Why do engineers smoke

In Switzerland every fourth person between the ages of 14 and 65 smokes. Almost every second person wants to quit. But what is the best way to do this? There are many options: You can quit "just like that", read through books on quitting smoking or talk to a doctor, pharmacist or smoking advisor.

He woke up and couldn't breathe. He felt like he was suffocating. Only after half an hour could he breathe freely again. “The experience was so terrible that I thought I'd better take a week off,” the 32-year-old engineer remembers. "I didn't really want to stop completely."

It got serious when the smoking ban was introduced in his adopted home Sweden four years ago. "Smoking outside the pub was no longer fun at all." He threw away the opened pack of cigarettes, bought nicotine chewing gum and has not smoked since.

In Switzerland every fourth person between the ages of 14 and 65 smokes. Almost every second person wants to quit. But what is the best way to do this? There are many options: You can “just quit”, read through smoking cessation books, take courses in quitting, do behavioral therapy or talk to a doctor, pharmacist or smoking counselor. Some hope for help from hypnosis or acupuncture. “Which method is the right one for whom depends on the personality, the illnesses and the degree of addiction,” says Carlos Quinto, a doctor in Basel.

About 85 out of 100 smokers are dependent on nicotine. "The earlier you light your first cigarette in the morning and the more you smoke a day, the greater the addiction," says Quinto. "Abrupt withdrawal, in particular, can lead to withdrawal symptoms in heavily dependent addicts: One becomes restless, irritable or aggressive, cannot sleep well, feels sad or depressed."

"Quitting works best when you are motivated and can imagine a life without smoking as a gain," says Aysel Han, head of the smoking advice service at the St. Gallen Lung League. Withdrawal symptoms can be relieved by nicotine replacement therapy (NET). "You use it to add nicotine, but without the harmful substances in tobacco smoke such as tar or carbon monoxide," explains Jochen Mutschler, senior physician at the Psychiatric University Clinic in Zurich. A NET comes in the form of patches, chewing gum, inhalers or micro-tablets. Chewing gum works the fastest after 15 to 30 minutes. "You can use it as soon as you feel like having a cigarette."

Mutschler recommends an additional patch if someone has smoked a lot and wants to stop suddenly. If someone smokes little and does not benefit from NET chewing gum, Mutschler advises varenicline. "For smokers who suffer from depressive moods, bupropion is more likely to come into question." Both drugs can cause significant side effects such as difficulty sleeping, seizures, or nausea. "You should only take it with close medical supervision."

Studies show that bupropion works as well as a NET, and varenicline possibly even better. In studies, about twice as many smokers were able to quit with a NET than when they took a dummy drug. But such studies should be viewed with the necessary skepticism: Simon Chapman, health scientist in Sydney, recently showed in an analysis of 511 studies that in over 9 out of 10 studies external measures such as drugs, individual or group therapies were examined. How well smokers were able to quit on their own was rarely analyzed. "The studies on the auxiliary measures are also often sponsored by the pharmaceutical companies," says Chapman. This does not have to be the case, but it can influence the result. «The advertising suggests that you can hardly do it with your own willpower. Medication can help, but almost 3 out of 4 ex-smokers quit without outside help. "

At least four pharmaceutical companies are currently researching a new smoking cessation aid in the form of a nicotine vaccination. Antibodies are supposed to catch the nicotine before it reaches the brain and works there. An American company is currently conducting a study for market approval.

The fear of weight gain prevents some smokers from quitting. Studies show that 10 years after stopping, ex-smokers weigh an average of 3 to 4 kg more than people who have continued smoking. The exact mechanisms are not yet known. The simplest explanation is that many people grab snacks instead of cigarettes. On the other hand, nicotine increases the metabolism in the body and "burns" more calories. In addition, the concentration of certain messenger substances that control food intake could change. "If you do not want to gain weight, you should reduce the daily amount of calories a little before you quit smoking," advises general practitioner Han. "Physical exercise also helps." NET and bupropion can also delay weight gain.

The engineer from Sweden also notices that his body is more sensitive to calories: "I make sure not to eat so much chocolate - it starts immediately." However, he has not regretted quitting smoking. «After a few days I felt that the food tasted good again and that the flowers smelled good. I felt fitter and was less tired. " The function of the heart and lungs improves just a short time after quitting smoking, after years arteriosclerosis in the blood vessels can recede and the risk of lung cancer returns to that of non-smokers. “It's always worth quitting,” says Aysel Han. "The sooner the better."