|
Choking on Smoke
|
|
|
It hurts to quit smoking, but it hurts a lot more to continue. You may not beat the habit your first go-round, but with all the help within reach, you owe it to yourself to keep trying
It hurts to quit smoking, but it hurts a lot more to continue. You may not beat the habit your first go-round, but with all the help within reach, you owe it to yourself to keep trying
By Marie Berry
You know you want to quit. It makes sense. More than 70 percent of smokers want to kick the habit, so chances are you’re about to become or already are one of the 60 percent to try to stop. Here’s a tip to the wise: If at first you don’t succeed, try again. Only about 20 percent of smokers are successful on their first attempt. Another 50 percent gain their independence after six more tries. So don’t give up; give it up.
Nicotine is what makes it tough to abandon tobacco. That’s the physical addiction. But it’s the smoke that makes it dangerous. Cigarette smoke contains over 4,000 components, some of which are known cancer-causing substances. Inhaled at high temperatures, their toxicity increases. You’ve probably heard about the dangers of tar and carbon monoxide, but tobacco smoke also contains cadmium, ammonia, benzene, formaldehyde, hydrogen sulfide, metallic ions, radioactive material, creosols and cyanides. The tars, along with the other irritants, are implicated in cancer, chronic bronchitis and emphysema. Carbon monoxide reduces the oxygen-carrying capacity of the blood and contributes to heart disease.
In other words, these harmless-looking fire sticks pack a powerful wallop. Who knew that Christopher Columbus’s discovery of North America and subsequent voyages would unleash the world’s most powerful addiction, when Indians introduced European explorers to the ceremonial burning of the weeds? It’s a New World trend that caught on big.
Smokers often refer to their morning cigarette as a quick “pick-me-up.” That’s because it takes seven seconds for nicotine to reach a smoker’s brain, where it arouses the nervous system. Ironically, nicotine also relaxes the neuromuscular system, which is why smokers rely on it as a crutch to cope with stress.
The addiction, however, is more than just physical attachment to nicotine. It’s also psychological and social. Sometimes it’s hard to know which is more compelling, the body’s craving for nicotine or a smoker’s unconscious hand-to-mouth routine. With each cigarette smoked, the hand is raised to the mouth at least 10 times — 250 times a pack. What else can replace the psychological habit of that motion? As well, smokers usually associate smoking with people: sharing a smoke with co-workers on a coffee break, lighting up after a good meal, taking a drag while chatting on the phone. Social habit reinforces the addiction.
Already fighting against enticing reasons not to quit, nasty withdrawal symptoms really test a smoker’s resolve. Symptoms of withdrawal from nicotine include irritability, anxiety, restlessness, depression, difficulty concentrating, drowsiness, increased appetite leading to weight gain, intestinal problems and difficulty falling asleep, although a similar side effect to nicotine is waking at night.
Coping with withdrawal is never easy. Yoga, meditation — even keeping busy with a hobby — can alleviate nervousness and irritability. Weight gain may be as little as three or four kilograms, but it’s still a concern because withdrawal definitely leads to increased food intake, slowed metabolism and bowel functions, and that tough-to-break hand-to-mouth habit doesn’t help. Good food choices and exercise will help, and they’ll also combat constipation. Drinking more fluids should improve the cough and perspiration; and rest may be all that’s needed to stop dizziness and that “spaced-out” feeling.
Nicotine replacement therapy is another way to prevent withdrawal symptoms and enable smokers to cope with the psychological and social side of the addiction.
What are the options? It takes strong motivation and willpower to quit smoking cold turkey, and that personal determination is why it has the greatest success. Of 88 percent who stop smoking absolutely and in one go, without treatment support, there’s a 48 percent success rate. More often, though, smokers turn to acupuncture, support groups, hypnosis, nicotine replacement or laser therapy to help get them through withdrawal. Success rates plummet when people try to wean themselves off the weed by gradually cutting down. They tend to counteract the effect of fewer cigarettes by inhaling deeper and smoking down to the filters.
Nicotine replacement is available in two nonprescription therapies: chewing pieces and the patch. Clinical studies show that nicotine replacement raises smoking-cessation success rates by 40 to 50 percent. While smoking delivers three to five times more nicotine than chewing pieces, the substitutes release enough to avoid physical withdrawal.
Nicorette chewing pieces aren’t chewing gum, though, and they require a specific chewing technique. The pattern is bite, bite, park — parallel to the puff, puff, pause of dragging on a cigarette. A couple of bites on the chewing piece release the nicotine, and then it’s parked between your gum and cheek so that mucosal membranes can absorb the drug. A chewing piece should last 30 minutes. You haven’t quite got the knack if you get hiccups, light-headedness, throat irritation, nausea, belching or gas. Acidic beverages like soft drinks, coffee, tea, alcohol and juice interfere with nicotine absorption and are best avoided while you’re chewing your up to 20 pieces a day.
Some people can’t use chewing pieces, namely: pregnant women, nursing mothers, people with mouth conditions and diseases, and children. And if you suffer a heart condition or ulcer disease, check with your physician.
