Smoking
is the leading cause of preventable death in the United States,
and is estimated to have caused approximately 440,000 premature
deaths in the United States annually. Cigarettes are the third most
accessible product in the United States, preceded by newspapers
and soda. About 4,000 chemical compounds are produced when tobacco
burns, 60 of these compounds are known carcinogens (cancer causing
compounds) including arsenic, formaldehyde, carbon monoxide, and
lead. While 7% of smokers achieve long-term success when trying
to quit on their own, implementing additional strategies such as
counseling and smoking cessation therapies has been shown to result
in success rates of up to 30%.
By
the early 1900's, the per capita consumption of cigarettes had begun
to skyrocket, but it was not until 30-40 years later that profound
health effects became evident. The first reports of a serious increase
in the risk of heart disease, lung cancer, and emphysema related
to cigarette smoking began to appear in medical literature in the
1940's and 1950's.
The
most common cause of death among Americans is coronary heart disease.
The relationship between cigarette smoking and development of heart
disease has been well recognized for over 40 years. There is also
a relationship between smoking and the development of vascular disease,
increasing the chance of stroke. The effects of cigarette smoking
on the lungs also have been known for decades, and the relationship
between smoking and development of lung cancer and emphysema is
quite clear. There are many other health consequences related to
smoking ranging from low birth weight infants born to women who
smoke, to premature aging of the skin (wrinkles!).
There
are many immediate benefits of quitting smoking including decline
in carbon monoxide levels in 8 hours, improved lung function, improved
sense of taste and smell, and saving money! Long term benefits include
decrease risk of heart attacks only one year after quitting and
decrease in lung cancer after 10-15 years. Lung function abnormalities
are substantially reversible in those who have not developed significant
chronic airflow obstruction.
Some
smokers think that stopping is simply a matter of willpower. For
most smokers, stopping is more than this. It is a process that begins
with a decision. Most people need to set a quit date and plan ahead.
Three major areas to be addressed are physical dependence, emotional
dependence, and behavior reinforcement.
Nicotine
is a highly addictive substance, comparable in its physiological
and psychological properties to other addictive substances of abuse.
Using nicotine replacement during quit attempts can reduce withdrawal,
block reinforcing effects, manage negative mood states, and provide
opportunity to "unlearn" smoking behavior. There are many
nicotine replacement products available, over the counter as well
as by prescription. Nicotine replacement should be used with behavioral
intervention.
Bupropion
(Zyban) can help reduce the urge to smoke. It does not contain nicotine,
and can be used in conjunction with Nicotine replacement, increasing
the chances of staying tobacco free. Zyban needs to be prescribed
by a health care provider.
Quitting
smoking takes a lot of emotional energy and can be very stressful.
The average number of quit attempts before achieving complete cessation
is three-four. These attempts should not be viewed as failures,
but rather as a learning tool to use for future attempts. Learning
various ways to handle stress assists previous smokers to stay tobacco
free. It takes courage to quit smoking and a decision to quit should
be applauded. If you are a smoker and are ready to quit,
contact your health care provider an individualized quit plan.
Download
Medical Associates Smoking Cessation Program brochure
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