Is the Surgeon General Really Right About the Risks of Smoking Cigarettes?

Yes -- absolutely. The medical evidence proving the health hazards of smoking is now beyond question. Tobacco use, including pipe and chewing tobacco, increases your risk of developing cancer, heart disease, stroke, and lung disease. Consider the following questions:

What About Cancer?

Tobacco smoke and tobacco juices contain carcinogens, chemicals that can cause normal cells in the body to change into cancer cells. The result is:

Smoking:  How and Why to Quit

Beside Cancer, What Else?

Tobacco users suffer a loss of the elasticity of their body tissues more rapidly than other persons of their same age. This means that those body tissues that need to be flexible, to expand and contract, cannot do so as well. The loss of elasticity in the smoker leads to hardening of the arteries; high blood pressure; heart attacks and strokes at an earlier age than nonsmokers. In fact, smokers have two times the risk of dying of heart attacks and three times the risk of dying of strokes than nonsmokers.

Tobacco is even a health risk to unborn babies of mothers who smoke. It increases the risk of miscarriage, low birth weight complications during pregnancy, and the likelihood of health problems during infancy.

As if all that were not enough, smoking decreases the resistance of the nose, sinuses, and lungs to infections. Thus, the smoker is more likely to contract pneumonia, and catches "colds," bronchitis, and sinus infections more often and has more difficulty recovering from these than nonsmokers do. Even nonsmokers who work around or live with smokers (who cannot avoid breathing their "second-hand smoke") will suffer this decreased resistance to infections. This is especially true with little children who live in a smoker's household.

Tobacco is the most preventable cause of death. In the U.S., 340,000 people die each year from smoking-related illness. This number equals the number of people who were killed in seconds at Hiroshima.

Why Do People Still Smoke?

Smoking is a form of drug addiction because tobacco contains nicotine, an addictive drug. This means that a smoker goes through physical and psychological drug-withdrawal effects when trying to quit. These may include intense food cravings, jittery nerves, anxiety, short temper, depression and sleeplessness.

Some people smoke because they think it will help them appear more important, fashionable or glamorous. Others use it as a crutch to overcome self-consciousness in social situations. Teenagers often buckle under peer-group pressure and smoke because their friends do and they want to be accepted by the crowd. Fortunately, the last decade has seen these attitudes change as people become better educated and more sophisticated about health.

The more popular thinking today is that smoking is not glamorous at all when it yellows your teeth, gives you bad breath and fills the room with odors that are offensive and hazardous to others. Increasingly, smoking carries with it a social stigma. In fine restaurants, and in commercial airplanes, the smoker is assigned to segregated seating.

Unfortunately, some persons who have smoked for years feel "it's too late for them and the damage is already done so why quit?" But medical evidence has proven that this is not true. Your body starts the process of healing, as soon as you finish that last puff.

How Can I Quit?

Mark Twain once quipped, "It is easy to quit smoking; I've done it hundreds of times." For a few disciplined persons it is easy to quit abruptly or "cold turkey;" but for many others, it is not easy at all.

Since the prospect of never smoking again may seem unbearable to you, make your promise to quit for just one week. After you have conquered the first smokeless week then promise another week, and so on, until you are permanently cured. You have two major hurdles to overcome: First, the ADDICTION to nicotine, and secondly, the HABIT of smoking.

How Can I Kick the ADDICTION?

If you quit abruptly, the addiction-withdrawal symptoms will be at their worst in the first week and less severe in the second. After a month most of the withdrawal symptoms will be gone. If you quit gradually, the withdrawal may be less intense but will be more prolonged. This is why many experts recommend quitting abruptly.

Tell your friends, your family, your boss, and your fellow workers that you have just quit smoking. You may be temporarily irritable, depressed, and anxious for one week or so, but these withdrawal symptoms will pass. Ask for everyone's support and understanding.

Do anything to keep busy and keep your mind off smoking. Exercise; work on that talent or hobby you always wanted to develop, especially if it involves use of your hands (sewing, model building, practicing the piano, etc.). Go visit your nonsmoking friends, but avoid circumstances you associate with smoking such as cocktail parties, watching television, balancing the checkbook, talking on the telephone or your usual "cup of coffee and a cigarette."

An excellent time to quit smoking is when you are hospitalized. The controlled hospital environment is very helpful. Furthermore, physicians often insist that you quit smoking before surgery and anesthesia, so you can better resist post-operative pneumonia that smokers are more likely to develop.

Once you have conquered the addiction, NEVER try a cigarette again-not even just one little teeny one. Many a successful quitter has stumbled back into a full addiction by trying "one" cigarette "just to be sociable."

