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All about quit smoking & stop smoking health effects of smoking constituents of tobacco smoke smoking and lung cancer smoking and cardiovascular disease smoking and chronic obstructive pulmonary disease other cancers caused by smoking women's health and smoking harm to human body by smoking passive smoking (second hand smoking) health hazards of passive smoking avoiding passive smoking smoking addiction reasons to quit smoking stop smoking cigar smoking and health smoking cessation medications body weight and smoking cessation health benefits of quitting smoking

How to quit smoking?

The vast majority of smokers quit without external assistance. Research from the United States has estimated that more than 90% of successful quitters do so unassisted, and that those who quit unassisted are twice as likely to succeed as those who attend a quit program (although this is likely to reflect the fact that those who attend special programs are more likely to be heavily addicted). Stopping 'cold turkey' (that is, stopping smoking completely) appears to be a more successful strategy than attempting to quit by reducing consumption gradually or switching to lower tar cigarettes. The desire to quit

might be triggered by a wide range of influences or events, such as a cough or other unpleasant symptoms due to smoking, advice from a health worker or family and friends, or adverse publicity about smoking. Smokers may find 'self-help' guides with brief instructions or advice about how to stop, and lifestyle advice useful. Provision of this information is a cost effective way to help motivated smokers quit. Indicators for success with quitting smoking are: being highly motivated and expecting to succeed, having a supportive environment, and having the skills to cope with adaptation and change. Many smokers try several times before successful quitting. This does not have to be viewed negatively: smokers may learn from relapse and be successful next time.

Role of cessation clinics

Some smokers find attending a quit course helpful. These courses generally provide trained counsellors who assist intending quitters with skills to help them quit successfully. They may provide further information about smoking, teach relaxation techniques, provide advice about diet, exercise and managing withdrawal symptoms in an atmosphere of group support. Cessation clinics are sometimes criticised because of the expense taken to run them, compared with their overall impact on reducing national smoking rates. It is argued that if the money spent on running quit clinics were instead put into public education campaigns, a far higher impact would be made on the smoking rates of the community; and that as the majority of smokers are able to quit unassisted by professional guidance, a finite proportion of funding should be allocated to assist those who cannot. Proponents of this view recommend that existing contact with health professionals should be maximised to provide personal and expert help to smokers.

Cessation clinics are more likely to be used by those having special difficulty in quitting, particularly heavy, more addicted smokers, and there is counter argument that they serve a limited but nonetheless important role by providing intensive cessation programs for those who need them most. However a fault of the programs may be that they are inaccessible to high risk target groups (for example to the poor, the less educated, or high risk subgroups in the population such as pregnant women).

Nicotine replacement therapies

Nicotine replacement therapies (NRT), whether provided through oral gum or via skin patch, are intended to aid heavily dependent smokers in quitting smoking. NRT provides a replacement dose of nicotine, helping to ease nicotine withdrawal symptoms such as craving and mood changes when the smoker stops smoking. However they do not offer a 'magic bullet'. As with all smoking cessation programs, most quitters will take more than one attempt to quit successfully. Nicotine polacrilex ('chewing gum'): The nicotine released from the gum is intended to prevent the onset of nicotine withdrawal symptoms, allowing the patient to concentrate on breaking the psychological aspects of the smoking habit. Through a successive reduction in consumption of the tablets, the patient is then taken off the nicotine. Highly nicotine dependent patients benefit most from nicotine gum replacement therapy. The benefits are not clear for those who are less dependent, so gum is not recommended for this subgroup unless other cessation methods fail. Gum use may cause a sore throat or mouth, tired jaws, hiccups, nausea or other gastrointestinal symptoms, palpitations, and rarely, mouth ulcers. Some of these symptoms are relieved by encouraging slower chewing and having rest periods, allowing maximal absorption of nicotine through the lining of the mouth (and for less to be swallowed). Research has shown that consuming acidic foods or drinks prior to using gum can impair nicotine absorption, so as a general rule, gum use should be delayed at least 15 minutes after eating or drinking.

