Tag Archives: Smoking

Smoking Zaps Healthy Bacteria In The Mouth, Welcomes Pathogens

Main Category: Smoking / Quit Smoking
Also Included In: Infectious Diseases / Bacteria / Viruses;  Dentistry
Article Date: 17 Feb 2012 – 1:00 PST

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According to a new study, smoking causes the body to turn against its own helpful bacteria, leaving smokers more vulnerable to disease.

Despite the daily disturbance of brushing and flossing, the mouth of a healthy person contains a stable ecosystem of healthy bacteria. New research shows that the mouth of a smoker is a much more chaotic, diverse ecosystem – and is much more susceptible to invasion by harmful bacteria.

As a group, smokers suffer from higher rates of oral diseases – especially gum disease – than do nonsmokers, which is a challenge for dentists, according to PurnimaKumar, assistant professor of periodontology at Ohio State University. She and her colleagues are involved in a multi-study investigation of the role the body’s microbial communities play in preventing oral disease.

“The smoker’s mouth kicks out the good bacteria, and the pathogens are called in,” said Kumar. “So they’re allowed to proliferate much more quickly than they would in a non-smoking environment.”

The results suggest that dentists may have to offer more aggressive treatment for smokers and would have good reason to suggest quitting smoking, Kumar said.

“A few hours after you’re born, bacteria start forming communities called biofilms in your mouth,” said Kumar. “Your body learns to live with them, because for most people, healthy biofilms keep the bad bacteria away.”

She likens a healthy biofilm to a lush, green lawn of grass. “When you change the dynamics of what goes into the lawn, like too much water or too little fertilizer,” she said, “you get some of the grass dying, and weeds moving in.” For smokers, the “weeds” are problem bacteria known to cause disease.

In a new study, Kumar’s team looked at how these bacterial ecosystems regrow after being wiped away. For 15 healthy nonsmokers and 15 healthy smokers, the researchers took samples of oral biofilms one, two, four and seven days after professional cleaning.

The researchers were looking for two things when they swabbed subjects’ gums. First, they wanted to see which bacteria were present by analyzing DNA signatures found in dental plaque. They also monitored whether the subjects’ bodies were treating the bacteria as a threat. If so, the swab would show higher levels of cytokines, compounds the body produces to fight infection.

The results of the study were published in the journal Infection and Immunity.

“When you compare a smoker and nonsmoker, there’s a distinct difference,” said Kumar. “The first thing you notice is that the basic ‘lawn,’ which would normally contain thriving populations made of a just few types of helpful bacteria, is absent in smokers.”

The team found that for nonsmokers, bacterial communities regain a similar balance of species to the communities that were scraped away during cleaning. Disease-associated bacteria are largely absent, and low levels of cytokines show that the body is not treating the helpful biofilms as a threat.

“By contrast,” said Kumar, “smokers start getting colonized by pathogens – bacteria that we know are harmful – within 24 hours. It takes longer for smokers to form a stable microbial community, and when they do, it’s a pathogen-rich community.”

Smokers also have higher levels of cytokines, indicating that the body is mounting defenses against infection. Clinically, this immune response takes the form of red, swollen gums – called gingivitis – that can lead to the irreversible bone loss of periodontitis.

In smokers, however, the body is not just trying to fight off harmful bacteria. The types of cytokines in smokers’ gum swabs showed the researchers that smokers’ bodies were treating even healthy bacteria as threatening.

Although they do not yet understand the mechanisms behind these results, Kumar and her team suspect that smoking is confusing the normal communication that goes on between healthy bacterial communities and their human hosts.

Practically speaking, these findings have clear implications for patient care, according to Kumar.

“It has to drive how we treat the smoking population,” she said. “They need a more aggressive form of treatment, because even after a professional cleaning, they’re still at a very high risk for getting these pathogens back in their mouths right away.

“Dentists don’t often talk to their patients about smoking cessation,” she continued. “These results show that dentists should take a really active role in helping patients to get the support they need to quit.”

For Kumar, who is a practicing periodontist as well as a teaching professor, doing research has changed how she treats her patients. “I tell them about our studies, about the bacteria and the host response, and I say, ‘Hey – I’m really scared for you.’ Patients have been more willing to listen, and two actually quit.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our smoking / quit smoking section for the latest news on this subject. Written by Maureen Langlois.
Kumar’s collaborators include Chad Matthews and Vinayak Joshi of Ohio State’s College of Dentistry as well as Marko de Jager and Marcelo Aspiras of Philips Oral Healthcare. The research was sponsored by a grant from Philips Oral Healthcare.
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Do Smoking Bans Make People Smoke Less At Home? Probably

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Academic Journal
Main Category: Smoking / Quit Smoking
Article Date: 17 Feb 2012 – 0:00 PST

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A study of four European countries with smoke free legislation, published online in Tobacco Control, revealed that smoking bans do not encourage smokers to smoke more at home. According to the researchers, who base their findings on two waves of the International Tobacco Control Policy Evaluation Project (ITC Project) Europe Surveys, smoking bans may actually encourage smokers to smoke less at home.

