Smoking Cessation

The U.S government spends $1.8 billion in direct health care charges every year on smoking related illnesses.

One in four adults and one in five teenagers in the U.S. are current smokers, and lung cancer remains the number one cancer killer among men and women. Although smoking is the single most preventable cause of death in our society, more deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.

Smoking-Related Illnesses

Cigarette smoking accounts for at least 30% of all cancer deaths. It is a major cause of lung, voice box (larynx), mouth (oral cavity), throat (pharynx), bladder and esophageal cancer. Other cancers linked to smoking include cancers of the pancreas, cervix, kidney, stomach and some leukemias. It is also a major cause of heart disease, aneurysms, bronchitis, emphysema and stroke, and worsens pneumonia and asthma. In women, it is linked with reduced fertility and a higher risk of miscarriage, early delivery (premature birth), stillbirth, infant death, and is a cause of low birth-weight in infants. It has also been linked to sudden infant death syndrome (SIDS). Other health problems linked to smoking are gum disease, cataracts, bone thinning, hip fractures, and peptic ulcers.

Smoking not only affects people that smoke, but also causes harmful effects in nonsmokers exposed to it. More than 4,000 different chemicals have been found in tobacco and tobacco smoke, and among these, 60 are known to cause cancer (carcinogens). Some of the compounds found in tobacco smoke include ammonia, tar, and carbon monoxide.

Effects of Secondhand Smoke

  • Each year in the United States alone, second hand smoke is responsible for an estimated 35,000 deaths from heart disease in non-smokers who live with smokers, and about 3,000 lung cancer deaths in non-smoking adults
  • other breathing problems in non-smokers, including coughing, mucus, chest discomfort, and reduced lung function
  • 150,000 to 300,000 lung infections (such as pneumonia and bronchitis) in children younger than 18 months of age, which result in 7,500 to 15,000 hospitalizations annually
  • increases in the number and severity of asthma attacks in about 200,000 to 1 million children who have asthma
  • more than 750,000 middle ear infections in children

Faces of Tobacco

Tobacco comes in many different forms. It is found in cigarettes, cigars, spit, snuff, snus, hookahs, etc.

Cigar smoking may be viewed by some as more sophisticated and less dangerous than cigarette smoking. However, one large cigar can contain as much tobacco as an entire pack of cigarettes and the secondhand smoke it gives off can fill a room for hours.

If cigar smokers inhale, nicotine is absorbed through the lungs as quickly as it is with cigarettes. For those who do not inhale, the nicotine is absorbed more slowly through the lining of the mouth. Cigar smoke dissolves more easily in saliva than cigarette smoke, which means cigar smokers can get the desired dose of nicotine without inhaling the smoke into their lungs. Because cigars contain more tobacco than cigarettes, and because they often burn for much longer, they give off greater amounts of secondhand smoke. Secondhand smoke from cigars stet contains many of the same toxins (poisons) and carcinogens (cancer-causing agents) as cigarette smoke, but in higher concentrations.

Smokeless Tobacco: Tobacco that is put in the mouth is described by many different terms such as spit, oral, smokeless, chewing, and snuff tobacco. People who use oral or spit tobacco products absorb nicotine the same way. The juice from the smokeless tobacco is absorbed directly through the lining of the mouth and this causes sores and white patches called leukoplakia that often lead to cancer of the mouth. Other effects of spit tobacco include chronic bad breath, stained teeth and fillings, gum disease, tooth decay, tooth loss, tooth abrasion, and loss of bone in the jaw.

Hookah (or narghile) smoking has recently become popular on college campuses. It is marketed as being a safe alternative to cigarettes because the percentage of tobacco in the product smoked is low and people think the water filters out the toxins. However, this is not true as the water does not filter out many of the toxins. In fact, hookah smoke contains more toxins such as nicotine, carbon monoxide, tar, and other hazardous substances, than cigarette smoke. Several types of cancer have been linked to hookah smoking. Infectious diseases can be spread by sharing the pipe or through the way the tobacco is prepared.

Snus (sounds like "snoose") is a type of moist snuff which is often flavored with spices or fruit, and is usually packaged in thin bags much like tea bags. It is also sold loose, as a moist powder. Like snuff and other spit tobaccos, snus is held between the gum and mouth tissues where the juice is absorbed into the body. Because it is heated during processing, Swedish snus has fewer tobacco-specific nitrosamines that are known to cause cancer. Some people believe snus is "safe," but snus users have a higher risk of cancer of the pancreas than non-users. They also get sores or spots in the mouth (lesions) where the snus is held.

All forms of tobacco have a lot of nicotine. It is easily absorbed through the lungs with smoking and through the mouth or nose with oral tobacco (spit, snuff, or smokeless tobacco). All forms of tobacco are dangerous. Even if the health risks are smaller for some tobacco products as opposed to others, all tobacco products contain nicotine, which can lead to increased use and addiction.

