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Quitting Smoking: Meds, Methods and Madness, Oh My!

Posted in Health and Wellness, Workplace Wellness, tagged , , , on August 4, 2010| 4 Comments »

Some Kills
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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Today we have a guest post from Libery Kontranowski, a freelance writer and former pharmaceutical representative. Liberty has first hand experience representing a major smoking cessation product, Zyban.  Many of my friends and some clients have had good luck with Zyban and quitting smoking. So if you are a smoker or have someone in your life that still smokes, read on. (I am not affiliated with Liberty, Zyban or eDrugstore.md. I simply want to give my readers access to new information about smoking cessation!)

Note: Zyban does not work for everyone. If you try Zyban or similar products and have any adverse side effects, mood swings or feel depressed, contact your doctor immediately.

Quitting Smoking: Meds, Methods and Madness, Oh My!

By: Liberty Kontranowski

Quitting smoking is one of the hardest tasks to ever accomplish. But now that smoking is being banned in municipalities and public spaces, it’s a great time to kick the habit for good.

While you already know that smoking is dangerous to you and those around you (and even to those who visit your home, whether you light up in their presence or not), it’s important to realize that smoking is an addiction. Certain properties in nicotine have addictive qualities, and to be truthful, they are not all bad. Nicotine can help people focus, make them more alert and can soothe frazzled nerves. It’s the other stuff that cigarettes are made up of – the cancer-causing carcinogens – that are so harmful. In short, if nicotine could be bottled or manufactured without the rest of a cigarette’s components, we might all find ourselves racing out to buy some. Of course, that is not the case, so to prolong the health of your lungs, make quitting a priority.

In my previous life as a pharmaceutical sales rep, I had the pleasure of selling Zyban (buproprion). I say “pleasure” because on more than one occasion, I had physicians call me into patient rooms to give details about the medication right to the patient themselves. At first, it  was intimidating, but once I saw the genuine look of hope and relief wash over the patients’ faces, I knew I was making a difference.

Unlike nicotine patches, medications such as Zyban and Chantix do not deliver nicotine into the body, and quitters are allowed to smoke in the beginning of treatment. Once the medication reaches a steady state in the body, cravings are reduced little by little, to the point of none at all. This seems to be a particularly intriguing way to quit, since the quitter does not have to initially give up their cigarettes completely. As they find their cravings reduced, they feel a great sense of accomplishment and therefore tend to stick out the program – and are more successful in their effort to quit.

As an interesting side note, Zyban is actually a renamed version of Wellbutrin, an anti-depressant. In clinical studies for Wellbutrin, subjects reported the “side-effect” of fewer cravings for cigarettes, and thus the manufacturing company pursued FDA approval to repackage Wellbutrin with a support program and release it as Zyban for smoking cessation. What a great side-effect!

Now, while medications are wonderful choices for a lot of people, some folks try to avoid that road, or they save it for a last-ditch effort. That said, there are other ways a smoker can attempt to quit:

Cold Turkey – This is simply quitting altogether without cutting back, using medications, etc. If you’re a very strong-willed person, or if you’ve recently been diagnosed with an illness or disease that is directly affected by your smoking, this might be the quit choice for you.

Nicotine Replacement Therapy – Nicotine patches are often used in a step-down method, whereby they deliver a certain amount of nicotine to the body, gradually lessening the amounts until the body no longer craves it. Those using nicotine replacement therapies (also including gums, lozenges, sprays and inhalers) are urged NOT to smoke while using these devices, as this will both defeat the purpose of the step-down treatment and may overdose the quitter’s body with nicotine.

Behavioral Modification – A key factor to the success of any smoking cessation method is simply a change in habit, also known as behavior modification. If a smoker lights up first thing in the morning, they should distract themselves with a shower, cup of coffee or breakfast instead. If a cigarette is part of the daily ride to work, the quitter should take a different route to work, drive with the windows open or take public transportation. Any change in the routine will help offset the quitter’s auto-response to light up a cigarette.

