STOP SMOKING BREATHE EASY

INTRODUCTION

Cigarette smoking accounts for 6 million deaths annually worldwide mainly

due to cancer, heart disease and smoking related lung disease. India is no

exception with more that 1/3rd of Indian Adults using Tobacco either as

smokeless tobacco (26%) or as smokers (14%). Tobacco use is a risk factor

for six of the 8 leading causes of death in India.

WHY QUIT SMOKING?  

Giving up smoking at any age has major short and long term health benefits.

The earlier you quit, the greater the benefits. People who quit smoking before

the age of 50 reduce their risk of dying over the next 15 years by one-half, as

compared to those who continue to smoke. Exposure to second hand smoking

to your family and children

can lead to serious health

problems too.

Cardiovascular disease 

Cigarette smoking doubles

the risk of developing

coronary heart disease and

giving up smoking reduces

your chance of dying from it

by half within one year of quitting.

Lung disease 

Smoking increases the risk of chronic obstructive pulmonary disease (COPD)

and stopping smoking can reduce further damage to the lungs, and improve

chronic cough. Smoking predisposes exposed children to asthma.

Cancer

Cigarette smoking is responsible for almost 90 percent of cases of lung

cancer. Smoking cessation reduces the risk of lung cancer within five years of

stopping. Stopping smoking may also reduce the risk of other cancers, such

as cancers of the head and neck, esophagus, pancreas, and bladder.

Other conditions

Smoking increases bone loss (osteoporosis) and increases the risk of hip

fracture in women. Pregnant women who smoke have an increased risk of

underweight babies and birth defects. Smokers have increase risk of sexual

problems (e.g., impotence) and gastric ulcers. Stopping smoking reduces the

risk of these conditions.

PREPARING TO QUIT —

Quitting and staying away from cigarettes is difficult, but not

impossible. Smoking is an addiction and giving up smoking requires individual

approach. Generally, after deciding to quit smoking, the first step is usually to

set a quit date. This is the day when you will completely quit smoking. Ideally,

this date should be in the next two weeks, although choosing a special date

(eg, birthday, anniversary, or holiday) is another option.

Your chance of giving up smoking easily doubles when you use either

medications or counseling or ideally both for giving up smoking. A good start

can be with either:

1) Specialist Consultation to make a QUIT PLAN

2) Medical Therapy and/or counseling

3) Individually Tailored Medication plans

MEDICATION FOR QUITTINGThere are several medications that may help you stop smoking. However it is

important to choose the right medications, the right method of administration

and right combination to get the maximum benefit with which your healthcare

provider can help.

Nicotine replacement therapy: Nicotine Replacement Therapy (NRT) gives

your body the nicotine it craves without the toxic chemicals you get in

cigarettes like cyanide or carbon monoxide The usual recommendation is to

use a skin patch for sustained relief and a short acting method (gums or

lozenges) for breakthrough relief from effect of nicotine withdrawal.

Varenicline: The drug is started 7 days before the quit date and continued for

12 weeks. It should not be taken by patient with history of depression or

mental health problems.

Bupropion: This is preferred in patient with depression or the ones who are

worried about weight gain following smoking cessation. The therapy is started

a week before the quit date and carried on for 12 weeks. It should not be

taken by people with history of fits/seizure disorders.

BEHAVIORAL THERAPY AND COUNCELING 

Multiple studies show that using behavioral changes with a medication

increases your chances of success. A psychologist can help develop coping

skills for the situations or activities that increase your risk of smoking or

relapse. For example:

●Make lifestyle changes to reduce stress and improve quality of life

●Tell family & coworkers about the plan to quit and ask for support

●Minimize time with smokers. People who live with smokers can consider

negotiating with them to stop smoking at home or in the car

●Recognize that cravings frequently lead to relapse. Avoid smoking in home

and car and places where you spend a lot of time

●Avoid thoughts like "having one cigarette will not hurt"

RISKS OF QUITTING SMOKING

Generally, any risks of smoking cessation are far outweighed by the benefits.

●Symptoms of withdrawal are common and generally peak in the first three

days and include difficulty sleeping, irritability, frustration or anger, anxiety,

difficulty concentrating, and restlessness. These cravings are a common time

for ex-smokers to relapse. The cravings will go away if ignored.

●Depression●Weight gain can occur up to 3-5Kg while stopping smoking because people

tend to eat more after quitting. An exercise program and eating a reasonable

diet can minimize weight gain.

RELAPSE

Most smokers make many attempts to quit before they are able to quit

completely. Smoking is a "relapsing" condition, and relapse should not be

thought of as failure. Review your previous

attempts for what worked and what led to

relapse. The relapsed patients are likely to

need individualized tailored plan from their

healthcare provider to achieve long lasting

smoking cessation.

Consider rewards for not smoking; use the

money saved on cigarettes for a special treat such as a movie, a new outfit, or

a special dinner.

Each quit should be regarded a victory, and the longer it lasts, the better.