The first survey was conducted in 2003-2004, before the smoking ban in public places was enforced in the UK, Ireland, France, Germany and the Netherlands, excluding Scotland, before legislation was enacted. The second survey was conducted after legislation was enacted in 2008-2009.

Around 4,634 smokers (depending on when bans were enacted) in the four countries with smoke-free legislation participated in the surveys, as well as 1,080 smokers in the UK. The UK acted as a comparison country before the smoking ban had come into force.

Before a ban was enacted, the majority of smokers had at least partial restrictions on smoking at home, even though the proportions differed considerably among the four countries. France and Germany had the highest levels of restrictions.

Two of the leading factors linked to choosing to restrict smoking at home was the presence of a young child in the household and supporting a smoking ban in bars.

The researchers found that after the ban came into place, the number of smokers who quit smoking at home increased considerably among all countries by the time of the second survey: 38% in Germany 28% in the Netherlands 25% in Ireland 17% in France The team found that the increase was irrespective of whether the ban allowed for some exceptions or was comprehensive.

Smokers were more likely to ban smoking at home if they supported smoking bans in bars, planned to quit the habit, or when there was a birth of a child.

In the UK, the number of smokers who banned smoking at home also increased by 22% between the two surveys. The second survey was conducted only a few months before the smoking ban came into force.

After the researchers took into account several demographic and smoking history variables, they found that the number of current smokers banning smoking at home rose considerably in Germany, France, the Netherlands and Ireland, but did not considerably rise in the UK.

According to the current theory, public smoking bans either increase the amount of smoking at home as individuals try to compensate “the displacement hypothesis” or encourage smokers to adopt the same ban at home – the social diffusion hypothesis.

The researchers explain:

“Opponents of the workplace or public smoking bans have argued that smoke-free policies – albeit intended to protect non-smokers from tobacco smoke – could lead to displacement of smoking into the home and hence even increase the second hand smoke exposure of non-smoking family members and, most importantly, children.”

Findings from the study support the theory that banning smoking in public places may encourage smokers to ban smoking at home.

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our smoking / quit smoking section for the latest news on this subject. “Towards smoke-free rental cars: an evaluation of voluntary smoking restrictions in California” Georg E Matt et al.
Tob Control doi:10.1136/tobaccocontrol-2011-050231 Please use one of the following formats to cite this article in your essay, paper or report:

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posted by Bobby LaGuardia on 17 Feb 2012 at 9:06 am

I dont smoke but allow smokers to smoke freely in my home. When you pay our rent or mortgage you can decide that!

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Largest Addiction Treatment Facility in Central Texas Says, ‘No smoking’

HomeNewsLargest Addiction Treatment Facility in Central Texas Says, ‘No smoking’

February 13, 2012   The image of chain-smoking patients in treatment for drug addiction is no myth, but an Austin nonprofit hopes to make it history. Austin Recovery, the largest inpatient addiction treatment center in Central Texas and one of the biggest in the state, is going smoke-free April 30.

“When you’re in residential treatment, what better time to address your other deadly addiction, which is tobacco use?” said Jonathan Ross , president and CEO of Austin Recovery. The nonprofit treats 3,200 clients annually and has three residential campuses. Ross and his staff hope to dispel the old-school notion that it’s too hard to get people to quit smoking when they are trying to kick a drug or alcohol problem. “Not only are you continuing an addictive behavior and putting yourself at risk of relapse, you’re also killing yourself,” he said.

For More Information:
http://www.statesman.com/news/local/largest-addiction-treatment-facility-in-central-texas-says-2164142.html

Feb 14, 2012
New Book Examines Impact of the U.S. Tobacco Industry
Read the full story Feb 14, 2012
Smoke-Free Laws Lead to Less Smoking At Home
Read the full story Feb 13, 2012
UM Tobacco Ban Yields Only 3 Referrals Since Becoming Mandatory Jan. 1
Read the full story Feb 13, 2012
Largest Addiction Treatment Facility in Central Texas Says, ‘No smoking’
Read the full story

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Youths’ Smoking Influenced By Sports Teammates

Main Category: Smoking / Quit Smoking
Also Included In: Pediatrics / Children’s Health
Article Date: 10 Feb 2012 – 0:00 PST

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Young people’s choices about using drugs and alcohol are influenced by peers – not only close friends, but also sports teammates. A new study of middle schoolers and their social networks has found that teammates’ smoking plays a big role in youths’ decisions about smoking, but adolescents who take part in a lot of sports smoke less.

