The Medical Minute: Why smoking is such a bad idea

By John Messmer, M.D.

This is the 36th year for the American Cancer Society’s Great American Smokeout -- the day for focusing the nation on the importance of quitting smoking. Here’s a refresher on why smoking is such a bad idea:

Smoking increases the risk of serious health problems – heart disease, stroke, cancers (lung, mouth, stomach, pancreas, cervix, bladder, larynx and more), lung diseases (emphysema and chronic bronchitis), plus osteoporosis, stillbirth and other pregnancy and infant problems for women who smoke.

More deaths are caused each year by tobacco use than from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined – almost a half million people. Besides the lethal issues, smoking also causes other nuisance problems: chronic cough, shortness of breath, poor healing, erectile dysfunction (almost twice as frequent in smokers) and bad breath.

Smokers always smell like smoke to non-smokers. Since three out of four Americans do not smoke, you really stand out – literally, if you work in a nonsmoking job that requires you to leave the building to smoke. In fact, many employers will choose to hire only nonsmokers because smokers take more sick time and spend more on health care. Indoors, smoking increases maintenance costs.

Smoking is expensive. Over and above the health costs, smoking can cost around $1,700 (West Virginia) to $4,300 (New York) per year for a pack-a-day smoker. Imagine what you could do with that much extra money.

When you quit, your body starts to recover immediately. Your sense of smell and taste return, your lungs start to heal in weeks, your circulation improves within a couple months, and by one year, your heart disease risk is cut in half.

How to quit? Mark Twain noted, “Quitting is easy. I’ve done it a thousand times.” But we all know that anyone who smokes, chews tobacco or uses snuff regularly finds quitting to be very hard. Nicotine is powerfully addictive – as much as heroin or cocaine. In people genetically susceptible to nicotine addiction, some of the brain’s cells change from the first nicotine exposure to make nicotine more desirable. It results in increased levels of certain brain chemicals in the reward and pleasure areas. As the nicotine is metabolized, brain levels drop and the addicted person experiences physical and mental effects that only respond to more nicotine. Gradually, the nicotine-addicted person needs more nicotine to produce the desired effects.

The most important component to successfully quitting smoking is a strong desire to quit. Next, motivation to start on the road to being a nonsmoker is needed. That may be enough for some, but many people need extra help. There are nicotine replacement products and prescription drugs that can help. But the quit rate is higher with support.

The American Cancer Society has lots of information on its website at http://www.cancer.org/Healthy/StayAwayfromTobacco/GreatAmericanSmokeout/ and state and Federal governments provide help. Start with http://www.smokefree.gov/quit-guide.aspx and call 1-800-QUIT-NOW for help or see your doctor.

Once you quit, you will need to have a plan to deal with the urges and the habit of having a smoke at all the usual times. Both websites listed discuss preparing for being smoke free. Think about it and consider this Nov. 17 as your quit date.

Maybe this is your year to quit for good.

John Messmer, M.D., is an associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Hershey Medical Center.

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Last Updated November 18, 2011