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Dr West

Tips and Tools on Smoking Cessation, by Dr. Mark Millard

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This long-overdue podcast by Dr. Mark Millard, Medical Director of the Baylor Martha Foster Lung Care Center and Professor of Pulmonology at Baylor University in Dallas, TX, focuses on many aspects of smoking cessation: how physicians can effectively discuss it with patients, how anyone can discuss the issue constructively with a smoker, and how someone motivated to quit can use a wide range of tools — both behavioral and medical — to optimize their chance of quitting for good.

Here are the audio and video versions of the podcast, along with the transcript and figures for the program.

Dr. Millard Tips and Tools for Smoking Cessation Audio Podcast

Dr. Millard Tips and Tools for Smoking Cessation Transcript

Dr. Millard Tips and Tools for Smoking Cessation Figures

 

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Dr West

Introduction to Chantix (Varenicline) for Smoking Cessation

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Although we’ve established that 60% or more of the new cases of lung cancer in the US each year are now in never-smokers or former smokers, active smoking is still a big problem. Ongoing smoking can worsen survival in patients receiving active treatment for lung cancer, and the risk of developing lung cancer in people who don’t have it already can be decreased significantly by quitting smoking as early as possible (see prior post).

 

There are several approaches to consider, and several of these are highlighted in a prior post. But one that has emerged as among the more effective is chantix (varenicline), which is a drug that was developed by modifying the structure of a naturally occurring plant derivative called cytisine. The modified version gets into the brain much better than cytisine itself. Once in the central nervous system, chantix works by attaching to and partially stimulating the nicotine receptor (actually the nicotinic subtype of the acetylcholine receptor) in the reward centers of the brain (the same ones that mediate the pleasurable feeling of eating when hungry, drinking when thirsty, sex (gasp!), as well as reward of drugs like cocaine), but in partially activating the receptor, it blocks the receptor from being stimulated by nicotine, which provides the full reward effect.

 

Chantix MOA

(click to enlarge)

 

I don’t need to tell smokers that nicotine is truly addictive and leads to unpleasant withdrawal symptoms when those receptors are unoccupied for too long – this is exactly why it’s so hard to quit smoking. So chantix blocks the withdrawal symptoms by providing just enough stimulation of the nicotine receptor, at the same time blocking the more powerful reward effects of tobacco-delivered nicotine itself.

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