Smoking Cessation
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It's time to kick smoking!

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.

Chantix is a prescription drug that targets nicotine receptors in the brain. It helps to block Nicotine, therefore taking away the feelings of pleasure that comes from smoking a cigarette or using smokeless tobacco.

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 or Kim Ehlers in the Internal Medicine department to help you develop an individualized quit plan.