Articles written by me on Self-care and Palliative Medicine
On Self-Care & Palliative Medicine

Up in Smoke

Have I got a deal for you! I’d like to give you a package of individually wrapped, dried, powdered, and cured leaves plucked from a stimulant plant. For good measure, let’s add up to 4000 chemicals to the ingredients to affect the taste, the curing properties, etc. You can light these powdered leaves and inhale the fumes, stimulant, and tar directly into your lungs. If you do this regularly, you’ll significantly increase your risk of:

Premature Death 5–6 million smoking-related deaths in the U.S. in the decade 1990-1999 (more than half of these in the 35–69 age group)

Stroke 18% of stroke-related deaths occur in smokers

Heart Attack 21% of coronary heart disease deaths occur in smokers

Emphysema and Chronic Bronchitis 82% of the deaths related to these lung diseases occur in smokers

Diabetes–smokers have 3 times the risk of developing non-insulin dependent diabetes as nonsmokers

Cancer
Lung Cancer 87% of deaths in lung cancer occur in smokers
Cancer of the Mouth, larynx, and esophagus is increased in smokers
Cancer of the pancreas is increased in smokers
Cancer of the kidneys and urinary bladder is increased in smokers
Cervical Cancer is increased in smokers

Osteoporosis is accelerated by smoking

Peptic Ulcers (which will also heal more slowly) are increased in smokers

Tooth Decay and Gum Disease are both promoted by smoking

Premature Wrinkling and Premature Aging of the Skinare direct consequences of smoking

Insomnia is increased in smokers because of the stimulant effect of nicotine

Susceptibility to Colds and Viruses is increased because of the inflammation that cigarette smoking creates in the sinuses, nose, throat and lungs

Infertility and Impotence both have an increased incidence in smokers

Since the stimulant, nicotine( especially when inhaled) has a greater addictive potential for casual users than cocaine, alcohol-containing products, or morphine, you’ll probably become addicted and spend large sums of money fueling your habit over a lifetime of escalating purchase prices. Additionally, in smoking these products, you’ll have the opportunity to alienate and anger a host of strangers who find the smoke and smell repugnant. Too, you’ll be able to expose family members and close friends to increased lifetime health risks–including a 30% greater risk of developing lung cancer. Last, but not least, on the list of smoking pluses. . .you’ll leave a smokey trail where ever you go. . .in your clothes, in your house and car. . .on your breath and in your hair. The brown tinge that develops on teeth and fingertips only heightens the allure. How could anyone shun the habit of cigarette smoking, which provides such predictable opportunity for all of the above outcomes and effects?

If you’re a current cigarette smoker or are considering initiating the habit (to fit in with certain social subsets, to lose weight, to make an alcoholic beverage taste better, to relieve stress), please understand the folly of such motivations and the realities of smoking consequences itemized above. No butts about it, there is no question that tobacco use is the single most important preventable health risk in developed countries of the world. And, what seems even more tragic about this statistic to me is that the use of tobacco is completely voluntary.

Thankfully, smoking cessation truly does make a difference. . .both immediately and long term. Within hours to days after smoking cessation, blood oxygen levels return to normal as carbon monoxide levels fall; blood pressures and pulse rates return to normal; food tastes and smells better, and overall energy levels increase as coughing and congestion decrease. The insomnia generated by the stimulant effect of nicotine resolves rapidly. And, the sex drive of your spouses and/or significant others increases quickly and dramatically once you quit smelling so foul. One year after quitting, a smoker’s risk of heart disease is cut in half, and within 15 years after quitting, an ex-smoker’s risk of dying from heart disease is nearly the risk of a lifetime nonsmoker. Risks of stroke, emphysema, and lung cancer also decrease over time. . .but more slowly. 14 years after smoking cessation, lung cancer risk in former smokers approaches that risk of neversmokers. People who stop smoking before age 35 will have greater lifetime health benefits than those who wait until later in their lives.

Fuming and fretting won’t break your smoking habit. But,there are a multitude of smoking cessation aids and programs available. These range from self-help and behavioral strategies such as meditation, hypnosis, and support groups to gradual withdrawal programs with clearly delineated steps. Pharmacologic assistance with nicotine containing patches, gums, and inhalants can help in short term smoking cessation but will not break the psychological addiction that many long term smokers develop to cigarettes. Whatever means you choose, please let your physician help you to quit. There is no reason to let your good health status go up in smoke.

The majority of statistics cited above were obtained from a position paper written by the Joint Committee on Smoking and Health. Contributors to the paper include: American College of Chest Physicians, American Thoracic Society, Asia Pacific Society of Respirology, Canadian Thoracic Society, European Respiratory Society, and International Union Against Tuberculosis and Lung Disease.

Stephen L. Hines, M.D.
August 2000

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