As some of you may know, the Mayo Clinic has an 8 –day residential treatment program for tobacco users. On the first day of the program patients have a series of appointments including meeting with a provider and developing a medication plan. It is common at the outset of the program for patients to be reluctant about using the recommended nicotine medications. Patients are frequently more afraid of the medications that are proven safe and effective in helping stop smoking than they are of the leading cause of preventable death in the USA. It is common to hear patients talk about not wanting to use more than one medication or to use a lower than recommended dose.
Over the first few days of the program the patients are provided with information about nicotine addiction and withdrawal, how the nicotine medications can help, and talk to one another about what medications are working. The patients tend to watch one another and see that others are managing withdrawal and craving with medications. They open up to increasing their patch dose or adding a second medication, as recommended. They are frequently surprised how much more comfortable they feel when they get the correct dose.
Outpatients commonly demonstrate a similar reluctance about using higher patch dose and combination therapy, however they don’t have the benefit of a residential program to give them the chance to see the benefits. Rather than having patient and provider support, they may be influenced by others who can be misinformed about the relative safety of nicotine replacement.
Working with a provider trained in tobacco treatment to determine your recommended dose of NRT, and then following through by using it that way can make a positive difference in the experience of becoming tobacco free.