The study was conducted at the University of Southern California (USC) and appears in the journal Child Development.

Researchers looked at 1,260 ethnically diverse, urban, middle-class sixth through eighth graders. They asked the students about their own smoking behavior, and they asked them to name friends at school as well as the organized sports they took part in at school. Then, using a social network method they developed, they examined how participation in sports with teammates who smoked affected adolescents’ smoking behavior.

They found that youths were more likely to smoke as they were increasingly exposed to teammates who smoked, and that this tendency may be stronger among girls than boys. But they also found that youths who took part in a greater number of sports were less likely to smoke than those who participated in fewer.

“This result suggests that peers on athletic teams influence the smoking behavior of others even though there might be a protective effect overall of increased participation in athletics on smoking,” according to Kayo Fujimoto, assistant professor of health promotion and behavioral sciences at the University of Texas Health Science Center at Houston, who led the study when she was at USC.

The study has implications for programs aimed at preventing teens from smoking. “Current guidelines recommend the use of peer leaders selected within the class to implement such programs,” Fujimoto points out. “The findings of this study suggest that peer-led interactive programs should be expanded to include sports teams as well.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
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Society for Research in Child Development. “Youths’ Smoking Influenced By Sports Teammates.” Medical News Today. MediLexicon, Intl., 10 Feb. 2012. Web.
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Gay, Lesbian, Bisexual And Transgendered Adults Have Twice The Level Of Smoking And Half The Level Of Plans To Quit

Main Category: Smoking / Quit Smoking
Also Included In: Public Health
Article Date: 10 Feb 2012 – 0:00 PST

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Gay, lesbian, bisexual and transgendered Coloradans who smoke are not thinking about quitting or getting ready to quit, and a quarter are uncomfortable approaching their doctors for help, report University of Colorado Cancer Center researchers in a recent article published in Nicotine & Tobacco Research.

These and other findings from the study may help identify new approaches to encourage GLBT smokers to quit.

“Among most smoking populations, we almost always find 20 percent getting ready to quit and another 40 percent are thinking about quitting,” says Arnold Levinson, PhD, MJ, investigator at the CU Cancer Center and the paper’s senior author. “But the rates from our study were half of what we expected.”

For more than 70 percent of the GLBT smokers who were surveyed in Colorado, quitting was not on their agenda. GLBT adults are roughly twice as likely as heterosexual adults to smoke cigarettes. And little research has been done to determine which smoking cessation methods the group might prefer.

The GLBT Community Center of Colorado and other GLBT organizations across Colorado approached Levinson to create the survey of 1,633 Colorado GLBT smokers to see if they were less likely than other smokers to use “proven” cessation methods such as nicotine replacement therapy or telephone counseling.

Prior to the study, advocates thought GLBT smokers wouldn’t use smoking cessation strategies that didn’t take sexual orientation into account. But the surveys, collected at more than 120 GLBT-identified venues in Colorado, showed that GLBT smokers generally use the same strategies that other smokers use.

“More than a quarter of the GBLT smokers we surveyed had used proven methods to try to quit in the past, which is similar to what other populations report,” says Levinson, who is also an associate professor at the Colorado School of Public Health. “There was a minority, though, who wanted programs offering GLBT-identified cessation counselors and advice based on GLBT identity.

“This diversity of preferences makes the GLBT smoker population just like any other smoker population – a group of individuals with varying needs and preferences for cessation strategies.”

In contrast to other smoking populations however, more than 25 percent of respondents were uncomfortable asking their doctor for smoking cessation advice, which is one of four factors significantly associated with preparing to quit. Other factors include daily smoking, previous nicotine replacement therapy use and a smoke-free home rule.

Last month, the One Colorado Education Fund found similar widespread physician distrust among GLBT adults in a report titled Invisible: The State of GLBT Health in Colorado.

Taken together, these findings suggest that public health professionals have an opportunity to develop nonsmoking promotion campaigns in non-clinical settings. For example, a majority of survey respondents said they frequent GLBT bars and events and read GLBT publications. Additionally, promoting smoke-free homes could make a significant impact.

“Only half of our survey respondents had a smoke-free home,” Levinson says. “Since a smoker who lives in a smoke-free household is more likely to try quitting, we need to encourage more GLBT households to adopt this policy.”

“Before we worry too much about how to help GLBT smokers quit, we need public health campaigns to get the GLBT smoker population thinking about quitting,” he says.

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
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University of Colorado Denver. “Gay, Lesbian, Bisexual And Transgendered Adults Have Twice The Level Of Smoking And Half The Level Of Plans To Quit.” Medical News Today. MediLexicon, Intl., 10 Feb. 2012. Web.
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University of Colorado Denver. (2012, February 10). “Gay, Lesbian, Bisexual And Transgendered Adults Have Twice The Level Of Smoking And Half The Level Of Plans To Quit.” Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/241360.php.

