Erin Sinisgalli, Director of Community Health Programs at St. Peter’s Health Partners, said the average age for people to start smoking is 13.
“We are seeing these ‘power walls’ in stores particularly drug stores where they go in and maybe buying candy or a snack and they see all these tobacco products and ads right behind the cashier,” Sinisgalli said. “Or they look at magazine ads or see people they respect smoking. So that leads kids to go and try it.”
The addiction process starts the very first time someone has his or her first cigarette. Receptors in the brain take up the nicotine in the cigarette and like it.
“You don’t necessarily feel good the first time you smoke but your body gets accustomed to it pretty quickly,” Sinisgalli said. “Over time, it is going to demand more and more cigarettes to meet the demand for nicotine in the brain.”
This addiction has adverse consequences to the smoker.
Sinisgalli said so many people come to their smoke cessation program to quit smoking when they have had a health scare including cancer and emphysema, or chronic obstructive pulmonary disease (COPD). Other ailments include heart disease and poor circulation.
“Smoking affects every single organ of the body,” Sinisgalli said.
“We know the vast majority of smokers will have some level of emphysema. Cancer is a big one, but emphysema is where part of the lungs can’t expand anymore,” she said. “Research suggests that every single smoker has a level of this.”
“Every time you go to the doctor, and you have an ailment, you can link that back to tobacco use because that is literally putting thousands of different poisons into your body every time you smoke a cigarette,” she said.
Smokers can and do quit their tobacco habit. In fact, since 2002 there are more former smokers than current smokers, according to the Centers for Disease Control and Prevention.
When I was a three pack a day smoker, I had trouble breathing. I would get up in the morning, cough a few times, take up chain smoking for the day, then repeat the cycle of destruction. It wasn’t until my third attempt at quitting that I managed to go without a cigarette.
I went cold turkey. Subsequently everything tasted and smelled a lot better. Turning to comfort foods instead of cigarettes made me gain weight, but in the long run I am glad I quit.
Sinisgalli said some of the adverse consequences of smoking reverses within 24 hours including the chances of having a heart attack.
“Your chance of a heart attack goes down in just 24 hours. Just 20 minutes after your last cigarette, your blood pressure decreases, your heart rate returns to normal, and the list goes on,” she said. “Up to the next weeks, months, and maybe year, the body can reverse the damage done.”
She said Emphysema cannot be reversed, but former smokers’ risk of heart attacks and cancer can go back to someone who never smoked before.
Most people will feel withdrawal symptoms for the first two weeks after they quit and that’s their body healing, Sinisgalli said. They will cough more as their body gets rid of the tar.
“Some people don’t realize how their health is affected until they quit and then all of a sudden they can taste better, smell better, breathe better, and they just feel good,” Sinisgalli said. “ They didn’t realize how bad they were feeling as a smoker.”
Weight gain, as well as facing withdrawal symptoms and stress from kicking the habit, may be reasons not to quit for many who remain smokers, but the benefits of quitting far outweigh the weight gain.
A CDC study states that when smokers quit tobacco use, they lower the risk of getting sick including:
- Lung and other types of cancer
- Heart disease, stroke, and other vascular diseases
- Respiratory symptoms (coughing, wheezing, and shortness of breath)
- Lung diseases like chronic obstructive pulmonary disease (COPD)
- Infertility in women of childbearing age.
- Lower risk of low birth weight babies.
Many smokers who wish to quit may be hesitant because of the fear of weight gain, stress and withdrawal symptoms. Believe me, they are real.
But as an ex-smoker, I can tell you that they are temporary lasting a few short weeks or, for some, months. They eventually subside.
For most people, withdrawal symptoms like anger, anxiety, and depression are the most intense during the first week of quitting, then their intensity tapers off during the first month, according to the National Cancer Institute.
For those concerned with potential weight gain, the National Cancer Institute suggests the following:
- Ask your doctor about the medication bupropion. Studies show that it helps counter weight gain.
- Studies also show that nicotine replacement products, especially nicotine gum and lozenges, can help counter weight gain.
- Because some people who quit smoking increase their food intake, regular physical activity and healthy food choices can help you maintain a healthy weight.
- If all else fails, consult a nutritionist or diet counselor.
The American Cancer Society has a statistic that a third of the people will gain weight, a third will stay the same and a third will lose weight.
“There is evidence that smoking increases your metabolism. There are also those people who smoke cigarettes when they are hungry instead of eating,” Sinisgalli said.
