Today a patient of mine requested me to blog about how one can try quitting to smoke, he also had doubts about Nicotine replacement therapy. I am skipping that part since I believe that the mind is the biggest challenger, so here it goes....
There are over 4,000 chemicals in cigarette smoke including formaldehyde (used to preserve dead bodies); ammonia (used in strong cleaning liquids) and cadmium (a highly poisonous metal used in batteries). Quitting smoking is not easy, but it can be done.
Why do people
start to smoke?
Common reasons for starting include peer
pressure, the desire to be ‘grown-up’, natural curiosity and a sense of
rebellion or freedom. Youngsters with parents who smoke are particularly
susceptible. Children see adults smoking in an attempt to relieve stress,
tension and boredom. Adult smokers may appear more confident and better able to
cope and children want to mimic this ‘grown-up’ behavior. Many actors, film stars and singers smoke.
Indeed, it could be argued that smoking is sold as a lifestyle rather than a
product and the illusion of style is that smoking is a ‘cool thing’ to do.
Why do people continue to smoke?
The main factors that contribute to
people continuing to smoke are the physical addiction to nicotine, the daily rituals
around the habit and the emotional and psychological dependence.
Physical addiction
Nicotine is a drug
found naturally in tobacco and is highly addictive. Over time, the body becomes
both physically and psychologically dependent on nicotine. When smoke is
inhaled, nicotine is carried deep into the lungs, where it is absorbed quickly
into the bloodstream and carried throughout the body. Nicotine can be found in breast milk of smokers. During pregnancy, nicotine
freely crosses the placenta and has been found in the umbilical cord blood of
newborn infants. Nicotine produces pleasant feelings that make the smoker want
to smoke more. After a while, the smoker develops a tolerance and then smokes
to maintain this level of nicotine. In fact, nicotine, when inhaled in
cigarette smoke, reaches the brain faster than drugs that enter the body by way
of injections!
Psychological
and emotional dependence
Smoking means different things to
different people. For many, cigarettes are a friend, a relief from boredom, and
are also seen as a form of stress relief. For those on a low income, smoking is
often identified as their ‘one luxury ’.
Stress
Many smokers believe that smoking
relieves stress and there is no doubt that nicotine withdrawal may be followed
by unpleasant mood changes. Stress levels can worsen withdrawal, strongly
linking tobacco use with poor emotional and mental health. Talking to a
friend or family member about what is causing the stress could be a good way to
clearly identify just how smoking is a contributory factor.
Benefits
of quitting
Half of all smokers die early from a
smoking related disease and one in four smokers die in middle age (35-64) as a
result of their habit. Diseases caused by smoking can cause a great deal of
pain and suffering for smokers and their loved ones. Additionally, the sudden
loss of an only parent can be particularly hard for the surviving children.
There are many serious and fatal diseases directly caused by smoking.
The following are the most common causes
of smoking-related death:
• Coronary heart disease, which may
result in heart attack, or other vascular disease, perhaps leading to stroke.
• Chronic Obstructive Pulmonary Disease
(COPD), which may include chronic bronchitis and emphysema. Infections such as
pneumonia are more likely to be fatal
• Lung cancer, as well as most other
forms of cancer.
• In addition, impotence, peptic and
duodenal ulcers and fertility problems may be associated with smoking.
• Even everyday complaints such as
coughing, sneezing and shortness of breath on exertion can be attributed to
smoking.
Smoking also causes premature wrinkling
of the skin, bad breath, bad smelling clothes and hair.
