Tobacco dependence: bad habit or chronic disease?

April 2nd, 2008 by admin

Smoking is the most importan cause of preventable death in the developed world. In spite of this, tocacco dependence is still viewed by many just as a bad habit. Because of the strong bonds created by the dependence, most smokers wanting to quit find it difficult and many fail if not following a strict treatment.

In a recent article in the specialized journal “Annals of Internal Medicine”, Dr Steinberg and collaborators from the University of Medicine and Dentistry of New Jersey discussed the importance of regarding tobacco dependence as a medical condition that requires a specific medical treatment, rather than a bad habit or a lifestyle choice. They compare smoking to diabetes. Diabetes, they say, is similar to tobacco dependence in “their potential to exacerbate other diseases, their behavioral components of treatment, and their effectiveness of medications”. In spite of this, treatments for diabetes are amply covered by health insurance plans, whereas coverage for tobacco cessation products and treatments are usually very limited.

In the article, the authors review some of the available treatments that usually have satisfactory results. Among the safest options is behavioral counseling, but there are also pharmacotherapies that are safe and effective. “Nicotine replacement therapy effectively delivers nicotine in safer doses without exposure to the toxins and chemicals in cigarette smoke”. As everybody is different, optimal duration of tobacco dependence treatment cannot be established, and some smokers may require more extended courses or treatment than others.

They conclude that limited coverage constitutes a severe downside for this important problem. For those smokers for whom normal methods don’t work, health care providers should encourage using long-term cessation treatments and insurance carriers should cover them. To achieve this, “tobacco dependence should share the status of other chronic illnesses, with effective treatments given as long as is necessary to achieve successful clinical outcomes”.