Sunday, November 29, 2015         


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Nicotine's strong pull makes quitting smoking difficult



After years of research, the message is clear: Smoking kills. Tobacco use is responsible for 1 in every 5 deaths in the United States. It kills more people than alcohol, AIDS, car crashes, drug abuse, murders and suicides combined. Smoking harms nearly every organ in the body, causing many diseases and complications, and reducing quality of life and life expectancy. Men who smoke lose, on average, 13.2 years of life, and female smokers lose 14.5 years.

If these statistics aren't alarming enough, consider the side effects on a more personal level.

Smoking injects about 5,000 substances into your body, of which about 4,000 are poisonous or toxic. Your lungs distribute these toxins to your blood very efficiently, within a minute in most cases. That's why tobacco is implicated in so many different diseases. Cigarette smoking is a known cause of heart disease, many types of cancer, stroke and chronic respiratory disease.

Despite these statistics and all we know about tobacco use, giving up smoking is tough. In Hawaii there are about 170,000 adult tobacco smokers, most of whom are acutely aware of the risks and damage caused by smoking. Their inability to quit in the face of overwhelming and compelling medical evidence speaks to the strength of the addiction, whether they are new or lifelong smokers.

Addiction to nicotine depends on the speed of distribution throughout the body, and smoking is one of the fastest ways. It is akin to a drug addict "shooting up." And make no mistake, smoking is not just a bad habit, it is an addiction.

This makes it tough, but not impossible, to quit. Professional counseling and the understanding support of friends and family are critical to kicking cigarettes. In many instances, successfully breaking the addiction might require the use of both medication and counseling.

At Kaiser Permanente we have found that the combination works better than either option alone. All prescription medications on the market work about the same, though some preliminary evidence might support Varenicline (Chantix) as more effective. However, the drug is a fairly new one, is expensive and might have some behavioral side effects in some patients. Over-the-counter medications like nicotine patches and gum are also effective, don't require a prescription and are less expensive than prescription medication.

At Kaiser Permanente we believe that an ounce of prevention is worth a pound of cure, and have eliminated co-payments for smoking cessation counseling and will be eliminating co-pays for smoking-related medications next year for almost all plans as they are renewed.

We encourage you to talk to your doctor about how smoking could be affecting your immediate and long-term health, and learn more about professional counseling, online quit programs and other smoking cessation resources, like the Hawaii Tobacco Quit Line.

The annual Great American Smokeout coming up on Nov. 17 is a great time to start mapping your next steps to ending nicotine addiction. Let this opportunity be a reminder to clear the air, clear your lungs and clear your conscience by beginning the healthier and higher-quality life you deserve.

Dr. Nicolas A. Nelken is a vascular surgeon with Kaiser Permanente Hawaii and physician champion of its smoking cessation program

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