For women, there are unique risks. Women over 35 who smoke
and use birth control pills are in a high-risk group for heart attack, stroke,
and blood clots of the legs. Women who smoke are more likely to have a
miscarriage or a lower birth-weight baby. People who stop smoking before age 50 cut their risk
of dying in the next 15 years in half compared with those who continue to
smoke. Ex-smokers also enjoy a higher quality of life with fewer illnesses
Improved health benefits
Smokers are always being told about the
harmful effects of their habit; however, people are far less aware of the
dramatic health benefits of quitting and just how quickly they begin. It’s
always worth emphasizing that the health benefits from stopping begin almost
immediately and continue to increase for many years:
20 minutes - Blood pressure and pulse return to normal
8 hours - The
oxygen level in your blood increases to normal level. Chances of a heart attack
start to fall
24 hours - Carbon monoxide leaves the body. The lungs start to clear out mucus
and debris
48 hours - Nicotine is no longer found in the body. Sense of taste and smell
improve
72 hours - Breathing becomes easier. Energy levels increase
2-12 weeks - Circulation improves throughout the body
3-9 months - Coughing, shortness of breath and wheezing improve.
5 years - Risk
of having a heart attack falls to about half that of a smoker.
10 years - Risk of lung cancer falls to around half that of a smoker.
During exercise, chemicals
called ‘endorphins’ are released in the brain, which have a tranquillizing effect
and make people feel good.
Stopping smoking can bring other
opportunities. Many ex-smokers
have found that the effort they invested in stopping smoking has helped them to
have more belief in themselves and their capabilities. As a result people who
have quit smoking have also gone on to make other positive life changes, such
as taking advantage of new opportunities at work.
Cost
Smoking is
expensive. It isn't hard to figure out how much you spend on smoking: multiply
how much money you spend on tobacco every day by 365 (days per year). The
amount may surprise you. Now multiply that by the number of years you have been
smoking and that amount will probably astound you. Multiply the cost per year
by 10 (for the upcoming 10 years) and ask yourself what you would rather do
with that much money. And this doesn’t include other possible expenses, such as
the health care costs due to tobacco-related conditions.
Social Acceptance
Smoking is less
socially acceptable now than it was in the past. Most workplaces have some type
of smoking restrictions. Friends may ask you not to smoke in their houses or cars. Public buildings, aircrafts,
music halls and even cinema halls are now largely smoke-free. Like it or not, finding a place to smoke is going to be a hassle.
Health of Others
Smoking not only
harms your health but the health of those around you. Exposure to secondhand
smoke (passive smoking) includes exhaled smoke as well as smoke from burning
cigarettes. Studies have shown that secondhand smoke causes thousands of deaths
each year from lung cancer and heart disease in healthy nonsmokers.
Smoking by mothers
is linked with
sudden infant death syndrome (SIDS) and low-birth weight infants. Babies and
children raised in a household where there is smoking have more ear infections,
colds, bronchitis, and other respiratory problems than children from nonsmoking
families. Secondhand smoke can also cause eye irritation, headaches, nausea and
dizziness.
Setting an Example
If you have
children, you probably want to set a good example for them. When asked, nearly
all smokers say they don't want their children to smoke, but children whose
parents smoke are more likely to start smoking themselves. You can become a
good role model for them by quitting now.
How can I stop smoking?
Quitting
is hard. Usually people make 2 or 3 tries, or more, before finally being able
to quit. Each time you try to quit, you can learn about what helps and what
hurts. Write down your personal reasons for stopping. Be specific. Keep your
list with you so you can look at it when you feel the urge to smoke. To help
you understand your smoking habit, keep a diary of when and why you smoke.
Using information from this diary, you can make a plan to deal with the things
that make you want to smoke.
Smokers often say, "Don't tell me why to quit, tell me
how." There is no one right way to quit, but there are some key elements
in quitting smoking successfully:
1. Making the
Decision to Quit
The decision to
quit tobacco use is one that only you can make. Others may want you to quit,
but the real commitment must come from you.
You will be more likely to stop tobacco use if you:
- believe that you could get a tobacco-related disease and this worries you
- believe that the benefits of quitting outweigh the benefits of continuing tobacco use
- know of someone who has had health problems as a result of their tobacco use
3. Get support and encouragement: You have a better chance of being successful if you have help. Tell your family, friends and coworkers that you are going to quit. Ask them not to smoke around you or leave cigarettes out where you can see them.
4. Keep trying: Be
prepared for relapse. What if you do smoke? Don't be discouraged if you start
smoking again. Remember, most people try several times before they finally
quit. Here are some difficult situations to watch for:
- Alcohol. Avoid drinking alcohol. Drinking lowers your chances of success.