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Erlotinib Dose-Adjusted For Smoking Status Effective As First Treatment For Head And Neck Cancer

Main Category: Cancer / Oncology
Also Included In: Ear, Nose and Throat;  Smoking / Quit Smoking
Article Date: 27 Jan 2012 – 4:00 PST

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Head and neck cancers respond well to the anti-cancer drug erlotinib when it is administered before surgery and a stronger dose is given to patients who smoke, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM.

Erlotinib is an oral anti-cancer drug that can slow a tumor’s growth and spread by inhibiting specific growth receptors on the surface of the cancer cells. Early detection of a patient’s response to EGFR inhibitors, such as erlotinib, is critical to personalizing head and neck cancer treatments.

In a first of its kind study in patients with head and neck cancer, researchers sought to determine how well tumors unaffected by other therapies respond to erlotinib, when the drug dose was adjusted according to the patient’s smoking status. It has been recently shown that smokers metabolize the drug faster than nonsmokers.

Nonsmokers received 150 mg per day and smokers received 300 mg per day for at least 14 days before surgery. A FDG-PET scan and neck CT was performed before treatment and at the end of erlotinib administration. In addition, an early FDG-PET was performed after four to six days of treatment.

The results showed that erlotinib is effective as a first line of therapy when the dose is adjusted per smoking status, even when used for a limited duration. Both smokers and nonsmokers tolerated the dose of erlotinib and neither experienced serious adverse effects. The study also showed that the FDG-PET scan taken early can show changes in the standard uptake value and predict a patient’s response to erlotinib.

“We hope our results will motivate clinicians to consider and investigate further the use of erlotinib in patients with head and neck cancer and adjust the dose for smoking status,” Mercedes Porosnicu, MD, lead author of the study and an assistant professor of internal medicine at Wake Forest Baptist Medical Center in Winston Salem, N.C., said. “We also hope that our study will help better select the patients expected to respond to erlotinib.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our cancer / oncology section for the latest news on this subject. The abstract, “Pilot study to evaluation the effect of erlotinib administered before surgery in operable patients with squamous cell carcinoma of the head and neck (SCCHN),” was presented as a poster presentation.
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Male Smoking Leads To Faster Cognitive Decline

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Academic Journal
Main Category: Smoking / Quit Smoking
Also Included In: Psychology / Psychiatry;  Alzheimer’s / Dementia
Article Date: 10 Feb 2012 – 6:00 PST

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Findings of a report published Online First in the Archives of General Psychiatry, one of the JAMA/Archives journals shows that men who smoke seem to be linked with a more rapid cognitive decline.

According to background information, smoking is more and more renown as a risk factor for dementia in the elderly. In 2010, the number of dementia diagnoses around the world was estimated at 36 million with numbers increasing and predicted to double every 20 years.

Séverine Sabia, Ph.D., of the University College London and her team assessed the link between smoking history and cognitive decline during the transition from midlife to old age by obtaining data from 5,099 men and 2,137 women from the Whitehall II cohort study, which is based on employees of the British Civil Service. The average age of the participants was 56 years at the first cognitive assessment.

In their new study, the researchers evaluated data from six assessments of smoking status over a 25 year-duration and three cognitive assessments over 10 years and established four major findings, which indicate that men who smoked are linked to a more rapid cognitive decline, and that those who continued smoking over the follow-up period had a bigger decline in all cognitive tests.

They also observed that those who quit smoking in the 10 years before the first cognitive measure were still at risk of greater cognitive decline, in particular in executive function, an overall term for various complex cognitive processes involved in achieving a particular goal, whereas there was no faster cognitive decline in long-term ex-smokers.

The researchers conclude:

“Finally, our results show that the association between smoking and cognition, particularly at older ages, is likely to be underestimated owing to higher risk of death and dropout among smokers.”

They also observed no link between smoking and cognitive decline in women, even though the underlying reasons remain unclear, and hypothesize that one explanation for the sex difference could be that men smoke greater quantities of tobacco.

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our smoking / quit smoking section for the latest news on this subject. Arch Gen Psychiatry. Published online February 6, 2012. doi:10.1001/archgenpsychiatry.2011.2016. Please use one of the following formats to cite this article in your essay, paper or report:

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Smoke-Free Laws Lead to Less Smoking At Home

HomeNewsSmoke-Free Laws Lead to Less Smoking At Home

February 14, 2012   Anti-tobacco laws in several European countries prompted many smokers to ban smoking at home and to cut their cigarette consumption, according to a study published in the journal Tobacco Control. The study looked at smoking habits in France, Germany, Ireland, and the Netherlands, both before and after bans on smoking in the workplace, restaurants, and bars took effect in the last decade. The trends in these countries were compared to Britain, which at the time did not have smoke-free legislation. After the law took effect, the percentage of smokers who banned all smoking at home rose by 17 percent in France, 25 percent in Ireland, 28 percent in the Netherlands, and 28 percent in Germany. The overall number of cigarettes that an individual smoked each day also fell significantly in Ireland, the Netherlands, and Germany. These findings rebut those who claim banning smoking in public places would simply shift the habit to home, exposing family members to dangerous second-hand smoke.

