Every year, the World Health Organization (WHO) draws attention to a serious dependence on World No Tobacco Day: smoking. This year's motto was "Smoking and Lung Health". Smoking is the leading cause of lung disease, COPD (Chronic Obstructive Pulmonary Disease), which is also described in a familiar way by the term "smoker's lung".
Even the head doctor of the Mental Illness Clinic at Burgenlandkreis Hospital, Felix Böcker, and his team are constantly facing smokers and their addiction. It explains why nicotine addiction can interfere with treatment. An MZ employee, Janine Friedrich, spoke to her.
Why is it so difficult for many smokers to quit?
Felix Böcker: Tobacco addiction is a serious addiction disorder with a high level of physical dependence. It is very difficult for the smoker to stop because his brain tells him to "smoke". While smoking, we activate our reward system in the brain, the system called dopamine. The man finds it so nice that he wants to repeat it.
Normally, the reward system is activated by positive experiences and experiences. With nicotine, we activate the dopamine system and learn that this remedy can quickly lead to a sensation of exaltation, such as a good meal.
Most smokers want to quit or at least smoke less, but they can not. How do you support these smokers?
Böcker:At admission, psychiatric patients are asked if they smoke. Through the so-called Fagerströmtest, we discover how strong the addiction is. After the classification, we will ask them if they want to continue smoking or not. We support the people involved in the decision-making process.
Unfortunately, many say: this is not a problem for me, I am here to treat my mental illness. Few decide to stop smoking. We can accompany them with a nicotine replacement therapy and make sure with a nicotine patch or gum that smoking cessation and nicotine withdrawal are separated in time.
Why is it important for doctors to know if the patient is smoking and in what proportion?
Böcker: Of course, it has been proven that smoking is harmful to health; As doctors, it is in our interest to have a patient as healthy as possible. On the other hand, it is extremely disturbing in the treatment of mental illness. Smoking reduces the effects of psychotropic drugs. The treatment is worse when the patient is smoking. This complicates the doctor's treatment options.
And how does the patient want to stop?
Böcker:We then set an appointment for smoking cessation. We see patients every day and we ask them, as part of the speech therapy, what experiences they make, what difficulties arise, what distraction maneuvers they use to end the desire to smoke. Compelling need, the English term for intense desire, is the reason why withdrawal is often stopped.
Can e-cigarettes help with weaning? Or is the smoker caught in the snow by the rain?
Böcker:We do not recommend switching to e-cigarettes because nicotine, which is addictive, continues to be used. It does not free people from their addictions. Tobacco smoke contains many harmful substances. Electronic cigarettes are less, but they also contain carcinogens.
Do the smoker's lungs recover when it stops or is it a myth?
Böcker:A stop smoking is worth it, regardless of age or stage. Of course, after 40 years, the effect is less than after 25 years. A lot improves significantly, for example, freer breathing, the skin is clean and you have more stamina. In addition, it can of course be recognized by blood levels. Above all, I would like to appeal to young people not to start smoking at all. As a young smoker, you should stop immediately and not say: I can stop later.