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Smoking Cessation Improves Your Health at Any Age
Omar P. Haqqani, MD
Midland Daily News
September 11, 2016
I hear it every day – “Doc, quitting smoking is the hardest thing I’ve had to do.” I’ve had patients who were able to address addictions to alcohol and drugs who still struggled with smoking cessation, often making several attempts before finding success.
People don’t necessarily struggle with quitting due to their age, amount they smoke daily, or the number of years they’ve smoked. Smoking cessation is difficult because nicotine, the active drug in tobacco, is highly addictive. In fact, research suggests that nicotine is as addictive as heroin or cocaine.
Regardless, I can’t stress enough the importance of smoking cessation on your vascular health. Smoking can be attributed to increased stroke risk and overall vascular disease. In fact, statistics show that half of active smokers with symptoms of vascular disease will not survive five years. These are daunting yet eye opening statistics.
Smoking negatively affects the vascular system in significant ways. The nicotine in cigarettes raises blood pressure, speeds up heart rate, and constricts blood vessels, causing a narrowing that makes it harder for blood to be pumped through.
The body reacts to this narrowing of blood vessels by releasing stores of fat and cholesterol into the blood, causing plaque to build up on the inner walls. This plaque accelerates the hardening and narrowing of blood vessels and places you at much higher risk of a host of vascular health issues, including stroke, leg wounds, and pain with walking.
As with any addictive substance, withdrawal is what makes it so difficult to quit smoking. Nicotine withdrawal can leave you feeling irritable or anxious. You may have trouble thinking clearly and may experience incredible tobacco cravings. These effects tend to be most profound within the first 1-3 weeks of your last cigarette.
Once you quit smoking you will breath more easily, have more energy, and likely add years to your life. You will also save money. If you are a pack a day smoker, you could fund a nice annual vacation on the money you will save.
The CDC attributes smoking cessation to reduced risk for many types of cancer, heart disease, stroke, and peripheral vascular disease. Health benefits are greater for those who quit at an earlier age, but there are benefits at any age. In fact, once you quit, risks become that of a non-smoker over ten years.
There are various ways that people have found success when quitting, including behavioral support, cold turkey, nicotine replacement therapy, or medications. I find a combination approach of medications (Buproprion) and a nicotine-free e-cigarette has produced the best results in my patients. Regardless of approach, it’s advisable to have a strong support team in place before quitting. This can consist of family, friends, and healthcare providers.
If quitting cold turkey, pick a date and stick to it. Make a list of reasons why you need to quit and post it in a visible area. Rid your home, car, and workplace of every reminder of tobacco use. Create diversional activities to occupy your hands and mouth. Avoid areas where you will be exposed to second-hand smoke to decrease temptation and reach out for support when temptation is greatest.
Many employers, insurance plans, hospitals, and clinics offer counseling sessions to help with quitting. You can also call the National Smoking Cessation Hotline at 1-800-QUIT-NOW for 24-hour support when trying to quit.
Nicotine replacement therapy is a viable option for those who can’t quit cold turkey. This is a safe method that alleviates withdrawal symptoms by giving you less nicotine than cigarettes, and can be gradually tapered off over the course of a few months.
Effective replacement therapies include nicotine inhalers, lozenges, gum, patches, and nasal spray. Nicotine-free vapor cigarettes can serve as a diversion for those who don’t know what to do with their hands and mouth.
Medications such as Buproprion and Varenicline are available through doctor’s prescription and have shown positive results in aiding smoking cessation. As with any medication, consult with your care provider to see if the medication is right for you and take only as directed.
Whatever method you choose, stick with it. Continually remind yourself of the reasons you are quitting and lean on your support team in those toughest moments. Finally, think about the potential years you may be adding to your life as you improve your vascular health and reduce your risk of vascular disease.
No matter your age, you’re not too old to reap the health benefits of smoking cessation.
Dr. Omar P. Haqqani, MD is the Chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.
What is the best way for me to quit smoking?
Quitting smoking is definitely not an easy task, because it has both a physical and mental control over a person. There are four main ways to quit smoking: quitting on your own, behavioral support, nicotine replacement therapy, and prescription medications. Discuss with your physician the best method or combination that will work for you.
How can I quit on my own or “cold turkey”?
This method works, but requires preparation and support from your family and friends. Ways to better prepare your self includes:
- Pick a quit date and commit to it.
- As you get closer to your quit date, throw out every reminder of tobacco use. Clean your house, car, and office, throwing away all cigarettes, lighters, and ashtrays.
- Make a list of reasons of why you want or need to quit and another list of people you know who have quit. These will remind you of why quitting is so important and that you are just as strong as the others you know who have stopped smoking.
- Plan a way to deal with withdrawal symptoms, which peaks about 1-3 weeks after you quit. Make a list of diversional activities to do with your hands and mouth.
- Avoid areas where you could be exposed to secondhand smoke to decrease temptation. This includes family and friends. Make sure they understand how important it is to you to quit and that you need their support.
- Reward yourself once you have quit for good. Save the money you would have spent on cigarettes every week and spend it on something special for yourself.
How can I quit smoking with behavioral support?
When you quit cold turkey, it can be very helpful to have extra support from others. Many employers, insurance plans, hospitals, and clinics offer individual or group counseling sessions to help with quitting. The National Smoking Cessation Hotline at 1-800-QUIT-NOW provides telephone support 24 hours a day for those who are trying to quit.
How can I quit smoking with nicotine replacement therapy?
This is a safe method to assist with the withdrawal symptoms when you quit smoking. These therapies give you less nicotine than cigarettes and you aren’t taking in any of the tar and carbon monoxide associated with use of tobacco. Start with the daily nicotine dose that you were averaging every day from smoking cigarettes. There is an average amount of 1-2 mg of nicotine per cigarette. Gradually taper the dose down over the course of a few months, until you can stop using the replacement therapy completely. Remember that you should not be smoking cigarettes during this time. Therapies include the following:
- Nicotine inhalers (such as Nicotrol): Available by prescription, these cartridges deliver a vapor like puff that contains about 4 mg of nicotine. Average dose is 6-12 cartridges daily for 3 months, then gradually reducing the over the next 3 months until addiction resolves.
- Nicotine lozenges (such as Commit): Available over the counter, the average dose is 1 lozenge every 1-2 hours for 6 weeks, with a gradual reduction over another 4 week period until addiction resolves.
- Nicotine gum (such as Nicorette): Available over the counter, the average dose is one piece of gum whenever the urge to smoke arises- up to 30 pieces a day. The goal is to gradually wean use over a 3-month period until addiction resolves.
- Nicotine patches: Available over the counter, one patch is applied daily, with a reduction in patch dose every 1-2 months until the addiction resolves.
- Nicotine nasal spray (such as Nicotrol NS): Available by prescription, one spray in each nostril can be used whenever the urge to smoke arises, up to 10 sprays an hour, or 80 sprays a day for up to 3 months.
- Vapor cigarettes: These are available with and without nicotine; patients should use the nicotine free variety because those containing nicotine aren’t formulated for those who want to quit. Nicotine free vapor cigarettes can be a good diversion for people who need something to do with their hands during withdrawal.
What medications can I use to help me quit smoking?
There are two prescription drugs that have been approved for use to help people stop smoking.
- Buproprion (Wellbutrin, Zyban): Initially approved to treat depression, it was then approved to help people quit smoking. The drug should be started two weeks prior to the planned quit date and can be used in conjunction with other nicotine replacement therapy.
- Varenicline (Chantix): This is a new drug that helps reduce nicotine withdrawal symptoms. There are some undesirable side effects that can occur with this medication, such as nausea and nightmares.
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