While rates of smoking have decreased over the past decade, it is estimated by the National Cancer Institutes that 20 percent of the U.S. adult population currently smoke cigarettes.
“Quitting smoking is perhaps one of the hardest tasks to accomplish,” says Ching-Fei Chang, M.D., assistant professor in the division of pulmonary and critical care medicine at the Keck School of Medicine of USC. “The nicotine in cigarettes can be as addictive as heroin or cocaine.”
Chang points out that the general public often misunderstands how difficult it is to quit because they see smoking as a psychological problem, not a physical problem.
“However, medical science has long realized that cigarette nicotine addiction is a true disease affecting receptors in the brain and should be treated as such,” she says. “Nicotine stimulates the production of pleasure hormones which then triggers the brain to seek out more, creating a vicious cycle.”
Reasons for quitting
Most people are aware that smoking can increase the risk of heart disease, stroke and lung cancer, as well as cause chronic obstructive pulmonary disease (COPD) such as emphysema. However, this doesn’t seem to help motivate them to quit, despite the potentially life-threatening nature of these complications, says Chang.
“Ironically, what may be more persuasive to the average smoker are side-effects which have a more immediate impact on their lives, such as erectile dysfunction/decreased testosterone, infertility, premature wrinkling, bad breath, and ugly discoloration of fingers, nails and teeth,” she says.
In addition, Chang points to the impact smoking may have on smokers’ children as possibly a greater motivator. Smoking can lead to pregnancy complications, underweight babies and sudden infant death syndrome (SIDS), as well as increase the risk of asthma and upper respiratory infections in young children.
Furthermore, many people are unaware that second-hand “side stream” smoke is far more toxic than directly inhaled smoke, says Chang. It contains double the nicotine and tar, three times the amount of carcinogens, and 10 times the concentration of carbon monoxide, which interferes with the ability of your blood to carry oxygen.
“People who are chronically exposed to second-hand smoke have a 30 percent higher risk of developing lung cancer and heart disease, despite following healthy lifestyles otherwise,” Chang says. “Again, infants and children whose parents smoke are at risk of dying from SIDS, asthma and frequent upper respiratory infections.”
Breaking the cycle
According to Chang, studies show that the most effective way of quitting smoking is to combine pharmacologic therapy with behavioral changes.
“In the past, the only drugs available were nicotine patches and gum, which really do not fix the nicotine addiction problem itself,” she says. “Now, there are several non-nicotine based prescription medicines, such as Wellbutrin and Chantix, which rely on altering brain chemistry to curb the desire for cigarettes.”
In conjunction with drug therapy, Chang points to several key behavioral changes that can help patients quit smoking more easily. These include avoiding stressful situations where the temptation to resume smoking may occur, joining a support group, exercising and keeping the mouth busy with substitutes such as lollipops, gum or mints. In addition, smokers who want to quit should designate a specific stop date and stick to it.
“Finally, it often helps to remind people that smoking damages not only their own health, but that of loved ones around them, especially children and pregnant women,” says Chang. “Quitting smoking for the sake of your families and friends may be the best motivator of all.”
In a nod to the health of others, many states and communities have passed anti-smoking laws in public places, meant to protect the innocent from second-hand smoke. However, it may have an additional benefit of helping smokers quit their deadly habit.
“Those who are trying to quit may consider places where they can’t smoke a refuge from temptation,” says Chang. “These public arenas can also provide entertainment and other distractions from cravings.”
Finally, while she does not believe there are any sufficiently rigorous studies in the medical world to support the use of hypnotherapy or acupuncture in smoking cessation, Chang says as long as the practitioner is well-trained and uses sterile equipment, these modalities are probably harmless and worth a try.
She points to the following Web sites for more help and information on quitting smoking:
www.cdc.gov (Centers for Disease Control and Prevention)
www.lungusa.org (American Lung Association)
www.cancer.org (American Cancer Society)