How Can I Break the HABIT of Smoking?

You must break that habit of automatically lighting-up and taking a puff before you think of it. So from now on, every time you start to light-up, become conscious of the fact that you are doing so. Next, try to think of why you are doing this: Are you upset about something? Are you in an environment where you usually smoke? Are you nervous? If you can determine exactly when it is you most often smoke and why it is you do so at that time, you will then be in better control of the situation and able to effectively deal with it.

Instead of having a cigarette, keep a pack of chewing gum in the place where your cigarettes would usually be. Or, drink a glass of water each time the urge to smoke occurs. Also, try hiding your cigarettes in places where you ordinarily wouldn't look for them, such as in the trunk of your car, down in the basement or in a bureau drawer. You will then have to make a conscious effort to look for them, and hopefully, this will be troublesome enough so that you will smoke fewer of them. Also, from now on, buy cigarettes by the single pack only and not by the carton. The added inconvenience may deter you even more.

Weight gain is a frequent problem for smokers who are quitting. This is because food tastes better and also helps to satisfy an oral craving. So avoid sweets and other fattening foods, and use low calorie, healthful ones instead, e.g., chew carrots or celery sticks. Start an exercise program to burn off those calories. Exercise also reduces stress and anxiety.

Do Nicotine Gum and Patches Really Help?

Nicotine gum and patches may help as you try to break the HABIT of smoking: both systematically reduce your nicotine ADDICTION. By providing an alternative source of nicotine, without the other harmful additives found in tobacco products, they allow the smoker to concentrate on overcoming psychological and social factors of the smoking habit.

The patches contain nicotine which is slowly released into your bloodstream through the skin; they come in different styles and strengths. Depending on how much you smoke, you may start with a higher dose and reduce to a lower strength. Remember, when you use the patch you cannot keep smoking. If you do, the double amounts of nicotine can lead to a very serious condition called nicotine toxicity and a heart attack. If you continue to smoke while using the patch, you may end up with a trip to the hospital.

Nicotine gum also provides an alternative source of nicotine. Once the habit is broken, you then stop chewing the gum and go through drug withdrawal. For some, separating the withdrawal from the habit breaking makes quitting easier.

Although either can help satisfy your nicotine craving, they are only aids.

• They are no substitute for willpower and won't work unless you are committed to quitting.
• The gum or patch should be used in conjunction with a smoking cessation program. You can't be magically cured of your habit.

Another factor is cost. Nicotine patches and gum are expensive. On the other hand, serious smokers spend as much on cigarettes and related health care costs.

For those ready to quit smoking, who are having trouble with nicotine withdrawal, nicotine gum or a patch might provide the extra edge needed to quit for good.

Where Can I Seek Help?

Your physician can help motivate you by discussing your personal health and the risks you take when you smoke. Some physicians recommend hypnosis to help you quit. Your physician might even prescribe a tranquilizer for your worst few days of withdrawal, but he would not want you to substitute a new addiction for an old one.

Additional help is often available through community health programs that offer group counseling. Many smokers find group counseling encouraging because they are in an environment where everyone shares the same problems, thus making it easier to discuss them openly. The American Cancer Society, the American Lung Association, Smokenders®, and the Seventh Day Adventist Church offer excellent group programs. The American Heart Association offers a "do-it-yourself" program for those who feel more comfortable handling this problem alone.

Is It Worth It?

Ask anyone who has quit smoking. Most who have quit are justly proud of this significant personal accomplishment. They feel healthier, more attractive and more robust; they breathe better: food tastes better; and some people even feel younger. Their homes and offices no longer are polluted with smoke, cigarette butts and ashes, and they are finished finding cigarette burns on their carpets, furniture and clothes.

Yes, it's worth it. Doctors and medical statistics say so. Even if you have smoked for many years, you can beat the odds by quitting.

WHAT IS OTOLARYNGOLOGY-HEAD AND NECK SURGERY?

Otolaryngology-head and neck surgery is a specialty concerned with the medical and surgical treatment of the ears, nose, throat and related structures of the head and neck. The specialty encompasses cosmetic facial reconstruction, surgery of benign and malignant tumors of the head and neck, management of patients with loss of hearing and balance, endoscopic examination of air and food passages, and treatment of allergic, sinus, laryngeal, thyroid and esophageal disorders.

To qualify for the American Board of Otolaryngology certification examination, a physician must complete five or more years of post-M.D. (or D.O.) specialty training.

©1994. American Academy of Otolaryngology-Head and Neck Surgery, Inc. This leaflet is published as a public service. The material may be freely used so long as attribution is given to the American Academy of Otolaryngology-Head and Neck Surgery, Inc., Alexandria, VA.