Smoking Cessation:
This web page was most recently revised on March 10, 2004.
Thank you for your courtesy of returning the web form from the Lung Cancer and Cigarette Smoking Web Page and he kind words.
I hope that the information in the page was useful to you in planning a life free of tobacco smoke.
New and improved versions of the web pages can now be found at
The Lung Cancer and Cigarette Smoking Web Page
URL http://www.smokinglungs.com
The Young People’s Cyber-Library of Information on Tobacco
URL http://www.smokinglungs.com/cyberlib.htm
I have pasted some information below that might be helpful to you, or to help you help another quit.
Some of the links below
are no longer operative. I am updating
now. Please forgive any inconvenience
you experience.
I would be interested in
hearing from you again to know if you are successful in quitting, and if so,
whether the information I have provided below or information you have found
elsewhere on the Web has been helpful to you in your attempt to stop smoking.
Best wishes,
Fred Grannis MD
Long Beach, CA
You can also access all of this information at
http://www.smokinglungs.com/SmokCessresources.htm
The most important ingredient in success in
smoking cessation is for the individual smoker to make a personal decision that
he or she is going to stop smoking in order to avoid the risks to future health. Once you have made such an informed decision, it is inevitable
that you will succeed. More than half
of all people who were ever smokers have eventually been able to quit.
Having said that, it must be understood that it is very hard to
stop smoking. The smoker is addicted to
nicotine and also has a complex behavior pattern and habit of smoking. Although some people can quit "cold
turkey", without any help, most people fail on their own and need some
help. There are three forms of help
that have been proven effective in prospective randomized clinical research
trials.
1.
Counseling, either individual or group is important. In my opinion the best choice for most
people is a six-week group session offered by the American Lung Association or
American Cancer Society in most towns in the US.
2.
Nicotine replacement therapy.
The patch is probably easiest, but some people prefer gum or
inhalers. The patch is now available
over the counter, without an MD prescription.
It is very important to follow the package insert instructions EXACTLY.
3. A
drug called bupropion (Zyban) has been shown to be effective in increasing the
chance that a smoker will be successful in smoking cessation. A prescription is required for Zyban.
In people who fail on one or two of the
above, it is probably best to combine all three approaches together.
Unfortunately, although
smoking cessation is a very important step in health promotion that will reduce
further death, disease and medical expenditure, neither MediCare, MedicAid nor
private health insurors will pay for smoking cessation interventions, and both
nicotine replacement and bupropion are not inexpensive. On the other hand, the last time I looked,
cigarettes were $3.25/pack in California, so that smoking cessation will also
be cost effective.
There is what appears to be a good online 4 week smoking cessation program at
OnHealth Stop Smoking Center at
http://onhealth.com/ch1/resource/ssc/item,39917.asp
I don’t know what their success rate is, but I have tried out the introductory pages and it appears to be a very well constructed and thoughtful project. The program appears to be free of charge.
American Lung Association
has a new WWW based smoking cessation program available on the Internet. It is brand new and there are no published data to determine how successful it is in comparison to conventional counseling programs.
Linda Ferry MD and her colleagues at Loma Linda University have an experimental web based group smoking cessation program available at
http://www.nicotinefreedom.com/
Two medical advances that have increased the success of smoking cessation are nicotine replacement and bupropion. You might try discussing these options with your doctor. Each of these medications reduces craving for nicotine and increases the success of cessation if used (exactly) as directed.
There is an excellent commercial page giving very complete information on the use of Nicotrol patches, nasal spray and inhalers at
http://www.nicotrol.com/etc/amlung.html
Some benefits of smoking cessation that may help emphasize the POSITIVE nature of quitting the tobacco addiction are listed below. You will not be giving up something, you will be gaining many health and social benefits!
Improved breath.
Get rid of yellow stains on fingers and teeth. Save lots of money.
Get rid of smell in car, home, clothes
Reduce embarassing situations where you are asked not to smoke. Reduce risk of home fires.
Reduce cost of insurance, car, health etc.
Reduce risk of harming your children, friends, family and strangers with environmental smoke from your cigarette.
