Tips to help you quit smoking
Smoking is the single most harmful behaviour which mankind inflicts on itself. It leads to premature ageing and is linked to over 100 chronic diseases, ranging from arthritis to dementia. Most people are aware it causes lung, head and neck, oesophagus and stomach cancer, but it also increases the risk of liver, cervix, bladder, kidney, breast, bowel and skin cancer. It’s never too late to quit smoking – people benefit almost immediately after quitting. Patients who quit smoking after a diagnosis of cancer have a much better chance of survival than those who do not.
This section describes the risks of smoking, the underlying mechanisms of harm, and practical tips to help you, a friend or relative quit.
What makes smoking harmful?
Tobacco smoke contains over 4000 different chemicals, many of which are carcinogenic, including Benzene, Formaldehyde, Ammonia, Hydrogen cyanide, Acetone and Arsenic. The three components of smoke which we know are particularly damaging are:
- Carbon monoxide
Nicotine: This is a powerful, fast-acting and addictive drug. Most people who smoke become dependent on the nicotine in cigarettes. When a smoker inhales, nicotine is absorbed into their bloodstream, and the effects are felt on their brain seven to eight seconds later. Nicotine also has many complex effects on the rest of the body. In small amounts, nicotine stimulates nerve impulses in the central and the autonomic nervous system, but in large amounts, nicotine inhibits these nerve impulses. The immediate effects of nicotine include:
- Increased heart rate
- Constriction of the small blood vessels in the skin
- Increased blood pressure
- Mood and behavioural changes
- Anxiety & tremors
Carbon monoxide: A poisonous gas found in relatively high concentrations in cigarette smoke, carbon monoxide combines quickly with haemoglobin, the oxygen-carrying substance in the blood, to form carboxyhaemoglobin. Alarmingly, it combines more readily with haemoglobin than oxygen does, meaning that up to 15% of a smokers blood may be carrying carbon monoxide around the body instead of oxygen. Oxygen is essential for body tissues and cells to function efficiently. If the supply of oxygen is reduced for long periods, this can cause problems with growth, repair and absorption of essential nutrients. Carbon monoxide can also affect the ‘electrical’ activity of the heart and, combined with other changes in the blood associated with smoking and diet, may encourage fatty deposits to form on the walls of the arteries.
Tar: When a smoker inhales, the cigarette smoke condenses, and about 70% of the tar contained in the smoke is deposited in the lungs. Many of the substances in tar are already known to cause cancer (see below). Irritants in tar can also damage the lungs by causing narrowing of the bronchioles, coughing, an increase in bronchiole mucus, and damage (ciliostasis) to the small hairs which help protect the lungs from dirt and infection.
What are the risks of smoking?
Smokers are at greater risk of illness and early death compared to non-smokers. Those who smoke more than 25 cigarettes a day are twenty-five times more likely to die from cancer and almost twice as likely to die from coronary heart disease (CHD). Smoking is associated with countless health problems, including:
- Premature ageing and skin wrinkles
- Coronary heart disease
- Hardened arteries – strokes, peripheral vascular disease and gangrene
- Damaged to major arteries causing aortic aneurysms.
