Smoking Cessation

Smoking cessation is something that physicians take extremely seriously, as few things can improve a patient’s long-term health more than quitting smoking. Although smoking has been on the decline for a while, and only about 16 percent of U.S. adults continue to do so, it still remains the number one cause of preventable deaths in the nation. Every year, tobacco use kills about half a million people in America. Smoking affects nearly every single system in the body, in ways that are both obvious and subtle. As it is a physician’s duty to protect the health of their patients, they work to support patients going through the process of quitting and provide pharmacological options that can improve the chances of success.

Smoking Cessation: A New Lease on Life

Decades of research have been compiled on the effects of smoking, but even with that research, it’s still difficult to totally quantify the effects of tobacco use. That said, here’s a quick look into how smoking affects the body:

1. Lungs – The lungs receive the brunt of the tobacco blow and they are damaged at several levels. The small air sacs in the lungs, termed the alveoli, are responsible for promoting the oxygen change in the lungs that fuels all of respiration. Smoking destroys the alveoli, and they don’t grow back. It is possible to destroy so many alveoli that emphysema sets in, which presents with serious shortness of breath, which can end up being fatal.

Smoking also kills cilia throughout the respiratory system, and these cilia are responsible for snatching dust and pushing mucus out of the airways. As cilia die, the lungs’ ability to block mucus and dust from entering the lung declines, which can increase the chances of respiratory infection.

Finally, smoking kills and scars lung tissue, which builds up in the lungs over time. Eventually this buildup of scar tissue affects the physical structure of the lungs and can lead to difficult breathing, a constant cough or even cancer.

2. Heart – The heart suffers nearly as much as the lungs during smoking, as tobacco use immediately creates a spike in blood pressure. This, combined with the presence of carbon monoxide, forces the heart to work harder and sustain a great deal of stress. Cardiac stress is a major contributor to heart disease and cardiac arrest, which is why chronic smokers are much more likely to sustain sudden heart failure.

Smoking also thickens and makes the blood “sticky,” turning it into something akin to sludge. This places even more stress on the heart, as it must work harder to push higher viscosity fluids through the circulatory system.

Tobacco use even increases the prevalence of fats in the blood, which then leads to a greater rate of fat depositing along arteries. Fat deposits in the arteries are a primary cause of blocked blood flow, which is often followed by heart attack.

3. Brain – The brain is changed by long-term exposure to nicotine, as the substance is as addictive as heroin. As nicotine levels rise and fall, they have a profound effect on the user’s mood and behavior, which is why smokers are often characterized as being irritable or quick to frustrate. Mood changes usually get worse as a user attempts to stop smoking, but this passes after a few weeks.

4. Face and senses – Not even the senses are spared by smoking. Tobacco use can cause moderate hearing loss, as it reduces oxygen delivered to the cochlea. The cochlea is responsible for delivering auditory signals to the brain, and any disruption to the organ means less sound is picked up. Smoking damages the eyes as well, and has a particularly deleterious effect on night vision. Tobacco use also increases the risk of macular degeneration and cataracts. A well-known effect of smoking is the loss of taste, but it can also result in tooth loss, gum disease and sores in the mouth.

There are many more negative effects of smoking, and as research continues into tobacco use, many more will likely be discovered.

How Physicians Can Help with Smoking Cessation

The benefits of quitting smoking are obvious. What’s less obvious is how to get there. Nicotine dependence is extremely powerful, and cravings only make it harder to stay on the right path. But this isn’t something that patients have to go alone, and in fact, it’s much easier to defeat tobacco use if physician assistance is readily available.

Primary care physicians can provide the information and tools needed to commit to quitting. This is how a doctor can make the road to being smoke-free easier:

1. Assessment – Before a patient is set on quitting, they may have reservations about whether it’s truly necessary. A physician can offer a set of tests to get a clear picture of the patient’s health. This includes a lung age test, which can paint a stark picture of what condition a patient’s lungs are in. And if there are any serious complications on the horizon due to smoking’s interaction with other health conditions, a physician can provide insight into this possibility.

2. Inform – Smoking cessation usually brings with it a host of undesirable side effects, but these effects are only temporary. Symptoms like disturbed sleep, mood changes, anxiety and sinus irritation are expected and can be frustrating to deal with. A physician, though, can help assure their patient about what to expect and when to expect it, so the patient goes into the process armed with information. Physicians can also provide strategies on combatting these complications and act as a confidant through each stage.

3. Support – In addition to information and psychological support, physicians can provide pharmacological aids to boost the chances of success. Most of them come in the form of nicotine replacement strategies, like nicotine gums, patches or inhalers. The benefit of these nicotine replacement therapies is that they can be calibrated to the individual so that they provide maximum effectiveness.

There are second line therapies and alternative therapies as well, for patients that don’t respond well to typical nicotine replacement options. Bupropion, for example, was originally prescribed as an antidepressant but doubles the odds of smoking cessation over placebo. Nicotine replacement therapies, as a whole, improve odds of quitting by 50 to 70 percent, so they are powerful tools in a doctor’s arsenal.

Quitting smoking can be a tough process that comes with numerous challenges, but the benefits are far greater than the obstacles. Once someone leaves smoking behind, they will experience health improvements that last a lifetime, and a primary care physician is there to back their patients during every step of the way.