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Ask Dr. Dunn: quitting smoking

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By Maren Dunn, D.O.

I’ve attempted to quit smoking and have had a difficult time. Are there treatments to help me? Are they expensive?

When quitting tobacco, a person encounters two obstacles: nicotine withdrawal symptoms and overcoming the triggers that lead to smoking. As you know, nicotine is a drug that causes physical dependence and tolerance. In the absence of nicotine, cravings kick in, as can the following symptoms: depressed mood, insomnia, anxiety, anger or irritability, difficulty concentrating, restlessness and weight gain or increased appetite.

Treatments include nicotine replacement (the patch, gum, lozenges, inhaler or nose spray), behavioral counseling with a medical worker, help-line or group-based therapy, or use of medications like Chantix or Zyban. Studies show that success is more likely in smokers who use medication or nicotine replacement in combination with counseling than with medications or counseling alone. That’s why most states, including Montana, offer a free support service called Quit Line and reduced cost medications or free nicotine replacement therapy to enrollees.

Keep in mind that the medications and nicotine inhalers or nose sprays require a prescription from your healthcare provider. Both Chantix and Zyban are excellent for blunting the symptoms of withdrawal, but need to be discussed with your provider to make sure they are safe for you. Chantix is priced similarly to the cost of a pack-per-day habit, as is Zyban. Nicotine patches and gum can be purchased over the counter.

Overcoming triggers, or “kicking the habit” can be quite difficult. This is because smokers associate the pleasurable effects of tobacco with environmental triggers such as morning coffee, alcoholic drinks or the end of a meal. It’s important to anticipate these triggers and find ways to overcome them. This can be discussed with your help-line counselor or healthcare provider, especially when they seem insurmountable. Often alternative activities such as exercise or friendly support are all that are needed to beat the triggers.

If you feel you’ve tried everything, talk to your medical provider about your concerns. You can also call the Montana Tobacco Quit Line at 1-800-QUIT-NOW. Likely you’ll find the help you need to achieve a tobacco-free life.

Maren Dunn, D.O., is owner of Gallatin Family Medicine, a medical clinic in the Big Sky Meadow Village. Have a question? Email her at

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