Transdermal nicotine (nicotine 'patches'): Adhesive nicotine patches provide replacement nicotine from a reservoir for absorption through the skin. As with nicotine chewing gum, the patches are intended to ameliorate withdrawal symptoms while the smoker becomes accustomed to no longer smoking. Patches may be more effective than gum in that patient compliance is likely to be higher because they are simpler to use; further, since they provide a steady level of nicotine, the risk of long term use caused by the reinforcing effects of receiving a bolus of nicotine when craving starts is avoided. In general, rate of success increases with intensity of behavioural intervention (through physician's advice, provision of educational information, counselling, follow-up and so on). Highly dependent smokers are more likely to succeed with quitting if dosages of NRT are extended and modified to suit their requirements, and if behavioural intervention is included in their treatment.

Nicotine aerosols: Nicotine aerosols for administration orally, nasally or by inhalation, are currently undergoing clinical testing and are not yet commercially available. The aerosols produce rapid increases in blood-nicotine level, which may make them more effective for heavily addicted smokers, or in combination with other nicotine replacement or other therapies. Although there has been concern that they may cause too great an elevation in blood-nicotine levels and local irritation, recent research on the effectiveness of nasal nicotine spray is encouraging.

Roll-on tobacco products: Tobacco extract in roll-on form is available over the counter in some states. It differs from the transdermal nicotine patches in that it contains full tobacco extract, rather than nicotine alone. Success of these products has not been supported by any appropriately controlled studies. Further, topical carcinogenicity of tobacco is well established (for example oral carcinomas in those who chew tobacco) so use of tobacco extract on the skin cannot be regarded as safe. Nicotine is not carcinogenic in its own right, and is the only useful constituent of tobacco derived smoking cessation products.

Nicotine blockade

Blockade therapy aims to reduce the rewarding effects gained through cigarette use. Drugs are used to block the nicotine receptors in the central nervous system, so that smoking delivers no pharmacological benefit to the smoker. One such drug is mecamylamine, but it is unlikely to develop as a viable cessation aid as it has major incapacitating side effects, and does not alleviate the behavioural aspects of smoking.

Aversion therapy

There are a number of methods for inducing aversion to smoking, the aim of which is to reduce the incentive to smoke. These include associating smoking with unpleasant imagery (covert sensitisation), with discomfort caused through electric shock or other stimuli, or with the unpleasant effects produced by smoking itself (directed smoking procedures). Strategies used to induce aversion include satiation smoking in which the smoker dramatically increases consumption prior to quitting; rapid smoking in which the smoker inhales frequently and consistently until reaching the point of nausea; and variations on smoking technique designed to engender distaste, displeasure or disgust ('reduced aversion' techniques). Rapid smoking should not be practised by those with a history of cardiovascular disease or other risk factors. Aversion therapy has shown mixed success. Satiation smoking does not appear to be successful, but rapid smoking is effective at least in the short term, especially if combined with appropriate counselling. Reduced aversion techniques produce effects similar to rapid smoking. Shock treatments have not been shown to be successful.

Acupuncture

Acupuncturists commonly treat smoking by applying needles or surgical staples to the surface of the nose, the ears or the wrist. Acupuncture is intended to provide relief from withdrawal symptoms, rather than to cure the addiction itself, and is more effective when combined with appropriate counselling.

Hypnosis

As with acupuncture, the success of hypnosis has been poorly evaluated. It appears, however, that when used in isolation, hypnosis does not produce high rates of success. Rates rise if hypnosis is used in conjunction with counselling and follow-up support, and if the quitter is highly motivated and expects to succeed. Hypnosis generally involves giving smokers direct suggestions to change and suggesting alternative behaviours, fostering an aversion to smoking, and teaching self-hypnosis and relaxation techniques.

