Stopping smoking: You can do it!

By now, even the tobacco companies agree: Smoking is bad for your health  very bad. Cigarettes are the most hazardous, but cigars, pipes, and smokeless tobacco also contribute to tobacco’s terrible toll. And second-hand smoke is an important cause of death and disability in people who never light up.

We are making progress. Many Filipinos have quit, and many communities prohibit smoking in public places. But 17.3 million Filipinos, aged 15 years and older, still smoke. And that constitutes 28.3 percent of the 61.3 million Filipinos who belong to such an age group. Tragically, smoking kills 10 Filipinos every hour and hundreds of teenagers take up smoking every day. We can do better. Fortunately, there are more ways to kick the habit than ever before.

THE HAZARDS OF SMOKING

Tobacco is responsible for thousands of deaths every year in the Philippines. Smoking will kill about 650 million of the world’s 1.3 billion smokers alive today and millions more will suffer from chronic illnesses caused by smoking. All in all, the average nonsmoker lives about 14 years longer than the average smoker.

Smoking is a major cause of cardiovascular disease, including heart attacks, strokes, and peripheral artery disease. About 20 percent of all cardiac deaths are caused by smoking. Between 80 and 90 percent of all patients with emphysema owe their lung disease to smoking. Chronic bronchitis and pneumonia are among the other lung diseases that are increased in smokers.

And there’s more. Smoking contributes to many other health problems, including cataracts, sinusitis, dental disorders, aging skin, heartburn, diabetes, osteoporosis, cancer (breast, lung, and bladder) and erectile dysfunction.

The more you smoke, the higher your risks — but even a few cigarettes a day will harm your health. “Light” and “low tar” cigarettes are no safer than high-test brands. The only truly safe dose of tobacco is zero.

THE BENEFITS OF QUITTING

Quitting helps, even if you’ve smoked for years. Within days, your blood vessels will regain much of the normal function that is damaged by smoking. Within weeks, you’ll be able to taste food better, and your sense of smell will recover from tobacco’s assault. Within months, symptoms of chronic bronchitis ease up, and lung function improves within a year. Quitting reduces the risk of heart attack and stroke within two to five years. And the risk of lung cancer begins to drop substantially within five to nine years of quitting. People who kick the habit, regardless of age, live longer than those who continue to smoke.

HOW TO QUIT

Nicotine is addicting, and quitting is hard work. There is no way to succeed without really trying. But if you set your mind to it, you can quit.

Most smokers start by trying to quit on their own, but many end up needing several attempts before they kick the habit. And even after you quit, it’s important to keep your guard up. Just as an alcoholic can fall off the wagon after a single drink, just one cigarette can fire up nicotine craving even after years of abstinence. There are four basic strategies for quitting. Look them over and decide which one is best for you.

Do it yourself. Don’t kid yourself by trying to cut down; nearly everyone who tries slides back up to their usual dose of nicotine. Cold turkey is the way to go, but it takes preparation. And even without professional help, cooperation from family and friends can be important. Here are some tips:

• Make a list of reasons to quit and another list of people who have kicked the habit. The first list will remind you why quitting is important and the second will show you that folks who are no stronger or smarter than you are have succeeded. Keep your lists handy and refer to them whenever you waver.

• Pick a quitting date and stick to it. Plan to quit on a special day, such as the day after your birthday, or during the start of Lung Cancer Awareness Month. Steer clear of stressful periods and avoid holidays if you are likely to be invited to smoke-filled parties.

• Try to get other smokers in your household or circle of friends to join in quitting. A 2008 study found that smoking behavior spreads through both close and distant social ties; your resolve and success can help your friends and, ultimately, your community.

• As your quit date approaches, throw out your ashtrays, clean your house, car, and clothes, and clean your teeth. Once you’re away from it, you’ll see that smoking stinks.

• Anticipate withdrawal symptoms such as grumpiness, restlessness, irritability, hunger, headache, anxiety, and drowsiness or insomnia. The discomfort usually peaks one to three weeks after you quit, and then it gradually diminishes.To get through the rough patches, stock up on low-calorie snacks and sugarless gum or candy to keep your mouth busy. Think of ways to keep your hands busy, too.

• If you feel tense, try meditation, deep breathing or yoga.

• Begin an exercise program. It will relieve tension, promote good sleep, and help control weight gain. Walking for 30 minutes a day can really help.

• Eat a healthy diet.

• Stay away from second-hand smoke. Don’t even think about smoking “just one” — even a single puff will set you back.

• Reward yourself. Put your tobacco money aside in a kitty, and then spend it on a special treat.

• Think positively — you can quit. Take it one day at a time. And if you slip, try, try again — either on your own or with one or more of the other strategies for quitting.

• Get behavioral support. Quitting is your responsibility; it may be hard, but it doesn’t have to be lonely. Your doctor or organizations, such as the Philippine Cancer Society, may be able to refer you to a program in your area. Hypnosis is another alternative that has helped some smokers break free.

• Go on a nicotine-replacement therapy. Cigarette smoke contains thousands of chemicals. Many are harmful, but nicotine is the most addicting. Like other addicting substances, it acts on receptors in the brain’s “reward center,” creating a sensation of pleasure and a craving for more nicotine. Nicotine-replacement therapy can short-circuit the craving without introducing the other disease–producing chemicals.

Nicotine replacement is safe. You’ll get less nicotine than from cigarettes, and you won’t get any of the tar, carbon monoxide, and other damaging substances in tobacco. Plan to start nicotine-replacement therapy on the day you quit smoking. If you are a heavy smoker, you’ll need higher doses. Estimate how much nicotine you need based on an average of one to two mg. of nicotine per cigarette. Start with the full dose, then gradually taper down over several months. Underdosing is more common than overdosing, but you should not smoke while using nicotine-replacement therapy.

Five types of nicotine-replacement are available. Here are the options – nicotine patches, nicotine gum, nicotine lozenges, nicotine inhalers, and nicotine nasal sprays. Individual smokers may prefer one form over the others. Experiment with various types and talk to your doctor. Remember that nicotine replacement works best when combined with behavioral support, prescription drugs, or both. And smoke cessation always requires a good dose of will power.

PRESCRIPTION DRUGS

• Buproprion. This does not contain nicotine and can be used in combination with nicotine-replacement therapy. It can reduce weight gain after quitting. Possible side effects include dry mouth and insomnia.

• Varenecline. It’s the newest drug approved for smoking cessation. Although experience is still limited, it also promises to be the most effective. It blocks nicotine receptors in the brain while also partially stimulating these receptors to reduce nicotine withdrawal symptoms. More research, however, is needed to establish long-term safety.

TOP PRIORITY

Smoking is Public Health Enemy Number One — so if you smoke, quitting should be your top priority. It will take willpower and hard work. You may gain a few pounds, you may go through a rough spell as your body adjusts to life without tobacco, and you may have to try several times before you finally kick the habit. Don’t be discouraged. Hundreds of thousands of Filipinos have quit smoking. You can do it, too!

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For additional information: Centers for Disease Control and Prevention (www.cdc.gov/tobacco) and Try to Stop Tobacco Resource Center (www.trytostop.org).