What does smoking do to you?

Smoking can affect from every single part of your body from your skin to your heart. More than 400,000 deaths occur each year in the United States as a result of cigarette smoking, this is nearly one in five deaths. In addition, exposure to secondhand smoke is estimated to cause 40,000 deaths each year from heart disease and contributes to other diseases as well.

Cardiovascular disease — Cigarette smoking doubles the risk of developing coronary heart disease and stroke, and quitting smoking can rapidly reduce this risk. Smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. Clots can also form. Stroke can happen when a clot blocks the blood flow to part of your brain or when a blood vessel in or around your brain bursts because of increased blood pressure. Blockages caused by smoking can also reduce blood flow to your legs and can cause peripheral vascular disease (PVD). If patients PVD develop infection or wounds in the legs, it is highly unlikely to heal and can even lead to amputation of the legs.

The risk of dying from coronary heart disease is reduced by about one-half in 1 year of quitting smoking and continues to decline over time.

Lung disease — Smoking increases the risk of long-term lung diseases such as chronic obstructive pulmonary disease (COPD). Patients who develop COPD eventually become dependent on Oxygen supplement and quality of life is significantly compromised. While much of the lung damage caused by smoking is not reversible, quitting smoking can reduce further damage to the lungs. In addition second hand smoke is as dangerous as first hand smoke and can cause asthma and sudden infant death syndrome (SIDS) among children exposed to smoke.

Cancer — Smoking can contribute to developing cancer ANYWHERE in your body. Cigarette smoking is responsible for almost 90 percent of cases of lung cancer. Quitting smoking reduces the risk of lung cancer within five years of stopping, although former smokers still have a higher risk of lung cancer than people who have never smoked. Stopping smoking may also reduce the risk of other cancers, such as cancers of the head and neck, esophagus, pancreas, and bladder.

Peptic ulcer disease — Cigarette smoking increases the risk of developing peptic ulcer disease. Quitting smoking decreases that risk and increases the rate of ulcer healing, if ulcers have developed.

Osteoporosis — Smoking increases bone loss and increases the risk of hip fracture in women. Stopping smoking begins to reverse this risk after about 10 years. Increased bone loss has also been noted in male smokers, although it is not clear how much a man's risk of fracture is increased by smoking.

Pregnancy - If you're pregnant smoking can cause preterm delivery, baby with low birth weight, Still birth, placental abruption and congenital defects.

Other – In addition smoking can delay wound healing, cause wrinkles in skin, affect sperm count and may lead to infertility, can affect the teeth and gums and lead to tooth loss.

Are you ready 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. Once the quit date is decided start reducing the number of cigarettes

• Identify behavioral or lifestyle triggers that can cause you to fail smoking cessation

• Identify what benefits do you get from smoking. Some may say that it helps with their stress and some use it for weight loss while others use it as a way to have social interaction.

• Ask yourself what benefit can you gain by quitting smoking? (try to think of direct benefits, such as " I don’t want to smoke in front of my children" or "I want to be healthy to play with my children"

• If you smoke to handle stress, make lifestyle changes to reduce stress and improve quality of life, such as starting an exercise program or learning relaxation techniques.

• People who smoke due to stress can benefit from psychotherapy to bring the stress under control

• Some people smoke as a habit when they hang out with their family or friends. Minimize time with smokers and in places where smoking is allowed. People who live with smokers can consider negotiating with them to stop smoking in their presence

• Do not let the cravings take control of you, it is never one cigarette. 1 cigarette will lead you back to old habits.

Talk to your doctor about the resources available to help you quit successfully Nicotine replacement therapy:

one of the major problem people face while trying to quit smoking is the nicotine withdrawal symptoms. These include depression, difficulty falling or staying asleep, irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, and nicotine craving.

Skin patches — Nicotine patches deliver nicotine to the blood through a skin patch. Several doses are available. The highest dose patch (21 mg/patch) is usually appropriate for people smoking 10 cigarettes (half a pack) or more daily. Lighter smokers might choose the 14 mg/patch.