“When you quit smoking if you start eating every time you used to have a cigarette there is a risk of you gaining weight,” she said. “We recommend that people get physically active, take walks without cigarettes and without any money, that they watch what they eat, and they’re cautious about their overall health.”
Sinisgalli said there are three big times when people attempt to quit the smoking habit: New Year’s Day, September, and Mondays. New Year’s Day as part of their resolutions, September as the start of the school year, and Mondays as the beginning of the week, all reasons for a fresh start.
“We have this phrase in Public Health that Mondays are the days that people change their health behaviors. Every Monday is the day that all health breaks loose because people who want to change their diet, people who want to quit smoking, they tend to do it on a Monday because that is the start of a week – That whole fresh start,” she said.
The number one thing that people need to do when they make that decision to quit is to prepare for it: talking to a doctor, a mental health counselor, or even a dentist, all specialists trained to help people quit smoking.
Many can write a prescription for any of the medications to help quit smoking. There are seven different medications that are specifically designed to help people quit smoking, according to Sinisgalli.
“We highly recommend getting a script, some of them are over-the-counter, but if you have a script many times your insurance will cover it even if it’s over the counter,” she said.
“We recommend people use them because it increases the chance of preventing a relapse greatly,” she said.
Sinisgalli said another helpful strategy for quitting is by calling the quit line, joining a cessation group, and just really getting support from family and friends.
“We’ve had so many people wake up that morning saying I’m going to quit today with no preparation. That leads to relapse,” she said.
Sinisgalli said if someone was to wake up this morning and say they are going to quit smoking, they did it on their own with no medication, within a year only about 2 percent of those people would still be smoke-free. It they decide to talk to their doctor about it for just 30 seconds, 4 percent of them would still be smoke-free a year from now. If they made an appointment with their doctor for about 20 minutes, 15 percent of them would be smoke free in a year. And if they added medication on to it, 30 percent of them would be smoke free within a year.
“E-cigarettes are really controversial right now. In the public health world we are not at the point that we would recommend them,” Sinisgalli said. “I have seen success with people who want to quit and use them to help them stop smoking, but they are not FDA approved for that.”
E-cigarettes are not regulated, which causes a leery-eyed Sinisgalli to be concerned. “There are so many chemicals in e-cigarettes. We believe they are the lesser of the two evils when you are comparing them to cigarettes,” she said.
“But we don’t quite no the effects. E-cigarettes have been around for about ten years.
If people are going to use them temporarily, to wean themselves off, sure it may be a possible resource,” Sinisgalli said.
The problem we are having with e-cigarettes is that the user rates of e-cigarette smoking are going up, according to Sinisgalli. It has gone up over the last ten years. In the last couple of years it went from ten percent of high school students using them to 20 percent of high school students using them.
“We believe it is a gateway product to regular cigarette use as well as the harmful effects of whatever they are breathing in and putting them into the air when exhaling,” she said.
E-cigarettes are little electronic devices and come in all sorts: there are reusable ones, rechargeable ones, disposable ones, and they are usually filled with a liquid nicotine which is flavored.
“That is why the kids are attracted to them. They come in over 700 different flavors, flavors like Gummy Bears. Adults are not looking to smoke Gummy Bear flavored e-cigarettes,” Sinisgalli said.
They are a concoction of chemicals and can have many different things in them containing nicotine.
“When you replace a cigarette with nicotine, you don’t have withdrawal symptoms.
That is why we say use a nicotine patch or gum or nicotine lozenge, nicotine nasal sprays, use any of those to help you wean off cigarettes,” Sinisgalli said.
Sinisgalli said it is a good six-month process for quitting smoking.
“We say by the time you quit and the time you can be on the maintenance stage, is six months. That is when the risk of relapse goes down significantly. Even the medications, the box may say use the medication for four weeks, we say use the patch for six months. That is your best chance for success,” she said.
“With a healthcare provider, you can make follow up appointments. Some insurance plans will cover you going to a healthcare provider just for talking about smoke cessation and for others you can see your doctor for something else and discuss quitting smoking too. There are ways around it,” Sinisgalli said.
When people quit smoking, they will have some withdrawal symptoms unless they are using medications. Using medications like the nicotine patch and using enough of them, they shouldn’t have any physical withdrawal symptoms, Sinisgalli said.
“You can quit smoking without feeling bad physically. Emotionally is a whole other issue. That is why we like to talk to people about it,” she said.
Sinisgalli said most people will attempt to quit four, five, six times before they succeed.
“It is one of the hardest things people will ever do,” she said.