- Other smokers. Being around smoking can make you want to smoke.
- Bad mood or depression. There are a lot of ways to improve your mood other than smoking.
How should I get ready to stop smoking?
Just
before your stop date, get rid of all of your cigarettes, matches, lighters and
ashtrays.
Quitters can approach their attempt in
different ways.
Cold turkey: The phrase ‘going cold turkey’ means stopping smoking immediately.
In other words if someone smoked a pack today, they would be going ‘cold
turkey’ if from tomorrow they smoked none at all. Stopping outright is most
likely to be successful.
Cutting down: Cutting down over a length of time can be particularly difficult, as
consumption often goes back to what it was before. Smokers may inhale longer
and harder to get the nicotine they want.
What will happen when I stop smoking?
How
you feel when you stop depends on how much you smoked, how addicted your body
is to nicotine and how well you get ready to stop smoking. They are called nicotine withdrawal
symptoms. The symptoms are strongest during the first few days after you stop
smoking, but most go away within a few weeks.
Craving
An intense desire to smoke which
typically lasts 2 to 3 minutes before subsiding. This becomes less frequent and
less intense during the first 3 weeks.
Increased appetite
Nicotine is known to suppress a person’s
appetite, which leaves many smokers able to skip meals. When people give up,
the resulting lack of nicotine can cause cravings, which may also be
interpreted as hunger and an increased appetite cause weight gain.
Light-headed / dizzy feelings
This may occur as the level of carbon
monoxide in the blood starts to fall and oxygen supply to the brain increases.
Tingling sensations in the body
This could be a sign of better
circulation to the hands and feet.
Constipation
Tobacco has a laxative effect on which
the bowels learn to rely.
The above are signs of recovery and all the symptoms are temporary
and none of them are life threatening, unlike smoking!
How do I deal with urges to smoke?
If
you have tried to quit before, you will probably recognize many of these common
rationalizations.
- I’ll just use it to get through this rough spot.
- Today is not a good day; I’ll quit tomorrow.
- It's my only vice.
- How bad is tobacco, really? My uncle chewed all his life and he lived to be 90.
- You've got to die of something.
- Life is no fun without smoking.
You probably can add more to the list. As you go
through the first few days without tobacco, write down any rationalizations as
they come up and recognize them for what they are: messages that can trap you
into going back to using tobacco.
Avoid: people and places where you are tempted to
smoke. Later on you will be able to handle these with more confidence.
Alter: your habits. Switch to juices or water instead of
alcohol or coffee. Take a different route to work. Take a brisk walk instead of
a coffee break.
Alternatives: Use oral substitutes such as sugarless gum or
hard candy, raw vegetables such as carrot sticks.
Activities: Learn how to handle
stress and the urge to smoke Try and distract yourself from urges to smoke.
Talk to someone, go for a walk, or get busy with a task. Take a hot bath, exercise, read a book.
Deep breathing: When you were smoking, you breathed deeply as
you inhaled the smoke. When the urge strikes now, breathe deeply and picture
your lungs filling with fresh, clean air. Remind yourself of your reasons for
quitting and the benefits you'll gain as an ex-smoker.
Delay: If you feel that you are about to light up,
delay. Tell yourself you must wait at least 10 minutes. Often this simple trick
will allow you to move beyond the strong urge to smoke.
What you're doing is not easy, so you
deserve a reward. Put the money you would have spent on tobacco in a jar every
day and then buy yourself a weekly treat. Buy a book, go out to eat, or save
the money for a major purchase. What if I smoke again?
Staying stopped
is the key issue for most smokers. And most relapses occur
within the first 3 months of quitting. So don't be discouraged if you start
smoking again. Don't feel like a failure. Think about why you smoked and what
you can do to keep from smoking again. Set a new stop date. Many ex-smokers did
not succeed at first, but they kept trying. In fact, smokers usually need
several attempts before they are able to quit for good.
Just remember that
even one puff on a cigarette can cause a relapse, so don't risk it.
