Tobacco

Perspectives for Better Neurological Care
: C. Robert Adams, M.D.; Board Certified Neurologist

Dealing with Tobacco

How to Deal with Tobacco:

Tobacco kills, whether it is cigarettes, cigars, pipes, or smokeless.

Even worse than that, the habit will make your life miserable.

Lung cancer would almost not exist if it was not for the effects of smoking over long periods of time. Early strokes and heart attacks occur in 20 and 30-year-old smokers. Smoking markedly accelerates atherosclerosis, particularly in the setting of other risk factors, including familial diathesis, hyperlipidemia, diabetes, and others.

Other unappreciated adverse effects of smoking are an insidious destruction of lung tissue. Chronic smoking brings about the progression of both bronchitis and emphysema. Some smokers that do not cough or wheeze are losing their lung tissue as it turns to nonfunctional “sponge.” Unfortunately, the destruction of lungs by smoking is not very “forgiving.” Lung tissue is gradually lost through the course of a smoker’s long-term habit. The lungs eventually give out and an individual has marked dyspnea upon exertion or even discomfort in just trying to get their breath at rest.

Smoking causes a slow destruction of lung tissue such that a person over a period of years will develop problems of fatigue, cough, breathlessness. Smoking exacerbates sinus congestion and inflammation or chronic sinusitis. It brings out problems of sleep apnea, accentuating snoring and impairing respiratory airway movement.

Smoking also causes marked peripheral vascular disease, shutting or clamping off the blood flow to the extremities, accentuating coldness and limiting blood flow to the arms, legs, and other organs. Smoking-related vascular disease can lead to amputation of fingers and feet. Raynaud’s phenomenon is caused by or markedly exacerbated by smoking.

Even the “smell” of smoke on clothes is deleterious to children and other adults with respiratory problems. It is a “crime” to expose children to passive smoke or “smoky” vehicles and rooms.

“Smokeless” tobacco also causes a host of problems. It is much more addicting than even cigarettes. Adverse personality change, depression, irritability, and anger outbursts are common in “chewers.” Mouth cancer from smokeless tobacco is far too common along with the more mundane problems of bad breath and gross spitting.

Tobacco stimulates “cocaine receptors” in the brain, although it has only very short-lived effects of stimulation as opposed to cocaine itself. No wonder it is so addicting.

Important considerations in coping or dealing with tobacco include:

It is just as important to cut down or taper down on a smoking or tobacco habit as it is to quit. Many individuals cannot quit or at least cannot quickly get away from a long-term, addicting habit. Therefore, tapering down and decreasing the amount of cigarettes and altering overall smoking habits is extremely helpful in getting started.
Never smoke inside, and that includes the house, the garage, and most importantly vehicles. Vehicular smoking is a “killer” habit.
Never smoke the entire cigarette. The mouth end of the cigarette is the most dangerous.
Always completely empty your lungs or completely exhale twice after smoking. Studies have been done with three pack-a-day smokers. They could get just as much tar or nicotine in their systems when they cut down to two packs as with three, merely holding the smoke more in their lungs.
It is always good to have a substitute in the mouth as with chewing gum, holding a toothpick, and sometimes more pleasantly with breath mints. In particular, Altoids can be helpful as they stimulate the mouth. The latter often helps with regards to appetite.
Any type of social support or encouragement by friends and relatives is important. On the other hand, individuals should always let their “smoking buddies” know that they are backing off, they are serious about dealing with their tobacco habit, and they want to get away from the adverse, long-term health effects.
Associated problems such as anxiety, depression, and pain sometime have to be dealt with by taking other medications or treatments. Smoking is a poor “crutch” in these circumstances. That is still no excuse for using smoking as a crutch, however, as there are other ways to deal with the above mentioned issues.
More specific drug treatment to help taper back on smoking can include a variety of different kinds of bupropion or Wellbutrin products, which actually replace the neurotransmitter effects of cigarettes in the brain and decrease the urge towards smoking. Bupropion can be taken indefinitely.
Chantix has also been useful as a short-term help in dealing with the smoking habit but does have occasional adverse psychiatric effects. However, neither of these medications (Chantix, bupropion) will work, unless the smoker deals with the ongoing habit and follows the above-mentioned recommendations.
Nicotine replacement as with patches or gum are not often helpful, simply replacing “poison with poison” or adding nicotine to an already troublesome nicotine habit.

In conclusion, your future with a tobacco habit is dismal, dreadful, and unhappy for you and those around you. It would be “stupid” to stand with your face over the smoke of a campfire. Similarly, it makes little sense to irritate mucus membranes of the nose, throat, voice box, and lungs with harmful, cancer-inducing gas and ash.

06/04/2009