Tobacco is one of the main causes of death and illness in most societies, and it accounts for half a million deaths in America yearly. Tobacco smoking is known to cause several strokes, heart disease cancer, pregnancy complication, chronic obstructive pulmonary disease (COPD), and other diseases. Despite people comprehending the adverse effect of tobacco its use is still prevalent and it is perplexing. A recent estimate shows that close to twenty-one percent of Americans do smoke, and this represents close to forty-five million adults Americans (Thurgood, McNeill, Clark-Carter, & Brose, 2016). Treatment of tobacco users has cost society as well as individuals. It is estimated that close to $96 billion per year is lost on medical whereas $97 billion is lost in a year because of the lost productivity ( US Department of Health and Human Services, 2008) . Over the years, health care system and clinician have failed to effectively and consistently treat tobacco addicts. However, in the recent year, the trend has changed since the issue has been addressed adequately (Lancaster & Stead, 2017) . However, the issue has not been fully addressed since there are some barriers that clinician experience. Some clinicians luck the skills, equipment, and knowledge to identify smokers and manage their addiction effectively. This paper highlights how behavioral treatment and pharmacological treatment can be used by clinicians to treat adults who are heavy users of tobacco.
Rationale
Cessation for tobacco will lead to improved health that is contributed significantly by the behavior and pharmacotherapy for its dependence and withdrawal. The duration an individual smoke adds hugely in the exposure to the disease (Thurgood, McNeill, Clark-Carter, & Brose, 2016). Early treatment of tobacco addiction will help significantly in the abstinence process even though other individuals may abstain from the use of tobacco without going through any therapy. When discussing various ways of controlling tobacco use, some topics are always considered.
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When dealing with particular disease things like how the disease utilizes treatment, its nature and various issues that will hinder its effectiveness is essential that they are well understood. The understanding makes the control process simple. When we look at tobacco, three significant points gets considered (Stead, Carroll, & Lancaster, 2017). Tobacco users often affected by the denial by the addicts. The users think that they don't need any treatment because they are okay or fear the process of therapy. When in denial, the addicted people assure themselves that they don't require a cure for tobacco use and mostly presume that the treatment will get associated with various risks (Lancaster & Stead, 2017). Also, the common and powerful biological procedure plays a significant role in the dependence on tobacco use. The process makes it hard to attain abstinence. Also, Since the use of tobacco is always slot in a social, economic and political setup, the tobacco industry promotes the disease making it hard for the attaining of sustainable dependence of smoking.
The attainment of ceasing of tobacco use is not usually a simple process, but also, it's possible when an individual is ready and open. The medication process designed for the tobacco addicts that focuses on reducing the overuse of the substance is not generally in an appealing compared to when the tobacco products get marketed to the consumers (Thurgood, McNeill, Clark-Carter, & Brose, 2016). The medication process clearly shows that the procedure of treating tobacco addiction is not appealing in any way. The treatment mostly focuses on how it will ensure conformity to attain the use of tobacco adequately for its abstinence which is also a problem (Nathan & Gorman, 2015). Even, the tobacco treatment is not readily available to tobacco addicts when compared to tobacco products. The tobacco industry makes sure that available readily to everyone in beautiful packaging and cheap rates to acquire it.
On the other hand, pharmacotherapy is expensive when offered and, in most cases, available only when prescribed. The pharmacotherapy treatment process is costly because of the manner in which distribution happens usually done in units that don't encourage a tobacco user to adopt them as a substitute for the use of tobacco (Stead, Carroll, & Lancaster, 2017). Behavior treatment and guidance are some of the treatment packages offered. The inadequacy in the human resource also makes the behavior therapy not available to everyone but a section of the tobacco addicts’ population.
A lot of options are available to tobacco users' individuals when using the evidence-based approach for pharmacotherapy treatment. This approach makes it easy to match the various preferences from the tobacco users (Thurgood, McNeill, Clark-Carter, & Brose, 2016). Some of the options include the replacement of nicotine and bupropion. When comparing the two approaches, that are behavior therapy and evidence-based procedures; the behavior therapy is more effective over a short time. An evidence-based approach, on the other hand, tends to give a long-term cessation of smoking.
Apart from the constant effort to ensure that treatment is made relevant to the culture and appropriate to all the individuals across the population which is a challenge, the products affiliated to tobacco is also a significant problem currently in the twenty-first century (Nathan & Gorman, 2015). Concrete measures for the cessation of through education should be emphasized to let individuals know the risks associated with tobacco use.