Set a better role model for young people.
Reduce the profits of the predatory cigarette industry. Reduce rate of development of facial wrinkles.
Get rid of smokers cough.
Stop ongoing damage to lung function immediately.
Reduce risk of heart attack, stroke and other vascular disease. This benefit starts almost immediately.
Reduce risk of getting a lung, tongue, mouth, larynx, esophagus, pancreas and bladder cancer. Risk reduced 50% by 10 years and 75% by 20 years.
There are probably many other benefits I have not included, but this list should be a start.
From Ann Landers:
"As a life trustee on the board of the American Cancer Society, I am delighted to print the article. You might think it is too late to quit smoking, but here is some good news from the American Cancer Society:
'As soon as you snuff out that last cigarette, your body will begin a series of physiological changes.
Within 20 minutes: Blood pressure, body temperature and pulse rate
will drop to normal.
Within 8 hours: Smokers breath disappears. Carbon monoxide level in
blood drops and oxygen level rises to normal.
Within 24 hours: chance of heart attack decreases.
Within 48 hours: nerve endings start to regroup. Ability to taste
and smell improves.
Within 3 days: Breathing is easier.
Within 2-3 months: Circulation improves. Walking becomes easier.
Lung capacity increases up to 30%.
Within 1-9 months: sinus congestion and shortness of breath
decrease. Cilia that sweep debris from your lungs grows back. Energy increases.
Within one year: Excess risk of coronary heart disease is half that
of a person who smokes.
Within 2 years: Heart attack risk drops to near normal.
Within 5 years: lung cancer death rate for the average former pack a
day smoker decreases by almost half that of a smoker.
Within 10 years: lung cancer death rate is similar to that of a
person who does not smoke. The pre-cancerous cells are replaced.
Within 15 years: risk of coronary heart disease is the same as a
person who has never smoked.
Some of the information in the Ann Landers article above is outdated. I think that the information below is more up to date and accurate.
When you stop smoking you immediately start to accrue multiple health benefits.
Damage to the airways and blood vessels stops immediately.
Pulmonary function reductions stop immediately and may even improve slightly.
Danger of heart attack decreases to the level of a non-smoker within about one year.
The risk of lung cancer of a smoker is about 28X that of a never smoker. Risk ratio (RR)=28:1.
After smoking cessation, at 10 years, RR=approximately 50% less or 14:1 (relative to people who continue to smoke).
After 20 years RR is down to about 25% or RR=7:1.
For assistance with smoking cessation, try a
Visit to the fine site of the American Lung Association at URL
HTTP://WWW.LUNGUSA.ORG/featureset2.html
or this site at the University of Indiana
http://iumeded.med.iupui.edu/tobacco/scguide.htm
This site has good information on nicotine replacement therapy.
http://iumeded.med.iupui.edu/tobacco/scguide.htm
Quit Net is probably the best site on the web for this purpose.
Greetings from the
QuitNet!
I'm writing to suggest
adding The QuitNet (http://www.quitnet.org)
to your list of
quit-smoking links. We think your visitors would
want to know about the
oldest and most popular quitting site on
the Internet--and the
world's largest smoking cessation program.
A FREE nonprofit service
of the Boston University School of Public
Health, The QuitNet
attracts over 3,000 visitors viewing 24,000
pages every day--and has
20,000 registered users who've joined the
online community. They
take advantage of features found on no other
quit-smoking website,
including:
--Online questionnaires
that provide individualized assessment and
interactive help in
forming a personal quitting plan.
--Peer support forums--the
heart and soul of the QuitNet--that carry
over 400 messages posted
every day from people helping each other
quit,and stay quit.
--Unique
community-building tools, like a personal Q-Mailbox,
real-time buddy lists and chat,
and public quitting anniversaries.
--An extensive library of
quitting guides and information on topics
like the nicotine patch,
gum and other tools.
TAKE THE TOUR
Stop by and take the site
tour--it's quick, fun and will let you
try out the interactive
features that make the QuitNet a truly unique
resource. Just go to http://www.quitnet.org or click the Q-Tour
graphic on the home page.
