Doctor Explains
Smoking is responsible for over 19000 Australian deaths, with around 11% of the population continuing to smoke it’s time to kick the habit for good.
Smoking Is Addictive
Nicotine, within a cigarette, is an addictive substance. It’s thought that if you smoke more than 10 cigarettes a day or have a cigarette within 30 minutes of waking that you are addicted to nicotine.
Nicotine is a chemical that once inhaled into the lungs crosses into the blood circulation rapidly and is carried to the brain. Once it is in the brain, it affects the reward pathway — the pathway that makes us feel good due to another chemical that is released called dopamine. Nicotine triggers this pathway so that “good feelings” occur. The trouble is, once the cigarette has finished, the brain wants to continue feeling good, and so there is a craving for the next cigarette. Each time you smoke, there is a feeling of reward. The longer you smoke, the longer the body learns that it needs nicotine to feel good. Which is why quitting is hard, because the body craves nicotine and when there is no nicotine, the “feel good” pathway doesn’t release dopamine and so causing withdrawal symptoms. Such symptoms can start within hours of your last cigarette and can mean feeling irritable, unable to concentrate or feeling sleepy. However, the longer you can avoid a cigarette the better as the brain can go back to how it was before prior to smoking.
Smoking And The Body
Aside from having an addiction to nicotine, there are many other impacts that smoking has on the body. Cigarette smoke contains over 4000 chemicals of which 43 are known to be carcinogenic (or causing cancer). We know through studies and trials that the once glamourised white stick now causes serious conditions such as lung cancer, chronic bronchitis, emphysema (where the lungs no longer expand and contract as they should causing shortness of breath) and is a major risk factor in heart disease. If that wasn’t enough, we also know that smoking prematurely ages the skin, it reduces elasticity and causes wrinkles. Aside from this, it also causes gum disease, oral cancers and is a contributing factor to erectile dysfunction.
Why Stop?
It’s easy to see why someone would want to stop smoking, I often get asked in practice what will happen after stopping smoking. Well, the longer you stop smoking the better your health outcomes. Take a look at some pointers below and the time after your last cigarette.
- 20 minutes: the heart rate and blood pressure reduce
- 12 hours: almost all nicotine has been metabolised
- 24 hours: blood levels of carbon monoxide (a nasty gas that deprives the body of essential oxygen) is dropped dramatically
- 5 days: sense of smell and taste are improved
- 3 months : Cilia, or small hairs that act as a barrier to bugs in our airways recover and lung function improves
- 1 year: risk of heart disease is halved compared to that of smokers
- 10 years: risk of lung cancer is less than half that of a continued smoker
- 10–15 years: all cause mortality declines to the same level as those who have never smoked.
If those points weren’t convincing enough, consider the monetary value of cigarettes. A pack of 20 in Australia is around $28 at time of writing. If you smoked 20 a day that’s a huge saving of over $10,000 a year!
How To Stop
Stopping smoking can be tricky for many as it is highly addictive, the quit rate of those unassisted at one year is only 7% and so it is vital to seek support and help with your journey. There are many organisations that can assist with this as can your own medical doctor.
Some general measures include nicotine replacement therapy for those that are thought to have a nicotine addiction. This can take the form of tablets, gum, lozenges, patches or even sprays. There is no significant difference between the forms and the idea is that it replaces the harmful toxins inside cigarettes.
There are also medications that are available on prescription which help to reduce cravings. However, these are medications that must be deemed as being suitable for you individually.
Vaping is another method, whereby nicotine is mixed with a solution for inhalation, however, it is not considered as a first line treatment. In October 2021, Australia recommended that vaping or e-cigarettes only be prescribed by a medical practitioner if other methods have failed. It is important to note that this is not an approved medicine by the TGA (therapeutic Goods Administration).
The reasons are due to the unknown long term safety effects as there is a lack of long term studies. There is also a concern with intentional and accidental poisoning, burns and lung injury. Some may also choose to continue concurrent smoking, which of course is not helpful. There is also much concern about the potential to promote nicotine use in young people as it could be seen as trendy, especially when flavours are introduced.
It is important to note that vaping is not considered suitable for everyone such as those under 18 year olds, pregnant or breast feeding people or those with mental health concerns. It is therefore vital you discuss this option individually with your own medical practitioner.
Other Measures
With the aid of your general practitioner and helplines listed below, successful cessation of smoking is possible with numerous benefits.
You could consider taking two different approaches — cognitive and behavioural.
The cognitive approach uses the power of logical thought to overcome addiction. For example, you could write a smoking diary for a few days prior to intending to quit. This then allows you to identify triggers or situations that could be substituted with other activities, reducing your chance of picking up a cigarette. You could also think about the benefits of stopping or keep a list and hang it in a popular place as a reminder.
The behavioural approach includes strategies to help with the triggers. Firstly when you have an urge to smoke, try to delay this by getting engaged with another activity. If you struggle, try deep breathing for a minute. Perhaps you could even take a drink of water, let the taste and feeling simmer in your mouth for a moment, allowing you to get distracted from the thought of smoking. Failing this, you could do something entirely different like going for a walk or doing the dishes.
Stopping smoking is much easier when you have your family and friends on board. I often advise my patients to have a target date to stop. In preparation of this, clean out any paraphernalia of smoking — lighters, ash trays — anything that could remind you and tempt you. Let your friends know your target date so that hopefully they can support you with your goal. It’s often nice having someone to steer you in the right direction. If your partner also smokes, why not share with them what you’ve learnt and why it’s important for you both to stop emphasising the health benefits. If you are both on board, you are more likely to both succeed.
Apart from your local doctor, take a look at here for more help. I hope that you have found this article helpful.
Take care and stay healthy,
Dr Nora x
Please note that the contents of this article are not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or medical condition
