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60% of People Who Smoke Will Die From it — But You Can Quit!

Posted Sep 12 2010 6:23pm

Besides causing cancer and any one of a number of other health problems, smoking can destroy organs like the heart and lungs and can seriously damage or destroy others. 

There are about 110,000 people in the U.S. waiting for organ transplants and there are not enough donor organs, so each year thousands of our loved ones, friends and neighbors die waiting. The number of organ donors is not increasing fast enough to end the shortage any time soon so one way of dealing with the crisis is to prevent the need for organ transplants.  One way to do that is to quit damaging our organs by quitting smoking. 

From time to time I will be publishing blogs from guest writers.  The following post was written by Dr. Michael Burke, Ed.D, Assistant Professor of Medicine at the Mayo Clinic School of Medicine and Program Coordinator at the Mayo Clinic Nicotine Dependence Center.  Dr. Burke is a highly respected expert in the field of tobacco addiction and smoking cessation. 

There is nothing that is healthier for a person who smokes than to stop. Within a short time after one stops smoking, lung function and circulation improve, risk of heart attack and stroke diminish, and the likelihood of acquiring 14 different cancers begins to drop. 

Symptoms from illnesses as different as diabetes, sleep apnea, and Crohn’s disease get better after a person stops smoking.  Stopping before surgery significantly improves surgical outcomes through less infection, better wound healing and bone mending.  Stopping smoking leads to less skin wrinkles and better erectile function, and the list goes on and on. Although people usually underestimate how dangerous smoking is, nearly everybody knows that it is unhealthy.  However, about 1 in 5 Americans continue to smoke, and each day in the US, as many people die from smoking as three fully loaded 747’s crashing.   Worldwide 100 million people died from smoking in the 20th century.  Predictions are that one billion people will die from smoking tobacco this century.  So why doesn’t everyone quit? 

One reason is that cigarettes are quite addicting.   A cigarette delivers nicotine to the brain more quickly than a hypodermic needle.  It is probably the best drug delivery device ever created by man.  It delivers volatile high dose nicotine that, for some people, causes physical changes to a part of the brain that is responsible for pleasure, attention and stress.  I say ‘for some people’.

Smoking affects people differently.  Stopping smoking is actually physically harder for some people than it is for others.  The differences are in large part due to genetics. To shed light on these genetic differences a group at the Mayo Clinic is, oddly enough, studying Zebra fish. http://discoverysedge.mayo.edu/zebrafish-genetics/ Dr. Steve Ekker’s group has discovered two genes that make the fish more reactive to nicotine.  If exposed to nicotine when in the larvae stage Zebra fish bred to have these two specific genes will become sensitized to the nicotine.   Later in life they will move and dart more quickly in the water when nicotine is added to the tank.  However, if these genes are ‘knocked out’ the fish won’t become sensitized to nicotine and then later will not react when exposed to nicotine.   It is wonderful to have a geneticist with a sense of humor.  Dr. Ekker’s group named the nicotine activating genes Humphrey Bogart and Bette Davis after those two Hollywood stars whose style of smoking became iconic.

Although it is a more complex story in human beings, some people have Humphrey Bogart and Bette Davis genes.  These people experience a heightened reward from cigarettes when they first start smoking and more intense craving and withdrawal when they try to stop.  Too often these people feel ashamed, think that they just have less willpower, or think that they just don’t want to stop badly enough. Instead these folks can stop, they just need more tools and ammunition.

I once treated a woman, a nurse, from Bayonne NJ.  She was clearly a strong lady.  My dad would have admirably described her as a ‘tough old broad’.  “People tell me I’m weak, that I should just quit smoking” she said “But, when I go half a day without a cigarette, I’m on my knees in tears I just feel so awful”.  “I’m not weak” she went on.  “I left a bad man, raised three kids, worked sometimes two jobs, bought my own home, and sent all three kids to college.  I’m not weak! What is it about this that is so hard?” she asked me.  She was most likely genetically set to have a more difficult time stopping, and she needed treatment to match that extra difficulty.   We provided treatment and one year later she was still tobacco free.

Many people try and stop ‘cold-turkey’.  That’s good if it works.  However, less than 5% of the people who use this method are successful at six months.  Counseling and medications have been proven to significantly increase the chances of successfully stopping smoking.  You can learn more about how counseling works by viewing the short video at this link. http://www.youtube.com/watch?v=5EDaA26unVw  

Your health care provider may provide counseling or they may have a Tobacco Treatment Specialist in the office or local area.  Professional help is also available through a telephone Quit line.  Every state in the US, and province in Canada have one that can be accessed through calling 1800 QUIT NOW.   One online resource that many people find helpful is www.becomeanex.org .  Mayo Clinic also has a Residential Treatment Program – an 8 day program that works for people who have ‘tried everything’.  http://ndc.mayo.edu

There are seven ‘first line’ medications that have been proven to be safe and effective for helping people stop smoking.  Five are nicotine replacement products and two are pills available by prescription: varenicline (Chantix) and bupropion (Zyban).  

There is too much confusion about nicotine replacement.  Nicotine replacement medications have saved many lives and can save many more. Nicotine is not the ingredient in cigarettes that causes health problems.  Smoking health problems are caused by 4,000 other chemicals that people ingest when they smoke.  Some of these chemicals are natural to tobacco others are added by the tobacco industry.  Nicotine replacement helps manage cravings and withdrawal symptoms safely, while eliminating exposure to the awful toxins in tobacco.  We encourage people to take enough of these medicines for long enough to stop smoking.

People who smoke can also talk to their health care provider about two other medications varenicline and bupropion.  These medications are proven to help people safely stop smoking.  Like most medications, there are some potential side effects and you should talk to your health care provider before taking these medications.   But remember, if the tobacco industry had to list the side effects from smoking, it would probably fill a telephone book.  Cigarettes are the only product that will kill over 60% of the people who use it in the way it is intended.   Stopping smoking, by any means necessary, is the healthy choice.

Please comment in the space provided or email your thoughts to me at bob@baronson.org .  And – please spread the word about the immediate need for more organ donors.  Whenever you can, help people formally register even if you have to drive them to a driver’s license office.  There is nothing you can do that is of greater importance.  If you convince one person to be a donor you may save or positively affect over 50 lives.  Some of those lives may be people you know and love.

Also…visit and join my Facebook site, Organ Transplant Patients, Families and Friends at  http://tinyurl.com/225cfh   OR — my Facebook home page   http://www.facebook.com/home.php .  The more members we get the greater our impact on increasing life saving organ donation.     


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