Everyone knows that smoking is a major health hazard: it’s the leading preventable cause of death in the United States. But some people may be surprised to learn that smoking is also the most potent cardiac risk factor, increasing risk by 250 percent. Another surprise: exposure to secondhand smoke is also a major cardiac risk factor, which is why passive smoking is the nation’s thirdleading preventable cause of death. (Alcohol is the second.)
In all, smoking accounts for 20 percent of all deaths from coronary artery disease. But within a year of quitting, smokers can cut this risk in half. Within two years, the cardiovascular risk for a former smoker is very close to that of a person who never smoked. Because smoking probably contributes to blood vessel inflammation, removing that irritant should slow the inflammatory process, resulting in a quick drop in heart disease risk.
In all, smoking accounts for 20 percent of all deaths from coronary artery disease. But within a year of quitting, smokers can cut this risk in half. Within two years, the cardiovascular risk for a former smoker is very close to that of a person who never smoked. Because smoking probably contributes to blood vessel inflammation, removing that irritant should slow the inflammatory process, resulting in a quick drop in heart disease risk.
I see a lot of patients who know they should quit smoking, but they’re not sure how. The best approach is two-pronged: use medicine, and get counseling and support.
Easing the craving for nicotine is a key part of stopping smoking. Nicotine patches, gum, lozenges, nasal spray, and cigarette-shaped inhalers deliver enough nicotine to satisfy the body without the tar, carbon monoxide, and other harmful chemicals found in cigarette smoke. An antidepressant known as bupropion (Zyban, Wellbutrin) also alleviates the symptoms of nicotine withdrawal, even in people who aren’t depressed. Combining bupropion and nicotine replacement may work the best of all.
Nicotine replacement is safe, even after a heart attack, and it’s much safer than continued smoking. These products don’t increase the clotting potential of blood or damage the fragile but important lining of blood vessels, as smoking does.
Nicotine replacement often isn’t enough on its own. Counseling and social support can help you break your “smoking cues,” the things you link to lighting up, like drinking coffee or finishing a big meal. You can get counseling one-on-one at a support group run by a hospital or local department of health, via the phone, or online. (Some options are listed in the Resources section.)
Remember that quitting smoking is a huge change, so it might take you a few tries to get off cigarettes for good. If you slip by having a cigarette or two after your quit date, try to figure out what went wrong and how to fix it the next time. Don’t convince yourself that as long as you had one, you may as well have another, and another. . . . The same holds true if you return to your old smoking habit. You may have to quit a few times. Not succeeding may just mean you need more help.
Easing the craving for nicotine is a key part of stopping smoking. Nicotine patches, gum, lozenges, nasal spray, and cigarette-shaped inhalers deliver enough nicotine to satisfy the body without the tar, carbon monoxide, and other harmful chemicals found in cigarette smoke. An antidepressant known as bupropion (Zyban, Wellbutrin) also alleviates the symptoms of nicotine withdrawal, even in people who aren’t depressed. Combining bupropion and nicotine replacement may work the best of all.
Nicotine replacement is safe, even after a heart attack, and it’s much safer than continued smoking. These products don’t increase the clotting potential of blood or damage the fragile but important lining of blood vessels, as smoking does.
Nicotine replacement often isn’t enough on its own. Counseling and social support can help you break your “smoking cues,” the things you link to lighting up, like drinking coffee or finishing a big meal. You can get counseling one-on-one at a support group run by a hospital or local department of health, via the phone, or online. (Some options are listed in the Resources section.)
Remember that quitting smoking is a huge change, so it might take you a few tries to get off cigarettes for good. If you slip by having a cigarette or two after your quit date, try to figure out what went wrong and how to fix it the next time. Don’t convince yourself that as long as you had one, you may as well have another, and another. . . . The same holds true if you return to your old smoking habit. You may have to quit a few times. Not succeeding may just mean you need more help.
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