If the hand-to-mouth motion is what the quitter misses most, chewing gum, gnawing on the end of a pen, or drinking a glass of water may suffice. Type an email, write a letter, cook a meal or take a walk to keep the hands occupied.

While quitting smoking is not easy, there are plenty of resources to help a person be successful. There are many websites and support groups available for quitters, and online discussion boards can be a great place to share your successes and downfalls, as well as get and give inspiration.

Best of luck to you on your smoking cessation goals. Your lungs (and family and friends and co-workers) will thank you, for sure!

Liberty Kontranowski is a freelance writer and blogger with hundreds of health, sex and lifestyle articles published online and print. She is a frequent contributor to eDrugstore.md, the top-rated online medications facilitator.

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Coping With Nicotine Withdrawal When Quitting Smoking

Posted in Health and Wellness, Stress Management, Workplace Wellness, tagged , , , , , on February 28, 2010| 4 Comments »

By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Deep breathing from Anxiety Therapy Online

Non smokers don’t get it. I’ve heard nonsmokers say, “Why don’t you just quit?” Or “How can any intelligent person smoke?” (Knowing what we know about smoking and health.) Smoking addiction isn’t a rational decision. People don’t get up in the morning and say, “Gee, I think I will fill my lungs with carcinogens.” Like any addiction, smoking is a habit and a physical dependence on a powerful chemical substance. The addiction to nicotine can override people’s intellectual beliefs about health. If you’ve ever had the stomach flu or persistent diarrhea, you know what it’s like to have an overwhelming urge you can’t control. Being addicted to smoking is a similar situation. It gives people strong urges that are very difficult to deny or control.

Read more from the American Cancer Society about nicotine withdrawal:

Nicotine withdrawal symptoms can lead quitters back to smoking

When smokers try to cut back or quit, the lack of nicotine leads to withdrawal symptoms. Withdrawal is both physical and mental. Physically, the body reacts to the absence of nicotine. Mentally, the smoker is faced with giving up a habit, which calls for a major change in behavior. Both the physical and mental factors must be addressed for the quitting process to work.

Those who have smoked regularly for a few weeks or longer, and suddenly stop using tobacco or greatly reduce the amount smoked, will have withdrawal symptoms. Symptoms usually start within a few hours of the last cigarette and peak about 2 to 3 days later when most of the nicotine and its by-products are out of the body. Withdrawal symptoms can last for a few days to up to several weeks. They will get better every day that you stay smoke-free.

Withdrawal symptoms can include any of the following:

  • dizziness (which may only last 1 to 2 days after quitting)
  • depression
  • feelings of frustration, impatience, and anger
  • anxiety
  • irritability
  • sleep disturbances, including having trouble falling asleep and staying asleep, and having bad dreams or even nightmares
  • trouble concentrating
  • restlessness or boredom
  • headaches
  • tiredness
  • increased appetite
  • weight gain
  • constipation and gas
  • cough, dry mouth, sore throat, and nasal drip
  • chest tightness

These symptoms can lead the smoker to start smoking cigarettes again to boost blood levels of nicotine back to a level where there are no symptoms. (For information on coping with withdrawal, see the section, “How to quit.”)

Smoking also makes your body get rid of some drugs faster than usual. When you quit smoking, it may change the way your body handles medicines. Ask your doctor if any medicines you take regularly need to be checked or changed after you quit.

Dealing with withdrawal

Withdrawal from nicotine has 2 parts — the physical and the mental. The physical symptoms, while annoying, are not life-threatening. Nicotine replacement and other medicines can help reduce many of these physical symptoms. Most smokers find that the bigger challenge is the mental part of quitting.

If you have been smoking for any length of time, smoking has become linked with nearly everything you do — waking up in the morning, eating, reading, watching TV, and drinking coffee, for example. It will take time to “un-link” smoking from these activities. This is why, even if you are using a nicotine replacement, you may still have strong urges to smoke.

