SMOKING CESSATION

Smoking cessation means "to quit smoking," or "withdrawal from nicotine." Because smoking is highly addictive, quitting the habit often involves irritability, headache, mood swings, and cravings associated with the sudden cessation or reduction of tobacco use by a nicotine-dependent individual. There are many good reasons to stop smoking; not the least is that smoking cessation may speed postsurgery recovery. Smoking cessation helps a person heal and recover faster, especially in the incision area, or if the surgery involved any bones. Research shows that patients who underwent hip and knee replacements, or surgery on other bone joints, healed better and recovered more quickly if they had quit or cut down their tobacco intake several weeks before the operation. Smoking weakens the bone mineral that keeps the skeleton strong and undermines tissue and vessel health. One study suggested that even quitting tobacco for a few days could improve tissue blood flow and oxygenation, and might have a positive effect on wound healing. If a patient has had a history of heart problems, his chances of having a second heart attack will be lowered. Quitting may also reduce wound complications, and lower the risk of cardiovascular trouble after surgery. If surgery was performed to remove cancerous tumors, quitting will reduce the risk of a second tumor, especially if cancer in the lung, head, or neck has been successfully treated.

Description
Quitting smoking is one of the best things a person can do to increase their life expectancy. On average, male smokers who quit at 35 years old can be expected to live to be 76 years old instead of 69 years if they were still smoking. Women who quit would live to be 80 years old instead of 74 years.

Effects of smoking on the body
Nicotine acts as both a stimulant and a depressant on the body. Saliva and bronchial secretions increase along with bowel tone. Some inexperienced smokers may experience tremors or even convulsions with high doses of nicotine because of the stimulation of the central nervous system. The respiratory muscles are then depressed following stimulation.

Nicotine causes arousal as well as relaxation from stressful situations. Tobacco use increases the heart rate about 10 - 20 beats per minute; and because it constricts the blood vessels, it increases the blood pressure reading by 5 - 10 mm Hg.

Sweating, nausea, and diarrhea may also increase because of the effects of nicotine upon the central nervous system. Hormonal activities of the body are also affected. Nicotine elevates the blood glucose levels and increases insulin production; it can also lead to blood clots. Smoking does have some positive effects on the body by stimulating memory and alertness, and enhancing cognitive skills that require speed, reaction time, vigilance, and work performance. Smoking tends to alleviate boredom and reduce stress as well as reduce aggressive responses to stressful events because of its mood-altering ability. It also acts as an appetite suppressant, specifically decreasing the appetite for simple carbohydrates (sweets) and inhibiting the efficiency with which food is metabolized. The fear of weight gain prevents some people from quitting smoking. The addictive effects of tobacco have been well documented. It is considered mood-and behavior-altering, psychoactive, and abusable. Tobaccos addictive potential is believed to be comparable to alcohol, cocaine, and morphine.

Health problems associated with smoking
In general, chronic use of nicotine may cause an acceleration of coronary artery disease, hypertension, reproductive disturbances, esophageal reflux, peptic ulcer disease, fetal illnesses and death, and delayed wound healing. The smoker is at greater risk of developing cancer (especially in the lung, mouth, larynx, esophagus, bladder, kidney, pancreas, and cervix); heart attacks and strokes; and chronic lung disease. Using tobacco during pregnancy increases the risk of miscarriage, intrauterine growth retardation (resulting in the birth of an infant small for gestational age), and the infants risk for sudden infant death syndrome.

The specific health risks of tobacco use include: nicotine addiction, lung disease, lung cancer, emphysema, chronic bronchitis, coronary artery disease and angina, heart attack, atherosclerotic and peripheral vascular disease, aneurysms, hypertension, blood clots, strokes, oral/tooth/gum diseases including oral cancer, and cancer in the kidney, bladder, and pancreas. Nicotine is also associated with decreased senses of taste and smell. During pregnancy, nicotine may cause increased fetal death, premature labor, low birth weight infants, and sudden infant death syndrome. Nonsmokers who are regularly exposed to second hand smoke also may experience specific health risks including:
• Increased risk of lung cancer.
• An increased frequency of respiratory infections in infants and children (e.g. bronchitis and pneumonia), asthma, and decreases in lung function as the lungs mature.
• Acute, sudden, and occasionally severe reactions including eye, nose, throat, and lower respiratory tract symptoms.

The specific health risks for smokeless tobacco users include many of the diseases of smokers, as well as a 50-fold greater risk for oral cancer with long-term or regular use.

In diabetics taking medication for high blood pressure, it has been reported that smoking may increase the risk of kidney disease and/or kidney failure.

Making a plan to quit
Long lead times for elective procedures like joint operations offer a good opportunity for doctors to encourage their patients to quit smoking, but only the smoker has the power to stop smoking. Before a smoker decides to quit, he should make sure he wants to quit smoking for himself, and not for other people.

The following are some questions as well as some suggestions the smoker may want to consider:
• When is the best time to quit smoking? The answer may be different for women and men. Women should set their quit date to begin at the end of their period for best results. The first step is to set a quit date.
• Make a written list of why you want to quit smoking.
• Will you use an aid to help you quit? Will it be the patch, nicotine gum, Zyban, nicotine spray, soft laser therapy, nasal inhaler, or some other method? If you plan to use Zyban, set your quit date for one week after you begin to use it.
• smoke only in certain places, preferably outdoors
• switch to a brand of cigarettes that you dont like
• do not buy cigarettes by the carton
• cut coffee consumption in half (You will not need to give it up.)
• practice putting off lighting up when the urge strikes
• go for a walk every day or begin an exercise program
• stock up on non-fattening safe snacks to help with weight control after quitting
• enlist the support of family and friends
• clean and put away all ashtrays the day before quitting