Smoking cessation
Once, it was a symbol of status and a man needed to light up to appear macho, but now, with too many harms of smoking coming out every day, time has come to kick the butt. But can we ignore the complicated conditions following the
cessation of smoking?
Smoking cessation is the process of quitting smoking. It involves withdrawal from nicotine addiction and a change in habits.
At least 70% of smokers in the United States have made at least one quit attempt. The nicotine in tobacco is as addictive as cocaine. It is because of this addiction that quitting can be so difficult. Nicotine is a poisonous chemical found in tobacco. It is the substance that produces many of the effects of tobacco. Nicotine withdrawal occurs when the person takes in a lesser amount of nicotine. To stop smoking, a person must deal with nicotine addiction. The individual also needs to change learned associations, or habits.
Signs and symptoms
The symptoms of nicotine withdrawal are actually good news. They are signs that the person’s body is flushing out the harmful tobacco chemicals. They won’t last long, usually from a few days to 2 to 3 weeks. Few people experience all of the withdrawal symptoms listed. For the first few days, the person may have the following: · cough · dizziness · dry mouth or throat For the first few weeks of smoking cessation, the person may have: · constipation · difficulty concentrating · fatigue · headaches · hunger · insomnia · irritability · restlessness · stomach upset Causes and risks People quickly become dependent on nicotine when using tobacco products. Anyone who uses these substances is at risk of experiencing withdrawal symptoms. A trigger is anything that creates an impulse to use tobacco. Triggers can be feelings, such as stress, anxiety, depression, or boredom. They can be visual, such as a picture of a poised glamorous movie star taking a long, seemingly satisfying drag. Triggers can even be certain times of the day, such as work breaks or meals.
Prevention
Once a person starts smoking, he or she quickly becomes addicted to nicotine. The key is to never start smoking. Antismoking campaigns can be effective in getting this message out.
Diagnosis
Someone who is addicted to nicotine will have strong cravings for it. When the person doesn’t smoke for a period of time, he or she will have nicotine withdrawal symptoms.
Long-term effects
There are typically no long-term effects from nicotine withdrawal. The most intense symptoms last only a few weeks. Craving for nicotine is the only symptom that persists longer than a month.
The health risks from the chemicals found in tobacco are enormous. Tobacco use can cause the following diseases: · chronic bronchitis · coronary artery disease and other forms of heart disease · emphysema · gastroesophageal reflux disease · lung cancer
Tobacco use can also cause the following conditions: · decreased life expectancy · erectile dysfunction, or impotence · gray hair and baldness · high blood pressure and circulation problems · infertility in men and women · osteoporosis and increased risk for bone fractures · premature wrinkles · weakened immune system
The good news is that the health damage caused by tobacco is preventable and may be reversible. Within 20 minutes of quitting, the healing begins. By year 15, the person’s risk of heart disease and early death is almost the same as that of people who have never smoked. In addition, an individual’s risk of dying from chronic bronchitis or emphysema decreases as long as he or she remains smoke free.
An individual who quits smoking will have the following advantages: · circulation to the hands and feet will improve· food will taste better · general health will improve · risk for serious illness will decrease · sense of smell will improve · skin will look healthier
Risks to others
Smoking cessation poses no risk to others. In fact, it will reduce the amount of secondhand smoke that friends and family are exposed to.
Treatments
The first step in smoking cessation is setting up a Quit Plan. A Quit Plan includes the following: · quit date and written commitment to stop smoking · preferred quit option(s) · preferred quit method(s) · support team · coping strategies for dealing with triggers, withdrawal symptoms, and other challenges
There are a number of methods for quitting smoking that address the addiction to nicotine. Going cold turkey, which means stopping smoking abruptly, is one method. Two other methods are non-nicotine medication and various forms of nicotine replacement therapy. The person’s level of nicotine dependence and any prior quit attempts should be taken into consideration. The individual can work with the healthcare provider to choose the best method.
Regardless of the method chosen, the person must also pay attention to breaking the smoking habit. Research shows that smokers who use behavior modification strategies in addition to addressing the physical addiction have a better chance of succeeding.
Nicotine replacement products help reduce the physical withdrawal symptoms that occur with smoking cessation. These medicines reverse the process in which the person’s body learned to crave more and more nicotine. Over time, they help the person’s body stop craving nicotine. Nicotine replacement therapy doesn’t completely eliminate withdrawal symptoms. It doesn’t give the individual any more willpower. It does let the person focus on breaking the habit of smoking as the body adjusts to lower levels of nicotine.
Following are the types of nicotine replacement therapy: · nicotine gum, which is available over-the-counter or by prescription · nicotine inhalers, which are available by prescription · nicotine nasal spray, which is given by prescription · nicotine patches, which are available over-the-counter in various strengths
Since these products replace the nicotine the person would have gotten from a cigarette, nothing new is being introduced into the body. The direct effect from nicotine is the same.
A person using nicotine replacement products should not continue to smoke. Nicotine can cause serious medical problems, including death, if it is abused. Nicotine replacement products are not recommended in certain situations: · people who have had a heart attack within the past 2 weeks · people who have serious arrhythmias, or irregular heartbeats · people who have angina, the chest pain associated with heart disease · women who are pregnant, unless their healthcare provider recommends it.
