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How to quit smoking

Dr. Drew WernerVail, CO Colorado

EAGLE COUNTY – I was just starting to get used to writing 2007 instead of 2006 when February arrived. I can hardly believe our calendars are already on their second page. With the anticipation of good things to come, and the energy of a new year upon us, I hope 2007 is living up to your expectations. More importantly (for this article at least), I hope your New Year’s resolutions are going equally well.Dear Doc: I have set the day and am ready to quit smoking. I know I have to, but am stressed about it. What suggestions do you have to help me get through it and stay away from those cancer sticks?- Ready in GypsumDear Ready: If you are married or have children, I cannot say quitting smoking is the most important decision you have ever made, but it is close. Truthfully, it is perhaps the single most important health decision you can make. Whether you have only just started smoking or have done it for 50 years, you will be a healthier person once you have quit. In 2006, lung cancer accounted for 12 percent of all new cancer cases. Tragically, lung cancer was also responsible for 29 percent of all cancer deaths. More people die from lung cancer than any other type of cancer. The bad news does not stop there. While most people associate smoking and lung cancer, it actually increases the risk of all forms of cancer. At the same time, smoking is a major factor in heart disease, the single most common cause of death in the United States. When I counsel patients on the benefits of quitting smoking, however, I often focus more on how devastating it is on an individual’s quality of life, than how much it is likely to shorten their life. This simple wisdom is all too often true: Longtime smokers watch their grandchildren play ball. Non-smokers, or those who have quit, play ball with their grandchildren.The benefits of quitting smoking are enormous. Consider these facts from the American Cancer Society: Within 20 minutes of your last cigarette, blood pressure and pulse drop significantly and the temperature of your hands and feet increase to normal. Within eight hours, smoker’s breath disappears and carbon monoxide levels in your blood drop to near normal levels. Within 24 hours your chance of heart attack actually decreases. Within three days, your breathing becomes easier. By two to three months, your circulation improves and walking becomes easier as lung function increases up to 30 percent. Within one to nine months, coughing, sinus congestion, fatigue and shortness of breath all decrease. At that time the cilia that sweep debris from your lungs grow back, increasing your ability to handle mucus, clean your lungs and reduce your risk of infection. Not surprisingly, you will have more energy and endurance. By the time a year has passed, your risk of coronary heart disease is half that of a smoker. You will have saved over $1,000 if you previously smoked just one pack per day. Within five years, your risk of dying from lung cancer is half that of a pack-per-day smoker. Lung cancer death rates drop to those of a person who never smoked 10 years after quitting.Impressive, isn’t it? So, what helps someone quit and not start again? The first and most important thing is making a serious commitment. Next comes developing a plan to change behaviors and habits. Try brushing your teeth after meals if that is when you smoke. Rearrange your furniture or sit at a different spot on the couch or at the dinner table if that is your smoking spot. Do whatever works to avoid putting yourself in the same place and same situation that is a trigger to smoke. Smoking for many is an excuse to take a stress break, so take a break but do something besides lighting up. Go for a short walk, play a quick game on the computer, put a piece in a puzzle or anything that just distracts you for a bit. Now that you are ready to change your routine, tell everyone. It helps to make your commitment public. Write it down. Tell your smoking friends, and ask them not to offer you a cigarette. Finally, there is the nicotine addition. While it only lasts days to two weeks after the last cigarette is smoked, it can be pretty rough getting through it. The right thing for you is the help that works. There is a variety of over-the-counter products geared to help change habits, calm the addiction and focus on something other than the best friend (I mean cigarettes) you’ve just given up. Medications come in three flavors: nicotine replacement products; Zyban, an antidepressant; and the new medication Chantix. The nicotine patches help and increase your chances of quitting to 30 percent or more. The gum is especially good for people who chew tobacco. It is used by parking (like chew) between the cheek and gum and chewing it after the nicotine flavor disappears. There are nicotine inhalers, which work well for those with a need to keep the hands busy. With all of the nicotine-replacement products, it is important to stop smoking before using them. Smoking in addition to using some form of nicotine replacement can lead to an overdose. Zyban is actually the same medication as the anti-depressant Wellbutrin. It helps reduce stress and relieves the nicotine triggers in the brain. People who use it have a 30 to 40 percent chance of quitting, which is pretty good considering how difficult it is. Finally, there is Chantix, which works by blocking the nicotine receptors in the brain. One study showed that it is even more effective than Zyban. The bottom line is that there is no best way for everyone, and if you don’t succeed at first, try and try again. Dr. Drew Werner of the Eagle Valley Medical Center writes a weekly column for the Daily. He encourages health questions. Write him by e-mail to editor@vaildaily.com or c/o Editor, Vail Daily, P.O. Box 81, Vail, 81658.


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