- Increased anxiety and risk of depression
- Cancer of respiratory tract– lung, mouth, nose and throat, larynx, oesophagus
- Other cancer – pancreas, bladder, stomach, cervix, bowel, breast, kidney
- Doubles the risk of bowel cancer relapse after initial therapies
- Leukaemia, lymphoma
- Chronic bronchitis, emphysema and other lung diseases
- Recurrent infections and general loss of efficiency in the lungs
- Peptic (stomach) ulcers increase in incidence and take longer to heal
- Tobacco amblyopia (defective vision)
- Increased risk of osteoporosis – brittle bones that are liable to fracture
- Infertility and earlier menopause
- Increased risk of erectile dysfunction and vaginal dryness
- Pregnancy miscarriage and low birth weight are more common
- Blood clots – deep-vein thrombosis, pulmonary embolism, strokes
- Macular degeneration and blindness
- Dementia and memory loss
- Parkinson’s Disease
- Psychological illness, particularly anxiety
- Hot flushes
Passive smoking: Breathing the smoke from other people’s cigarettes is called passive smoking. It consists of smoke from the burning end of the cigarette — called sidestream smoke — and smoke inhaled and exhaled by the smoker. The US Environmental Protection Agency has declared passive smoking, or exposure to environmental tobacco smoke (ETS), a ‘Class A Carcinogen’, meaning that it is capable of causing cancer in humans. Passive smoking may cause the following: irritation to the eyes, nose and throat; increased acute respiratory illness in early childhood (including infections); headaches, dizziness and sickness; chronic cough, phlegm and wheeze; aggravation of asthma and allergies; chronic middle ear lesions (glue ear); increased risk of coronary heart disease; reduced levels and capacity of lung functions; 10% to 30% increased risk of lung cancer for non-smokers.
Benefits of quitting
It is never too late to quit smoking. Breaking the habit is the greatest single step smokers can do at any stage in their life. When the daily assault of nicotine, carbon monoxide, tar and other poisons has stopped, the body begins to repair the damage. Quitting smoking results in the following general benefits, many of which can be experienced within a few weeks:
- Breathing improves
- Improved ability to cope with sudden exertion
- Loss of smoker’s cough and reduction in phlegm
- Sense of taste and smell improves
- Hair, skin and breath no longer smell of tobacco smoke
- The natural decline in lung efficiency slows down to a rate similar to non-smokers
- Exercising gets easier, energy levels increase
- Improved mood and lower anxiety
How to quit smoking?
There is no quick and easy way to quit. Up to half of smokers continue to light up cigarettes after being diagnosed with cancer. You have to want to stop smoking. At any one time, one in three smokers are trying to quit, and more than 11 million people in Britain alone have become successful ex-smokers. Most of those who stop do so by themselves. Being determined is the vital ingredient, and it is also helpful for smokers to have a plan when it comes to quitting.
Cutting down or stopping outright?: Cutting down is less likely to work than simply stopping outright. Unfortunately, even if you do manage to cut down, the numbers tend to creep back up again. So once you have planned ahead and chosen your date it is better to stop outright.
Diet and physical activity: Both of these have an important effect on your body. Stopping smoking is a major change for your body to adapt to, and a healthy diet and regular physical activity will establish a suitable level of fitness which will make the adaptation much easier.
Helping other people: When you smoke cigarettes, other people around you are also being exposed to harm. It is a good ploy to think of the people you are helping as well as yourself.
Ask for extra help: If you have tried to quit and have gone back to smoking again, there are other things that can help such as joining a stop-smoking group.
Complementary therapies: There is some evidence that alternative therapies such as hypnotherapy or acupuncture can help.
Products to help you stop smoking
There are many different smoking cessation aids on the market. It is important to check whether the product is safe and effective before you spend time and money on it. Some manufacturers claim very high success rates for their products, but remember, a smoking cessation aid can’t stop you smoking or make you want to stop. It can, however, make it less painful, relieve withdrawal symptoms, boost your confidence and morale, and lessen the urge to smoke.
There are two main types of commercial aids available to help break the smoking habit – nicotine-containing replacement products and non-nicotine replacement products.
Nicotine replacement products
These products replace some of the addictive nicotine that smokers get from smoking. Nicotine replacement therapy has been well researched, and tests have shown that, if used correctly, it will double your chance of successfully quitting. They are particularly good at easing the withdrawal symptoms many suffer when trying to quit, and are recommended for heavy smokers – if you smoke your first cigarette within 30 minutes of waking up, then you are particularly likely to benefit from nicotine replacement therapy.
Nicotine replacement products are generally safer than smoking, but if you have, or have had, a heart problem you must check with your doctor or pharmacist before starting to use them. It is also important to use the product properly, so always follow the manufacturer’s instructions, and remember that you must stop smoking completely while using these products. Nicotine replacement products may also affect the action of some drugs such as warfarin and beta-blockers. The forms of nicotine replacement commonly available include patches, gum, nasal sprays and inhalators. Your family doctor may be able to give you a prescription for nicotine replacement patches and gum, but they are also available over the counter without a prescription.
