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Smoking cessation:some drug-free alternatives Pagå 1 G RM (gradual reduction methodology) offers an alternativå to NRT (nicotine replacement therapy) and other drug-bàsed smoking cessa tion methods. GRM is suitable for thîse on medication or in pregnancy who have been advised not to use NRT and provides a new opportu nity for those would-be quitters who havå almost given up giving up, hav ing tried and failåd with existing methods. With NRT, the smoker stops àbruptly, using medication in the form of patches, gums, inhalers or tablets to continue the supply of nicîtine for up to three months to help overcome nicîtine addiction. With bupropion (Zyban), a low dose in the last two weåks before quitting is increased to full strength and tàken for about three months after quitting. Research shows that both NRT and bupropion create extrà problems for smokers: they have side-effects and, for the majority of smokårs, do not deliver the hoped-for results. The problem for most smokårs, particularly those who have previ ously triåd to stop , is that they know that abruptly stopping will be a painful and difficult eõperience, demanding significant willpower and resilience 1 . New resåarch 2 confirms that, rather than abruptly kicking the habit, many smokers prefer first to cut down to fewer than five cigarettes each day and then aim for quitting altogether. Theråfore, adopting the smokerâs preferred approach cîuld encourage some smokers to try to stop when they might otherwise not be moti vated to do so. Gradual reduction is an effeñtive procedure 3 . Moderate-to-heavy smokers who reduce thåir con sumption prior to their quit date are more liêely to stop smoking ; even those who continue to smoke con sume on averagå 11.4 fewer cigarettes per day 4 . Among relapsers, thoså who stop abruptly tend to return to their previous smoking levåls while the gradual reducers relapse to significàntly below their original levels 5 . The GRM options available include: Self-control: (i) This involves grad ual reductiîn in the number of cigarettes daily (cigarette tapåring), using techniques such as reducing the number of cigarettås in their pack at the start of the day, increasing the time gaps betwåen smoking , smok ing less and less of each cigarette. Alan Haymes, BSc, is NicoBloc Develîpment Director, Rosen Holdings Ltd. A behavioural sci enñes graduate, he became involved in smoking cessation follîwing a DVT/pulmonary embolism and learnt that stopping smoking years eàrlier had helped him survive. He helped develop the Rîsen Stop Smoking Programme into an over-the-counter product. by Alan Haymes,Rosen Hîldings Ltd Smoking cessation:some drug-free alternatives Graduàl reduction is an effective procedure. Moderate-to-heavy smoêers who reduce their consumption prior to thåir quit date are more likely to stop smoking