Smoking cessation: the work must focus on violations of abstinence, says specialist

Prevention of tobacco times must be present at all times of weaning, a lung-esteem tobaccologist, which suggests to focus the work on violations of abstinence that support unquestionably increases chances of success.

In a study published in a Special Issue of the "Journal of respiratory diseases," Dr. Philippe Guichenez, lung-tobacco specialist at the Centre hospitalier de Béziers, provides a model for support of smoking relapse, which occurs on average four times before a final judgment.

For the specialist, it should investigate the causes of relapse, which can be combined and mutually reinforcing: it can be a negative emotion, a past situation associated with smoking behavior, even taking weight.

The smoking addiction, in dialogue with the patient, should help to identify high-risk situations, find ways to deal with these situations, remain vigilant against "small decisions" favoring the exposure (to find coffee with smoking friends ...), prevent violations of abstinence and the pitfalls that the candidate falls withdrawal or minimizing the release of a cigarette ("Today is the feast") or, on the contrary, by maximizing ("I picked one, it's over").

It must also be aware of the patient's automatic thoughts before, during and after smoking a cigarette, to define the context of the first resumption of smoking behavior, says Dr. Guichenez.

Citing as an example the case of a young woman who had relapsed after 45 days of withdrawal initiated with a smoking addiction, Dr. Guichenez believes that functional analysis is required to determine the underlying problem unnoticed initially.

"Automatic thoughts that can be facilitative (tobacco used to be quiet) are landmarks, permissive thoughts immediately (a small cigarette tonight to destress me), thoughts focused on addictive behavior (a small cigarette, it really well), thoughts after (I have no desire, I'll never make it). "

The goal of the physician is then change the automatic thoughts, to highlight the logical errors on smoking behavior and beliefs change, summarizes the smoking addiction. "The prevention of tobacco times must be present at all times of weaning, focusing the work on violations of abstinence that may seem harmless to both the physician and the patient. It is by taking support the monitoring of these smokers can improve, "he says.