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Feb 14, 2012
New Book Examines Impact of the U.S. Tobacco Industry
Read the full story Feb 14, 2012
Smoke-Free Laws Lead to Less Smoking At Home
Read the full story Feb 13, 2012
UM Tobacco Ban Yields Only 3 Referrals Since Becoming Mandatory Jan. 1
Read the full story Feb 13, 2012
Largest Addiction Treatment Facility in Central Texas Says, ‘No smoking’
Read the full story

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The Biggest Killers Of Japanese Adults Are Tobacco Smoking And High Blood Pressure

Main Category: Smoking / Quit Smoking
Also Included In: Hypertension;  Cardiovascular / Cardiology
Article Date: 25 Jan 2012 – 1:00 PST

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The life expectancy of a person born in Japan is among the highest in the world (82.9 years) yet tobacco smoking and high blood pressure are still the major risk factors for death among adults in Japan, emphasizing the need to reduce tobacco smoking and to improve ongoing programs designed to help people manage multiple cardiovascular risk factors, including high blood pressure, according to a study published in this week’s PLoS Medicine.

In an analysis of available data led by Nayu Ikeda from the University of Tokyo in Japan, the authors found that in Japan in 2007, tobacco smoking and high blood pressure accounted for 129,000 and 104,000 deaths, respectively, among adults aged 30 years and over. Physical inactivity accounted for 52,000 deaths, high blood glucose and high dietary salt intake accounted for 34,000 deaths each, and alcohol use for 31,000 deaths. Furthermore, the authors found that life expectancy at age 40 would have been extended by 1.4 years for both sexes, if exposure to multiple cardiovascular risk factors had been reduced to an optimal level.

According to the authors, in order to sustain the trend of longevity in Japan for the 21st century, additional efforts in a variety of fields are required for decreasing adult mortality from chronic diseases and injuries. They say: “A first step will be to powerfully promote effective programs for smoking cessation.”

Tobacco smoking is deeply rooted in Japanese society, but the authors argue that health professionals can play a big role: “Health care professionals, including physicians, who are highly conscious of the harms of tobacco will play the primary role in treatment of smoking and creating an environment for implementation of stringent tobacco control policies.

As for high blood pressure, the authors say: “it is urgent to establish a monitoring system for management of high blood pressure at the national level. Further investigation through national health surveys will help understand factors that contribute to the inadequate control of blood pressure in the Japanese population.”

The authors conclude: “Measuring the quality of the care that is actually delivered by interventions will be of paramount importance in the assessment of current policies and programs for the treatment of multiple cardiovascular risks including hypertension. These concerted actions in research, public health, clinical practice, and policymaking will be the key for maintaining good population health in the aging society.”

Article adapted by Medical News Today from original press release. Click ‘references’ tab above for source.
Visit our smoking / quit smoking section for the latest news on this subject. Funding: This research was supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labour and Welfare (H22-seisaku-shitei-033) and a Grant-in-Aid for Scientific Research (B) from the Japan Society for the Promotion of Science (No. 2239013). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Ikeda N, Inoue M, Iso H, Ikeda S, Satoh T, et al. (2012) Adult Mortality Attributable to Preventable Risk Factors for Non-Communicable Diseases and Injuries in Japan: A Comparative Risk Assessment. PLoS Med 9(1): e1001160. doi:10.1371/journal.pmed.1001160
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How To Give Up Smoking

Editor’s Choice
Main Category: Smoking / Quit Smoking
Article Date: 08 Feb 2012 – 3:00 PST

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“It’s easy to quit smoking; I’ve done it hundreds of times.” — Mark Twain

There are many different ways to quit smoking. Some experts advocate using pharmacological products to help wean you off nicotine, others say all you need is a good counselor and support group, or an organized program. To add to the confusion, you may find there is a study that says this way works better than that one, and then when you look again, you find there is another study that says, no, that one works better than this one.

But one thing most experts agree on is that a combination works best. For example, nicotine replacement therapy on its own, or counseling on its own is not as effective as a combination of the two.

In this article you can read about some of the more common elements of successful quit smoking programs. And at the end is a list of Top Tips to Quit Smoking.

