Rev Mal Respir. 1990 ; 7(4): 307-12.

[Methods of stopping smoking]

Molimard M, Hirsch A.

Service de Pneumologie, HÃ´pital Saint-Louis, Paris.

The majority of smokers who stop smoking do it alone. The methods of stopping are aimed at helping those who cannot achieve this. The different methods used include psycho-therapy (individual-group), medication, and in the first place is nicotine chewing-gum (but also clonidine which opens a new perspective), aversive behaviour and reinforcement methods, hypnosis and acupuncture. The inadequacy of validated controlled trials by biological measurements makes it difficult to compare different methods. The levels of cessation evaluated varies as a function of recruitment, the relationship between the patient and the therapist, and between the association of the different methods. An important factor in the success resides in the motivation of the subjects explaining that the bias of recruitment readily lead to differences in the results which are superior to the action of the therapy itself. Associated to psychotherapy is the use of nicotine chewing-gum in pharmacologically dependent smokers, and seems to give good enough results. Behavioural methods have an important early success level but these are somewhat deceiving in the long-term and are not totally without risk. Acupuncture, hypnosis and the progressive reduction in nicotine levels (nicotine fading) requires controlled studies to judge their own efficacy. The frequency of failure in the first year remains the major current problem in the methods of stopping. It is convenient not only to develop maintenance strategies but also at the sociological level to diminish the environmental pressures inciting people to smoke.