Posts Tagged ‘Smoking Cessation’

November is Lung Cancer Awareness Month and lung cancer is the leading cause of cancer death in the United States. The next most common causes of cancer death are colorectal, breast and pancreatic cancer; lung cancer is still responsible for more deaths than the three combined. The best thing one can do to prevent lung cancer is to stop smoking or to continue to abstain from smoking if you are not a smoker.

For individuals who have smoked, you may benefit from a lung cancer screening. A CT scan is recommended for those who are 50 to 80 years old and have a 20 pack-year history and currently smoke or have quit within the past 15 years. Pack-year refers to the average amount of packs of cigarettes smoked per day for one year.

Lung cancer screening also has its own risks, so it is only recommended for those that are high risk of developing lung cancer due to age and smoking history. Talk to your health care provider to find out if screening is recommended for you.

Aside from the reduced lung cancer risk, quitting smoking has a wide range of health benefits. It lowers the risk of heart disease, lung disease, kidney failure, infection, stomach issues, and osteoporosis.

Quitting smoking may be easier said than done for some people, but there are support and resources available. It is possible to stop smoking without any help, but with help the chances of being successful with quitting improve greatly.

Here are some steps to get started with quitting:

• Discuss the decision to stop smoking with your primary care physician or local pharmacist.
• Pick the date you want to quit.
• Tell your family and friends that you plan on quitting.
• Make a plan and account for challenges you may face, like cravings.
• Remove cigarettes from your home and car.
• When your quit date arrives, follow your plan and follow up with your health care providers.

There are over-the-counter medications to help you stop smoking, like nicotine replacement therapy (NRT). As you may know, nicotine is the main addictive substance in tobacco. When you try to quit smoking, you may experience symptoms of withdrawal due to your body not getting nicotine anymore. Nicotine replacement therapy helps with the physical withdrawal symptoms of quitting.

NRT comes in different forms including skin patches, gum, and lozenges.

While NRT helps with the physical symptoms, you may need to attend counseling or support groups to help with the emotional aspects of quitting. There are also prescription-only medication options that may work for you.

When you are ready to quit, talk to your primary care physician or pharmacist about the options that are available for you. Also, make sure that they have an accurate list of your medications and are aware of all of your medical conditions.

Make the decision to quit smoking today!

For help quitting, visit smokefree.gov, call 1 (800) QUIT-NOW (784-8669), or text “QUIT” to 47848.

References:

1. Lung Cancer Awareness Feature. Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/dcpc/resources/features/lungcancer/index.htm. Published October 20, 2022. Accessed November 7, 2022.

2. Lung Cancer Awareness month. American Association for Cancer Research (AACR). https://www.aacr.org/patients-caregivers/awareness-months/lung-cancer-awareness-month/. Published November 1, 2022. Accessed November 7, 2022.

3. Nicotine replacement therapy to help you quit tobacco. American Cancer Society. https://www.cancer.org/healthy/stay-away-from-tobacco/guide-quitting-smoking/nicotine-replacement-therapy.html. Published August 2, 2021. Accessed November 7, 2022.

4. Patient education: Quitting smoking (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/quitting-smoking-beyond-the-basics. Published January 21, 2021. Accessed November 7, 2022.

Is it the right time to quit smoking?

Am I able to quit smoking?

Where do I even start?

It’s understandable to be hesitant when quitting smoking. The initial cravings, headache, shaking, fatigue, and cough can come on quickly, but so can the benefits to your health.

In a matter of minutes after stopping smoking, your heart rate will return to a normal rhythm.

After several days, the level of carbon monoxide in your blood drops to the same as a non-smoker.

Make it a whole year and your risk of heart attack drops drastically.

At three to six years, your risk of a cardiac event drops by half.

After ten years, your risk of lung cancer drops by half.

After twenty years, your risk for cardiac events and various cancers including esophageal, pancreatic, and throat cancers drops to the same as a person who never smoked.

With those benefits in mind, there really is no time to waste on the road to recovery.

