Smoking Cessation

Smoking cessation refers to the process of discontinuing tobacco smoking, aimed at reducing the risk of tobacco-related diseases including cardiovascular, respiratory, and malignancies. It involves behavioral, pharmacologic, and supportive interventions.

Definition

Epidemiology

Tobacco use affects over 1 billion people worldwide
Smoking is a leading preventable cause of morbidity and mortality
Global prevalence declining slowly, but remains high in low- and middle-income countries
Higher prevalence among males, young adults, and lower socioeconomic groups
Effective cessation significantly reduces risk of cancer, COPD, cardiovascular disease, and premature death

Etiology

Nicotine addiction: psychoactive and physically addictive component of tobacco
Behavioral reinforcement: habitual smoking patterns and environmental cues
Genetic predisposition to nicotine dependence
Psychological factors: stress, depression, anxiety
Social and peer influences
Coexisting substance use disorders

Pathophysiology

Nicotine binds to nicotinic acetylcholine receptors in the brain
Activation of dopaminergic pathways reinforces reward and dependence
Chronic exposure leads to neuroadaptation and withdrawal symptoms on cessation
Inflammatory and oxidative stress effects on cardiovascular and respiratory systems
Impact on pulmonary function: airway inflammation and impaired mucociliary clearance
Promotion of atherosclerosis and endothelial dysfunction
Carcinogenic effects due to tobacco smoke components