Rationalizations are sneaky

One way to overcome these urges or cravings is to notice and identify rationalizations as they come up. A rationalization is a mistaken thought that seems to make sense to you at the time, but the thought is not based on reality. If you choose to believe in such a thought, it can serve as a way to justify smoking. If you have tried to quit before, you will probably recognize many of these common rationalizations:

  • I’ll just have one to get through this rough spot.
  • Today is not a good day. I’ll quit tomorrow.
  • It’s my only vice.
  • How bad is smoking, really? Uncle Harry smoked all his life and he lived to be over 90.
  • Air pollution is probably just as bad.
  • You’ve got to die of something.
  • Life is no fun without smoking.

You probably can add more to the list. As you go through the first few days without smoking, write down any rationalizations as they come up and recognize them for what they are: messages that can trick you into going back to smoking. Look out for them, because they always show up when you’re trying to quit. After you write down the idea, let it go from your mind. Be ready with a distraction, a plan of action, and other ways to re-direct your thoughts to something else.

Use the ideas below to help you stay committed to quitting.

Avoid temptation: Stay away from people and places where you are tempted to smoke. Later on you will be able to handle these with more confidence.

Change your habits: Switch to juices or water instead of alcohol or coffee. Take a different route to work. Take a brisk walk instead of a coffee break.

Alternatives: Use substitutes you can put in your mouth such as sugarless gum or hard candy, raw vegetables such as carrot sticks, or sunflower seeds. Some people chew on a coffee stirrer or a straw.

Activities: Do something to reduce your stress. Exercise or do hobbies that keep your hands busy, such as needlework or woodworking, which can help distract you from the urge to smoke. Take a hot bath, exercise, or read a book.

Deep breathing: When you were smoking, you breathed deeply as you inhaled the smoke. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remind yourself of your reasons for quitting and the benefits you’ll gain as an ex-smoker.

Delay: If you feel that you are about to light up, delay. Tell yourself you must wait at least 10 minutes. Often this simple trick will allow you to move beyond the strong urge to smoke.

Reward yourself

What you’re doing is not easy, so you deserve a reward. Put the money you would have spent on tobacco in a jar every day and then buy yourself a weekly treat. Buy a magazine or book, go out to eat, develop a new hobby, or take a yoga class. Or save the money for a major purchase. You can also reward yourself in ways that don’t cost money: visit a park, go to the library, and check local news listings for museums, community centers, and colleges that have free classes, exhibits, films, and other things to do.

Read more at the American Cancer Society’s website here.

Notice that many of the strategies for handing nicotine withdrawal are the same strategies people use for stress management!

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What Makes It So Difficult to Quit Smoking?

Posted in Health and Wellness, Workplace Wellness, tagged , , , , , , , , on February 25, 2010| 4 Comments »

Unlit filtered cigarettes
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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Coping with stress can be tough. Some people turn to cigarettes as a way to cope with stress. In the long run, smoking doesn’t help your body ward off stress…it creates new health and social problems that lead to more stress. Quitting smoking is also tough but the rewards are numerous.  I was once a heavy smoker myself and quitting was one of the toughest things I’ve ever done. Quitting smoking also freed me from a crippling dependence not only on nicotine but on the habit of ingesting smoke with the result of having my clothes and hair smell like smoke and having yellow fingers and skin that was aging more rapidly than normal.

The American Cancer Society has great information on smoking cessation. In the next few posts we will share some tips o quitting smoking with you.

Why is it so hard to quit smoking?

Mark Twain said, “Quitting smoking is easy. I’ve done it a thousand times.” Maybe you’ve tried to quit, too. Why is quitting and staying quit hard for so many people? The answer is nicotine.

Nicotine

Nicotine is a drug found naturally in tobacco. It is as addictive as heroin or cocaine. Over time, a person becomes physically and emotionally addicted to (dependent on) nicotine. Studies have shown that smokers must deal with both the physical and psychological (mental) dependence to quit and stay quit.