Here are some steps to get started:

1. Discuss the decision to stop smoking with your primary care physician or local pharmacist. Make sure to bring a list of your medications with you.
2. Choose a date to quit.
3. Have a plan to quit ahead of your date including medication or counseling service support.
4. Initiate your plan to quit on that date, and continue to periodically follow-up with your primary care physician or local pharmacist.

When it comes to quitting smoking, some of the best aids are found over-the-counter (OTC).

Nicotine replacement therapy (NRT) is the gold standard in smoking cessation and is readily accessible in multiple forms.

Here are some NRT OTC medications to help you quit:

• Nicotine patches
  • Come in 21 mg, 14 mg, and 7 mg patches
  • Starting dose is determined by number of cigarettes smoked per day
    • Over 10 cigarettes per day: Start with 21 mg patch daily for six weeks, then 14 mg patch daily for two weeks, then 7 mg patch daily for two weeks
    • At or under 10 cigarettes per day: 14 mg patch daily for six weeks, then 7 mg patch daily for two weeks

• Possible adverse effects
  • Abnormal or vivid dreams (can be alleviated by removing patch a few hours prior to sleep)
  • Skin rash at site of application
• When removing, ensure to fold the patch inward. Wash hands before and after applying patches.
• Nicotine gum or lozenges
  • Come in 4 mg or 2 mg gum and lozenges
  • Starting dose is based on when you have the first cigarette of the day
    • If first cigarette is within 30 minutes of waking: Use 4 mg
    • If first cigarette is after 30 minutes of waking: Use 2 mg
  • Dose incrementally by week
    • Week 1 to 6: Use one lozenge or gum piece every one to two hours as needed for cravings (max 20 pieces per day, max of 5 pieces in 6 hours)
    • Week 7 to 9:  Use one lozenge or gum piece every two to four hours as needed for cravings (max 20 pieces per day, max of 5 pieces in 6 hours)
    • Week  10 to 12:  Use one lozenge or gum piece every six to eight hours as needed for cravings (max 20 pieces per day, max of 5 pieces in 6 hours)
  • Possible adverse effects:
    • Irritation of the mouth or throat
    • Jaw ache
    • Dry mouth
    • Hiccups
    • Heartburn
  • Can be used concurrently with patches for breakthrough cravings.
  • Use proper technique with gum which includes biting down until flavorful, then resting between cheek and gum until flavor fades, before repeating until flavor is gone.
  • For the lozenge, do not use if allergic to soybeans.

In addition to NRT, other smoking cessation options are available and require consulting with your primary care physician. These options can include referral for counseling services and prescription medications.

Now is the best time to quit smoking and some of the best smoking cessation aids are available immediately without a prescription at your local pharmacy.

References: 

1. A clinical practice guideline for treating tobacco use and dependence: 2008 update. (2008). American Journal of Preventive Medicine, 35(2), 158–176. https://doi.org/10.1016/j.amepre.2008.04.009
2. U.S. Department of Health and Human Services. The Health Consequences of Smoking: What It Means to You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2022 January 7].
3. Lexi-Drugs: Nicotine. Wolters Kluwer. Updated 12/29/2021. https://online.lexi.com. Accessed January 7, 2022.

 

The war on tobacco started in 1964 with the Surgeon General landmark report titled, Nicotine Effects on Smoking and Health.

Following the report, anti-tobacco campaigns on quitting strategies and legislation helped decrease the use and reduce the appeal of tobacco products. One would say that the war on tobacco was successful. However, in the past few years the use of tobacco has increased. This increase has contributed to the use of electronic nicotine delivery system (ENDS).

ENDS is an e-cigarette, also known as vape pen, e-cigars, vaping devices, mod systems, or pod systems. ENDS products contain a flavor solution that also often contain nicotine to produce an aerosolized mixture. These devices are very appealing and popular among youth and young adults.

Are e-cigarettes safe?

The safety of e-cigarettes is unknown at this point. There are currently multiple studies being conducted to answer this question.

So far, this is what we know about vape products.

