The New Year is a time for many people to make resolutions — and among the most popular (and most frequently un-kept) every year is the pledge to quit smoking. Philadelphia has the highest smoking rate of any major city in the country. In the LGBT communities, where rates of tobacco use are significantly
higher (one in three LGBT adults is a smoker, versus one in five among the general population), this is an especially serious health concern. Smoking rates nationally are decreasing overall, but within our community (especially among our youth), rates are actually increasing.
Recent, alarming data have shown the especially deadly effects of tobacco use in HIV-positive people. Smoking, on average, decreases life expectancy by six years. For HIV-positive smokers, it’s a decrease of 12 years. In people on estrogen therapy, tobacco greatly increases the risk for potentially deadly blood clots. Data are now emerging on tobacco’s effect on the worsening of HPV infection and effects on oral and anogenital cancer.
Smoking and its related illnesses are of special concern to my practice at Mazzoni Center. There are various reasons why smoking can be a hard habit to break, but too many people set themselves up to fail due to misinformation and/or mental blocks. Since many of you have vowed to kick the habit for good in 2015, I wanted to explore eight common myths about smoking that you may have mistakenly bought into.
Myth 1: I’ve been smoking for so long that the damage is already done.
While it is true that the damage caused by tobacco adds up over time, there are health benefits to quitting at any age. In the first day without smoking, your blood pressure will decrease and poisonous carbon-monoxide levels normalize, taking stress off your heart and blood vessels and increasing oxygen flow to all parts of your body. After the first month, your breathing eases as paralyzed cilia (microscopic structures that clear debris from the lungs) start to work again. At one year after quitting, your risk for heart disease is cut in half. After five years, your risk for head and neck cancers are half. These changes occur regardless of a person’s age. Even for people who already have smoking-related disease (heart disease and COPD, for instance), quitting decreases the severity and progression of those diseases.
Myth 2: My smoking only affects my health.
Secondhand smoke is the smoke that is inhaled from the burning end of tobacco product. There are many risks to non-smokers who inhale secondhand smoke, even if in a ventilated area or outdoors. Non-smokers regularly exposed to secondhand smoke are more likely to have breathing disease, catch pneumonia and can have a 20-30-percent increase in risk for heart disease and lung cancer. The health risks are even greater for children and the elderly. Secondhand smoke even affects your pets.
Thirdhand smoke is the toxic residue left on surfaces after someone has smoked. Clothing, curtains, walls, carpets, car seats and even hair exposed to smoke can release dangerous chemicals for as long as months.
Myth 3: If I can’t do this cold turkey, then I’m just trading one addiction for another.
I hear this all the time as an excuse to continue smoking.
Many people want to quit without any assistance and use willpower completely Nicotine, the addictive chemical in tobacco, acts on a very primitive, impulse-driven part of the brain that can quickly overpower conscious thought and reason. This is an uphill battle for willpower that only one in 20 smokers can overcome without any extra help.
There are many medications available to help with quitting smoking. Many of these are nicotine-replacement therapies. Some are drugs that work to decrease a person’s “drive” to smoke. The goal of therapy is not to replace one addiction for another, but to help you bust the habit for good. Asking for help, in my opinion, is not a sign of weakness but a demonstration of one’s determination for success.
Myth 4: I’m in this all by myself.
There are many supports to help you with quitting. Any primary-care provider can help you come up with a strategy to quit. Many of the city’s health systems have intensive smoking-cessation programs that are covered by insurance. Here in Philadelphia, residents can use the QuitLine (1-800-QUITNOW) for free coaching sessions and nicotine-replacement therapy. There are also online resources (www.smokefreephilly.org) and even a nicotine-focused 12-step program (1-877-TRY-NICA). Using medications and coaching support can double your chances of quitting!
Myth 5: Cutting back is good enough.
There is no “safe” amount of smoking, as every inhalation of tobacco draws toxic chemicals into the body. Additionally, smokers who are trying to “cut back” often take deeper breaths and longer puffs on the fewer cigarettes they have, resulting in just as much toxic exposure.
Myth 6: My healthy diet and exercise cancel out the bad effects of smoking.
I often hear this said as, “It’s my only vice, Doc.” Although marketing might tell us otherwise, there is no “vice” that any of us needs to lead happy and healthy lives. Smoking is one of the worst “vices,” however, especially when it comes to health effects.
A healthy diet and regular exercise are wonderful habits that will benefit anybody’s health. No vitamin, diet or exercise regimen can undo the effects of tobacco smoke.
Myth 7: The weight gain from quitting smoking is just as unhealthy.
Smokers, on average, gain about 14 pounds after quitting smoking. While there may be some health risks from this weight gain, they are minute compared to the risks of continuing smoking.
I often encourage people who are concerned about this to build a weight-control strategy into their smoking-cessation strategy. Exercise, for example, is a great way to stay busy and help manage nicotine cravings.
Myth 8: I switched to “lights” (or vaping or hookah) so I’m OK.
Light cigarettes still expose a person to harmful chemicals. Additionally, smokers who switch to lights often smoke these cigarettes longer and more deeply in order to get the same amount of nicotine. This results in inhaling similar amounts of toxic chemicals as regular cigarettes. Many tobacco products are marketed as organic or natural. These are no safer than regular cigarettes.
Electronic cigarettes work by heating liquids (presumably containing nicotine) that are inhaled as a vapor. These products are completely unregulated in the United States. I tell patients that we really have no idea what they are inhaling when they use one of these and that the chemicals in the vapor could be as bad, or even worse than, cigarettes.
Hookah, smoking tobacco or other products through a water pipe, is just as dangerous (maybe more) than cigarette-smoking. Studies have shown that the smoke from tobacco burned through hookah contains similar amounts of dangerous chemicals as cigarettes, even after passing through water. Because of the way hookah is used, the amount of chemical a person is exposed to is often much greater than with a cigarette. In an average hour-long session, a hookah user will inhale 200 puffs of smoke. An average cigarette smoker will inhale 20 puffs.
Final thoughts: Kicking the cigarette habit may seem like a tough battle, but it is one that you can absolutely win. Ask for help and make a plan. If you’re a non-smoker, be supportive to those in your life who are in the process of quitting. You can make 2015 the first year in the rest of your tobacco-free life.
Andrew Goodman, MD, is assistant medical director at Mazzoni Center Family and Community Medicine.