Zyban, or bupropion, has been approved by the FDA for smoking cessation. How Zyban works is largely unknown. It is thought to act on certain pathways in the brain that are involved in nicotine addiction and withdrawal. The person feels less of an urge to smoke. Zyban also helps reduce some of the more bothersome nicotine withdrawal symptoms associated with smoking cessation. For example, it can reduce anxiety, irritability, frustration, difficulty concentrating, and restlessness.
Side effects
The most frequently reported side effect from the nicotine patch is skin irritation. Those who use a 24-hour patch sometimes report having vivid dreams. The patch may also cause headache or joint pain.
Nicotine gum can cause some minor mouth, tongue, and throat irritation. It may also cause an arrhythmia and palpitations. Swallowing the gum can cause nausea or vomiting.
The most common side effects from the nasal spray are irritation of the nose and throat, watering eyes, sneezing, and cough. These side effects may lessen in intensity after the first week of use.
The most common side effect of the nicotine inhaler is irritation of the lining of the mouth and throat. Some people may experience cough, runny nose, or nausea.
The most common side effects of Zyban include dry mouth and insomnia. If side effects occur, they are generally mild and disappear after a few weeks. Other side effects include shakiness, skin rash, dizziness, and anxiety.
What happens after treatment
for the condition?
Withdrawal symptoms are temporary. They usually last only 1 to 2 weeks. The person can derail smoking triggers by using counteractions. Counteraction involves actively responding to the trigger, but not in the usual way. Instead of smoking, the individual comes up with a different and healthier response. There are three main ways to cope with triggers. · Avoid the situation. Someone who smoked while driving a car can choose a different route that requires more concentration. · Change the situation. The person may choose to sit in the nonsmoking section of restaurants. · Find a substitute for a cigarette. Pens, small toys, or rubber bands are good options. Chew sugarless gum or hard candy, or try carrot sticks.
A relapse occurs when a person who has stopped smoking slips and has a cigarette. Following are some keys to dealing with a relapse. · Learn from the relapse and move on. · Figure out the details that led to the slip. · Review the Quit Plan and reasons to stop smoking. · Revise the Quit Plan and set a new quit date.
To remain nicotine free, smokers should avoid tempting situations and do something else when the urge to smoke arises.
— Discovery Health
Women under stress
by Christine Soares
‘Adding to a woman’s increased dose of stress chemicals, are her increased ‘opportunities’ for stress. ‘It’s not necessarily that women don’t cope as well. It’s just that they have so much more to cope with,’ says Dr. Yehuda. ‘Their capacity for tolerating stress may even be greater than men’s,’ she observes, ‘it’s just that they’re dealing with so many more things that they become worn out from it more visibly and sooner.”
While still catching-up to men in some spheres of modern life, women appear to be way ahead in at least one undesirable category. “Women are particularly susceptible to developing depression and anxiety disorders in response to stress compared to men,” according to Dr. Yehuda.
Studies of both animals and humans have shown that sex hormones somehow modulate the stress response, causing females under stress to secrete more of the trigger chemicals like CRF than do males under the same conditions. In several of the studies, when stressed-out female rats had their ovaries removed, their chemical responses became equal to those of the males.
Adding to a woman’s increased dose of stress chemicals, are her increased “opportunities” for stress. “It’s not necessarily that women don’t cope as well. It’s just that they have so much more to cope with,” says Dr. Yehuda. “Their capacity for tolerating stress may even be greater than men’s,” she observes, “it’s just that they’re dealing with so many more things that they become worn out from it more visibly and sooner.”
Dr. Yehuda, also chief psychiatrist at New York’s Veteran’s Administration Hospital, notes another difference between the sexes. “I think that the kinds of things that women are exposed to tend to be in more of a chronic or repeated nature. Men go to war and are exposed to combat stress. Men are exposed to more acts of random physical violence. The kinds of interpersonal violence that women are exposed to tend to be in domestic situations, by, unfortunately, parents or other family members, and they tend not to be one-shot deals. The wear-and-tear that comes from these longer relationships can be quite devastating.”
Adeline Alvarez told She TV how a lifetime of chronic stress finally overwhelmed her. “My mom was diagnosed with paranoid schizophrenia in 1964 when my sister was born,” she recalls, “and there were times that she wouldn’t even know who we were, and it wasn’t good for us to be with her, so they would separate us. I just had this little world of my own and I cried a lot.”
Alvarez married at 18 and gave birth to a son, but was determined to finish college. “I struggled a lot to get the college degree. I was living in so much insanity that that was my escape, to go to school, and get ahead and do better.” Later, her marriage ended and she became a single mother. “It’s the hardest thing to take care of a teenager, have a job, pay the rent, pay the car payment, and pay the debt. I lived from paycheck to paycheck.”
Finally, the relentless pressure became too much to bear. “I went into a severe depression. I found myself in the attic looking at these pictures and crying over them, blaming myself like ‘what did I do?’” Alvarez recalls. “I was beating myself up. I lost my job, and I really broke down. Then the car broke down on top of that. I had a nervous breakdown for two months in the house and I couldn’t function. I wouldn’t even go out to shop.”
Not everyone experiences the kinds of severe chronic stresses Adeline Alvarez describes. But most women today are juggling a lot of obligations, with few breaks, and feeling the strain. Alvarez’s experience demonstrates the importance of finding ways to diffuse stress before it threatens your health and your ability to function.
— BBC Health
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