If you are looking to put together or select a quit smoking program, I suggest you consider four elements in your “combination”: Appropriate use of pharmacological products. If you feel you are severely addicted to smoking, you may wish to consider nicotine replacement products so your body gradually gets used to living without nicotine: always talk to your doctor, pharmacist, or qualified quitting expert first before using these drugs.
Advice and support. Advice and support can help you become more self-aware, identify your triggers and when moments of weakness may occur, develop strategies and contigencies, keep you realistically grounded and on track with your plan, and prevent relapse. Examples include one-to-one or in-person counseling, telephone counseling, internet programs, group support, mentoring, and coaching.
Measuring and recording. To help you see in black and white how much you smoke, how much it costs you, how much you could save; also keeping a journal of your quitting journey.
Improving your knowledge: Read the science, talk to experts, and learn for yourself how smoking damages your health and the health of those around you. Learn how others tackled the challenge.If you have had a health problem, such as a heart attack or stroke, or if you are pregnant or planning to start a family, go and see your doctor and discuss your quit plan before you start. There are more than 4,000 harmful chemicals in tobacco. Nicotine is the one that makes you addicted to smoking. The idea of nicotine replacement products is to help you gradually wean yourself off nicotine. They deliver a small amount of nicotine to relieve the symptoms of withdrawal. Giving up the replacement product is easier than giving up smoking.

Nicotine replacement products come in many forms, the main ones being: Nicotine gum,Nicotine patch,Nicotine nasal spray, andNicotine inhaler.Proper use of such products can often be the key to successfully quitting for good. Here is an example of how it works:

Stage 1: Stop smoking (NEVER use nicotine replacement products if you are still smoking).

Stage 2: Use nicotine replacement therapy (having first consulted an expert about the best product and dose for you) to help manage your cravings. Gradually reduce the dose in line with the program you are following.

Stage 3: Meanwhile, seek out and start on a support program, such as counseling or group therapy. Make sure you discuss your use of nicotine replacement products in your counseling so the two therapies work with each other.

Aim to be free of both cigarettes and the nicotine replacement product within three to six months.

To decide which product is most likely to help you, talk to a qualified expert. Go and see your doctor, he or she may advise you, or refer you to a smoking cessation expert who knows about appropriate use of nicotine replacement products.

Knowing how dependent you are on nicotine can help you decide whether you wish to use replacement products. Some quitting centres may ask you to fill in a short questionnaire, such as the “Fagerstrom Test” to assess your nicotine dependence. This asks you: How soon do you smoke your first cigarette after waking up?
Do you find it difficult to abstain from smoking in places where it is forbidden?
Which cigarette would you most hate to give up?
How many cigarettes do you smoke a day?
Do you smoke more frequently in the morning (in the hours after getting up), than the rest of the day?
Do you smoke even if you are so ill you have to stay in bed?Your answers generate a score that indicates how dependent you are on nicotine. The higher your dependence, the more likely you are to benefit from pharmacological products to help you cope with withdrawal symptoms and quit smoking.

Click here to seen an example of the Fagerstrom Test as part of online Quitting Smoking resources offered by the government of New South Wales in Australia.

Other products are also available, such as bupropion hydrochloride, that target the biologic basis of tobacco addiction. Bupropion is sold under various brand names, eg Zyban, Wellbutrin, and is available on prescription. The drug has a similar effect on the brain as nicotine, it boosts levels of dopamine and norepinephrine to create a sense of wellbeing and vitality. Like all nicotine substitutes, the drug is intended for use with a quit smoking behavior change program.

Evidence suggests that advice and support from others makes a difference to long-term success in quitting smoking. Randomized controlled trials of commonly used techniques, including one-to-one, group, and telephone counseling, show they help smokers quit and remain abstinent. Even brief advice from a doctor has an effect on cessation rates.

The World Health Organization (WHO) takes the view that any professional trained in the appropriate skill should be involved in helping smokers quit: that it is an activity for the whole health care system, providing as many access points as possible for smokers to connect with and benefit from support to help them quit.

Many quitting practitioners employ techniques from cognitive behavioural therapy (CBT). These help you change your habitual thinking and behavior around smoking: for example, identifying and managing triggers (the things that make you want to smoke), developing and reinforcing alternative “good habits” such as exercise, relaxation, or self-rewards for each day without a cigarette or each cigarette or packet not smoked.

The techniques should focus not only on the period leading up to and during quitting, but also afterwards, helping you sustain changes in thinking and behavior to remain abstinent.

You don’t have to go to a cognitive behavioral therapist to benefit from CBT techniques. Many other care professionals are trained in CBT because it complements how they deliver their own service. I have met doctors, nurses, social workers, physiotherapists, hypnotherapists, business coaches, Reiki healers and yoga teachers trained in CBT.

