Everyone is aware that smoking is not good for your health, but many do not realize that smoking is also closely linked to chronic pain.
Also, patients who are considering spine fusion surgery will most likely be asked by their surgeons to quit smoking first.
In my experience as a spine physician, if a patient has had pain for a long time and continues to smoke, he or she is highly unlikely to find pain relief from any type of treatment. The reason for this is not entirely understood, but it is probably due to multiple factors, such as blood vessel spasms and not allowing oxygen to get to tissues.
For people who are in a lot of pain, this information alone should be good motivation to help them kick the smoking habit, but many patients will need some assistance to stop smoking due to the strong physical and emotional addictive qualities of smoking.
Nicotine replacement therapy options
Nicotine replacement therapy helps you deal with the sudden withdrawal of nicotine when you quit smoking by giving you a small amount of nicotine without the other dangerous chemicals found in cigarettes. You can slowly decrease the amount of nicotine in these medications allowing your body to gently withdraw from the drug. Nicotine replacement therapy is available over the counter in lozenges, gums, and patches, and with a prescription in nasal sprays and inhalers. Nicotine replacement therapy is the most common way to quit smoking, but if you are still having a problem quitting, you may want to consider a couple of other options.
Currently, 2 other medications, Zyban and Chantix, are available to help curb cravings, but they must be prescribed by a physician.
Zyban is an antidepressant that has also been approved to help people stop smoking. This drug works by keeping a neurotransmitter (serotonin) around longer in the brain, which seems to helped decrease the craving for nicotine.
A newer drug, Chantix, has been approved that has a different mechanism of action. Chantix is designed to bind right to the nicotine receptors in the brain. Many patients even report that after starting Chantix smoking is repulsive to them and they can’t stand the smell.
Like all drugs, Chantix does have some side effects (such as difficulty sleeping, loss of appetite, nausea, etc.), but the one that has gotten the most media attention is a possible link to suicidal ideation. While this is a concern, it should be noted that many people who are trying to quit smoking are already depressed, so it is difficult to know if this is a causal link or not.
In my clinical experience, Chantix has worked remarkably well, especially for people who are motivated to quit smoking.