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Quit Smoking! (But How?)

Dr. Ami Abraham, Pulmonology, Sleep Medicine

June 15, 2023

Quit Smoking! (But How?)

“Cigarette Smoking May Be Hazardous to Your Health,” read the initial Surgeon General’s warning that was introduced to cigarette packages in 1965. That warning has since been revised many times, with today’s FDA-mandated warnings ranging from “Smoking causes head and neck cancer” and “Tobacco smoke causes fatal lung disease in nonsmokers” to “Smoking during pregnancy stunts fetal growth.”

The much more direct and graphic warnings seem to be having their intended effect. According to a scientific study based on Gallup polls and other data, in 1944 an estimated 49% of American adults said they smoked (and did so at a rate of over 17 cigarettes a day). In the wake of the Surgeon General’s warning and ongoing education, that number had dropped to roughly 11% last year; those people smoke an average of about 5 cigarettes a day.

Even with such dramatic progress – the CDC reports that smoking declined sharply from 20.9% of adults in 2005 to 11.5% of 100 adults in 2021 – an estimated 28.3 million adults in the U.S. currently smoke cigarettes, and over 16 million are living with a smoking-related disease.

In addition, cigarette smoking remains the leading cause of preventable disease, disability, and death in the U.S., accounting for more than 480,000, or about 1 in 5, deaths every year.

Those smokers are undoubtedly aware of the health risks they are facing, which in addition to those listed above include a host of respiratory and cardiovascular diseases, as well as the likelihood of developing cancer nearly anywhere in your body; the CDC maintains that, if no one smoked, cancer deaths in the U.S. would decrease by roughly one third. (Note that other ways of consuming tobacco, including orally, also present significant health risks.)

But for many, quitting tobacco is easier said than done. All tobacco includes nicotine, which as the FDA says:

“… can change the way the brain works, causing cravings for more of it. Some tobacco products, like cigarettes, are designed to deliver nicotine to the brain within seconds, making it easier to become dependent on nicotine and more difficult to quit. While nicotine naturally occurs in the tobacco plant itself, some tobacco products contain additives that may make it easier for your body to absorb more nicotine.”

Even so, there are a few strategies that can help start you on the path to kicking the habit:

1. Set a “quit” date. Whether you decide to quit cold turkey or kick the habit gradually, it is a good idea to set your goal and try your best to stick to it. When it comes to smoking, the sooner the better, as research has shown that quitting before the age of 40 reduces your chance of dying prematurely from a smoking-related disease by 90% and quitting by age 54 reduces it by two-thirds. If you are on the fence about the best strategy, it’s worth mentioning that one clinical paper on smoking cessation found that smokers who went cold turkey had better luck quitting at four and six months, compared to those who paired back on cigarettes over two weeks.

2. Say no to e-cigarettes. Patients often ask about vaping as both an alternative to smoking as well as a cessation strategy – but this is not something I recommend in either case. In addition to nicotine, e-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde – which can cause lung disease and heart disease. The American Lung Association notes that e-cigarettes “also contain acrolein, a herbicide primarily used to kill weeds.”

3. Consider medications to help you quit.In addition to nicotine-infused patches, gum and candy that can help you avoid withdrawal on the path to smoke-free, the FDA has approved two medications without nicotine to help people quit smoking – and they can actually double your chances of succeeding. These medications work on the pleasure centers of the brain. Stopping smoking is difficult and you should talk to your physician about using these therapies to provide help.

4. Explore hypnotherapy. Various studies indicate, that when combined with other treatments for quitting, hypnosis can enhance their effectiveness. While probably not sufficient on its own, hypnotherapy may help strengthen your desire to quit and help you maintain your overall plan to stop smoking.

5. Try acupuncture. As you may know, this practice targets certain areas of the body for specific conditions. Treating Pressure points in the ears can be effective in suppressing cravings, and the National Acupuncture Detoxification Association maintains that certain approaches to the ear can help combat addiction of various types.

Your physician can also suggest support groups, resource material and potentially some natural therapies that may also be able to help with this important step toward better health.

Lastly, make sure you get screened! Breaking the chains of smoking and nictotine dependence does not mean you don’t have to worry about developing lung cancer. Low-dose CT scanning is recommended as a screening test for lung cancer in people ages 50 to 80 who have a 20-pack year smoking history and currently smoke or have quit in the past 15 years.

Dr. Ami Abraham

Dr. Ami Abraham is a board-certified physician specializing in pulmonology and sleep medicine. To make an appointment in White Plains, Harrison and Rye Brook, please call 914-849-7180.