Get Rid Of The Nicotine Monkey

It's that time of year, resolution time, and millions of smokers are promising themselves a smoke-free new year. But where to start? How much will it cost? And how do you make it stick?

These issues are addressed in the January issue of Money magazine. Editor Marion Asnes helps sort it all out on CBS News This Morning.

The addiction to nicotine has been compared to addictions to heroine or cocaine. In 1998, sales of over-the-counter nicotine replacement products exceeded $568 million.

Asnes says it is important to always check with your doctor before beginning any program. She adds, you should try quitting on your own first though. Use another method if you can't do it on your own. Which method?

Asnes say she quit 10 years ago using the American Lung Association method:

"Everyone met once a week. We talked about addiction, and we got homework to break the cycle. A lot of the help I got from quitting was through group therapy. My first homework assignment was to change to a cigarette brand that I didn't like. That cut the pleasure giving element."

There are other methods, however. For example, Nicorette gum, Nicotine patches, Nicotrol Inhaler and Nictotrol Nasal Spray have a 10 to 15 percent quit rate and Zyban (prescription pills) has a 23 percent rate of success.

• Zyban is the first pill to be approved by the FDA as a smoking-cessation aid. The drug is also sold as an antidepressant called Wellbutrin SR (SR stands for sustained release). It lessens the desire to smoke by raising the dopamine levels of the brain. Zyban also lessens the weight gain experienced by most smokers to about 5 pounds. The pill is sometimes coupled with the use of other nicotine replacements such as gum, the patch or the nasal spray. To avoid dangerously high blood pressure or nicotine overdosing, these products should only be used under a doctor's care.

  Some health plans don't cover Zyban, but many smokers have gotten around that by asking doctors to diagnose them with depression and prescribe Wellbutrin SR, which is usually covered. Zyban also carries a 1-in-1,000 risk of seizures so some doctors prefer to start their patients on the patch instead. Other side effects are dry mouth and insomnia. It's quit rate over a one-year period is 23 percent and costs $84 to $100 monthly. The one-year quit rate going cold turkey is about 10 percent.

• For the smokers who find they crave the hand-to-mouth activity of smoking, nicotine gum, the inhaler or nasal spray may work better. The average smoker chews six to nine pieces daily (this specifically refers to Nicorette gum), each piece has 4mg of nicotine. The one-year quit rate is 10 percent to 15 percent and the monthly cost is $120. It's available without a prescription. A side effect is jaw pain.
• The Nicotrol Inhaler most closely miics the act of smoking. This is only available through prescription. One puff on the plastic mouthpiece contained in the nicotine cartridge gives 4mg of nicotine. Its quit rate is 10 percent to 15 percent per year. It will set you back $160 a month.
• The Nicotrol Nasal Spray can only be obtained through a doctor. It delivers 0.5mg of nicotine per spray and can be used for up to six months. The spray gets nicotine to the bloodstream the fastest. The quit rate is 10 percent to 15 percent per year and cost about $120 a month.
• Nicoderm and Nicotrol are both over-the-counter nicotine replacement patches. Other brands are sold by prescription only. Patches are applied daily directly on the skin. The absorption of nicotine can range from 7mg to 21mg. A side effect is skin irritation. The quit rate is 10 percent to 15 percent. The monthly cost is $108.

The following are some numbers of support groups that all have quit smoking programs:

American Cancer Society: 1-800-227-2345
American Lung Association: 1-800-586-4872
Nicotine Anonymous: 415-750-0328

The American Society of Addiction Medicine can help you find a doctor who specializes in smoking cessation: 1-301-656-3920

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