The patch provides you with a continual supply of nicotine at a low dose while you are wearing it, while the gum, nasal spray and inhalator deliver a higher dose quickly, so you can respond to an immediate craving with a ‘quick fix’. Side effects of nicotine replacement products include nausea, indigestion, headaches, dizziness and palpitations.
Vaping: E-cigarettes are battery-powered devices that heat a liquid, usually containing nicotine mixed with the chemicals propylene glycol and glycerin, and flavourings into a vapour that users can inhale. Public Health England and the Royal College of Physicians have concluded that the potential of serious vaping danger is probably very low, with the RCP stating vaping is “unlikely to exceed 5% of the harm from smoking tobacco”. On the other hand, the U.S. Food and Drug Administration announced that e-cigarettes, along with cigars, hookah and pipe tobacco, will now be regulated in a similar way to conventional cigarettes. The new rules also banned the sale of these products to people under age 18 both in stores and online. One trial has already linked their exclusive use to an increased risk of lung cancer, and future trials are likely to find further risks given the carcinogens they contain. Nevertheless, these products are a useful short-term tool in helping you quit, especially if you smoke in response to cravings or stress, and you miss the ‘hand to mouth’ action of smoking.
Non-nicotine replacement options
Products: These are many and varied. They are easily available through mail order, newsagents, health shops or pharmacists. Often they do not require a license under the Medicines Act. Generally, there is not enough firm evidence to say how effective they are. Be wary of claims of very high success rates. Non-nicotine replacement products include nicobrevin capsules, scented inhalers, dummy cigarettes, tobacco-flavoured chewing gum, herbal cigarettes and filters.
Other complementary therapies: While these undoubtedly help some people, research is limited, and their effectiveness remains unproven. The two most popular forms of complementary therapies for stopping smoking are hypnotherapy and acupuncture.
Support groups: Joining a ‘stop smoking’ support group can help you feel less alone in your attempt to quit. Being with other people who are also stopping can provide all-important mutual support, a feeling of being understood and a sense of competition! They are usually run over a period of weeks and take you through the different stages of stopping. Specialist smoker’s clinics, using nicotine replacement products, can improve your chances of stopping by between three and four times.
Summary – Tips to quit smoking:
- Make a date and stick to it: Commit yourself to a time and date. Most people who successfully quit smoking do so by stopping altogether and not by gradually cutting down
- Keep busy: Keeping busy helps to take your mind off cigarettes. All ashtrays, lighters and unopened cigarette packets should be thrown away
- Drinking plenty of fluids: Your mouth may feel strange – keep a glass of water or sugar-free juice handy and sip it steadily
- Get more active: Try walking or cycling instead of using the bus or car. Use the stairs instead of the lift. Physical activity helps relaxation and can boost morale
- Think positively: Withdrawal symptoms, irritability, mood swings and poor concentration are common, but keep reminding yourself they will disappear after a couple of weeks
- Change your routine: Try to avoid shopping in places where you have previously bought cigarettes. Avoid the pub garden or smoker’s corner at work if there are lots of smokers around
- Try doing something totally different: Until the cravings go, consider going to the gym instead of the pub
- No excuses: Don’t use a crisis, or even good news, as an excuse for ‘just one cigarette’. There is no such thing
- Treat yourself: This is important. Use the money that is saved to buy something special, big or small, that you couldn’t usually afford.
- Punishment and reward: Make a promise to yourself and a punishment if you fail (e.g. give money to an organisation you dislike).
- Be careful of what you eat: You may get hungry when you are giving up – try not to snack on fatty foods. Instead, try fruit, raw vegetables or sugar-free gum or sweets
- Take one day at a time: Each day without a cigarette is good news for your heart, your health, your family and your wallet