Quitting Smoking • How to stop smoking … for good! Hongbiao (Hank) Liu MD PhD 1-26-2013
• Leading the News• Study: Smoking can take at least ten years off life expectancy.• Two studies on smoking and mortality published this week in the New England Journal of Medicine received significant coverage from print and online news sources, and from two national news broadcasts. One study was led by Dr. Prabhat Jha of the Center for Global Health Research in Toronto, while the other study was led by Michael J. Thun of the American Cancer Society. Both studies found that quitting smoking helped to reduce the risk of death associated with smoking - a point that most reports focused on. Additionally, much of the coverage discussed the finding that women are now as likely to die from smoking-related illnesses as men.
NBC Nightly News (1/23, story 10, 0:25, Williams) reported, "good news and bad newson the smoking front. From the New England Journal of Medicine, they state flat out,smokers lose at least one decade of life expectancy over nonsmokers on average." CBS Evening News (1/23, story 9, 0:25, Pelley) reported, "A new study is finding thatsmoking is taking a much greater toll on women than it used to." USA Today (1/23, Payne, 1.71M) reports that one of the studies found that "people whosmoke take at least 10 years off their life expectancy." The article adds, "on the other hand,those who kick the habit before age 40 reduce the excess risk of death associated withcontinued smoking by about 90%, according to the study in Thursdays New England Journalof Medicine." According to USA Today, "the study examined data from the U.S. NationalHealth Interview Survey between 1997 and 2004.”New York Times (1/23, OConnor, 1.68M) quotes Dr. Tim McAfee, an author of the study andthe director of the CDCs Office on Smoking and Public Health, as saying that the findings"paint a much more dramatic picture of the horror of smoking. These are real people that aregetting 10 years of life expectancy hacked off - and thats just on average."
The Washington Post (1/24, Vastag, 489K) reports that the other study found that"smoking-related deaths among women have soared in recent decades. For the first timesince research on smoking and health began in the 1950s, the rate of smoking-relateddeaths is now nearly equal between male and female smokers.”The Los Angeles Times (1/24, Khan, 692K) reports that "in the early 1960s, womensmokers were 2.73 times more likely to die from lung cancer than their nonsmokingcounterparts; by 2010, they were 25.66 times more likely to die of the disease, Thunfound.”WebMD (1/18, Boyles) notes that "both studies were supported by the National Institutesof Health." Also covering the story are the Wall Street Journal (1/24, Winslow, SubscriptionPublication, 2.29M), the AP (1/24, Marchione), and the NBC News (1/23, Rettner) "Vitals"blog.
Live longer and healthier20 minutes after quitting:• Your heart rate drops12 hours after quitting:• Carbon monoxide levels in your blood drop to normal Source: CDC Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
Live longer and healthier2 weeks to 3 months after quitting:• Your heart attack risk begins to drop• Your lung function begins to improve1 to 9 months after quitting:• Your coughing and shortness of breath decrease Source: CDC Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
Live longer and healthier1 year after quitting:• Your added risk of coronary heart disease is half that of a smoker’s5 -15 years after quitting:• Your stroke risk is reduced to that of a nonsmoker Source: CDC Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
Live longer and healthier10 years after quitting:• Your lung cancer death rate is about half that of a smoker’s • Your risk of cancers of the mouth, throat, esophagus, bladder, kidney and pancreas decreases Source: CDC Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
Live longer and healthier15 years after quitting:• Your risk of coronary heart disease is back to that of a nonsmoker’s Source: CDC Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion
Steps to quitting1. Get ready2. Get support3. Learn new skills and behaviors4. Get medication – if recommended by your doctor – and use it correctly5. Be prepared for cravings and withdrawal symptoms
Steps to quittingStep 1: Get Ready• Set a quit date• Get rid of all cigarettes and ashtrays at home, work, and in your car• Keep a diary of when and why you smoke• Call 1-800-QUIT-NOW for free materials• Tell friends and family you’re going to stop
Steps to QuittingStep 2: Get Support• Your chances of success increase if you have a support network• Ask friends, family, and coworkers for their support in helping you quit• Ask others not to smoke around you or leave cigarettes out in the open
Steps to quittingStep 2: Get Support• Talk to your family physician about tobacco’s effects on the body, choosing a quit plan, and dealing with withdrawal• Get individual, group, or telephone counseling
Steps to quittingStep 3: Learn New Skills & Behaviors• Distract yourself from urges to smoke – Talk to someone – Go for a walk – Get busy with a task – Go somewhere you’re not allowed to smoke
Steps to quittingStep 3: Learn New Skills & Behaviors• Change your routine – Take a different route to work – Drink tea instead of coffee – Eat breakfast in a different place
Steps to quittingStep 3: Learn New Skills & Behaviors• Reduce stress – take a hot bath, exercise, or read a book• Plan something enjoyable to do every day• Drink a lot of water and other fluids
Steps to quittingStep 4: Get Medication• Your family physician may recommend one of these to help you quit: – Bupropion SR – Nicotine gum – Nicotine inhaler – Nicotine nasal spray – Nicotine patch – Varenicline
Steps to quittingStep 5: Avoid Relapse• Most relapses occur within the first three months• Avoid drinking alcohol – drinking lowers your chances of success• Avoid being around other smokers – can make you want to smoke
Steps to quittingStep 5: Avoid Relapse• Expect a small weight gain (usually less than 10 pounds)• Eat a healthy diet• Stay active• Look for ways to improve your mood other than smoking
Will it work?Successful quitters are• Ready to change• Motivated to quit
Managing withdrawalSymptoms• Most intense during the first three to seven days• May continue for several weeks but will get less severe• Triggers or cues associated with smoking can cause cravings
Managing withdrawal• Exercise• Reduce or avoid caffeine or other stimulants• Relax before going to bed• Make your bedroom quiet• Keep a bedtime routine• Drink plenty of water• Use cough drops to relieve throat irritation
Managing withdrawalIf you’re having trouble concentrating• Adjust your schedule to a lighter workload• Lower your expectations on the amount of work you can do• Understand the amount of energy and time it takes to stop smoking
Managing withdrawalIf your appetite has increased• Eat healthy snacks• Don’t delay regular meals• Drink more water• Exercise regularly
Managing withdrawalIf you crave a cigarette• Wait out the craving (usually less than five minutes)• Try deep breathing• Use distractions• Call someone in your support network• Chew gum• Brush your teeth
Renew your dedication• Reward yourself for resisting urges to smoke• Review your reasons for stopping• Remind yourself often how well you’re doing
You can do it!• Tobacco addiction is a chronic disease – seek advice, support, and care from your family physician to increase your chance of success• Quitting smoking can reduce illness, prevent death, and increase your quality of life• Quitting can be difficult – remember to ask for help• You can do it!
ResourcesFree Quitlines:• 1-800-QUIT-NOW (1-800-784-8669) – You’ll be automatically routed to a state-run or National Cancer Institute quitline – You’ll get immediate advice on quitting and an offer to have materials mailed to you