If you agree that the QuitNet is a resource
your visitors shouldn't
miss, we'd love to hear from you when you've
added the link.
Best regards,
Dan Ross
Join Together Online
Web Outreach Consultant
Email: dross@quitnet.org
(The QuitNet is operated
by Join Together, a national project at
the Boston University
School of Public Health helping communities
reduce substance abuse. We
are primarily funded by a grant from the
Robert Wood Johnson
Foundation)
http://www.quitnet.org
Habitrol has a useful commercial web site at
ALA Washington is also a good site at
Click on the highlighted links “Lung Health Information” then “tobacco”.
There is also a truly great web page in
Canada with multiple areas that will definitely be helpful to you
http://www.hc-sc.gc.ca/english/tobacco.htm
The Center for Disease Control has an excellent help page with multiple pages and links on smoking cessation assistance.
http://www.cdc.gov/tobacco/how2quit.htm
Another good source of information for assistance with smoking cessation would be the American Lung Association or the American Cancer Society. Look them up on the Web or in the phone book and call them to ask when and where they have smoking cessation group programs in your area. I am sure that they will be very helpful to you.
Here are some 800 Numbers on smoking cessation.
CDC 800-232-1311
American Cancer Society 800-227-2345
American Lung Assn. 800-LUNGUSA
And their corresponding web pages:
For Smoking Cessation Help in Canada you can also try http://www.tobaccofacts.org/smoker1.html
This page has resources for young people who want help quitting.
The following CONSENSUS STATEMENT on smoking cessation is a very complete and up to date compilation of scientific information on this topic put together by national experts and published in the June 28 issue of the Journal of the American Medical Association. It is intended for physicians, but is very reader friendly. It is also available on the WWW at
http://jama.ama-assn.org/issues/v283n24/full/jst00005.html
but a password may be required.
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;283:3244-3254
Research Shows Exercise Can Help Smokers Quit
An article in the WASHINGTON POST Health section reports that an increasing number of studies show that exercise can significantly improve a smoker's chances of kicking the habit.
A study of more than 4,000 male runners published in PREVENTIVE MEDICINE shows that over 70 percent of those who smoked at the time they started running subsequently quit smoking. Other research suggests that exercise is especially important for women who want to quit, because it helps minimize weight gain, a common reason why women don't quit smoking. Brown University School of Medicine recently conducted a study of 281 sedentary, overweight, middle-age women. Half of the group attended a cessation a program combined with a three-times-a-week wellness program, and the other half attended a cessation program with vigorous exercise three-times-a-week. The researchers found that 49 percent of the women who went through the exercise program quit smoking while only 29 percent of the women in the control group did so.
In addition to minimizing weight gain, exercise can also help smokers deal with the stress and mood changes that frequently occur when they stop smoking. "When people start exercising regularly, they realize how good it makes them feel," said Michael Sacks, a professor of psychiatry at Cornell University's Weill Medical College. "They also begin to realize that they can take care of their stress without resorting to destructive things," such as smoking.
Source(s):
WASHINGTON POST (Health section), (3/23/99)
"Smoke And Mirrors", Carol Krucoff, p. 20
============================================================================ Swedish Study Says Dieting Helps Women Quit
Smoking
Dieting can help women
quit smoking when combined with a comprehensive
smoking cessation-program,
according to a study published in the latest
issue of BRITISH MEDICAL
JOURNAL. The team of researchers from
Karolinska
Hospital in Stockholm
found that 50 percent of dieters who were on a
low-calorie diet were able
to quit smoking but only 35 percent who were not
dieting quit smoking. Also, the dieters lost an average of 4.5
pounds while
the other women gained 3.5
pounds.
Source: "Dieting H. O'Hara Can Help Women Quit Smoking," CHICAGO
SUN-TIMES (on-line),
August 20, 1999.
======================================================================
The IRS made a change to
Code Section 213, in June of
this year, which now makes
the cost of smoking cessation programs
deductible. This clears
the way for smoking cessation programs to be
reimbursable under medical flexible spending accounts, including employers providing smoking cessation programs on a tax-favored basis.
