If patients can stop on the advice of a physician and through behavior modification with the assistance of these practical instructional materials, the expense and adverse effects of drugs may be avoided. Success also has been reported anecdotally with acupuncture and hypnosis in selected patients. Exhaled carbon monoxide testing , available through some hospital respiratory therapy departments, may convince the smoker of the poisonous effects of inhaling cigarette or cigar smoke. This test should be performed on admission because the decay curve for carbon monoxide is rapid. Many respiratory therapy departments offer smoking cessation advice and instruction.
Strategies differ depending on the class of drug used.
For example, nicotine replacement, if used, should be started on the quit date, whereas bupropion, if prescribed, should be started between 1 and 2 weeks before the quit date. Behavior modification deals with changing the habit patterns that are cues to smoking in the patient's normal activities of daily living. These cues may be phone conversations, coffee breaks, meals, sexual activity, boredom, traffic problems, or other frustrations. Absolute stopping, known as quitting cold turkey, is generally preferable to tapering off. Use of the gum allows for maximum dosing flexibility and mimics some of the oral activities of cigarette smoking.