First, ENDS do not contain many of the carcinogens found in conventional tobacco products. However, they do contain many chemicals that appear to be equally or even more damaging. These chemicals include volatile organic compounds (VOCs) which can lead to eye, nose, throat irritation, headaches, as well as nausea. There have been a few reports that believe e-cigarettes cause damage to the liver, kidney, and nervous system. Some reports show that e-cigarettes produce formaldehyde, which is a cancer causing substance. There is even evidence that shows flavoring chemicals are linked to serious lung disease.

What long term complications are associated with e-cigarettes?

E-cigarettes were first approved in the United States in 2008. In 2016, the Center for Tobacco Products was given authority to regulate e-cigarettes as tobacco products. Based on this short timeline, the product has not been on the market long enough to observe the long term effects associated with e-cigarettes. Some recent reports have shown e-cigarettes to cause serious lung disease in some people.

Do e-cigarettes deliver a consistent nicotine concentration? 

No, recent findings show that e-cigarettes can deliver high concentrations of nicotine. E-cigarettes which provide inconsistent levels of nicotine delivery pose health concerns for the user. Increasingly, there have been reports of nicotine overdose in users.

Can vape help with quitting tobacco attempts?

A major statement that is used to market e-cigarettes is the thought that they will help smokers quit. There are studies that showed e-cigarettes decrease nicotine consumption while other studies showed little to no evidence to support they assisted with helping individuals quit.

When reviewing the studies on this statement, many studies were flawed because of two factors.

First, the studies enrolled patients who had no intention of quitting.

Second, the e-cigarettes could not be counted on to provide consistent levels of nicotine.

These two factors, therefore, show that there have not been any appropriate studies performed that prove e-cigarettes help with smoking cessation. The U.S. Preventive Services Task Force concludes that the current evidence is insufficient to recommend ENDS for smoking cessation.

My interpretation of the data is that ENDS could potentially, in the future, be used as a device to help smokers quit who are highly motivated to quit.

Worku., D. & Worku, E. report that, in motivated smokers with clinician support, e-cigarettes can provide superior outcomes than traditional nicotine replacement therapy (NRT), but these results need further confirmation.

Currently, I would still recommend smokers use conventional resources (NRT) when it comes to helping them quit.

Smoking Cessation

Clinically, behavior therapy, as well as NRT, is recommended to help an individual stop smoking.

An individual looking to quit smoking should seek out a motivational or coaching program dedicated to helping individuals quit. If one can not be found, regularly scheduled therapy visits can suffice as a replacement. Be wary of programs that charge high fees. Smoking Cessation services are usually free or low cost.

The next step would be to talk to your doctor about prescription or over-the-counter nicotine replacement therapy. NRT products range from patches, to gums, to inhalers.

Both therapies should be used together to help increase your chance of successfully quitting.

Smoking Cessation Resources:

CDC Free quit help:

1-800-QUIT-NOW or 1-800-787-8669

CDC How to Quit Smoking Campaign – offers quit plans, tips from former smokers, and quitSTART app

https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/index.html

Smokefree.gov’s Make Your Quit Plan

https://smokefree.gov/build-your-quit-plan

American Cancer Society’s Great American Smokeout

https://www.cancer.org/healthy/stay-away-from-tobacco/great-american-smokeout.html

NiAnon by Recovery.org

https://www.recovery.org/support-groups/smokers-anonymous

QuitLogix – Offers coaching and an online support community.

https://helpline.quitlogix.org/en-US/Just-Looking

NSW Cancer institute and Quitline Team

Quit Kit and a diary to help you quit smoking

https://www.icanquit.com.au/media/QuitKit/QuitKit.pdf

References:

Nicole van Hoey. Nicotine addiction and the evolution of tobacco products: How can pharmacists counter new trends? America’s Pharmacist. Published April 2, 2020 Accessed August 11, 2020

E-Cigarettes. American Academy of Pediatrics. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Richmond-Center/Pages/Electronic-Nicotine-Delivery-Systems.aspx. Published … Accessed August 11, 2020

The American Cancer Society Medical and Editorial Team. What Do We Know About E-cigarettes? American Cancer Society. https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html.Published November 19, 2019 Accessed August 11, 2020