I would be interested in hearing from you again to know if you are successful in quitting, and if so, whether the information you have found on the Web has been helpful to you in your attempt.
An open letter to smokers from John H. O'Hara:
If you are a smoker then you surely must know by now that you have been
victimized by the tobacco industry. The release of tobacco industry
documents and the testimony of former tobacco industry employees clearly
reveals the industry knew for decades that they were selling a deadly
addictive product yet they seduced you with their slick advertising and
dis-information. In addition to raping both your lungs and pocketbooks, they
convinced men to believe smoking made them macho when in fact it is a leading
cause of male impotence. They convinced women to believe they were liberated
when in fact they were actually dependent on a drug that caused birth defects
and other diseases. Anyone doubting this simply has to go to the many tobacco
web sites where the courts have forced the industry to reveal their
previously secret documents.
There is a very powerful way to get even with the tobacco industry.... simply stop smoking. If you succeed, you will break their hearts, because you will be depriving the tobacco executives of their massive profits. You will also make the life of those who love you much safer and more enjoyable.
One cynical argument proposed by tobacco industry propagandists is that society actually saves money when people smoke, because elderly smokers die before they can become disabled and incur increased medical costs. The following articles prove that this is incorrect. Quitting smoking not only increases the duration of life, but also decreases the total amount of time of individual disability and compresses the time of disability into a shorter interval at the end of life.
J Epidemiol Community
Health 2000 Aug; 54(8):566-574
Smoking and the compression
of morbidity.
Nusselder WJ, Looman CW, de
Mheen PJ, van De Mheen H,
Mackenbach JP
Department of Public Health, Erasmus University Rotterdam, PO
Box 1738, 3000 Dr Rotterdam, the Netherlands.
http://jech.bmjjournals.com/cgi/content/full/54/8/566
A brief editorial discussing this topic can also be found at the British Medical Journal web site. http://jech.bmjjournals.com/cgi/content/full/54/8/564
Updated guidelines for smoking cessation can be found at
http://www.surgeongeneral.gov/tobacco/
A file intended for consumers is at
http://www.surgeongeneral.gov/tobacco/consquits.htm
The Mayo Clinic now offers online smoking cessation advice at http://www.mayo.edu/ndc/index.html
Patrick Reynolds has an excellent smoking cessation page at
http://www.tobaccofree.org/quitting.html
Scott Goold, Ph.D. of
Albuquerque, http://www.infoimagination.org
Has written a very clear description of just why nicotine is addictive and how it behaves just like cocaine in our brains.
http://www.tobaccofreedom.org/issues/addiction/
A
consortium called PACT (Professional Assisted Cessation Therapy) has just
published
it's first publication, Reimbursement for Smoking Cessation
Therapy:
A Healthcare Practitioner's Guide.
The
guide offers an overview of the issue, and advocacy strategies for
organizations
that are working on getting health insurers to reimburse for
smoking
cessation treatments in their area. The 46 page guide is available
on-line
at www.endsmoking.org. This site also
has multiple other excellent resources for patients and physicians.
The
State of Massachusetts has a great new smoking cessation help web site that
offers assistance in English and TEN other languages!
http://www.trytostop.org/home.htm
Q: I am a smoker of 40 years. The past year, I have been
using a filter that cuts out 97% of tar,and nicotine. How safe am I smoking
this way. I know that I shouldn't smoke,but I use the filter to lower my
chances of disease. Am I correct to assume this,by using the filter. D.
A:
D.:
You are by no means "safe".
As a chronic smoker, you are addicted to
nicotine. What this means is that you
change the way you smoke in order to obtain approximately 1 mg. of nicotine
from each cigarette. To do this you
inhale more smoke, bring it deeper into your lungs and hold it there longer
than you would if you were smoking non-filtered cigarettes. The end result is that you probably get only
marginally less tars in your lungs. Tars are the chemicals that you can see if
you forcibly blow smoke out through a white handkerchief after inhaling a
cigarette. Tar contains at least 60
known cancer causing chemicals.