An effective program also offers several ways or “modalities” to help you stay connected and on track. For instance, as well as offering one-to-one advice and support, such a program might include group discussions, access to online materials and knowledge bases where you can read articles on smoking cessation, tips and stories from successful quitters, as well as the opportunity to pair up with a buddy or a mentor.

In the UK, under the NHS Smokefree campaign, there are free local services that provide expert advice, information and support to smokers who want to quit. They can help you get stop smoking aids such as nicotine patches and gum, or other prescription products from your GP such as Champix or Zyban if they are suitable for you.

One such example is in Buckinghamshire, where support centres throughout the county offer confidential sessions for a minimum of six weeks. They also work with local employers and set up free workplace groups for staff who find it difficult to get to support centres.

Many quitting programs have an element where where you sit down and quantify the effect that smoking has on your life. For example, you work out how many cigarettes you smoke per day, per week, per year, and how much this costs you. For some smokers this is often their first “reality check”.

For instance, if you smoke 20 per day at a cost of 4.95 a pack, then you discover that:
a wallet of money - savings if you quit smoking In a day you spend 4.95 on cigarettes.In a week you spend 34.65.In a month you spend 148.50.In a year you spend 1,806.75.In 5 years you spend 9,033.75.In 10 years you spend 18,067.50.Some people find it helps to keep a quit journal. You can use it to jot down your plan or little notes to remind you about why you want to quit, and to record snippets of your quitting experience. For example, you may wish to list your triggers and your options for alternative action to avoid taking up smoking again. You could list what you think will be your biggest challenges, such as keeping the weight off: how might you prepare for and deal with that?

Once you’ve reached your quit date, use your journal to keep track of how you are doing. How did you deal with those challenges?

Some people find their journal helps them put things in perspective. On bad days things can look much bleaker than they really are. Looking back through the journal you can see that there have been good days too: what was it about them that you can use in the bad days to help you along? Many countries have “quitlines” where you can call an expert who understands the health effects of smoking, the quitting process, and how difficult it can be to give up.

You may find it helps to stay motivated about quitting to keep up to date with the science surrounding tobacco and smoking. Finding out how other quitters faced and dealt with their challenges can also give you ideas that help you on your own quitting journey.

One resource that offers both these types of information and more is the About.com Smoking Cessation website.

Another resource that may help keep you motivated is the “Within 20 Minutes of Quitting” poster from the US Centers for Disease Control and Prevention (CDC). The poster, included in the 2004 US Surgeon General’s Report, lists the following statements: 20 minutes after quitting: your heart rate drops.
12 hours after quitting: carbon monoxide in your blood drops to normal.
2 weeks to 3 months after quitting: your heart attack risk begins to drop; your lung function begins to improve.
1 to 9 months after quitting: your coughing and shortness of breath decrease.
1 year after quitting: your added risk of coronary heart disease is half that of a smoker’s.
5 years after quitting: your stroke risk is reduced to that of a non-smoker’s 5 – 15 years after quitting.
10 years after quitting: your lung cancer death rate is about half that of a smoker’s; your risk of cancers of the mouth, throat, esophagus, bladder, kidney and pancreas decreases.
15 years after quitting: your risk of coronary heart disease is back to that of a non-smoker’s.You can also pick up leaflets, books, motivational CDs, and other resources at your doctor’s, local clinic, health centre and library. There are smoking cessation programs that come in a kit that you can have delivered to your home. In the UK, you can order a Quit Kit from the NHS. When you open the box, it contains materials and resources such as a guide, a route map of your day to day quitting journey, an addiction test, information about nicotine replacement products, calming audio downloads, a stress toy and a tool to help you work out how much money you can save by quitting.

An increasing number of do-it-yourself quit programs are also being offered over the internet. One example from the US is the free to use EX Plan, set up under the National Alliance for Tobacco Cessation. The program, which purports to “show you a whole new way to think about quitting” is based on personal experiences of real ex-smokers and research from the Mayo Clinic. You can explore the site before you sign up and register.

The EXPlan comprises three steps that have to be completed in sequence: How to Quit. This is the preparation phase, where you identify your triggers and patterns and “relearn how to handle them” without cigarettes. In this step you also gain knowledge about addiction and how smoking changes the brain, how medications work, and the importance of having a support network. There is also an online EX Community you can link up with.
Quit Smoking. This is where you set your quit date and put into practice what you learned in step 1.
Staying Quit. In this final step you learn how to keep on being an ex-smoker, make sure the weight stays off and stack up the rewards and benefits of your non-smoking lifestyle.Some nicotine replacement product manufacturers also have online programs. After registering, you answer questions about your smoking habits, reasons for quitting, potential barriers to quitting, what challenges you face, and other lifestyle factors. This information is then used to tailor program materials to the individual.