Behavioral Interventions
Behavioral Therapies depends on the stage that the tobacco user is in. Users who are less addicted require simple therapy to quit smoking whereas individuals who are heavy smokers require sophisticated therapy to help eradicate their addiction (Nathan & Gorman, 2015). The following are three types of therapy that will eradicate tobacco use among adults.
Behavioral support- this type of therapy involves sessions of a group or individual counseling to assist in smoking cessation. Both group or individual therapy has depicted to improve quit rates compared to the addict who use self-help material to quit smoking (Thurgood, McNeill, Clark-Carter, & Brose, 2016). Basing on rates at which addict quit smoking, it appears to be no difference between a group or individual therapy: consequentially, either therapy is beneficial (Stead, Carroll, & Lancaster, 2017). Theoretically, group therapy seems to be more effective. However, they are limited by conscripting and retaining partakers.
Aversive Smoking- this therapy involves guiding smoking where the patient smokes heavily, frequently to the point of vomiting, nausea, or discomfort. The therapy pairs the pleasurable stimulus of unpleasant stimulant with the pleasurable stimulus of smoking a cigarette (Lancaster & Stead, 2017). The objective is to stop smoking buy introducing unpleasant stimulant in the cigarettes that nullify the pleasurable stimulant of the cigarettes.
Person-To-Person Contact- these types of therapy depend on the duration that physician is in contact with tobacco addict. When the time in contact with the smoker is three minutes, then the chance of abstinence is 30 percent (Stead, Carroll, & Lancaster, 2017). Whereas, if there is intense contact the chance of abstinence is twice compared to when there is no contact (Lancaster & Stead, 2017).
Reasons Why Behavioral Interventions Treatment Is Best for Adults
Behavioral Intervention is one of the best treatments for adults because it offers a variety of therapy that can serve smokers depending on their addiction phase. For instance, behavioral support can serve smokers who are less addict and want to quit smoking (Thurgood, McNeill, Clark-Carter, & Brose, 2016). Aversive Smoking therapy can be applied to heavy smokers who want to quit. Additionally, this therapy applies to adults because some therapy needs the consent of an adult. For instance, Aversive Smoking is an extreme way to make a person quit smoking, and it might have repercussion, and a person needs to be an adult to comprehend and consent on the type of therapy they want.
Pharmacologic Interventions: Tobacco Dependence and Withdrawal
Individually can successfully quit smoking on their own. However, the majority of smokers are dependent on nicotine, and they can benefit from intercessions to address the physiological facets, especially the disorders caused by tobacco addiction and withdrawal which is recognized by International Classification of Diseases (Lancaster & Stead, 2017).
The development of pharmacotherapies to address nicotine addiction has engrossed on the alleviation of symptoms associated with tobacco-withdrawal. For instance, medication involving nicotine replacement reduce withdraw symptoms by partly replacing nicotine that smokers attain in cigarettes (Stead, Carroll, & Lancaster, 2017). Antidepressants like nortriptyline and bupropion can be efficacious for cessation since they reduce cessation-induced depression which is related to the withdrawal of nicotine.
Reasons Why Pharmacologic Interventions Treatment Is Best for Adults
Pharmacologic Interventions is best for adults because antidepressants such as nortriptyline and bupropion are provided to smokers to cater for the nicotine that causes the addiction (Thurgood, McNeill, Clark-Carter, & Brose, 2016). It is believed that adults can take the antidepressants as per the clinician’s instruction, following clinician prescription can aid in avoiding addiction to antidepressants.
Conclusively, behavioral treatment and pharmacological treatment is important in the treatment of tobacco reliance. The therapies available under this treatments are sufficient to address the problem of tobacco addiction effectively. Clinicians should be able to identify smokers to help them address the issue of tobacco addiction. This can only be archived if the clinicians are trained intensively and appropriately to be able to identify individuals who are tobacco dependent and help them.
References
Lancaster, T., & Stead, L. F. (2017). Individual behavioural counselling for smoking cessation. Cochrane database of systematic reviews, (3).
Nathan, P. E., & Gorman, J. M. (Eds.). (2015). A guide to treatments that work. Oxford University Press.
Stead, L. F., Carroll, A. J., & Lancaster, T. (2017). Group behaviour therapy programmes for smoking cessation. Cochrane database of systematic reviews, (3).
Thurgood, S. L., McNeill, A., Clark-Carter, D., & Brose, L. S. (2016). A systematic review of smoking cessation interventions for adults in substance abuse treatment or recovery. Nicotine & Tobacco Research, 18(5), 993-1001.
US Department of Health and Human Services. (2008). Treating Tobacco Use and Dependence
https://www.ncbi.nlm.nih.gov/books/NBK63958/#A28222\