Probably because of the different pattern of inhaling smoke, we have
seen a change to a preponderance of adenocarcinoma in the lungs, particularly
in women.
The
cigarette companies cheat on reporting the level of tar and nicotine in
cigarettes by continuing to use tests that were designed for unfiltered
cigarettes. The levels of both tar and
nicotine are actually much higher than they tell you on the pack. They lie for two good reasons. They know
that if the level of nicotine in a cigarette drops below a certain level
(approximately 1 mg.) then sales drop sharply.
They also know that if you decide to quit and are successful, they lose
a good customer and approximately $1000 or more each year in revenue. By implying that their product is safer,
they convince you not to quit and keep you as a customer. That way you will continue to smoke $1000
worth of cigarettes each year until you are too ill to smoke. When you are dead, they will simply snare a
young person, perhaps one of your children or grandchildren to replace you as
their customer.
Don't
be fooled. There
is no safe cigarette. The only safe option is to quit--NOW.
There is a great new web page with
information and resources on smoking cessation for older people courtesy
of
The Center for Social Gerontology
2307 Shelby Avenue, Ann Arbor, MI 48103 tel: 734
665-1126 fax: 734 665-2071
tcsg@tcsg.org
at
http://www.tcsg.org/tobacco/cessation.htm
There are now two new computer based smoking cessation aids. The first is a European web page “Stop.Tabac.ch” available in four languages. This page also has a large list of smoking cessation links.
http://www.stop-tabac.ch/en/addresses.html
There is also a very clever
freeware program called Smoke Free Stats written by Michael Alft, available at
that might be useful to an
individual or a group in the process of smoking cessation.
There is an excellent program in the State of California at The California Smokers Helpline
1-800-NO BUTTS
http://www.californiasmokershelpline.org/
The New York Times has an excellent web page giving access to a number of smoking cessation resources in the New York metropolitan area at
http://www.nytimes.com/ads/marketing/smoking/index.html
Nicotine Anonymous is a group that helps people who are nicotine dependent on the same principles used by Alcoholics Anonymous. The world services website is at
This website offers help in six different languages.
is the website for nicotine anonymous in NYC.
This new website offers smoking cessation statistics, assistance and other information on smoking in gay and lesbian communities.
http://www.ciggybuttz.com/gaysmokeout.html
A new British web site offers help on “Helping a Friend to Quit Smoking” at
http://www.cancerresearchuk.org/aboutus/publications/
Courtesy of Cancer Research U.K.
The World Health Organization (WHO) has created a tremendous online database of
information on nicotine habituation and how to treat it. There are large
bibliographies listing scientific articles on the topic and also power point
slide summaries that might be of use to non-professional readers.
http://www.treatobacco.net/home/
There is a new “I WANT TO QUIT” web page in
England
that offers help with smoking cessation by
phone or by Email.
They offer help in several languages and
offer specific help to young people and pregnant women.
Smoking cessation materials in Russian; slide
format http://www.pitt.edu/~super1/lecture/lec6931/001.htm
This is a fun site. Check out also:
Smoking Cessation and Pregnancy http://www.pitt.edu/~super1/lecture/pc0211/index.htm
Maternal Smoking and Infant Birth Weight http://www.pitt.edu/~super1/lecture/lec3721/index.htm
Prostate Cancer and Smoking http://www.pitt.edu/~super1/lecture/lec4721/index.htm
The Epidemiology of Smoking in Ukraine http://www.pitt.edu/~super1/lecture/lec4851/index.htm
New Smoking Cessation web site from NGA
http://www.cessationcenter.org/
If you are going to try to quit “cold turkey”
and will not be offended by very graphic images of disease caused by tobacco
products, this is an interesting web page that offers many features including
e-mail contact with others in the process of smoking cessation.
Best wishes,
Fred Grannis MD
Long Beach, CA
Frederic
W. Grannis Jr. MD
Head,
Section of Thoracic Surgery
City
of Hope National Medical Center
1500
E. Duarte Road
Duarte
CA 91010
626-359-8111
Ext. 2669