John R. Bennett, MD
1255 East 3900 South #301, Millcreek, Utah 84124
756 East 12200 South, Draper, Utah 84020
22 South 900 East, Salt Lake City, Utah 84102
Quitting Smoking, Tobacco and Nicotine
Congratulations on considering quitting smoking (or chewing or vaping)! Giving up nicotine will be one of the best things you ever do for yourself. Quitting is very hard. The average person tries to quit eight times before they succeed. Never quit trying to quit. Know that some day soon you will be a nonsmoker (nonchewer, nonvaper). Go ahead and get mad at the tobacco and the tobacco companies! Tobacco is robbing you of your health, your money, your youth, your good looks, and ultimately, your life. Think of tobacco as a dear friend, a friend you love being with, but a dear friend that is trying to kill you. It is time to say goodbye to tobacco.
The most important factor in quitting tobacco is deciding to quit. Get mad, and get motivated. Don’t let yourself grow much older before you quit. Stay young and healthy and good-looking as long as you can, and quitting nicotine and tobacco is the best way to do that. If your partner uses nicotine, talk to them about quitting with you. It is far easier to quit with someone else, and it is far harder to quit if your partner keeps using nicotine.
It is easier to quit if you aren’t consuming as much nicotine, so start by cutting back on how much you smoke, chew, or vape. When you have cut way back and are ready to quit, pick a quit date, and tell everybody. Make it a public event so you have lots of support. When you are heading out for an evening with friends, remind them that you are now a nonsmoker, and if they are nice friends, they will support you! As you are quitting, you will often not be in a very good mood for a month or so, so tell everybody to be understanding! It is common to get in a disagreement at home or at work when you are trying to quit, and you will want to go have a smoke. Don’t fall for that – that is just the nicotine addiction taking advantage of a weak moment! Think about when you like to smoke or chew, and try to replace the smoking with something else. If you smoke in the car, have candy or gum to distract you. If you smoke in the morning, have a piece of toast in your hand instead. You can still enjoy a drink with friends in the evening, but remind them to help you to not smoke with that drink!
There are many aids to assist you giving up nicotine, and you may want to try these, especially if you have already failed to quit several times. Check out SmokefreeTXT, QuitGuide app, 1-800-QUIT-NOW (1-800-784-8669), or 1-877-44U-QUIT (1-877-448-7848). Stay busy when you are quitting to distract you from your cravings- exercise, take a walk, chew gum or hard candy, keep your hands busy, drink lots of water, relax with deep breathing, go to a movie, spend time with nonsmoking friends, and go to a restaurant. Avoid smoking triggers- throw away your cigarettes, lighters, and ash trays, avoid caffeine (which can make you jittery), get plenty of rest and eat healthy, change your routine. Stay positive and reward your successes. Get help. Various devices are available to you. Nicotine patches have a 14% success rate of smoking cessation at 6 months. Zyban pills have a 30% smoking cessation at 6 months. Adding nicotine patches to Zyban increases smoking cessation to 35% at 6 months. Chantix pills have a success rate of 70% at 3 months, and 44% at 12 months. Some people like to use e-cigs to help them stop smoking, but be careful, as many people then just continue smoking and add vaping, and can actually increase their nicotine intake. E-cigs are probably less dangerous than smoking as you aren’t getting the tar and many other dangerous chemicals, but you are getting ten times the amounts of formaldehyde and acetaldehyde, both of which cause cancer. Although e-cigs aren’t as dangerous as smoking, they are still very bad for you. Other more helpful devices to help you quit smoking are gum, lozenges, and inhalers that don’t heat or vaporize the nicotine.
Nicotine exposure is very harmful to healing after surgery. Nicotine causes small blood vessels to spasm, and these are the small blood vessels that ‘knit’ wounded tissue back together after surgery. People who smoke, vape, chew, or take nicotine after surgery have much higher complication rates such as infection, wounds re-opening, and deep ugly scars. Do not use nicotine for three weeks before and three weeks after surgery, especially surgery on thin delicate tissue, such as nasal and facial surgery. If you find you are unable to stop using nicotine before your surgery, please cancel the surgery and reschedule for a later date when you can quit using nicotine, particularly elective surgery such as septoplasty and rhinoplasty.
Dangers of Smoking
Cigarette smoking causes 480,000 deaths in the USA every year. This is nearly 1 in 5 deaths.
People that continue smoking have a 50% chance of dying of their tobacco.
Smoking causes more deaths each year than the following causes combined: illegal drug use, alcohol, motor vehicle accidents, HIV, and firearm-related incidents.
More than ten times as many Americans have died of smoking than have died in all of the wars fought by the United States.
Smoking causes 2-4 times the risk of heart attack, and 2-4 times the risk of stroke.
Smokers die 10-14 years earlier than nonsmokers.
Smoking causes 1/3 of all cancers, and causes over 90% of lung cancers.
More women die from lung cancer each year than die from breast cancer.
One in 14 women smoke during pregnancy. Smoking during pregnancy causes premature birth, triples the risk of sudden infant death syndrome (SIDS), and causes asthma and heart defects in children.
Smoking causes 80% of all deaths from COPD (emphysema).
One out of seven smokers will get lung cancer, and smoking increases your risk of getting lung cancer 25 times.
People who smoke fewer than 5 cigarettes a day still have increased heart disease and stroke.
Smoking can cause the following cancers: bladder, blood, cervix, colon and rectum, esophagus, kidney and ureter, larynx, liver, mouth and throat, pancreas, stomach, as well as trachea, bronchus, and lung.
There is no risk-free level of secondhand smoke. Secondhand smoke contains more than 7,000 chemicals, hundreds of which are toxic, and at least 70 of these chemicals cause cancer.