One such example is GlaxoSmithKline’s Committed Quitters designed to be used with their nicotine replacement gum, lozenges, and patches. Their program, which incorporates cognitive behavioral techniques, includes a cessation guide, tailored newsletters delivered via the web, and behavioral support messages that arrive by email over a 10-week period.

Registered users also have access to an online library of articles where they can read about the health risks of smoking, common misconceptions about quitting, how to deal with barriers, the financial costs of smoking, tips for planning and alternative activities.

choose a smoking quit date and stick to it List your own reasons for quitting.
Choose a “low stress” time to quit. Set a date and stick to it.
Build a support network around you. Ask for help from your dentist, doctor, family, friends, work colleagues.
Use medicines that help your body get used to life without nicotine: they can double your chances of quitting for good. Ask your doctor, dentist, pharmacist about them first.
Seek tobacco-free environments to curb your temptations: eg movies, theatres, libaries, restaurants.
Plan activities that leave no opportunity for smoking.
Remove smoking paraphernalia from your home, office and car.
Anticipate problems and have a realistic plan to deal with challenges (eg if going out with smokers, practise what you are going to say when you refuse a cigarette).
Exercise: not only can it make you feel better about yourself and your decision to quit, it is hard to smoke when you’re cycling, swimming, or jogging.
Keep your hands occupied. Take up some manual activities: woodworking, gardening, do the housework, keep some needlework or a small book of puzzles or crosswords with you.
Practise the 4Ds when you feel cravings coming on: Delay (craving will pass in 5 to 10 minutes); Drink water (helps wash toxins from your body, keeps your hands and mouth busy); Distract yourself (keep active, do something else); Deep breathing (inhaling and exhaling deeply is soothing and relaxing).Tips list is adapted from the American Dental Association’s Oral Health Topics.

And finally, the most important tip of all:

Persevere and don’t let setbacks get you down. It is like learning to ride a bike: when you fall off, just get back on again and keep trying. There will be bad days, and there will be good days.

Remember, the majority of successful quitters did not stop on their first quit attempt.

Written by Catharine Paddock PhD


Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today Visit our smoking / quit smoking section for the latest news on this subject. Additional sources: What Works to Quit: A Guide to Quit Smoking from tobacco-cessation.org; Oral Health Topics from American Dental Association; A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report. The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives, JAMA 2000; Physician advice for smoking cessation, T Lancaster & L Stead, Cochrane Database Syst Rev 2004; CDC “Within 20 Minutes” poster; smokefree.nhs.uk Please use one of the following formats to cite this article in your essay, paper or report:

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Catharine Paddock PhD. “How To Give Up Smoking.” Medical News Today. MediLexicon, Intl., 8 Feb. 2012. Web.
14 Feb. 2012. APA

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posted by azure on 11 Feb 2012 at 10:56 am

Too bad the US lags so far behind the UK in offering quit smoking assistance.

I stopped 7 years ago. There were no support groups w/in a 60-70 mile range. The only “cessation expert” was a guy who knew less than I did, was charging $200 for his “assistance” and had worked w/a total of 2 clients.

I used no nicotine replacement, I had tried the gum during an earlier unsuccessful attempt, the nicotine delivery system was unpleasant (and not an effective replacement) for me.

What helped me was a 1986 ACS Quit Smoking book I found for 50 cents at a library book sale. It utilized some of the techniques listed above. It recommended writing down your primary 1-2 reasons for quitting on piece of paper, sticking that in your wallet & reading it at least once a day. I guess now people could type it into their i-phones-perhaps have it as the background of their screen. Just so you’re reminded frequently of why you’re quitting.

The state I lived in uses a portion of its tobacco settlement money to have a “quit line”. You speak to someone for maybe 2 minutes, you are sent some stuff, and that’s it. There’s no follow up call, nothing. Not much value.

At the time, I found a UK NHS site that had a place for people to write what was an important factor in their quit effort (having a new baby in the house, not wanting to expose it to second hand smoke, etc.). I found reading those entries very helpful. I found another UK site that had utilized US Surgeon General reports to create a list of all the conditions that were triggered or worsened by smoking. Again, a UK site, not US site. I printed that out, looked at it every day for about 2 weeks.

I noticed that it listed an autoimmune disorder that I developed when I was in the late teens. I had had the initial diagnosis confirmed by a board certified specialist years later. The BC specialist did not even mention that smoking worsened, maybe even triggered, this condition. If she had, that knowledge might’ve provided additional motivation for me to stop smoking and I might’ve quit years sooner.

I did get some support from my friends.

Overall, I’d say the US does a much worse job of providing people w/the (free) tools for quitting smoking or making it easier for people who want to quit. Now some minimal smoking cessation assistance via health insurance is mandated. That’s progress but it’s still nothing like the assistance the UK provides.

Gee, a single payer system doing more in preventive health care, what a surprise.

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