HEALTH-FITNESS

Quitting smoking: It takes a team

Doctors do not recommend e-cigarettes as an alternative

Karen Dandurant news@seacoastonline.com
Smoking is addictive and it’s hard to quit. One possible incentive might be to talk about the health benefits of quitting instead of the health risks that are so well known.

PORTSMOUTH – Dr. Jeffrey Kuvin, Chief of Cardiovascular Medicine at Dartmouth-Hitchcock Medical Center, said smoking continues to be one of the leading causes of death in the world.

“In the US, 15% of the adult population still smokes,” said Kuvin. “Abroad the numbers are even higher. It’s pretty staggering since we all know what can happen to people who smoke.”

Smoking is addictive and it’s hard to quit. One possible incentive might be to talk about the health benefits of quitting instead of the health risks that are so well known.

Kuvin said it is no longer suitable to tell a patient they need to quit smoking and expect them to be successful on their own.

“I believe that quitting smoking should be a team approach,” said Kuvin. “It should not all rest with the one individual. They need a care team, made up of their family, their health care provider, someone in behavioral health. I also think the person’s pharmacist needs to get involved, because it’s important to keep track of the smoking cessation medications and how they will interact with any other medication the person might be on. No medicine should be used without that oversight.”

There are health benefits for both the person who quits, and their family because of the risks of secondhand smoke.

“Some of the benefits are instantaneous and others occur over time,” said Kuvin. “Almost immediately the heart and vascular system respond in a favorable way. Your heart rate and blood pressure go down. In a very short period, your blood vessels will learn to constrict in a favorable way, to behave appropriately as they were not when you were smoking. That means all your blood vessels, throughout your entire body will begin working better again.”

Over the course of a few weeks, two to 12, said Kuvin, evidence shows that the person’s overall body circulation is improved.

“Within about one year, the risk of cardiovascular disease is reduced by half,” said Kuvin. “Within five years, the risk of stroke is greatly reduced.”

Kuvin said if a person truly quits, within 15-years, their cardiovascular system will return to that of a non-smoker.

“There are many causes for cardiovascular risks, but not smoking can reduce many of them,” Kuvin said. “These are real, reproducible benefits and very good reasons to quit.”

Sarah Stanley, a spokesperson for The New Hampshire Department of Health and Human Services’ Tobacco Prevention and Cessation Program (https://www.dhhs.nh.gov/dphs/tobacco/index.htm) offered their take on what quitting smoking will do for a person.:

• 20 minutes of quitting the heart rate drops

• 12 hours after quitting carbon monoxide levels in blood returns to normal

• 2 weeks-3 months after quitting, risk for heart attack begins to drop and lung functions improve

• 1-9 months after quitting, coughing/wheezing and shortness of breath episodes decrease

• 1 year after quitting, risk of coronary heart disease is half that of a person who smokes

• 5 years after quitting, risk of stroke is reduced

• 10 years after quitting, risk of cancer death rate is approximately ½ that of a person who smokes

• Risk of lung cancer and cancers of the mouth, throat, esophagus, bladder, kidney and pancreas decreases

• 15 years after quitting risk of coronary heart disease is back to that of a person who does not smoke.

“Additionally, the following are important, especially since chronic obstructive pulmonary disease (COPD) is the fourth leading cause of morbidity and mortality,’ said Stanley. “It comes at a very high price physically and in terms of health care costs.”

• Reduced risk of developing some lung diseases (such as chronic obstructive pulmonary disease, also known as COPD, one of the leading causes of death in the United States).

• Reduced risk for infertility in women of childbearing age. Women who stop smoking during pregnancy also reduce their risk of having a baby with a low birth weight

Kuvin said the recent concerns about vaping and e-cigarettes in the news should be heeded.

“There seems to be a huge interest in switching people from cigarettes to e-cigarettes,” said Kuvin. “In my mind the jury is still out and it remains very suspect. There is no long-term data. Many contain nicotine which is addictive. The aerosols used to deliver the product can damage the lungs. So, I say it is incredibly premature to say e-cigarettes are a better alternative.”

The only smart answer, said Kuvin, is to move to a culture where smoking in any form no longer exists.

“Clearly inhaling vapor in the lungs is in no way a good idea,” said Kuvin. “Equally clear to me are the efforts being made to hook a new generation through vaping and e-cigarettes. If quitting can reverse so many of the bad effects, some immediately, why not do it?”

Quitting smoking is not a one size fits all. Kuvin said number one is to admit that smoking is addictive and to decide to stop.

Cigarette manufacturers are now required by law to put warning labels on their product. Kuvin said look at that and see how bad it is, but then maybe quit because of how good that will be for you and for your family.

“How they do it depends on a person’s individual personality,” said Kuvin. “Some people think going cold turkey is best. For others, slow turkey is a better answer. Either way, making it a shared responsibility with family and health care people, surrounding yourself with help will make a difference.”