Smoking Cessation: Hang Tough, Don’t Puff!

Stoptober 2019 has now come to an end – and I believe this is a good time to reflect upon the tobacco epidemic, going over the effects of smoking, the reversal of smoking-related illnesses on smoking cessation, and looking into the success of the public health initiative, Stoptober.

An image with hundreds of cigarette butts

Did you know that tobacco kills up to half of all it’s users? This is by definition the tobacco epidemic. Tobacco is one of the biggest public health threats around the world, killing more than 8 million people each year. More than 7 million people die as a result of direct tobacco use and the remaining are the result of exposure to second-hand cigarette smoke. Smoking is the biggest cause of preventable deaths [1]. According to the Centre for Disease Control and Prevention, more than 10 times as many U.S. citizens have died prematurely from smoking than have in all the wars fought by the United States [2].

To put the problem into perspective further, cigarettes would never receive government regulatory approval if they were introduced to the consumer as a new product today. This is because they have proven toxicities that lead to lung cancer, heart disease, chronic obstructive pulmonary disease and many many many other health conditions.

How does smoking affect your health?

We all know that smoking can cause lung diseases including cough, asthma, chronic obstructive pulmonary disease, bronchitis, emphysema etc. These are caused by damage to the airways in the lungs. They result in difficulties in breathing, a persistent cough, breathlessness, etc.

We also know that smoking causes cancer. This could be cancer in the mouth, oesophagus, stomach, pancreas, lungs, etc. Quite honestly, the list is extensive.

Smoking can also affect your blood, increase your blood pressure, and chances of getting a stroke. Cigarette smoke contains carbon monoxide which strains the heart making it pump blood faster. Smoking also reduces the amount of oxygen that gets to your skin – which makes your skin age quickly [3]. Amongst all this, it can also make your bones brittle. It can reduce fertility in men, affect your teeth and gums, cause type II diabetes [3], and the list really goes on.

So it comes with no surprise, that a lot of smokers want to quit smoking. Maybe at some point they didn’t have responsibilities, or their friends smoked, or they were going through a rough patch in life and decided to start smoking – everyone has their reasons for smoking. But as life goes on, that reasoning changes – and now every new year, they attempt to quit smoking.

Are There Any Benefits of Quitting?

In short, YES! There are many benefits of quitting. But what are these benefits?

Smoking causes a number of changes in the human body – at a cellular level, as well as changes at an organ level; this eventually manifests as long term changes towards disease manifestation [4].

Once the exposure to tobacco stops, the body begins to ‘detox’ from the chemicals and starts to reverse some of the acute effects of smoking, including slowing of disease progression as well as potentially reversing some damage at the cellular and organ level. It should be noted that depending on the body’s exposure to tobacco smoking, the body may never fully revert to its healthy form even with long durations of abstinence [4]. This is particularly if it has caused permanent structural changes in the lungs, for example.

Generally speaking, early quitters have a risk of premature death very similar to lifetime never-smokers. However, be warned that this is a generalised statement for all smoking-related illnesses. Let’s just quickly run through and summarise some changes following cessation, shall we?

Cancer
For the majority of cancers, including lung cancer, risk increases far more strongly with each additional year of smoking than it increases for a higher average number of cigarettes smoked per day. The idea is like that of playing with a knife – the risk of cutting your finger is the same regardless of if you play with one tiny paring knife, or if you play around with a butchers knife.

Major published studies show that smoking-related cancer risk is lower in former smokers compared to smokers that continue to smoke. However, former smokers are at an increased risk of cancer than never-smokers [4].

Coronary Heart Disease
Smoking increases your risk of thrombosis as well as atherosclerosis. These risks increase with the amount smoked and the duration of smoking. Former smokers have a considerably lower risk of heart disease compared to current smokers [4], but this is still higher than never-smokers.

Cerebrovascular Disease
Smoking is a cause for stroke. A stroke is a brief interruption in the blood supply to the brain, which can lead to paralysis. Again, the risk of stroke is highest for current smokers. Former smokers are at a lower risk of smoking-related stroke, but are still at a higher risk to never-smokers.

Some studies have shown that the risk of stroke for former smokers returns to that of a never smoker by five to ten years. But other studies reveal small increased risks in former smokers, compared to never smokers [4]. This is a contended issue amongst researchers.

Chronic Obstructive Pulmonary Disease
Evidence suggests that former smokers have a lower risk of accelerated loss of lung function and COPD-related morbidity than continuing smokers. Research shows that symptoms of chronic bronchitis including chronic cough, and wheeze decrease rapidly within a few months of smoking cessation [4].

Other Benefits
According to the NHS [5], quitting smoking also:

  • Gives you more energy
  • Reduces stress
  • Boosts your immune system to help it fight infections
  • Improves fertility
  • Improves taste and smell
  • Improves your skin and teeth

These are just some of the benefits of quitting – again, the list does go on.

To conclude, a couple years of non-smoking can change the entire dynamic of how your body works. It is highly recommended that people give up smoking as soon as possible so they can start to make a difference in their health and wellbeing, and add more years to their lives.

Public Health Initiatives to Encourage Quitting – Success of Stoptober

Briefly then, what is Stoptober? Stoptober is a Public Health England tobacco marketing programme first launched in 2012. It is a quit smoking calendar event that takes place in October every year. It aims to motivate smokers to make a quit attempt from 01 October and maintain it for at least 28 days. Their evidence shows that if you stop smoking for 28 days, you are 5 times more likely to stop for good.

Every year, the campaign collects and analyses their results. These are then evaluated, and improvements are suggested to ensure that more people can be helped with quit smoking advice.

Stoptober uses a number of interfaces, including telephone, radio, TV, etc in their marketing strategies. It also provides for 24-hour services for people who are attempting to quit – you can even get support via email or through their app. The approach that Stoptober uses also gives you a more personalised quit plan, so you are more likely to succeed on your journey to quit smoking.

If you would like to quit smoking, it is recommended that you use support on your journey, although most people continue to attempt quitting based on willpower alone. Data shows that you are more likely to be successful in your quit attempt if you use a stop smoking support.

There are a number of places that you can get stop smoking support – you can start by having a talk with your GP, or by using the NHS Smokefree helpline on 0300 123 1044, or trying Stoptober, or even just go ahead and Google ‘stop smoking support’ which will yield a plethora of results for you to choose from.

Just remember – you do not have to start this journey to quit smoking all on your own! Just ask for a little help, and you will be amazed what you can achieve in a team together with other people – strangers or not.

References:

[1] https://www.who.int/news-room/fact-sheets/detail/tobacco

[2]https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

[3] https://www.nhs.uk/smokefree/why-quit/smoking-health-problems

[4]https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

[5] https://www.nhs.uk/live-well/quit-smoking/

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