Examine prevention strategies and treatments for substance abuse and addictive behavior
Tobacco use is a leading cause of death according to The World Health Organization (WHO). Smoking kills about six million smokers per year worldwide. The health costs of smoking-related diseases are rising. The WHO and governments adopt various prevention strategies to prevent young people from starting to smoke or to help people quit smoking.
The WHO’s Mpower strategy.
· Monitor tobacco use and prevention policies (e.g. help to build strategies)
· Protect people from tobacco smoke (e.g. smoke-free areas and smoke-free legislation)
· Offer help to quit tobacco (e.g. counselling and national quit services)
· Warn about the dangers of tobacco use (e.g. information and pictures on billboards)
· Enforce bans on tobacco advertising, promotion and sponsorships
· Raise taxes on tobacco
Primary and secondary prevention strategies
· Primary prevention: Strategies to prevent people from starting smoking (e.g. bans on smoking in public places, bans on tobacco marketing, and health promotion in the form of education about the dangers of smoking and anti-smoking campaigns.
· Secondary prevention: Interventions to help people stop smoking (cessation), such as nicotine replacement and therapy (i.e. treatment).
Effectiveness of primary prevention
Lemstra et al. (2008) and Gorini (2007) found that a ban on smoking in public places in Italy and Canada decreased the prevalence of smoking (i.e. decreased number of people who smoke).
Effectiveness of secondary prevention
Treatment for nicotine addiction is part of secondary prevention and typically based on nicotine replacement or drug therapy in combination with advice from health professionals.
Nicotine replacement therapy (NRT)
· Products such as nicotine chewing gum, patches, and nasal sprays contain low levels of nicotine and are used to relieve withdrawal symptoms and control cravings. Electronic cigarettes are a new form of NRT where people inhale nicotine in the vapour that comes from a device looking like a cigarette.
· NRT products do not produce the pleasurable effects of tobacco products and should in principle be less addictive.
· Nicotine gum is now one of the most used treatments but some smokers are unable to tolerate the taste and chewing demands.
· Hughes (1993) found that NRT is generally quite effective in smoking cessation but the problem is that some people become dependent on nicotine gum.
Bullen et al. (2010) Experimental research on electronic cigarettes on withdrawal
· Aim: investigate short-term effectiveness of electronic cigarettes on desire to smoke and withdrawal symptoms compared to inhalators.
· Procedure: The design was a single blind controlled randomized experiment. Participants were 40 smokers who smoke more than 10 cigarettes a day but had not smoked overnight. They were given either cigarettes, a nicotine inhaler or electronic cigarettes (either with 0 or 16 mg nicotine).
· Results: The electronic cigarette produced the same significant decline in the desire to smoke as the nicotine inhaler and had fewer side effects. Even the 0 mg cigarette suppressed the desire to smoke. This is interesting because it shows that simulation of smoking behavior was enough to reduce craving.