withdrawal symptoms and makes people taking it feel sick, if they do smoke a cigarette. The side effects include difficulty sleeping, flatulence, headaches and nausea.

According to expert Christian Kroeger at the Therapy Research Institute in Munich, such medicines are only really suitable for heavy smokers who are likely to experience severe physical and mental repercussions, if they simply give up smoking from one day to the other.


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