Sunday, May 30, 2004

Stop smoking 

Recognising the importance of smoking as a contributor to disease, the World Health Organisation (WHO) has declared tomorrow to be World No Tobacco Day. According to WHO, about 1.1 billion people around the world smoke. Around 3.5 million smokers die every year as a result of tobacco-related illnesses.

Illnesses long known to be caused by smoking include lung cancer, heart disease, stroke, emphysema and bronchial disorders. On 27 May, US Surgeon-General Richard Carmona said smoking also causes cataracts, acute myeloid leukemia and cervical, kidney, pancreatic and stomach cancers.

Smoking is addictive. The addiction is essentially due to the nicotine found in tobacco products. Nicotine stimulates the central nervous system to create feelings of pleasure. The effect of nicotine on the brain is rapid, but dissipates in a few minutes. This encourages the smoker to continue smoking throughout the day to maintain the drug’s pleasurable effects.

Treatments are available to help smokers quit while minimising withdrawal symptoms. The latest treatment being tested is laser (see the following stories: Laser Acupuncture for Adolescent Smokers—A Randomized Double-Blind Controlled Trial, New Treatment Offers Relief For Addicted Smokers and Laser Treatment to Quit Smoking).

The more conventional treatment, however, is nicotine replacement therapy (NRT). This comes in various forms, including nicotine gum, nicotine patches, nicotine lozenges and nicotine inhalers. The consistent use of one of these products is said to double a person's chance of quitting smoking.

The nicotine gum has only recently become available in Singapore, thanks to the Free Trade Agreement signed with the US last year (gum producers lobbied the US government to include it in the agreement). The first therapeutic gum to be sold here is Nicorette, produced by Pfizer.

The Sunday Times had an article today on Nicorette gum. It interviewed two people who had taken the gum. Interestingly, both said they failed to quit smoking despite taking the gum.

However, apart from its apparent lack of efficacy, another concern with NRT that is not pointed out in the Sundary Times article is the possibility that it may actually cause harm. In 2001, researchers at Stanford University found that nicotine promotes the growth of new blood vessels and can also stimulate tumor growth and the build up of plaque inside arteries (read article Researchers discover nicotine stimulates growth of new blood vessels).

Dr John Cooke, the lead author of the Stanford study, said, "As long as people are using nicotine replacements properly, it's a win for all of us, if we can get people to stop smoking. But, I would urge people not to use it long term."

Joel Spitzer, a smoking-cessation counselor and director of education at WhyQuit.com, recommends that smokers quit by going cold turkey. He says nicotine replacements keep ex-smokers in a protracted state of withdrawal.

According to the American Cancer Society, fewer than 5 percent of smokers who attempt to quit each year succeed. Of those who do, the society reported last year, 91 percent quit cold turkey.

For a one-stop guide to quitting smoking, readers should visit the American Cancer Society's Guide for Quitting Smoking at its site. And emulate Mark Twain, who is quoted as saying, "Quitting smoking is easy. I've done it a thousand times."

Then again, maybe that's not such a good idea.


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