February 2008
Quit smoking
While most antismoking campaigns focus on smoking’s role in the development of lung cancer, tobacco products harm the heart
in many ways, predominantly due to the impact of nicotine and fine smoke particles on the circulatory system and increased
carbon-monoxide levels that deprive organs of necessary oxygen. Smoking also exacerbates other risk factors for heart disease
and stroke, notably high blood pressure.
As many as 30 percent of all coronary heart-disease deaths in the U.S. each year stem from cigarette smoking. And overall, smokers have more than double the heart-attack risk of nonsmokers.
But many studies have found that quitting smoking drops your heart-disease risk dramatically. The longer the time since you've quit, the lower that risk is likely to become. And it can be done: Some 50 percent of all Americans who ever smoked have managed to quit permanently.
That said, the nicotine in cigarettes is a powerfully addictive drug. Most people—particularly those who smoke a pack or more per day—need counseling, medication, or both in order to overcome it.
When you're ready to quit:
See a doctor
He or she can help you choose the best drug therapy to ease withdrawal, and who can also detect and treat any smoking-related illnesses, such as bronchitis, emphysema, and heart disease.
Fight drugs with drugs
Most of the therapies approved by the Food and Drug Administration (FDA) involve nicotine-replacement products: over-the-counter patches, chewing gums, and lozenges, and prescription nasal sprays or inhalers reduce the symptoms of nicotine withdrawal.
Nicotine-replacement products help most during the first two to three months, when the risk of relapse is highest. People who continue to experience intense cravings may need to use the products longer, but they should do so under a doctor's supervision because of the risk of addiction to the replacements themselves. There is also some recent evidence that extended use of nicotine products may increase cancer risk.
Consider antidepressants
Two antidepressants—bupropion (Wellbutrin SR, Zyban, and generic) and nortriptyline—seem to work by stimulating some of the same brain chemicals as cigarettes. But only sustained-release bupropion is FDA-approved for smoking cessation. Combining the nicotine patch with antidepressants may be especially effective for people strongly addicted to nicotine.
Preliminary studies suggest that a newer oral medication called varenicline (Chantix) may be even more effective than bupropion for smoking cessation. It eases cigarette cravings by providing mild nicotine-like effects, while potentially blocking some of the satisfaction cigarettes provide.
But while its side effects are relatively mild, the drug is too new to judge its safety definitively. Try the more-established treatments first, and consider varenicline if they don’t work.
Get support
Counseling and support programs also play a crucial role in smoking cessation, and your attitude can make a huge difference. Try these tips:
As many as 30 percent of all coronary heart-disease deaths in the U.S. each year stem from cigarette smoking. And overall, smokers have more than double the heart-attack risk of nonsmokers.
But many studies have found that quitting smoking drops your heart-disease risk dramatically. The longer the time since you've quit, the lower that risk is likely to become. And it can be done: Some 50 percent of all Americans who ever smoked have managed to quit permanently.
That said, the nicotine in cigarettes is a powerfully addictive drug. Most people—particularly those who smoke a pack or more per day—need counseling, medication, or both in order to overcome it.
When you're ready to quit:
See a doctor
He or she can help you choose the best drug therapy to ease withdrawal, and who can also detect and treat any smoking-related illnesses, such as bronchitis, emphysema, and heart disease.
Fight drugs with drugs
Most of the therapies approved by the Food and Drug Administration (FDA) involve nicotine-replacement products: over-the-counter patches, chewing gums, and lozenges, and prescription nasal sprays or inhalers reduce the symptoms of nicotine withdrawal.
Nicotine-replacement products help most during the first two to three months, when the risk of relapse is highest. People who continue to experience intense cravings may need to use the products longer, but they should do so under a doctor's supervision because of the risk of addiction to the replacements themselves. There is also some recent evidence that extended use of nicotine products may increase cancer risk.
Consider antidepressants
Two antidepressants—bupropion (Wellbutrin SR, Zyban, and generic) and nortriptyline—seem to work by stimulating some of the same brain chemicals as cigarettes. But only sustained-release bupropion is FDA-approved for smoking cessation. Combining the nicotine patch with antidepressants may be especially effective for people strongly addicted to nicotine.
Preliminary studies suggest that a newer oral medication called varenicline (Chantix) may be even more effective than bupropion for smoking cessation. It eases cigarette cravings by providing mild nicotine-like effects, while potentially blocking some of the satisfaction cigarettes provide.
But while its side effects are relatively mild, the drug is too new to judge its safety definitively. Try the more-established treatments first, and consider varenicline if they don’t work.
Get support
Counseling and support programs also play a crucial role in smoking cessation, and your attitude can make a huge difference. Try these tips:
- Set positive, long-term goals. Replace “shouldn’ts”—“I shouldn’t smoke so much”—with affirmatives—“I will stop smoking.”
- Enlist friends and family. Our experts agree that whether you turn to a support group, friend, spouse, or child, it helps to have other people both
to encourage you and to hold you accountable.
- Recognize and plan for obstacles. When you're feeling down because of fatigue, stress, anger, disappointment, or sadness, the desire to smoke may be heightened.
The key is to find other, positive habits that you learn to associate with the relief of stress or fatigue. For example, a
few minutes of moderate exercise such as stretching or a short walk will not only keep you busy, it can reduce stress and
elevate energy and mood.
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