Jenssen BP, Wilson KM. What is new in electronic-cigarettes research?. Curr Opin Pediatr. 2019;31(2):262-266. doi:10.1097/MOP.0000000000000741

Bhalerao, A., Sivandzade, F., Archie, S.R. et al. Public Health Policies on E-Cigarettes. Curr Cardiol Rep 21, 111(2019). https://doi-org.proxy.lib.ohio-state.edu/10.1007/s11886-019-1204-y 

Farsalinos K. Electronic cigarettes: an aid in smoking cessation, or a new health hazard?. Ther Adv Respir Dis. 2018;12:1753465817744960. doi:10.1177/1753465817744960

Worku, D., & Worku, E. (2019). A narrative review evaluating the safety and efficacy of e-cigarettes as a newly marketed smoking cessation tool. SAGE Open Medicine. https://doi.org/10.1177/2050312119871405

Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions. U.S. Preventive Services Task Force Published June 02, 2020  Accessed. August 14, 2020

 

Picture References: 

E-Cigarette Dangers – 5 facts you need to know. Columbia Doctors Nurse Practitioner Group.https://www.columbianps.org/healthy-life-blog/e-cigarette-dangers-5-facts-you-need-to-know/. Published September 24, 2019 Accessed September 12, 2020 

https://www.columbianps.org/healthy-life-blog/e-cigarette-dangers-5-facts-you-need-to-know/

Components of the e cigarettes components:

Rom, O, Pecorelli, A, Giuseppe, Vet al. Are E-cigarettes a safe and good alternative to cigarette smoking. Ann N Y Acad Sci 2015; 1340: 65–74.

 

We all know that smoking is bad for a person’s health. We also know that smoking can be an incredibly difficult habit to kick. For this reason, I have decided to write about quitting smoking.

There are over 392,000 people a year who die from tobacco-caused diseases. Another 50,000 people die every year from secondhand smoke.

There are many advantages to quit smoking. These benefits include reduction in the risk of cancer and heart disease. Smoking cessation also helps people with high blood pressure and those with respiratory problems such as COPD or asthma.

There are many different ways that people quit smoking and there are a lot of valuable resources available to help a person quit. There are several websites which give advice to help quit smoking. There are also hotlines people can call to help them quit. Additionally, healthcare professionals, like pharmacists and doctors, can provide guidance to make quitting easier.

It is often recommended that people make a plan for quitting before they try to quit. The best method is to plan ahead and pick a date when the person wants to stop smoking. The smoker should also let those close to them know that they are going to stop smoking so that they have a support system around them to help them quit.

Additionally, it is recommended that smokers think about what type of things make them feel like they need to smoke. When they decide to quit smoking, they need to try to avoid these triggers. Many people also say that it is helpful to come up with ways to cope with any cravings or withdrawal symptoms when they stop smoking.

A couple of treatment options that people use to help them stop smoking are nicotine replacement therapy and prescription medications.

The idea behind nicotine replacement therapy is using smaller amounts of nicotine than are in normal cigarettes (or whatever form of nicotine a person uses) to help a person avoid withdrawals when trying to stop smoking. The amount of nicotine that a person uses from nicotine replacement therapy reduces over time until it reaches a point where they no longer need nicotine and do not have any withdrawal symptoms. Nicotine replacement therapy can include patches, gum, lozenges, and inhalers. The amount of nicotine that a person is used to using determines the level a person will start at with nicotine replacement therapy. A physician, pharmacist, or other healthcare provider can help a person get started with nicotine replacement therapy.

There are also prescription only medications that doctors will prescribe people to help them quit smoking. The two most common medications doctors prescribe are Chantix and bupropion. This is an option that can be discussed with a doctor.

Stop by the pharmacy and let us know if there is anything we can do to help you quit smoking. Ask us any questions you may have about stopping.

http://smokefree.gov/quit-plan

http://www.cancer.org/%20healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-benefits

http://www.lung.org/stop-smoking/about-smoking/health-effects/