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Why can’t you just stop? Don’t you know you are killing yourself? Why do you do it?”

Woman breaking cigarette

If you are a smoker, you are all too familiar with this chorus of questions. You inevitably feel frustrated or resentful when it comes to responding. Even if you have reached your own conclusion that it’s time to quit, you may feel that the addiction has too tight a grip on you. If so, don’t despair -- smoking cessation is not out of your reach.

Make no mistake; the act of quitting is not easy, but it’s not impossible. Smokers often attempt to quit several times and try a variety of different approaches. Studies have shown that the average smoker attempts to quit four times before they are able to fully overcome the addiction.

Mark Twain summed it up when he wrote, "Giving up smoking is the easiest thing in the world. I know because I've done it thousands of times." Cydne Marckmann, ARNP, smoking cessation specialist at Sound Family Medicine, believes Twain’s satirical comment rings true. Quitting is a physical and mental process, not just a solitary act of self-discipline.

Why Quit?
The risk of not quitting has become undeniable. According to the 2004 Surgeon General's Report, tobacco smoking remains the number one cause of preventable disease and death in the United States and will end up killing half of the people who don't quit.

Even with the rise of a wide range of cancer-causing chemicals in our world, tobacco smoke, which contains thousands of chemical agents and over 60 substances that are carcinogens, stands out as the leading cause of this disease. Despite these discouraging statistics, smoking cessation is indeed possible and has immediate health benefits. Most importantly, smoking cessation decreases the risk of lung and other cancers, heart attack, stroke, and chronic lung disease.

Recent studies have given us more than a glimpse into the effects of smoking. There are two ways that nicotine works on the nervous system - it is a mild relaxant and a mild stimulant, depending on the situation. Its effectiveness does not come from the level of mood shift, but in the frequency it is used to alter one’s mood. If you are a bit tired and smoke to make yourself more attentive, you've shifted your mood slightly. If you are irritable or anxious and you smoke to calm down and relax, then you are using nicotine to alter your mood.

Taking Ownership of an Addiction.
People who get serious about smoking cessation need external motivation as well as personal determination. For some people, that motivation can be your family. For others, it may take a brush with illness, a caring confrontation from close friends, or a sobering set of facts from a no-nonsense doctor. Whatever the motive, the successful quitter must have a plan for tackling the addiction. Here are several options to discuss with your physician:

  • Just Stopping ("Cold Turkey”) – When trying to stop smoking without help from aids of any sort can be abrupt and difficult to sustain. The biggest advantage is that most of the nicotine from tobacco leaves the bloodstream within three days. Nicotine withdrawal symptoms may be more intense than if a nicotine replacement therapy (NRT) is used, but while more acute, the pain of withdrawal may be shorter-lived.
  • Nicotine Replacement Therapy (NRT) – This involves a measured dose of nicotine to help ease the physical symptoms of withdrawal. Unlike cigarettes, which consist of thousands of poisonous and/or carcinogenic chemicals, NRTs contain only nicotine. NRTs allow one to withdraw from nicotine by gradually reducing the amount received in each dose. Products: Nicotine patch, gum, inhaler, lozenges, and nasal spray.
  • Counseling – This allows for support to help hold one accountable for their smoking habits, and can be a highly effective way to quit long-term.
  • Medications - Some people turn to medications to help them during the process. Anti-depressants and anti-anxiety medications are the most frequently prescribed. Common medications consist of Bupropion (includes the brands Zyban, Wellbutrin, and Buproban) and Chantix.

Cydne Marckmann, the Sound Family Medicine smoking cessation expert, explained the process she puts her clients through. “I have my clients sign a contract with themselves when they decide to quit and ask that they hold themselves accountable to that contract.  In addition, I ask that they plan for pitfalls, for the "I always smoke when…” behaviors, and equally important, for the way that they are going to reward themselves.  I ask for one day, one week, one month, six month and one-year rewards. I had one client put $6 a day in a jar and reward herself with a trip on her one-year anniversary.  The rewards don’t have to be monetary, either.  You can plan to take a walk and praise yourself for being less out of breath at any anniversary interval.” Cydne recommends that quitting programs be carefully planned in order to suit an individual’s needs for optimal success, and that any nicotine replacement product be discussed with a healthcare provider. “When stopping smoking, everyone is going require different treatment. A 40-year smoking history has different needs from a 2-year smoking history.”

Perks of not puffing
Smoking cessation is important for your health and provides many undeniable benefits. Soon after you quit, your circulation begins to improve, and your blood pressure starts to return to normal. Your sense of smell and taste return, and breathing starts to become easier. In the long-term, giving up tobacco can help you live longer. Your risk of getting cancer decreases with each year you stay smoke-free. The risk of coronary heart disease is reduced by half after one year off cigarettes, and in 5 to 15 years, the risk of stroke for ex-smokers returns to the level of those who've never smoked. If you are currently smoking, it may be hard to imagine yourself as an ex-smoker with freedom from the habit. Quitting is possible though, and you can quit just as surely as anyone else. It all starts with making the commitment to quit, and taking action. From there, it means creating a daily process – essentially, new habits – to learn to live your life free of the addiction. Don't let smoking have a hold on your life anymore.

Finding the best way to quit can be tricky so make sure you’re ready and willing. Being aware of your family health history and getting educated on the withdrawal issues are important to take into account before considering quitting. Take the first step by contacting Cydne Marckmann, SFM’s resident smoking cessation expert, or your SFM family physician. Here are some web links that may give you additional information:

Long-Term Benefits Of Quitting Tobacco
Cigarette Smoking and Cancer: Questions and Answers
Who Me . . . Stop Smoking Again?
Smoking Cessation