Nicotine Replacement Therapy can be helpful in recovering from addiction. It is important to educate

Do addiction treatment modalities and policies differ between countries, and what are the most effective forms of addiction treatment?

The ways of treating addiction vary from country to country, depending on the cultural, social, political conditions of a country. What is important is the awareness and knowledge of a country's population about addiction, the economic situation and the health care of its citizens. Positive examples include Scandinavian and some Western European countries, where access to addiction treatment is better organized due to funding and greater availability and variety of programs.

Addiction treatment is a complex and lengthy process. The type of therapy used is tailored to the individual patient's needs, depending on the type and degree of addiction.

An exemplary form of addiction therapy used in Poland is individual psychotherapy, which involves recognizing the mechanisms of addiction and working to level the effects and change the patient's behavior. Group therapy, support groups and self-help groups are also available to patients. Examples include the Alcoholics Anonymous AA or Narcotics Anonymous AN communities, where therapies take place under the guidance of a specialist in groups that bring together people with the same problem. You can also benefit from medical treatment, based on pharmacotherapy, in which drugs support therapy and recovery from addiction. It is also worth mentioning inpatient centers, where one undergoes the entire therapy over a period of time in isolation from the previous environment. Many of these therapies are effective, but it all depends on the individual needs of the patient, so it is impossible to point to one method as the most effective.

Have the stimulants that Poles are addicted to changed? In your opinion, is there any new trend visible?

Yes, new trends in stimulants can be seen in recent years. Many innovations in the production and types of psychoactive substances are observed. With changes in social norms, I see more and more clearly the acceptance and greater availability of new substances: such as, for example: synthetic cannabinoids - marijuana substitutes or synthetic opioids, such as fentanyl. There is an apparent resurgence in the use of psychedelics, such as psilocybin and ayahuasca, for example. There is also a noticeable change in the culture of cigarette smoking. Now classic cigarettes are losing popularity and are being replaced by so-called e-cigarettes and vaporizers. New trends in stimulants and ways of consuming them are changing our previous perception of a healthy lifestyle, we are more and more able to accept and find more and more arguments to use specific stimulants. I think this state of affairs forces us to gain more and more knowledge about the substances used and what addiction is. It's worth looking into so that we can stay fit and healthy in our daily lives.

What should we do to protect children from addictions? The vacations are approaching, a time off from school and normal duties and also, let's not hide it, a time of temptation and testing various new things, including illegal substances. The Senate has unanimously approved an amendment to the so-called Anti-Nicotine Law, which extends the ban on the sale of e-cigarettes to people under 18, to include nicotine-free products, as well as the sale of nicotine pouches. Is this a good step in that direction?

I often ask myself whether we are able to protect our children from something we consider bad or harmful in life. The answer is both yes and no. We, as parents, have a huge influence on shaping our child's personality through the behavioral patterns we give them ourselves. What we show with our lives, with our behaviors, is encoded in our children as a pattern. So if we ourselves reach for alcohol, smoke or take psychoactive substances, our children are likely to repeat it. If parents themselves are aware of the dangers, know what is currently "fashionable" when it comes to stimulants among young people, and talk a lot about it at home, educating their children about how to live a healthy and happy life, then surely such children-despite the availability of various substances-will not choose them or try them once and not repeat it again. The most important thing, therefore, is the behavioral patterns brought from home and that the child should not feel lonely by the unavailability of parents. For centuries, stimulants have functioned in human life for various reasons, but only we ourselves decide whether we reach for them. In order to make wise life choices we need knowledge and continuous development, as well as the support and love of the family. Sometimes, however, it happens that with the best efforts of the parents, something gets out of control and the child goes its own way - not necessarily the right way and there is nothing we can do.... but that's a topic for another talk.

From my point of view as a psychologist, I believe that an age restriction on the sale of nicotine or nicotine-free products to people under the age of 18, which is defined by law as the age of maturity, is most reasonable. It is important to give young people more time to mature into decisions that may consequently affect their health.

As for nicotine-free products, the issue is more complex. Even if their composition is neutral for health, their use can cause behavioral addiction. I believe that their effect on long-term health and the process of quitting smoking is not yet thoroughly studied.

What is your assessment of proposed legislation that would ban disposable e-cigarettes and flavored pouches with flavors other than tobacco?

Will this help reduce the number of smokers in Poland?

Evaluating legislative proposals to ban single-use e-cigarettes and flavored pouches requires a great deal of knowledge and diligence on the subject, as well as a systematic analysis of various scientific, but also economic and social aspects.

I have not encountered studies that verify the long-term effects of flavor additives and flavors in this type of product, however, from a psychological point of view, flavored products may be more attractive to consumers due to their effect through taste on the reward system. Thus, if they have a similar nicotine content to traditional cigarettes they may be a good alternative to them. Good from the point of view of at least being less harmful to the user and his environment. It is therefore important to spread the knowledge of what alternative substitutes are so that those who really need supportive therapy can benefit from them, so educational campaigns are important, and they should be available to children and adolescents as educational programs in schools.

I would also like to draw attention to a slightly different aspect and answer the question of whether the bans will reduce the number of smokers in Poland. In my opinion, the most important thing in terms of influencing the reduction of the number of smokers in Poland is the introduction of an effective education and information policy, which not only warns of the consequences of smoking, but also shows what it is to lead a so-called healthy lifestyle.

As for flavored or flavorless nicotine sachets, they probably work the same. I'm not a smoker myself, and it's hard for me to say which ones might work better for quitting. They certainly have their advantages and disadvantages, but it is possible that for some smokers they may be helpful in quitting cigarettes which is why educational campaigns are so important and should be widely available to people and especially be disseminated to children and young people in schools.

Another approach to leveling the number of smokers is also worth mentioning here. Interestingly, in the so-called Swedish model, which relies on hard scientific data, research as well as the availability of alternatives to reduce harm, positive results have been obtained when it comes to significantly reducing the number of cigarette smokers. Each country, however, has its own community and its own economic, social and cultural conditions. Everything we introduce is a kind of new social experience. In order to evaluate the results of these measures, we need time and observation of society through the prism of research and health improvement.

Where does nicotine replacement therapy have a place in addiction treatment, and can it complement harm reduction practice? NTZ products have different flavors

Nicotine replacement therapy can be a bridge to complete smoking cessation, but its use should only be part of a comprehensive quit plan, combining psychological therapy, physician support and health-promoting education. It is important to use NTZ in the right and wise way so that the health benefits are ultimately realized.

Nicotine substitutes, such as chewing gums, sprays, nicotine patches and sachets, are used in NTZ replacement therapy, as in some cases they can help people quit smoking by reducing withdrawal symptoms and tobacco cravings.

It is noticeable how more modern forms of nicotine delivery have emerged in recent years, such as nicotine sachets, e-cigarettes and tobacco warmers. However, the long-term effects of these substances on human health are unknown to us.

The use of nicotine substitutes in some people addicted to cigarette smoking can support the process of quitting, but it is important to remember that there is still a risk of becoming addicted to the new substances used. It is important for a person who wants to quit smoking to educate themselves about healthy living and strive to stop taking substances that are detrimental to their health.

In this regard, I think Nicotine Replacement Therapy has the hallmarks of a harm reduction practice, so education and acceptance of some alternative products with reduced health risks is important in this approach.