John Hopkins-Smoking Cessation

Johns Hopkins Health Alert

The Truth About Smoking Cessation



Quitting smoking is hard, but not impossible. In this excerpt from our newsletter Health After 50, Johns Hopkins reviews your options.

Despite a steady decline in the number of smokers, tobacco continues to cause twice as many deaths per year as AIDS, alcohol abuse, motor vehicle collisions, illicit drug use, and suicides combined. Understandably, knowledge of the dangers of smoking or the benefits of quitting smoking is typically not enough to motivate people to quit. Nicotine is highly addictive, and the habitual act of smoking adds a further psychological obstacle to becoming cigarette free.

The large majority of would-be quitters don’t succeed on their first attempt. Research suggests that people who get help with quitting tend to be more successful. The American Heart Association recommends:

Smoking Cessation Strategy 1 -- Nicotine replacement therapy (NRT): The nicotine patch, inhaler, gum, or lozenges are available over-the-counter (OTC).

Smoking Cessation Strategy 2 -- Zyban (bupropion): A prescription antidepressant that replaces the “high” of nicotine by increasing the brain’s supply of dopamine.

Smoking Cessation Strategy 3 -- Chantix (varenicline): A prescription drug that blocks nicotine receptors in the brain.

Smoking Cessation Strategy 4 -- Smoking cessation counseling: Individual therapy and support groups.

One study published in Chest randomly assigned 209 smokers who were hospitalized for a heart attack to receive either three months of weekly hour-long smoking cessation counseling or “standard care,” which included a self-help brochure and a brief counseling session on quitting. Participants who received the intense smoking-cessation intervention were also encouraged to use NRT and bupropion.

Two years later, 33% of those in the intense smoking-cessation group had successfully quit, compared with 9%who got standard care. Those in the intense cessation group were also 44% less likely to be hospitalized and 77% less likely to die during the study.

Although many studies show that NRT products can help you quit smoking, you shouldn’t rule out going cold turkey -- quitting smoking all at once, rather than tapering your nicotine use. Cold turkey may be a cheaper, quicker, and more effective option, particularly for lighter smokers. A survey of over 6,000 California smokers, published in the Journal of the American Medical Association, found that moderate to heavy smokers (those who smoked 15 or more cigarettes per day) benefited the most from NRT. But NRT didn’t increase the chances of quitting for those who smoked less than 15 cigarettes per day.

The bottom line: No matter how you approach quitting, you will need a genuine desire to quit and a lot of willpower. The good news is that 20 minutes after quitting your heart rate will improve. After a few weeks, blood circulation improves, cilia -- the tiny hairlike fibers in the lungs that remove mucus -- grow back, and your risk of pancreatic and esophageal cancer drops. A year later, your risk of heart disease is cut in half, and if you stay smoke free for 10 years, the same can be said for your risk of lung cancer.

Posted in Lung Disorders on April 10, 2008



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Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer