Quitting smoking is still a difficult task

“The only way to quit smoking is to stop smoking.” The Nobel Prize in Literature Gabriel García Márquez said that the “lazy joke & rdquor; He repeated it over and over again when he became a “retired smoker”. His last cigarette from the 80s that he smoked daily was crushed against an ashtray in a restaurant in Barcelona after a dinner with a doctor friend and his wife, according to what he wrote. ‘Gabo’ stopped smoking without help, by force of will. No patches, pills, books or acupuncture. Yours belongs to that scrawny 4% of attempts to quit smoking without outside support which, according to the WHO, work.

Among these supports are drugs that help to quit smoking. Two of them, varenicline and bupropion, were included in the prescription for the first time in 2020, and the National Health System went on to fund an annual attempt per patient. It was a historical claim from scientific societies, who believe that its cost was a barrier to access. “They are expensive treatments & rdquor ;, points out the head of the Drug Information Area of ​​the General Council of Pharmaceutical Colleges, Ivan Espada. “For a patient, it is around 300 euros & rdquor ;. The most widely dispensed drug is ‘Champix’, the commercial brand of varenicline, although it has had shortage problems for months, as Espada points out. The lack of supplies due to problems with some batches has caused the Spanish Agency for Medicines and Health Products (AEMPS) to have asked that it not be prescribed and that alternative treatments be sought. Cytisine is another new drug, costing around 200 euros, but it is not yet funded. Bupropion, the other one included in the prescription, was authorized for the first time in Spain as an antidepressant treatment. “It must be considered more as an investment than as an expense. We save the user’s own money, and also the pathologies that are associated with tobacco, an indirect cost of quality and life expectancy & rdquor ;, defends Espada.

Try … again

Carmen Pardo is 31 years old. At 26, he got tired of smoking for the first time. He quit for six months, but went back to smoking. A little over a year ago he tried again. “I had a lot of fatigue going up stairs, I was tired, I started doing sports and smoking made me very bad & rdquor ;, he explains. “I was also tired of running out of tobacco and having to go downstairs to buy & rdquor ;. At his job they organized sessions to quit smoking and he decided to sign up. He was prescribed varenicline and was taking it while attending motivational sessions with his doctor. At six months they did the first follow-up. Another a year. But a few months later they offered him a cigarette and it all fell apart. “They told me never to try it again & mldr; But I started taking a few hits, then I smoked a few cigars at a wedding, and eventually I bought a packet and completely relapsed again & rdquor; he laments. Success rates are not as high as you might expect, around 30% -35%, but they help.

One of those doctors who prescribe these drugs is Raúl de Simón, coordinator of the SEMERGEN Tobacco Workgroup. The doctor explains that, in consultation, it is necessary to distinguish between smokers who want to quit and those who have not yet considered it. Both should receive “anti-smoking advice”, but they should receive drugs first. Lucía Rubio, 64, is one of the proactive ones. “I decided that I should stop when the cardiovascular doctor told me that my arteries were clogged. I’m getting older and I see that the day is coming when it’s going to hurt me a lot & rdquor ;, he says. She asked her GP for help, who prescribed the “Champion & rdquor ;, as she calls it. She says that at that time she was not having a good time and her doctor told her not to start until she felt strong. “You have to be very psyched & rdquor ;, she says convinced.

According to data from the market consultancy IQVIA provided to EL PERIÓDICO, Varenicline sales grew 309% in January 2020, first month included in the recipe. The sale of tobacco cessation products doubled in value, and almost 4 out of every 10 units sold were reimbursed. However, the 2020 sales figure (1,427,345) was not as high as expected compared to 2019 (1,123,593 drugs). And in 2021 it has fallen (1,239,884 units). They are the ravages of the pandemic.

The ravages of the pandemic

Funding for these drugs can only be accessed by those included in the smoking cessation programs supervised by the medical staff of a primary care unit that has accumulated overflowing months between PCR tests and vaccine punctures. “These programs have been very limited and affected by the difficulty of access to health centers. There have been times when it has hardly been consulted. Smoking, like all chronic diseases, has been relegated in the pandemic, especially the first wave & rdquor ;, explains Dr. Simón. “But they have never stopped paying attention to the smoker who wanted to quit & rdquor ;, he adds.

Related news

Some communities also include nicotine patches or gum in their portfolio. It is in these non-prescription drugs that the pharmacist plays a key role. “These drugs are not magic, they do not replace the will& rdquor ;, Espada insists. “It is a substance that creates a very high dependence and what these drugs do is reduce the unpleasant effects of the monkey, but we must add that the user wants to quit & rdquor ;.

The Institut Català de la Salut Guide points out that “smokers move through the contemplation-action-relapse phases an average of 4-5 times before achieving success & rdquor ;. Carmen has stopped smoking again after a hypnosis session that cost her about 40 euros and that a friend recommended. “They tell you to imagine yourself as a white smoke that enters your throat and contaminates all the alveoli while you see images that generate a lot of aversion. So far it has been a push & rdquor ;, she says, animated. Although he has a few more attempts left according to the statistics, he has the proverb in favor: the third time lucky.