Since the 1964 Surgeon General’s Report alerting people to the dangers of smoking, 2.5 million adult nonsmokers have died of secondhand smoke.
In infants and children, secondhand smoke causes more frequent and severe asthma attacks, respiratory infections, ear infections, and Sudden Infant Death Syndrome (SIDS).
Secondhand smoke in adults causes coronary heart disease, stroke, and lung cancer.
Smoking during pregnancy results in more than 1,000 infant deaths annually.
Secondhand smoke causes nearly 34,000 premature deaths from heart disease each year in the US among nonsmokers.
Secondhand smoke causes 7,300 lung cancer deaths in nonsmokers each year in the US.
Secondhand smoke causes 8,000 deaths from stroke every year.
Secondhand smoke increases the risk of heart disease in nonsmokers 25-30%.
Secondhand smoke increases the risk of stroke in nonsmokers 20-30%.
Even brief exposure to secondhand smoke can damage the lining of blood vessels and cause platelets to stick, potentially causing a heart attack in susceptible individuals with heart disease.
Please do not allow anyone to ever smoke in your house or car, even if children and nonsmoking adults are not there at the time, because the dangerous chemicals linger.
What’s the good news?
Quitting smoking sharply drops your risk of heart attack within one year of quitting.
Your risk of stroke after quitting drops to the same risk of a nonsmoker in just 2-5 years.
Your risk of cancers of the mouth, throat, esophagus, and bladder drop by half within 5 years of quitting.
Ten years after quitting, your risk of lung cancer drops by half.
It is never too late to quit: 80 year-olds who quit smoking outlive other 80 year-olds who don’t quit smoking by 2-3 years.
Dangers of Chewing Tobacco
Smokeless tobacco has at least thirty chemicals that cause cancer.
Chewing tobacco causes cancers of the mouth, esophagus, and pancreas.
Chewing tobacco causes heart disease and stroke.
Chewing tobacco causes gum disease, tooth decay, and tooth loss.
Chewing tobacco absorbs more nicotine than cigarettes, potentially making it more addictive.
Those who chew tobacco (especially young people) are more likely to start smoking.
Pregnant women who chew tobacco have higher incidences of early birth and stillbirth; nicotine affects how the baby’s brain grows. Nicotine harms brain development if used below the age of 20.
Chewing tobacco can cause nicotine poisoning in children.
Dangers of Vaping
Vaping has up to ten times the levels of formaldehyde and acetaldehyde than smoking; both of these chemicals cause cancer. These are present even if the vaping has no nicotine.
Vaping with nicotine causes heart disease, strokes, birth defects, and poisoning.
Vaping reduces heart and lung function, and increases inflammation.
Vaping causes hypotension, seizure, chest pain, rapid heartbeat, disorientation, and congestive heart failure.
Vaping causes abdominal pain, headache, blurred vision, throat and mouth irritation, nausea, vomiting, and coughing.
Vaping with nicotine below the age of 20 harms brain development.
Vaping is a gateway to smoking in young people and other nonsmokers.
Vaping has a poor track record of helping people quit smoking, and often leads to both smoking and vaping, ultimately increasing your nicotine intake.
Vaping often leads to putting off actually quitting smoking.
There is dramatic variability in e-cigarettes and their liquid ingredients, and the aerosol you inhale. You really don’t know how much nicotine, chemicals, and heavy metals you are getting.
Dangers of Marijuana
Marijuana has 33 carcinogens (and counting), and deposits 4 times as much tar as tobacco, as people inhale much more deeply and hold it longer.
In high doses, marijuana causes hallucinations, delusions, and psychosis.
Marijuana causes respiratory problems and heart attacks.
Marijuana affects brain development in young people. Marijuana impairs thinking, memory, learning functions, general knowledge, and verbal ability. Teens who smoke marijuana into adulthood lose an average of 8 IQ points. Teens who use marijuana have worse school performance, and ultimately have lower income, increased use of welfare, higher unemployment, higher rates of criminal behavior, and decreased satisfaction with life.
Marijuana increases anxiety, depression, and psychotic illness. It can cause temporary hallucinations and paranoia, and worsens symptoms in people with schizophrenia, as well as increasing the risk of developing schizophrenia. Marijuana has been linked to suicidal thoughts.
Marijuana causes dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, intense nausea and vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucinations.
In the short term, marijuana alters the senses, alters sense of time, changes mood, impairs body movement, impairs thinking and problem solving, and impairs memory.
Marijuana use in pregnancy causes lower birth weights, and increased risk of childhood brain and behavioral problems. Children who have been exposed to marijuana have problems with attention, memory, and problem-solving.
The amount of THC in marijuana has been rising steadily over the last several decades. People trying marijuana for the first time have much higher risks of toxicity, causing rapidly rising numbers of visits to the ER. Edible marijuana has much slower onset of symptoms, so people tend to eat a lot more of it to get high before they realize how much they have consumed, with dangerous results. Higher levels of THC also cause higher levels of addiction.
Marijuana is addictive in 9 to 30% of people who use it. Teens who use marijuana, however, are 4-7 times more likely to develop addiction to it.
Marijuana has only moderate evidence of being helpful with chronic pain and spasticity. There is low evidence that marijuana helps nausea, vomiting, weight gain in HIV, sleep disorders, hepatitis C, Crohn’s disease, Parkinson’s, and Tourettes. It has been found to be helpful for Dravet’s syndrome, a rare form of childhood epilepsy. It is not helpful for sickle cell disease, PTSD, psoriasis, and ALS. Multiple studies have found no reduction in opioid use in chronic pain sufferers when they also used marijuana, but a single recent study has shown reduced opioid usage. Other studies have shown increased opioid usage when also using marijuana.