Tahlequah Daily Press

October 23, 2013

Kicking habit challenging, but there’s help

Staff Writer

TAHLEQUAH — For the past few decades, public and private organizations, agencies and action groups have worked to reduce the consumption of tobacco in the U.S.

The efforts have produced results. In 2010, it was reported that in the U.S., there are more ex-smokers than smokers – 47 million to 46 million. But that means a lot of people are still smoking, and many who want to quit to reduce health risks such as lung cancer.

Kenneth Gibson, an osteopathic doctor with the NeoHealth clinic in Hulbert and a specialist in addiction and pain management, said dopamine surges within the brain can fuel a dependency.

“About 10 percent of us have brains that are very reward-sensitive,” Gibson said. “That percentage is very susceptible to addiction, and it can be very difficult for them to quit.”

However, many – perhaps most – people would admit an addiction to something, be it adrenaline, sugar, television or nicotine.

“Addiction is also a spectrum,” Gibson said. “It can range from mild to severe. A person may smoke four cigarettes a day or four packs a day, and in either case find quitting difficult.”

Along with the mental dependency, some of the biggest hurdles to quitting smoking are the well-documented symptoms of nicotine withdrawal and their duration.

After quitting, the craving for nicotine can last a couple of months. Quitters also report dizzy spells in the first few days of withdrawal. Headaches, insomnia, constipation and chest pain are common symptoms during the first couple of weeks. The two most reported symptoms, fatigue and irritability, can last a month.

Longer-term effects are poor mental focus, cough and runny nose. An increase in appetite can last many weeks. Many who quit smoking report a weight gain of 8-12 pounds after a year of tobacco abstinence.

But also well-documented are the health benefits. For many years, the American Cancer Society has listed the benefits of cessation over time.

Going 20 minutes without smoking lowers heart rate and blood pressure. Carbon monoxide levels return to normal in the bloodstream after 12 hours, and the senses of smell, taste and touch begin to recover after 48 hours.

Blood circulation and lung function improve in about three months. Lung capacity improves and coughing decreases after nine months. After a year, the risk of coronary heart disease is halved. The risk of many associated cancers is greatly diminished and the risk of stroke returns to “normal” - that of a non-smoker - after five years of cessation.

Smoking does the most immediate and greatest damage to the lungs, but after 10 years off tobacco, the risk of lung cancer is reduced by half. After 15 years, the risk of heart disease is the same as a non-smoker, and the risk of chronic obstructive pulmonary disease is reduced.

Cessation methods are numerous. Gibson said the most scientifically vetted methods involve nicotine replacement.

“Patches, gums, lozenges probably do the most to enhance the chances of quitting,” he said. “There are also a number of medications like Chantix, which can be prescribed to reduce the symptoms of withdrawal.”

Studies have suggested that assistance from doctors or clinicians also increases the chances of long-term cessation. However, many ex-smokers report quitting without assistance, either by going “cold turkey” – ceasing all smoking immediately – or gradually decreasing their consumption.

An increasingly popular alternative to arise recently is the e-cigarette, which administers nicotine with vapor instead of smoke.

Gibson said there are no studies or medical literature suggesting that e-cigarettes are safe or an effective aid toward cessation.

“They don’t damage the lungs like smoke, but the person is still taking nicotine,” he said. “I don’t have any trouble recommending them, but only if a patient finds them helpful as an adjunct to quitting.”

When a person is trying to quit, Gibson said, persistence is key.

“The average number of attempts to quit is seven for a long-term ex-smoker,” he said. “It is most important that you don’t give up.”