The Medical Minute: Nov. 20 a good day to quit smoking

By John Messmer, M.D.
Penn State Milton S. Hershey Medical Center

Smoking kills 440,000 Americans annually -- almost one person every minute. Most smoking deaths are from lung cancer, heart disease and chronic lung disease. In fact, more women die each year from smoking related lung cancer than from breast cancer. Smoking also contributes significantly to cancers of the stomach, bladder, larynx, cervix and breast.

Everyone knows smoking causes lung cancer, but many people do not know that stroke risk is two and a half times higher in smokers. Dementia risk is increased, and smoking is a major contributor to impotence in men and osteoporosis in women. It doubles the risk of cataracts and macular degeneration, a significant cause of visual loss in older people. Parents who smoke increase the risk of bronchitis, pneumonia and ear infections in their children, even if they only smoke outside. Pregnant smokers have infant mortality rates one-third higher than nonsmoking women. Quitting early in pregnancy will reduce the risk.

Before the first Surgeon General’s report on the hazards of smoking in 1964, about half of adult Americans smoked. Fortunately today that number is about 22 percent overall. Rates of smoking are higher among teens who are more likely to become addicted. Although a minority of Americans smoke, the Centers for Disease Control reports that 90 percent of us have nicotine in our blood from secondhand smoke, which causes about 3,000 lung cancer deaths yearly among non-smokers.

Smoking is costly. A carton a week costs almost two thousand dollars annually to the smoker, but society’s costs are much higher. About 20 percent of our health care costs are for smoking related illness. That’s about $3,400 dollars per smoker annually. Put another way, one fifth of the amount we pay for health insurance is to pay for the care of smokers. With health care costs rising rapidly, it is sobering to consider that much of it is for illness that could be prevented simply by not smoking.

The American Cancer Society’s annual "Great American Smokeout" is Nov. 20. If you smoke, now is a good time to become a non-smoker. The first step is to decide to quit. It helps to make a list of all the reasons you want to quit. Perhaps it’s the health risk, the cost or the effect on your family and those around you. Maybe it’s just the smell, but you have to decide that you WANT to quit.

Change the way you think about smoking. Consider yourself a non-smoker rather than a reformed smoker. Have nothing to do with tobacco in any form. Plan what you will do at all the times when you would previously have smoked so that you don’t find yourself craving a cigarette with no alternative. Consider an oral substitute, such as, gum or mints. Have something else to do with your hands and to keep your mind active -- a hand held game, a crossword or a small object like a pen, for example. Ask friends and family to encourage you or agree to pay them a modest sum if they catch you smoking. If you don’t already smoke, make yourself a pledge never to start smoking.

It takes a just few days to withdraw from nicotine. You might consider using a non-prescription nicotine patch or gum to provide nicotine while you learn to live your life without tobacco. The prescription medication bupropion has been able to reduce the craving for nicotine in many people. Bupropion can double a person’s chance of successfully quitting when properly motivated. Using a counselor in addition to medication increases success even more.

While becoming a non-smoker, use the opportunity to improve your overall health. Some smokers use the fear of gaining weight as a reason not to quit. So eat a well balanced diet and minimize junk food to reduce the risk of weight gain. Remember regular exercise improves your heart and lung function and relieves stress. Drink plenty of water.

You can also try to encourage a smoking spouse to quit with you, but don’t be discouraged if he or she will not quit. There’s a good chance he or she will follow your lead once you have successfully become a non-smoker.

It’s not a question of whether to quit; it’s only a matter of when. Why not today?
For more information on quitting, visit http://www.hmc.psu.edu/cardiovascular/patient/articles/pe110.htm or http://www.cdc.gov/tobacco