Quitting Smoking- Set Up for SUCCESS!

The Surgeon General's report on smoking in young adults has spurred me to blog sequentially about quitting smoking. Yesterday, I talked about "7 Ways to leave your Cigarettes" Talking with your doctor is a great first step, but don't underestimate how important setting yourself up for success can be! Include as many of your friends and family in on your plan- the more, the better! Including one teenage child counts double, by the way- they are usually the toughest on their parents! What can you do?

1. PUBLICIZE your QUIT DATE. Believe me, your friends & family will love to ask you how you are doing and lavish praise on you- but they have to KNOW about it!

2. Stock up on healthy, crunchy, orally-gratifying snacks. Carrots, apples, popcorn, pretzels- all are good choices.

3. Super-sour hard candy- sucking on these (instead of nicotine) seems to really help curb cigarette cravings.

4. CLEAN- your house, your CAR, and your clothes- splurge on someone else to come in and deep clean. Your sense of smell heightens along with your taste buds when you quit smoking, and the positive feedback from the clean, fresh smells are a wonderful reinforcement.

5. MONEY- a clear jar works great to show off money growing daily! Place the money you would have spent on packs of cigarettes into the jar each day, and decide what "splurge" you will reward yourself with each month!

BOTTOM LINE: Just as SMOKING is usually a social activity, QUITTING SMOKING will be far more successful if you involve your friends & family, so set yourself up for SUCCESS!

"Just" a Social Smoker?

Stop and think- do you know a teenager who is smoking? Or one you THINK is starting to smoke? If you start smoking in junior high or high school, there is an astounding 80% chance you will be a smoker the rest of your life. Today, the Surgeon General released a report about smoking habits of our American youth. Despite tons of warnings and educational programs, one in FIVE high school students are smoking. Can you believe that for every American who dies annually from cancer-443,000- there are now TWO youths just beginning to smoke? If you do the math, you'll see that an average of 1,213 Americans die every day as a result of this deadly, intensely addictive habit.


Yes, there are those rare adults who can simply walk away from a pack per day smoking habit- God bless them! The majority of smokers, however, tell a different story. I have many men and women patients in their 30's and 40's who are incredibly frustrated that they cannot seem to permanently quit smoking. The typical story is that they started smoking "socially" along with drinks and happy hours during college, and never intended to become a "real" smoker. Many only still smoke on weekends, but they are so habitually tied in with a group of friends or co-workers that use smoking (and often drinking) as their social bond, that it feels rude and counter-culture to quit. Other smokers started out as "social" weekend users, but found more and more that stress was "relieved" with a quick cigarette, and that it served as a legitimate reason to step outside and take a break from work, home, or kids. Women tell me that they CAN"T quit because they will "get fat". There are a million reasons offered as reasons not to quit, including the fact that some simply enjoy it. BUT...there is simply no amount of nicotine & cigarette smoking that is good for you. We can rationalize an alcoholic drink per day, as there truly can be medical benefit from that, but absolutely none from smoking.

Very few adult smokers are thrilled with their habit. Most would like to quit, just as most overweight people would like to lose weight. If you are a smoker, PLEASE schedule an appointment with your doctor to discuss a plan to quit smoking. There are numerous ways your physician can help. The average long term smoker takes at least 5 serious attempts to permanently quit- and many take more than that, but you CAN be successful. Please don't wait for you or your loved one (smoking is rarely a solo sport) to suffer a heart attack, stroke or cancer to get serious about quitting.

BOTTOM LINE: SMOKING is addictive and deadly. Period. Don't let anyone you know START smoking, and help encourage those smokers you to to seek help from their physician to quit.

Caffeine, Alcohol and Peppermints, Oh My!

As if the cough last week weren't enough, are you now plagued with with heartburn? Yes, in our commercial-literate world, we may call it GERD (Gastro-Esophageal-Reflux Disease), but heartburn is still a great descriptor. December is often a very tough month for health! We are fully into cough and cold season, and at the same time, we are frantically running around in crowded public areas...touching the same escalator handrail, doors, etc. as the sneezing, coughing folks ahead of us. In addition, we are meeting old friends for our annual "catch up" coffee, drinks or meals, and burning the candle at both ends.

Caffeine, alcohol, and peppermints (did someone say candy canes?) abound, and ALL THREE of these have one common side effect in the body- they loosen the sphincter between the esophagus (food tube) and stomach that is supposed to function to keep acid down south in the stomach. Instead, these substances allow it to relax, and acid can slosh back up into the esophagus, and voila- HEARTBURN FOR THE HOLIDAYS!

What to do? Okay, first things first, stop the burn by popping a few antacid tablets. Not enough relief? Add in an OTC acid relief product like cimetidine (Tagamet) or ranitidine (Zantac) or even the next level up of acid blockers such as omeprazole (Prilosec). Still no relief? Time to see your doctor! Of course, it SHOULD go without saying that you need to STOP THE OFFENDING CAUSE (yes, the coffee, drinks and mints) if your symptoms are persisting beyond the occasional event!

