What do I need to know about quitting?
The US Surgeon General has said, "Smoking cessation [stopping smoking] represents the single most important step that smokers can take to enhance the length and quality of their lives."Quitting smoking is not easy, but you can do it. To have the best chance of success in quitting, you need to know what you're up against, what your options are, and where to go for help. You'll find this information here.Why is it so hard to quit smoking?Mark Twain said, "Quitting smoking is easy. I've done it a thousand times." Maybe you've tried to quit, too. Why is quitting and staying quit hard for so many people? The answer is nicotine.NicotineNicotine is a drug found naturally in tobacco. It is highly addictive -- as addictive as heroin or cocaine. Over time, a person becomes physically and emotionally addicted to (dependent on) nicotine. Studies have shown that smokers must deal with both the physical and psychological (mental) dependence to quit and stay quit.How nicotine gets in, where it goes, and how long it staysWhen you inhale smoke, nicotine is carried deep into your lungs. There it is absorbed quickly into the bloodstream and carried throughout your body. Nicotine affects many parts of the body, including your heart and blood vessels, your hormones, your metabolism, and your brain. Nicotine can be found in breast milk and even in mucus from the cervix of a female smoker. During pregnancy, nicotine freely crosses the placenta and has been found in amniotic fluid and the umbilical cord blood of newborn infants.Several different factors can affect how long it takes the body to remove nicotine and its by-products. In most cases, regular smokers will still have nicotine or its by-products, such as cotinine, in their bodies for about 3 to 4 days after stopping.How nicotine hooks smokersNicotine produces pleasant feelings that make the smoker want to smoke more. It also acts as a kind of depressant by interfering with the flow of information between nerve cells. As the nervous system adapts to nicotine, smokers tend to increase the number of cigarettes they smoke. This, in turn, increases the amount of nicotine in the smoker's blood. After a while, the smoker develops a tolerance to the drug. Tolerance means that it takes more nicotine to get the same effect that the smoker used to get from smaller amounts. This leads to an increase in smoking over time. The smoker reaches a certain nicotine level and then keeps smoking to maintain this level of nicotine. In fact, nicotine inhaled in cigarette smoke reaches the brain faster than drugs that enter the body intravenously (IV).Nicotine withdrawal symptoms can lead quitters back to smokingWhen smokers try to cut back or quit, the lack of nicotine leads to withdrawal symptoms. Withdrawal is both physical and mental. Physically, the body reacts to the absence of nicotine. Mentally, the smoker is faced with giving up a habit, which calls for a major change in behavior. The physical and mental both must be addressed for the quitting process to work.Those who have smoked regularly for a few weeks or longer, and suddenly stop using tobacco or greatly reduce the amount smoked, will have withdrawal symptoms. Symptoms usually start within a few hours of the last cigarette and peak about 2 to 3 days later when most of the nicotine and its by-products are out of the body. Withdrawal symptoms can last for a few days to up to several weeks.Withdrawal symptoms can include any of the following:dizziness (which may only last 1 to 2 days after quitting)depressionfeelings of frustration, impatience, and angeranxietyirritabilitysleep disturbances, including having trouble falling asleep and staying asleep, and having bad dreams or even nightmarestrouble concentratingrestlessnessheadachestirednessincreased appetiteThese symptoms can lead the smoker to start smoking cigarettes again to boost blood levels of nicotine back to a level where there are no symptoms. (For information on coping with withdrawal, see the section, "How to quit.")Smoking also makes your body get rid of certain drugs faster than usual. When you quit smoking, it changes the way your body handles some medicines. Ask your doctor if any medicines you take regularly need to be checked or changed after you quit.Why should I quit?Your healthHealth concerns usually top the list of reasons people give for quitting smoking. This is a very real concern: About half of all smokers who keep smoking will end up dying from a smoking-related illness.CancerNearly everyone knows that smoking can cause lung cancer, but few people realize it is also a risk factor for many other kinds