Chewing pieces come in different doses. If you smoke more than a pack a day and have your first cigarette early in the morning, you need a dose of four milligrams, or perhaps even the patch, which offers stronger therapy. If you smoke about a pack a day and have your first cigarette later in the morning, use the two-milligram dose. If you’re an infrequent smoker and your first cigarette varies, then you may not need nicotine replacement at all.
The patch can double and triple success rates. Like chewing pieces, they come in various strengths for gradual reduction, under the brand names Habitrol, Nicotrol and Nicoderm. Simply stuck on your body once a day, they’re more convenient than chewing pieces and generally better tolerated. Skin irritation is the most common side effect, so make sure you stick it to a non-hairy, clean, dry and intact spot on your body. And don’t forget to remove the patch from the day before.
The prescription medication bupropion — Wellbutrin or Zyban in the U.S. — helps cope with cravings. The first antidepressant specifically marketed to stop smoking, it appears to improve success rates, although science doesn’t quite know how, yet. However, there’s a high incidence of depression in smokers and a low incidence of success in depressed smokers, which adds credibility to taking an antidepressant. Nicotine therapy can be combined with bupropion but some people develop adverse side effects like insomnia, dry mouth and seizures.
With all the options available, isn’t it time you quit?
Here’s how to quit:
1. Look for the trigger factors that induce you to light up and find alternatives.
2. Keep a smoking diary of when you smoked, how much, what you were doing and how you were feeling. It can identify your triggers and point to alternatives.
3. Know your resources. Read everything from your pharmacist, physician and the Cancer Society, and find local support groups that help smokers quit. Ask your family and friends for support.
4. Choose a stop date, within two weeks, after which you won’t have another cigarette. Choose a less-stressful time with few trigger factors. Stop one cigarette at a time, and expect three to six relapses.
Cut it out:
Pros and Cons
One in five deaths in Canada is linked to tobacco use; the health risks are huge:
• A cigarette shortens life by eight minutes, one pack a day doubles risk for stroke
• 30 percent of coronary-disease deaths are caused by smoking
• 80 to 90 percent of lung-cancer deaths are caused by smoking
• 30 percent of all cancer deaths are cause by smoking
• 80 to 90 percent of deaths by chronic obstructive pulmonary disease, chronic bronchitis and emphysema are attributed to smoking
• Smoking increases risk of gastric ulcers, early menopause and osteoporosis
• Women who smoke have lower fertility rates and increased chance of miscarriage; newborns have lower birth weights
• Men who smoke a pack or more a day are four times as likely to be impotent
• Secondhand, passive or environmental smoke can be as harmful as direct smoke, causing lung cancer in nonsmokers. A nonsmoker who marries a smoker doubles the risk of lung cancer
• Parents who smoke more often take their children to hospital for bronchitis and pneumonia, acute respiratory illness and ear infection
You win, if you quit
• Coronary heart disease: risk reduced by half after one year, normal risk after 15 years
• Oral and bladder cancer: risk reduced by half after five years
• Stroke: average risk after five years
• Lung cancer: risk reduced by 30 to 50 percent after 10 years
• Physical endurance improves and smoker’s cough subsides
One of the pack
If you smoke, you aren’t alone. Statistics Canada claims that:
• 54 percent of Canadian children live with at least one smoker
• more women smoke than men, potentially because smoking can induce weight loss
• teenage girls often opt for a cigarette over food
• 94 percent of smokers first try smoking before age 17
• men aged 45 to 64 smoke the heaviest, more than a pack of cigarettes daily
• about 44 percent of Canada’s work force is exposed to secondhand smoke
What makes you smoke?
1. Getting up in the morning
2. Drinking coffee
3. Eating a meal, or after it’s over
4. Driving
5. Breaks at work
6. Social situations, like drinking with friends
7. Stress
8. Thinking constantly about smoking
9. Fear of gaining weight
10. Watching TV or talking on the phone
11. Your favourite spot
12. Smelling smoke
13. Cigarettes are everywhere and so easy to get
Find alternatives
1. Change routine: brush your teeth or shower first
2. Change your drink; do something with your hands: write, sew
3. Change routine or where you eat; get up after the meal and brush your teeth or do the dishes; sit in no-smoking
4. Change route so you have to pay attention to driving; clean and deodorize car; keep chewing gum in it; take the bus
5. Change location of break; do something else — go for a walk, pick up dry cleaning, read your book; break with nonsmokers
6. Change your drink; help the hostess; go with a nonsmoker or recovered smoker
7. Change coping methods: relaxation techniques, walking, exercise
8. Change your thoughts, focus on the benefits of quitting; photographs of loved ones at hand can help
9. Change your diet to boost fibre and fluids; increase activity; lose 10 pounds through lifestyle not cancer
10. Change location; rearrange furniture; keep your hands busy — pet the cat, do a puzzle or crossword, hold someone’s hand
11. Change the furniture; find a new nonsmoking favourite spot
12. Paint or deodorize your home; clean everything
13. Make it harder to get cigarettes — don’t buy by the carton; throw out all smoking equipment; get your teeth cleaned.
Marie Berry is a pharmacist based in Winnipeg.
|
|
|
|
