The negative reinforcement (which causes the smoker to not want to not smoke) is in the form of withdrawal symptoms produced by chronic use. Smokers also associate the pleasurable effects of smoking mentioned previously with the taste, smell, and feel of the smoke in their throat, as well as the manipulation of the smoking materials. This is called conditioning, which is the major cause of relapse once smoking cessation has occurred (Hunter et al.).
In order for an individual to quit smoking, the psychological, behavioral, and physical components of addiction must be considered so that an effective treatment plan can be developed. The most successful approaches involve a combination of behavior modification programs along with effective pharmacological agents. One of the best pharmacological approaches is nicotine replacement therapy, which reduces the craving and minimizes the physical withdrawal symptoms of nicotine (Hunter et al.). Three of the most widely used tools for nicotine replacement therapy are nicotine polacrilex (nicotine gum), the transdermal nicotine patch, and the nicotine nasal spray. However, each method is unique and the positive and negative aspects need to be considered by the individual when a therapy is being selected. .
Nicotine polacrilez, or nicotine gum, was the first replacement therapy for smokers, approved by the Federal Drug Administration (FDA) in 1984. It is a buffered gum bound to an ion exchange resin to allow controlled release of nicotine. Because of the nature of the gum, the smokers are able to take an active coping response in controlling their intake of nicotine, which produced a lapse-free abstinence for one year in 21-29% of smokers (Hunter et al.). When used according to directions, the gum provides nicotine concentrations approximately 30-64% of the pre- cessation levels, and the concentration peaks rather slowly, reaching its highest point after thirty minutes (smoking causes peak nicotine levels after only five minutes).