Quit Smoking — It Could Save Your Life

The decision to quit smoking is one of the healthiest choices you can make for your good health. After all, cigarette smoke contains over 43 known carcinogens (cancer causing chemicals), and one out of five smokers die early because of their tobacco use. Tobacco increases the risk of heart attack, emphysema, cancer, and stroke, and is listed as the chief avoidable cause of death in America today.

The benefits of quitting are measurable soon after the last cigarette is thrown away:

After 20 minutes:

• Blood pressure drops to normal
• Pulse drops to normal
• Body temperature of hands and feet returns to normal

After 8 hours:

• Oxygen level in blood increases to normal

After 24 hours:

• Chance of heart attack begins to decrease

After 48 hours:

• Nerve endings begin to re-grow
• Senses of smell and taste begin to return

After 2 weeks to 3 months:

• Circulation improves
• Lung function increases up to 30%

After 1 to 9 months:

• Coughing, sinus congestion, fatigue, shortness of breath decrease
• Overall energy level increases

After 1 year:

• Smoking related risk of heart disease is cut by 50%

After 5 years:

• Lung cancer risk is cut by 50% of a current smoker's risk
• Stroke risk returns to baseline of non-smoker
• Mouth, throat, and esophagus cancer risk is cut by 50%

After 10 years:

• Lung cancer risk is similar to nonsmokers

After 15 years:

• Risk of heart disease is 50% of a current smoker

The benefits of quitting are impressive. But as you also may know, quitting is not easy. Nicotine is an addictive substance, and because of this, withdrawal symptoms will occur when you quit. Not everyone has the same experience, but many people notice a combination of some of the following: irritability, fatigue, sleeplessness, cough with cold or flu symptoms, lack of concentration, upset stomach, depressed mood, or increased hunger. Most people who quit will only have a few of these, and nearly all will begin to decrease within a few days after quitting.

Additionally, since nicotine blunts the effects of caffeine, stopping smoking will lead to the full caffeine effect of sodas, coffee or tea. This increased caffeine effect frequently worsens the symptoms of irritability, sleeplessness, lack of concentration, and upset stomach. Lowering your caffeine intake as you quit smoking will often help reduce these symptoms.

Many people are concerned about gaining weight as they quit smoking. It’s true that about three-quarters of all quitters gain between three and seven pounds in the twelve months after their last cigarette. But it’s also true that 56% of smokers gain three to seven pounds in any given year. The difference is small. Your best bet is to try to regulate your new hunger in a well-balanced way. Try to eat healthy snacks with texture, taste, and crunch — take advantage of your improving senses of taste and smell.

Also remember that as your lung function improves over the first few months after quitting, you will begin to have symptoms here as well. The normal lung has a clearance mechanism to remove secretion produced in the airways. Nicotine stops this process, but it will return when you quit smoking. As this mechanism returns, many people notice cough and airway congestion. Keep in mind these symptoms will disappear as your lungs fully regain their normal clearance mechanism, usually in one to three months. In the long run, quitting smoking will result in fewer and less severe respiratory infections.

As people quit smoking, many want help with their symptoms. Medicines are available that can help in two ways. First is nicotine replacement, such as the nicotine patch or nicotine gum. Both of these are available without a prescription. The patch gives a more even dose of nicotine throughout the day, but may cause some skin irritation if the location is not changed each day. Some people sleep poorly while using the patch, and will do better if they remove it before going to bed. The gum gives a more immediate and temporary nicotine dose (much like cigarettes do), but is more challenging to use correctly. If you have questions about what is right for you, feel free to talk to your doctor for further advice and recommendations.

The other medical help available is a medicine called buproprion (also known as Wellbutrin or Zyban). This is a medicine originally introduced years ago for other reasons, and now re-released to help with the withdrawal symptoms of quitting smoking. Additionally, the medicine helps reduce the craving and urge to smoke, but needs to be started at least one week before you quit in order to work well. Whether you use nicotine replacement or buproprion, you should anticipate using them for at least six to twelve weeks after quitting. Remember that quitting smoking is one of the best decisions you can make for yourself.

Helpful hints for quitting smoking:

• Set a date, ideally within two weeks of deciding to quit
• Inform your family, friends, and coworkers of your plan, and ask for support
• Ask others not to smoke in your presence
• Apologize in advance — you may not be yourself for a few days
• Leave difficult situations if they are uncomfortable
• Remove cigarettes from home, car, and work
• Review your previous attempts to quit and learn from those trials
• Remember that total abstinence is the goal — not even one puff
• Anticipate challenges, especially during the first few weeks

Resources:
American Lung Association (800) LUNG-USA www.lungusa.org
Center for Disease Control (800) CDC-1311 www.cdc.gov/tobacco
American Cancer Society (800) ACS-2345 www.cancer.org
American Heart Association (800) AHA-USA1 www.americanheart.org

Dr. Eric Benson is a board certified family physician. He joined the staff of Longmont Clinic in August 1999.