The Medical Minute: The Great American Smokeout

By John Messmer

You already know smoking is bad, and that it contributes to heart disease, strokes, lung and other cancers and can lead to poor healing, chronic lung disease, wrinkled skin, erectile dysfunction, and it worsens asthma. Children exposed to second-hand smoke have more ear infections and more asthma attacks. Pregnant women who smoke have smaller, less healthy children with a greater risk of sudden infant death syndrome. Since you already know that, let’s focus on quitting.

Why quit?

As soon as you quit, things start to get better. Carbon monoxide levels (the lethal stuff in car exhaust) in your blood begin to drop. Lungs start to recover and a few months after quitting, you notice an improvement in energy. Sometimes mucus production increases for a while because the mucus producing cells come back to life. That settles down after a while.

The risk of cancer drops over years. It drops further the younger a person is when they quit, but it’s always lowest in someone who has never smoked.

Quitting saves a lot of money — not just the cost of the cigarettes, but the cost of health problems is reduced. Not quitting takes a heavy financial toll when heart and lungs fail.

How to quit?

Granted, it’s not easy. Smoking is an addiction much like cocaine. Because it’s legal there is not the stigma that there would be with other drugs. Yet, with workplace and restaurant bans on smoking, lighting up is quickly becoming almost as socially unacceptable as shooting up. But you CAN quit! The first step is to make the decision to quit.

Go to http://www.smokefree.gov/ to learn how to get ready and for tools to help you quit. Plan what you will do in place of smoking. When you started to smoke, you had to learn not to cause a fire or burn yourself. Now you must plan what to do with your hands instead of smoking or substituting eating for smoking.

Get help. Quitting suddenly leads to withdrawal. Although some people can quit with few withdrawal symptoms, most of the time there is some unpleasantness and a desire to resume smoking. Some people do better by using a nicotine replacement, such as nicotine gum, patches, lozenges, sprays or inhaler. The spray and inhaler are prescription products.

There are two prescription medications that are helpful: bupropion (Zyban or Wellbutrin) and varenicline (Chantix). Studies show these work best if you meet with your doctor during the process.

Even after quitting, relapse happens. Nicotine is a powerful addiction and relapse, while not desirable, is not a failure. If you have relapsed just go at it again. Keep trying; you won’t quit if you don’t try.

There is free help available at 1-800-QUIT-NOW. Trained counselors can help you with information if you are still thinking about it or can assist in developing a quit plan if you are ready.

You can also check out http://www.cancer.org/Healthy/StayAwayfromTobacco/GreatAmericanSmokeout/index for all sorts of information about quitting. Quick tips can be found at http://www.pennstatehershey.org/healthinfo/hie/1/001992.htm.

The Great American Smokeout is Nov. 18. Even if you are not ready to quit, try to give up smoking for one day. Or at least check out the resources for the day you eventually decide to quit. Smoking is the single most dangerous legal activity you can do. Don’t you think it’s time to put an end to it? Maybe this is the year.

John Messmer, M.D. is associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Hershey Medical Center.

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