I'd be remiss if I didn't add NICOTINE to the the list of irritants for GERD, by the way, so here is my chance to beg you to make QUITTING SMOKING your number one New Year's Resolution!

BOTTOM LINE: Caffeine, alcohol, peppermints and nicotine all cause HEARTBURN- watch out for the symptoms and recognize the cause!

Quitting Smoking...a WEIGHTY Issue

Why do people who quit smoking gain weight? Does it always happen, or can it be avoided? Do we really care that weight gain is really less detrimental to our health than smoking?
As a physician, I have found that women in particular choose to keep smoking because they simply do NOT want to gain weight. Period. I will confess that I will occasionally try to appeal to their vanity by discussing the yellow teeth or bad breath that tend to accompany cigarettes, but the reality is that what is important in this situation is helping patients understand why smokers gain weight with quitting, and how it can be avoided. So here are some things to remember:

1. Nicotine is an appetite suppressant, so obviously, when you initially take it away, your appetite is up.
2. Smoking KILLS taste buds, so just about the time the extra appetite from quitting is going away (around a week), suddenly food begins to TASTE better, because now you've actually got healthy taste buds!
3. Happily, ALL FOODS taste better, not only the high fat/high calorie ones.
4. Yes, oral gratification is a habit, so STOCK YOUR FRIDGE with some low calorie, crunchy and delicious snacks like carrot sticks with hummus, or apple slices, or ANY fruit or vegetable. Additionally, suck on sour hard candies the first week or two.
5. Don't forget EXERCISE! Getting and keeping your heart rate up for 30 minutes per day is equal to a low dose of an anti-depressant medicine, so exercise will not only balance extra calories consumed, but will make you HAPPY and less irritable!

BOTTOM LINE: Be proactive with your available food choices and exercise, and you will NOT pack on a bunch of weight when you quit smoking.

SEVEN Ways to Leave Your Cigarettes

SEVEN seems to be the magic number for habits of successful people, right? SO...smokers, step on up to the SEVEN choices to help with QUITTING SMOKING! In alphabetical order, here they are:

1. Bupropion SR (Wellbutrin SR)- this is an antidepressant that works via unknown mechanisms to decrease your desire for smoking; you start it a week or two before your quit date, and it significantly shuts down that craving for a cigarette.
Common side effects- insomnia and dry mouth.
2. NIcotine gum- do NOT chomp it like regular gum! It's chew, chew, stash it.
3. Nicotine inhaler- used every hour or two during the day; may cause throat/mouth irritation and cough
4. Nicotine nasal spray- 2-4 sprays per waking hour as needed; may cause local irritation in nose and throat
5. Nicotine patch (now OTC, but ask your doctor which dose)- may cause skin irritation; remove at night so no sleep issues
6. Nicotine lozenge- may cause mouth soreness and nausea
7. Varenicline (Zyban)- blocks nicotinic receptors and sharply decreases cravings; Common side effects: very vivid dreams and nausea.

Are they expensive? Puh-lease! Are cigarettes expensive? YES! These aids are money well spent, and will pretty much equal what you are already spending on your habit.

BOTTOM LINE: If you think you've tried everything to quit, double check the list and head to your doctor for a new cessation aid!

Attention SMOKERS: Get Ready to QUIT!

If you found yourself anxiously scanning yesterday's blog about CT scans for lung cancer screening in smokers, hoping for reassurance that we now have means to detect lung cancer early enough that you'll have time to quit before it's too late, then read on...

If you are a smoker today, then the SINGLE MOST IMPORTANT THING you can do for your health is to QUIT. Period. While we are learning to detect and treat smoking-related cancers better each year, believe me, you don't want to count on a CURE. Often times the surgeries and chemo are devastating, though life-sparing.

I have met very few smokers who do not WANT to quit, though yes (my friend who shall remain nameless) there are some out there who simply enjoy smoking and hope they don't live long enough to end up suffering poor quality of life because of chronic bronchitis or emphysema. MOST SMOKERS WANT TO QUIT, but have not found either the right motivation, medical aid, or family/friend support to do so.

First of all, let me say that it takes the average serious smokers multiple attempts to quit. Have you quit for a month, a year, a pregnancy or two, only to restart? That is COMMON, and NOT a reason that you "can't" quit!

There are SEVEN different medical aids that your doctor can recommend or prescribe to help you from the pharmacy end of things! Have you really tried them ALL?
There are numerous behavioral changes YOU can make NOW that will help you quit, too! Stay tuned for more blogs this week with more details...


BOTTOM LINE: NO amount of nicotine IMPROVES your health, so make an appointment with your doctor to find out which method might work best for you!