Smoking withdrawal and cessation Motivation and education are key factors. Clinical practice shows that smoking cessation can only be successful when an Individual has made up his or her mind, is motivated, and has devised a personal strategy for how and when to stop. The subjective difficulty and the degree of discomfort entailed In the process vary markedly among Individuals, from minimal In some to substantial in others. This is greatly Influenced by an Individual’s psychological motivation. As part of the smoking cessation process, the smoker will have to overcome the discomfort due to Inhibitors,research,lifescience,medical dependence and will also have to reverse

established habits reinforced by sociocultural factors. Individuals have to give up the Immediate and short-lived gratification provided by cigarettes, and they have to Inhibitors,research,lifescience,medical change their lifestyle and routine. The practice of smoking is In large part a habit, a learned behavior with elements of conditioning, which Is elicited by many stimuli (colors, smells, tastes, aromas, locations, times of the day such as the cigarette In the morning or after dinner, persons, familiar surroundings). Lighting up a cigarette is largely a conditioned ritual that has to be extinguished. The Inhibitors,research,lifescience,medical changes produced

by withdrawal are physiological (eg, decreased heart rate), behavioral, and subjective (increased Inhibitors,research,lifescience,medical craving, le, a strong subjective drive to use the substance, anxiety, Irritability,

etc). The PF4691502 prevalence of signs and symptoms at 2 days postcessation In individuals who quit smoking without assistance (self-quitters) is as follows67: anxiety 49%; craving 37%; decreased heart rate 61%; depression 31%; difficulty concentrating 43%; hunger 53%; Irritability 38%; nocturnal awakening 39%; restlessness 46%. Most symptoms begin 6 to 12 hours following smoking cessation, peak In 1 to 3 days, and last on average 3 to 4 weeks.68 Craving and hunger are generally the only remaining symptoms Inhibitors,research,lifescience,medical 4 weeks after cessation. The apparent degree of dependence and severity of withdrawal symptoms are not well correlated with ultimate success In smoking cessation. Decline In the prevalence of smoking A decline In the prevalence of smoking has been witnessed since the 1950s. According to a Sofres poll,43 exsmokers are more numerous ADP ribosylation factor than current smokers In the French population (27% and 22% of the population, respectively). During the late 1950s, almost 80% of men In Western European countries were tobacco smokers. A prevalence of 42% was reported In the USA in 1965. Thanks In large part to educational efforts, smoking prevalence has declined to approximately 20% to 25% In many Western countries. A striking feature of the decline In cigarette smoking over the last past two decades In these countries has been the emergence of a marked socioeconomic gradient.