Gum — Nicotine gum contains nicotine that is slowly released with chewing. Gum is available in 2 and 4 mg pieces. People who smoke 25 cigarettes per day or less can use 2 mg of nicotine gum when needed. Smokers who smoke more than 25 cigarettes per day can use the 4 mg dose. Smokers may use up to 24 pieces of gum per day. Intensity of withdrawal symptoms can be reduced by nicotine gum. The gum is meant to be chewed differently than regular chewing gum. To be absorbed well, you should chew it just enough to feel the tingling of nicotine being released, then hold the gum in the cheek until the tingling goes away. This cycle is repeated for 30 minutes, and then the gum is discarded.

Lozenges — Nicotine lozenges slowly release nicotine into the saliva in the mouth. The nicotine works similarly to the gum, as it must be absorbed in the mouth and not swallowed. Pharmacological treatments

Varenicline — Varenicline (Chantix) is a prescription medication that works in the brain to reduce nicotine withdrawal symptoms and cigarette cravings. Common side effects of varenicline include nausea and abnormal dreams.

Bupropion — Bupropion (Zyban or Wellbutrin) is an antidepressant that can be used to help you stop smoking. Bupropion is generally well-tolerated, but it may cause dry mouth and difficulty sleeping. The drug should not be used by people who have a seizure disorder or bipolar (manic-depressive) disorder, and it is not recommended for those who have head trauma, anorexia nervosa, or bulimia, or for those who drink alcohol excessively.

What about other forms of Tobacco?

E-Cigarettes - E-cigarettes have not yet been studied enough to know whether they are a safe and effective way to quit smoking or to know how they compare with FDA-approved smoking cessation medications like the nicotine patch or gum. The manufacture of e-cigarettes is not well-regulated, so their constituents vary greatly from product to product.

Hookah - Although many users think it is less harmful, hookah smoking has many of the same health risks as cigarette smoking. An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs. The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette.

Cigars and pipes- Smoking tobacco in a pipe causes lung cancer and increases the risk of cancers of the mouth, throat, larynx, and esophagus, even though pipe smokers don’t inhale the smoke into their lungs.

Smokeless Tobacco - Smokeless tobacco causes cancer of the mouth, esophagus, and pancreas. Using smokeless tobacco increases the risk for death from heart disease and stroke.

Medical interventions to reduce medical complications of smoking

Vaccine:

It is necessary for smokers to receive annual influenza vaccine (flu vaccine) as well as PPSV23 vaccine once before the age of 65. Smokers are at increased risk of developing lung infections and has slow healing abilities. PPSV 23 vaccine prevents from developing pneumonia.

Lung Cancer screening:

You can qualify for lung cancer screening If you are between the ages of 55 and 80 and currently smoke or quit smoking within the last 15 years with a 30-pack smoking history (a person could have a 30 pack-year history by smoking one pack a day for 30 years or two packs a day for 15 years). Lung cancer screening is performed by low dose CT scan of the lungs. The risks of lung cancer screening tests include the following finding lung cancer may not improve health or help you live longer, False-negative or false positive test results can occur. Chest x-rays and low-dose spiral CT scans expose the chest to radiation. Talk to your doctor about your risk for lung cancer and your need for screening tests.

Screening for abdominal aortic aneurysm (AAA):

The main risk factors for development of AAA are age, sex, smoking, and family history. The combination of male sex and age ≥65 years, and either smoking >100 cigarettes in a lifetime or having a family history of AAA repair or rupture, places a patient at high risk of AAA. The United States Preventive Services Task Force (USPSTF) recommends one-time screening with ultrasonography in men ages 65 to 75 years who have ever smoked.

Smoking Cessation Resources:

• Free telephone quit lines

• In the United States- 1-800-QUIT-NOW (1-800-784-8669)

• In Canada- 1-866-366-3667

• https://smokefree.gov/

• https://www.quit.com/quit-smoking/start/smoking-cessation-resources.html