Among the prevailing public health concerns is substance dependence. Although many associate addiction with illegal drugs, a previous article entitled ‘When Use Turns into Abuse: The Start of Addiction’ emphasizes how this condition can also stem from the unhealthy use of legal and publicly available substances, such as tobacco. Considering tobacco can alter the brain’s reward system, high rates of tobacco use raise concerns about the risk of developing addiction. Moreover, research has shown that cigarette smokers are more likely to develop substance dependence than users of tobacco products. Such findings entail a closer examination of the link between cigarette smoking and dependence while also highlighting accessible smoking cessation approaches in Texas, a state where smoking rates remain higher than the national average.
Cigarette smoking linked to tobacco dependence
In light of how substance addiction can take many forms, a 2023 study published in Nicotine & Tobacco Research identifies three types of tobacco users according to the product they predominantly consume, namely cigarettes, smokeless tobacco, and a combination of cigarettes, e-cigarettes, and cigars. By analyzing tobacco users’ profiles and their associations with tobacco dependence over time, the study found that cigarette smokers are more likely to develop substance dependence than those who use other tobacco product varieties. These findings imply that tobacco use reduction and cessation programs must be tailored to people who smoke cigarettes. Meanwhile, other types of tobacco users would benefit from interventions that prevent them from transitioning to predominantly or strictly smoking cigarettes. In Texas, the current cigarette smoking rate among adults (14.4%) is higher than the estimated national average of 11.5%, making it imperative to expand access to tobacco cessation approaches to decrease the risk of substance dependence and improve health outcomes.
Smokers can turn to tobacco cessation interventions
During the tobacco cessation process, smokers can search for cigarette alternatives that can help reduce cravings and withdrawal symptoms. Since e-cigarettes are also considered tobacco products, users can opt for an emerging product like nicotine pouches. VELO nicotine pouches are among the best-sellers in the category, as they do not contain any tobacco leaf or plant material despite delivering nicotine into the bloodstream. Not only are these pouches a smoke- and spit-free alternative to tobacco products like cigarettes, but online retailer Prilla features flavors like mint and citrus in 2mg and 7mg strengths accessible by shipping directly from warehouses to most US states, including Texas. Cigarette smokers can also rely on traditional nicotine replacement therapy (NRT) as tobacco cessation aids. While there are prescription-only NRT products like nasal sprays, certain types of NRT are also accessible over the counter at pharmacies and convenience stores. A notable example is the Nicorette nicotine gum, which delivers nicotine at 2mg and 4mg doses based on a user’s smoking history, nicotine tolerance, and frequency of cravings. Since nicotine gums are fast-acting with an oral delivery format, health experts advise combining them with slow-acting transdermal patches from brands like Nicotrol and Nicoderm CQ for higher cessation rates. The documented success of NRT may also explain why the state-wide Texas Tobacco Quitline (TTQL) includes various nicotine replacement products like gums, lozenges, and patches. Specifically, the TTQL serves qualifying patients up to two weeks of free NRT, complemented by phone- or web-based behavioral interventions like counseling, motivational messaging, and lapse/relapse prevention assistance. While a study exploring the use of TTQL among Texans found that patient referral was actively promoted for nearly half of the respondents, concerns about inconsistent services, long wait times, and the quitline approach remain among smokers. These qualitative findings point to the need for government bodies and health facilities in Texas to go beyond improving the accessibility of the quitline. They must also ensure the quality of service delivery to encourage more Texans who smoke cigarettes to quit, avoid dependence, and live healthier lives.