How nicotine gets in, where it goes, and how long it stays

When you inhale smoke, nicotine is carried deep into your lungs. There it is quickly absorbed into the bloodstream and carried throughout your body. Nicotine affects many parts of the body, including your heart and blood vessels, your hormones, the way your body uses food (your metabolism), and your brain. Nicotine can be found in breast milk and even in mucus from the cervix of a female smoker. During pregnancy, nicotine freely crosses the placenta and has been found in amniotic fluid and the umbilical cord blood of newborn infants.

Different factors affect how long it takes the body to remove nicotine and its by-products. In most cases, regular smokers will still have nicotine or its by-products, such as cotinine, in their bodies for about 3 to 4 days after stopping.

How nicotine hooks smokers

Nicotine causes pleasant feelings that make the smoker want to smoke more. It also acts as a kind of depressant by interfering with the flow of information between nerve cells. Smokers tend to increase the number of cigarettes they smoke as the nervous system adapts to nicotine. This, in turn, increases the amount of nicotine in the smoker’s blood. In fact, nicotine inhaled in cigarette smoke reaches the brain faster than drugs that enter the body through a vein (intravenously or IV).

After a while, the smoker develops a tolerance to the drug. Tolerance means that it takes more nicotine to get the same effect that the smoker used to get from smaller amounts. This leads to an increase in smoking over time. The smoker reaches a certain nicotine level and then keeps smoking to maintain this level of nicotine.

Read more at the American Cancer Society website here.

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Positive Reasons to Quit Smoking

Posted in Health and Wellness, Stress Management, tagged , , , , , on February 23, 2010| Leave a Comment »

A cigarette butt, lying in dirty snow.
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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Recently a client of mine quit smoking. He’s using a combination of tools to help him stay quit and I have to say I am so proud of his progress so far!   When I quit smoking about 17 years ago, I found that the negative press on smoking wasn’t motivation enough. Quitting smoking is one of the toughest things I’ve ever done. Knowing that I could get lung cancer some far off date in the future should have scared me enough to quit, but frankly it didn’t. I could rationalize my smoking, tell myself I had plenty of time to quit before my health was impacted. I could tell myself that I’d deal with the consequences later. To give me the mental courage to quit I needed something to hang onto. I needed reasons why quitting would make my life better. Strategies for coping with life to replace the coping crutch of smoking.

The reasons I quite smoking were many. Remembering them helped me cope with withdrawal symptoms and keep me away from smoking.
1. I didn’t want to hurt my pets. They could get burned from accidents with cigarettes. It also hurt their little lungs.
2. I got mad when I was winded after walking up a flight of stairs. I wanted to be in better shape. Smoking was hurting my cardiovascular fitness.
3. Smoking wasn’t making me any thinner. I had quit before, gained weight and started smoking again to take the weight off. Only it didn’t work.
4. Smoking made me less desirable as an employee and as a partner. I was single and wanted to look for a new job when I quit. Smoking was holding me back on both counts.
5. I wanted my hair and skin to smell cleaner.
6. I wanted to stop the rapid aging process of my skin. Smoking made me look 10 years older!
7. Cigarettes were getting expensive. Back when I quit they were up to about $2.00 a pack. Now they cost even more. At about $8/pack x 30 days=$240…that’s the price of a car payment!
8. Smoking was no longer “cool.” Being a smoker made me feel socially alienated.

What are/were your reasons for quitting?

The American Cancer Society lists more great reasons to help motivate you to quit smoking. Read on to find out what they are!

When smokers quit — What are the benefits over time?

20 minutes after quitting: Your heart rate and blood pressure drops.

(Mahmud A, Feely J. Effect of Smoking on Arterial Stiffness and Pulse Pressure Amplification. Hypertension. 2003;41:183.)

12 hours after quitting: The carbon monoxide level in your blood drops to normal.

(U.S. Surgeon General’s Report, 1988, p. 202)

2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.