Recommendations for Smokers

The American Cancer Society recommends periodic check-ups for smokers, which includes mouth (oral cavity) exams. By doing this, tobacco users may be able to find oral changes and leukoplakia (white patches on the mouth membranes) early and this may help prevent oral cancer.

Other symptoms a smoker needs to be aware of are:
  • a new cough
  • any change in a cough (for example, you cough up more mucus than usual)
  • coughing up blood
  • hoarseness
  • trouble breathing
  • wheezing
  • headaches
  • chest pain
  • loss of appetite
  • weight loss
  • general fatigue (feeling tired all the time)
  • frequent or repeated respiratory infections

Benefits of quitting:
One may ask: Can quitting really help a lifelong smoker? The answer is YES! It is never too late to quit using tobacco. Within minutes of smoking the last cigarette, the body begins to restore itself.
Some amazing facts about quitting include:
  • 20 minutes after quitting: Heart rate and blood pressure drop
  • 12 hours after quitting: The carbon monoxide level in the blood drops to normal.
  • 2 weeks to 3 months after quitting: Circulation improves and lung function increases.
  • 1 to 9 months after quitting: Coughing and shortness of breath decreases.
  • 1 year after quitting: The excess risk of coronary heart disease is half that of a smoker's.
  • 5 years after quitting: Stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting.
  • 10 years after quitting: The lung cancer death rate is about half that of a person who is still smoking. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decreases.
  • 15 years after quitting: The risk of coronary heart disease is that of a non-smoker's.

Other benefits of quitting include: better tasting food; sense of smell returns to normal; breath, hair, and clothes smell better; teeth and fingernails stop yellowing; ordinary activities leave you less out of breath; and a stop to premature wrinkling of your skin and gum disease.

Tips on Quitting

  • There is no single best way to quit smoking and quitting for good may mean using several different methods. Some people have been successful by stopping "cold turkey." For more than 32 years on the third Thursday of November, the American Cancer Society has helped and inspired Americans to quit smoking through the Great American Smokeout (GASO).
  • Others may need help through self-help classes, counseling, toll-free telephone-based counseling programs, or use of nicotine replacement therapies and other medication. Smokers may also need to make changes in their daily routine to help break smoking habits.
  • Some may find long-term support such as Nicotine Anonymous to be helpful. To improve chances of success in quitting, two or more of these methods should be used.
  • Nicotine replacement therapies (NRTs) help decrease or stop a smoker's withdrawal symptoms by giving controlled doses of nicotine without the other harmful chemicals of cigarette smoke. NRTs are sold as patches, gums, inhalers, nasal sprays, or lozenges. More information on behavioral change programs can be attained by calling the American Cancer Society at 1.800.ACS.2345 (1.800.227.2345).
  • Residents of Georgia can call the Georgia Tobacco Quit Line at 1-877-270-STOP. In addition, five health districts in Georgia have been chosen to be part of the NRT Pilot Project. Uninsured residents that qualify can receive 8 weeks worth of free NRT. More information on this can be obtained from the Coastal Health District website.
  • The American Lung Association offers an online program called "Freedom from Smoking" or FSS. It is a 7-module program that is virtually facilitated by Mary Ella Douglas, ALA representative/former smoker/cancer survivor. Here's what you do:
    1. go to American Lung Association
    2. click on the "Tobacco Control" button on the top right-hand corner
    3. on the left menu bar (blue boxes), click "Quit Smoking"
    4. on the left menu bar (blue boxes again), click "FSS Online Program"

Withdrawal Symptoms

As frustrating as withdrawal symptoms may be, they are a positive sign! Withdrawal symptoms are an indication that the body is beginning to repair itself and returning to good health. Not every smoker will experience withdrawal symptoms, but if you do, know that they won't last long.
Common withdrawal symptoms include:
  • Dizziness (may only last one or two days in the beginning)
  • Depression
  • Feelings of frustration and anger
  • Irritability
  • Trouble sleeping
  • Trouble concentrating
  • Restlessness
  • Headaches
  • Fatigue
  • Increased appetite

Tips to overcome withdrawal symptoms

  • Fight the urge to smoke. Be aware of all rationalizations as they come up (e.g., "I'll just have one cigarette to get me through the day", or "I'll quit tomorrow; today just isn't a good day").
  • Avoid situations, people and places where you are tempted to smoke.
  • Change your routine. If you smoke when you drink coffee or drive to work, switch to juices or water instead of coffee or take a different route to work.
  • Find alternatives. Consider oral substitutes such as sugarless gum, hard candy or raw vegetables.
  • Be active. Get involved with new hobbies or activities; exercise.
  • Deep breathing. When you were smoking, you breathed deeply as you inhaled the smoke. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remind yourself of your reasons for quitting & the benefits you'll gain as an ex-smoker.
  • Delay. If you feel that you are about to light up, delay.

The information in this article was obtained from CDC, ACS and Coastal Health District.