Time to quit

Posted in : Health Q&A on by : Around DB Comments: 0

Smoking – a habit so easily started, yet so hard to break. Dr Yau Wing Him of Discovery Bay Medical Centre gets serious about this harmful addiction.

Why is it so easy to get addicted to smoking? It’s simple really. Within seconds of inhaling cigarette smoke, nicotine travels from the lung to the brain. As nicotine binds to receptors in brain cells, it can enhance concentration and memory and reduce anxiety. It causes pleasurable sensations and of course it relieves nicotine-withdrawal symptoms and cravings.

The main dangers of smoking are multiple cancers of the lung, intestine, pancreas, bladder and kidney. Heart disease, such as coronary artery disease, and lung disease, such as chronic obstructive pulmonary disease, are both high-risk factors. Smoking also causes high blood pressure, which can lead to strokes.

Can smoking ever be casual?

Smoking is a strong dose-related risk factor for lung cancer. That means your chance of developing lung cancer and dying from it increases with the quantity of cigarettes you smoke, the tar content of the cigarettes and the number of years you smoke.

To illustrate this point, at least 90 percent of all lung-cancer cases are directly caused by smoking. Non-smokers account for about five percent of all lung-cancer deaths, possibly as a result of ‘passive’ smoking. Another example is that a heavy smoker (more than 15 cigarettes per day) is 40 times more likely to die from lung cancer than a non-smoker.

Any smoking is harmful because nicotine is an addictive drug. Once started, nicotine is tolerance producing (smokers need more and more to achieve the same positive effect), causing physical and psychological dependence. This can lead to unpleasant withdrawal symptoms and cravings when smokers try to stop.

What is the best way to quit?

Enumerating all the advantages of giving up can increase motivation, and anti-smoking support programmes can be a great help. Nicotine replacement therapy in the form of nicotine gum, lozenges and transdermal nicotine patches are popular options. Prescription drugs such as Chantix (containing varenicline) or the antidepressant Bupropion can also be used. Varenicline blocks nicotine receptors; Bupropion helps reduce the brain’s craving for nicotine.

Quit rates vary according to different studies. The quit rate at one year for nicotine patches varies from five to 16 percent versus nine to 30 percent for Bupropion. The higher success rates include behavioural support.

Studies show that a large number of ex-smokers report weight gain in the first year of stopping. Women seem to be more susceptible than men. The average weight gain is 5 kilogrammes for women and 4.4 kilogrammes for men.

The most probable explanation for this is that smoking reduces appetite and energy intake; quitting smoking increases appetite and calorie intake. Dietary counselling in smoking cessation is important to prevent or limit weight gain.

You can contact Dr Yau Wing Him on 2987 5633.

Image: Wikipedia

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