Quit Smoking Expert Interview
Are you or someone you love struggling to kick the smoking habit? If so, our expert, Norman Edelman, M.D., describes methods that can help you or your loved one succeed.
Q: How can my doctor help me quit smoking?
A: "Many patients try just one method, but we recommend a combination of a behavioral and a pharmaceutical approach," says Norman Edelman, M.D., chief medical officer at the American Lung Association (ALA). Behavioral modification smoking-cessation programs are widely available from the ALA, the American Cancer Society, local hospitals, county health departments and some doctors’ offices. There are also a variety of pharmaceutical approaches your doctor may prescribe.
Q: How can I get the right medication?
A: Your doctor may suggest nicotine replacement therapy (NRT), which uses lower doses of nicotine to reduce withdrawal and the urge to smoke, says Dr. Edelman. NRT is available over-the-counter as a gum, lozenge or patch, or by prescription as a nasal spray or inhaler.
There are also two nicotine-free smoking aids: Bupropion (brand name Zyban), an antidepressant pill, and the tablet varenicline (brand name Chantix). They work differently on the brain to reduce cravings. In July 2009, the FDA added a black box warning to bupropion and varenicline. If you experience agitation, depressed mood, suicidal thoughts or behavior, you should stop taking these medications and consult your doctor. According to the FDA, Chantix may be associated with a small, increased risk of certain heart problems including heart attack in people who have cardiovascular disease.
What medication a doctor prescribes depends on the individual. “If a patient says they like the feel of a drag on a cigarette, I’d prescribe a nicotine inhaler. If he or she is also depressed, I might prescribe Zyban,” says Dr. Edelman. (Zyban’s effectiveness as a medication to reduce nicotine cravings is unrelated to its antidepressant effect, so it may also be prescribed for individuals who aren’t depressed at all.) "And if you’ve attempted to quit before, the physician will prescribe something that you haven’t already tried."
Q: Should I quit outright or taper off?
A: Choose a quit dateand then quit outright, says Dr. Edelman. That works better than tapering off your use of cigarettes and other tobacco products.
- Quit with your spouse or a buddy.
- To motivate yourself, write down your reasons for kicking the habit.
- Identify your smoking triggers and plan around them.
- Rehearse out loud: "My cigarette smoking is dangerous to my health."
Q: I’m afraid I’ll gain weight if I stop smoking. Should I be concerned?
A: The typical weight gain after quitting may be 5 to 10 pounds. "The negative health effects of that extra weight are much less than that of smoking," Dr. Edelman points out. Try healthier methods to curb your appetite and lose weight: Exercise more and eat healthy foods.
Use these tips from the ALA for healthy snacking:
- When you want something sweet, try: berries, peaches, plums, pears, cantaloupe, fresh pineapple, a frozen fruit bar.
- For a crunchy treat, try: apples, fresh vegetables, popcorn, or graham or wheat crackers.
- For a chewy nibble, try: bagel or slice of raisin bread, raisins, cereal without milk, small bran muffin, whole wheat English muffin or banana.
Q: What should I do if I relapse?
A: Try again! The average number of attempts is five. “It’s very hard to quit on your own, so you need help from a health professional who can give you options,” says Dr. Edelman. A doctor measures initial success after three months of treatment; the chance of relapse is minimal after one year off cigarettes. NRT is typically prescribed for six months. Some people use the nicotine gum continually to curb cravings, but that use is not approved by the FDA.
Q: Can I reverse damage to my body from smoking?
A: Some long-term consequences such as artery damage can’t be reversed, but many short-term effects can. Within a day, blood pressure and pulse rate drop to normal, oxygen level in blood increases to normal and your chances of a heart attack decrease. Within weeks, circulation improves and inflammation in the airways of the lungs decreases. In the coming years, your added risks of disease from smoking will fall dramatically.
After I quit smoking, what else can I do to lower my risk for cancer?
A: These steps may help, suggests Dr. Edelman:
- Eat a healthy diet, rich in antioxidants.
- Exercise to help prevent colon cancer.
- Try to stay out of polluted areas.
- If you’re obese, lose weight.
Q: Where can I find support?
A: Many states have smokers’ help lines. For more information, call the American Lung Association at 800-LUNG-USA, or go to the American Lung Association website and click on “Freedom from Smoking.”