of cancer too, including cancer of the mouth, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, cervix, stomach, and some leukemias.Lung diseasesPneumonia has been included in the list of diseases known to be caused by smoking since 2004. Smoking also increases your risk of getting lung diseases like emphysema and chronic bronchitis. These diseases are grouped together under the term COPD (chronic obstructive pulmonary disease). COPD causes chronic illness and disability, and worsens over time -- sometimes becoming fatal. Emphysema and chronic bronchitis can be found in people as young as 40, but are usually found later in life, when the symptoms get much worse. Long-term smokers have the highest risk of developing severe COPD.Heart attacks, strokes, and blood vessel diseasesSmokers are twice as likely to die from heart attacks as are non-smokers. And smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles. Smoking also affects the walls of the vessels that carry blood to the brain (carotid arteries), which can cause strokes. Men who smoke are more likely to develop erectile dysfunction (impotence) because of blood vessel disease.Blindness and other problemsSmoking causes an increased risk of macular degeneration, one of the most common causes of blindness in older people. It also causes premature wrinkling of the skin, bad breath, bad-smelling clothes and hair, yellow fingernails.Special risks to women and babiesWomen have some unique risks linked to smoking. Women over 35 who smoke and use birth control pills have a higher risk of heart attack, stroke, and blood clots of the legs. Women who smoke are more likely to miscarry (lose the baby) or have a lower birth-weight baby. And low birth-weight babies are more likely to die, or have learning and physical problems.Years of life lost due to smokingBased on data collected in the late 1990s, the US Centers for Disease Control and Prevention (CDC) estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking. And given the diseases that smoking can cause, it can steal your quality of life long before you die. Smoking-related illness can limit your activities by making it harder to breathe, get around, work, or play.Why quit now?No matter how old you are or how long you've smoked, quitting can help you live longer and be healthier. People who stop smoking before age 50 cut their risk of dying in the next 15 years in half compared with those who keep smoking. Ex-smokers enjoy a higher quality of life with fewer illnesses from cold and flu viruses, better self-reported health, and reduced rates of bronchitis and pneumonia.For decades the Surgeon General has reported the health risks linked to smoking. In 1990, the Surgeon General concluded:Quitting smoking has major and immediate health benefits for men and women of all ages. These benefits apply to people who already have smoking-related disease and those who don't.Ex-smokers live longer than people who keep smoking.Quitting smoking lowers the risk of lung cancer, other cancers, heart attack, stroke, and chronic lung disease.Women who stop smoking before pregnancy or during the first 3 to 4 months of pregnancy reduce their risk of having a low birth-weight baby to that of women who never smoked.The health benefits of quitting smoking are far greater than any risks from the small weight gain (usually less than 10 pounds) or any emotional or psychological problems that may follow quitting.When smokers quit -- What are the benefits over time?20 minutes after quitting: Your heart rate and blood pressure drops.(Effect of Smoking on Arterial Stiffness and Pulse Pressure Amplification, Mahmud, A, Feely, J. 2003.Hypertension:41:183.)12 hours after quitting: The carbon monoxide level in your blood drops to normal.(US Surgeon General's Report, 1988, p. 202)2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.(US Surgeon General's Report, 1990, pp.193, 194,196, 285, 323)1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.(US Surgeon General's Report, 1990, pp. 285-287, 304)1 year after quitting: The excess risk of coronary heart disease is half that of a smoker's.(US Surgeon General's Report, 1990, p. vi)5 years after quitting: Your stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting.(US Surgeon General's Report, 1990, p. vi)10 years after quitting: The lung cancer death rate is about half that of a continuing smoker's. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease, too.(US Surgeon General's Report, 1990, pp. vi, 131, 148, 152, 155, 164,166)15 years after quitting: The risk of coronary heart disease is the same as a non-smoker's.(US Surgeon General's Report, 1990, p. vi)