(U.S. Surgeon General’s Report, 1990, pp. 193, 194, 196, 285, 323)

1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.

(U.S. Surgeon General’s Report, 1990, pp. 285-287, 304)

1 year after quitting: The excess risk of coronary heart disease is half that of a smoker’s.

(U.S. Surgeon General’s Report, 1990, p. vi)

5 years after quitting: Your stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting.

(U.S. Surgeon General’s Report, 1990, p. vi)

10 years after quitting: The lung cancer death rate is about half that of a person who continues smoking. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease, too.

(U.S. Surgeon General’s Report, 1990, pp. vi, 131, 148, 152, 155, 164, 166)

15 years after quitting: The risk of coronary heart disease is the same as a non-smoker’s.

(U.S. Surgeon General’s Report, 1990, p. vi)

Immediate rewards of quitting

Kicking the tobacco habit offers some benefits that you’ll notice right away and some that will develop over time. These rewards can improve your day-to-day life a great deal:

  • your breath smells better
  • stained teeth get whiter
  • bad smelling clothes and hair go away
  • your yellow fingers and fingernails disappear
  • food tastes better
  • your sense of smell returns to normal
  • everyday activities no longer leave you out of breath (such as climbing stairs or light housework)

Cost

The prospect of better health is a major reason for quitting, but there are other reasons, too. Smoking is expensive. It isn’t hard to figure out how much you spend on smoking: multiply how much money you spend on tobacco every day by 365 (days per year). The amount may surprise you. Now multiply that by the number of years you have been using tobacco and that amount will probably shock you.

Multiply the cost per year by 10 (for the next 10 years) and ask yourself what you would rather do with that much money.

And this doesn’t include other possible costs, such as higher costs for health and life insurance, and likely health care costs due to tobacco-related problems.
Social acceptance
Smoking is less socially acceptable now than ever.

Today, almost all workplaces have some type of smoking rules. Some employers even prefer to hire non-smokers. Studies show smoking employees cost businesses more because they are out sick more. Employees who are ill more often than others can raise an employer’s need for costly short-term replacement workers. They can increase insurance costs both for other employees and for the employer, who often pays part of the workers’ insurance premiums. Smokers in a building also can increase the maintenance costs of keeping odors down, since residue from cigarette smoke clings to carpets, drapes, and other fabrics.

Landlords may choose not to rent to smokers since maintenance costs and insurance rates may rise when smokers live in buildings.

Friends may ask you not to smoke in their homes or cars. Public buildings, concerts, and even sporting events are largely smoke-free. And more and more communities are restricting smoking in all public places, including restaurants and bars. Like it or not, finding a place to smoke can be a hassle.

Smokers may also find their prospects for dating or romantic involvement, including marriage, are largely limited to other smokers, who make up less than 21% of the adult population.

Health of others
Smoking not only harms your health but it hurts the health of those around you. Exposure to secondhand smoke (also called environmental tobacco smoke or passive smoking) includes exhaled smoke as well as smoke from burning cigarettes.

Studies have shown that secondhand smoke causes thousands of deaths each year from lung cancer and heart disease in healthy non-smokers.

If a mother smokes, there is a higher risk of her baby developing asthma in childhood, especially if she smoked while she was pregnant. Smoking is also linked to sudden infant death syndrome (SIDS) and low-birth weight infants. Babies and children raised in a household where there is smoking have more ear infections, colds, bronchitis, and other lung and breathing problems than children in non-smoking families. Secondhand smoke can also cause eye irritation, headaches, nausea, and dizziness.
Setting an example
If you have children, you probably want to set a good example for them. When asked, nearly all smokers say they don’t want their children to smoke. But children whose parents smoke are more likely to start smoking themselves. You can become a good role model for them by quitting now.

Read more at the American Cancer Society website here.

How to Quit

Government Resources from the CDC website here.

Pathways to Freedom
Pathways to Freedom

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