More information on quitting smoking

How to quit smoking? - Many smokers know they need to quid smoking to avoid health risk. Smoking cessation is of the most importance for people who is suffering from unpleasant smoking symptoms.
What health effects are associated with smoking? - The main health risks in tobacco smoking pertain to diseases of the respiratory tract and also to diseases of the cardiovascular system, in particular smoking being a major risk factor for a myocardial infarction (heart attack).
What're the constituents of tobacco smoke? - Tobacco smoke is a complex mixture of several thousand chemical compounds. These include particulates (tar) of sticky solids, gases such as carbon monoxide, and volatiles. Most importantly, the smoke contains nicotine ĘC the addictive drug.
Smoking and lung cancer - Lung cancer is directly related to smoking. Over 40 carcinogens have been identified in cigarette smoke. The risk of developing lung cancer is directly related to the number of cigarettes smoked.
Smoking and cardiovascular disease - There are a number of cardiovascular diseases that can be related to smoking. They include heart disease, stroke, and peripheral vascular disease. Smoking aggravates and accelerates of the development of atherosclerotic lesions in the arterial walls.
Smoking and chronic obstructive pulmonary disease (COPD) - Chronic obstructive pulmonary disease (COPD) is a lung disease in which the lung is damaged, making it hard to breathe. Prolonged tobacco use causes lung inflammation and variable degrees of air sack (alveoli) destruction.
Other cancers caused by or associated with smoking - Cigarette smoking is a major cause of cancers of the oral cavity, oesophagus and larynx. Smoking is a cause of bladder cancer. Cigarette smoking is at least a contributory and may be a causal factor in the development of pancreatic cancer.
Women's health and smoking - Women smokers suffer all the consequences of smoking that men do such as increased of risk various cancers (lung, mouth, larynx, pharynx, esophagus, kidney, pancreas, kidney, and bladder) and respiratory diseases.
Harm to human body by smoking - Chemicals in tobacco cause damage to the macula (the most sensitive part of the retina, the back of the eye). Smoking is a risk factor for all cancers associated with the larynx, oral cavity and oesophagus.
What is passive smoking? - "Passive smoking" or "secondhand smoke" - also known as "environmental tobacco smoke" (ETS) or "involuntary smoking" - occurs when the ambient smoke from one person's cigarette is inhaled by other people.
Health hazards of passive smoking - Some of the immediate effects of passive smoking include eye irritation, headache, cough, sore throat, dizziness and nausea. Adults with asthma can experience a significant decline in lung function when exposed, while new cases of asthma may be induced in children whose parents smoke.
How to avoid passive smoking? - Let your visitors know your home is a smoke-free zone, request them to smoke outside. Ask your visitors to put off the cigarette before entering your room. Ask to be seated in non-smoking areas as far from smokers as possible when dining out.
What is a smoking addiction? - A smoking addiction means a person has formed an uncontrollable dependence on cigarettes to the point where stopping smoking would cause severe emotional, mental, or physical reactions.
Why quit smoking? - Smoking increases the risk of respiratory diseases such as emphysema, chronic bronchitis and chronic obstructive pulmonary disease (COPD). Smokers have twice the risk of dying of heart attacks, as do non-smokers.
How to stop smoking? - Quitting smoking is a lot like losing weight; it takes a strong commitment over a long period of time. Withdrawal from nicotine has two parts - the physical and the psychological.
Cigar smoking and health - A cigar is defined, for tax purposes, as "any roll of tobacco wrapped in leaf tobacco or in any substance containing tobacco," while a cigarette is "any roll of tobacco wrapped in paper or any substance not containing tobacco.
What smoking cessation medications are available? - Nicotine for NRT is available by prescription as an inhaler or nasal spray (Nicotrol Inhaler and Nicotrol NS).
Changes in body weight and smoking cessation - Smokers weigh, on average, around 3 kg less than non-smokers, although heavy smokers are more likely to be moderately or severely overweight. For many people, the fear of gaining weight prevents them from quitting smoking.
Health benefits of quitting smoking - Smoking cessation has major and immediate health benefits for men and women of all ages. The health benefits of smoking cessation far exceed any risks from the average 2.3 kg (5 pound) weight gain or any adverse psychological effects that may follow quitting.
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