I typically discuss weight loss and related issues, however there are other factors that play strong roles in our overall health and longevity. Certainly the disease of excess body fat will shorten our lives and contribute to other debilitating disorders such as Diabetes, Hypertension, Dyslipidemia, Arthritis, Cancer, Immune system disorders, and multiple Digestive Tract Disorders and diseases.
Equally, if not more deadly, is tobacco smoking and use. I have had many patients who have worked hard to achieve an ideal body weight and developed a good exercise program, but will never be healthy. How's that? They still smoke. It is impossible to become healthy and smoke. The data is strong regarding this. In fact, 1 in every 5 deaths is related to smoking.
As of this past year, it's estimated that about 15% of Americans smoke. Certainly, this is a dramatic reduction from the 50% plus that smoked in the 1960's. Only 8% of individuals over 65 are current smokers, but this is skewed as by this age many have not survived or have become disease burdened and smoking is no longer an option for them.
Nicotine addiction is a powerful addiction and one of the most difficult to break. We are not born with nicotine receptors, but our brain cells develop them rapidly with intake of nicotine. Once created, these brain receptors are permanent. They can become dormant, but will immediately re-fire upon contact with nicotine. This is why I tell my quitters, that a pack is just a puff away.
Most smokers want to quit. Every year about half of all smokers attempt to quit but only about 6% are successful. This is a testament to the strong addictive power of nicotine. The addiction occurs because nicotine actually causes physical changes to the brain. Nicotine stimulates Dopamine receptors in the brain cells. When nicotine attaches, dopamine is released. Dopamine is a pleasure substance, so nicotine gives a strong pleasurable feeling when consumed. Human studies have shown that nicotine habituation can occur in a new smoker within 15 minutes of nicotine exposure.
Besides physical dependency, nicotine habituation also is strengthened through psychological connections or triggers. Certain behaviors trigger smoking such as being on the phone, driving, drinking coffee, work breaks, and social situations.
I've decided to not focus on all the negative health effects of smoking and nicotine, but rather discuss the cessation of nicotine use. It would be a rare person who is not familiar with the harmful effects of smoking and tobacco use.
Also, focusing on this as the disease process of addiction, which it is, rather than beating people down for this issue, we can work toward providing proper treatment to eliminate the physical dependency of nicotine.
For many years, I ran a smoking cessation clinic. We utilized many methods to reduce nicotine addiction. We even used a method of injecting FDA approved drugs in a non-approved way to break the withdrawal symptoms upon cessation of smoking. This method had a nearly 90% success rate, but when the medications were no longer manufactured, our program stopped. I've used many other techniques to work with patients to eliminate tobacco use and in a motivated patient, success rates reach about 40%.
I use nicotine reduction with patches, lozenges, and vape, though vape reduction has been difficult for most patients. This is likely due to the psychological triggers of physically inhaling vape just like cigarettes. I have used Clonidine therapy, bupropion therapy along with slow nicotine withdrawal. I've had good success with Chantix therapy. Because these therapies themselves have some significant nuisance side-effects, it requires a very motivated patient to work through a treatment course.
Just as in weight reduction, smoking cessation can be a lifelong project. Even when stopped, returning to smoking, just like a returning to poor eating and reduced exercise, can reverse the remission. I remind all of my smoking patients who want to quit, that a failed single attempt or even many attempts does not mean it isn't possible to achieve success. Internal motivation is a key component of beating either of these diseases.
We know this because all doctors, including myself, have seen instant smoking cessation occur upon the diagnosis of a heart attack or lung cancer. I have had these patients throw their pack of cigarettes in the trash and never smoke again immediately when diagnosed. That is powerful motivation, but unfortunately, a bit late for many of them.
Nagging and prodding people to stop smoking is as detrimental as nagging people to exercise or eat healthier. This is an internal decision that must be made. Many men have come to me to quit smoking because their wife is "on their case" to stop. Most of them are destined to fail as they are not ready themselves. We can't make a patient change behavior, we can only help them when ready.
The two things we can do that will prevent the most downstream disease is weight reduction and smoking cessation. If you are working on weight reduction and a smoker, don't attempt treating both at the same time. I have found, however, that when someone accomplishes one of these, the other often becomes a bit easier as they have developed new self-confidence in their own personal power.
Whether you've decided to lose weight or quit smoking or both, an important factor is to never give up. No one is a failure. We only have failed events. We can learn from our failed events. Not reaching a goal one time or a dozen times does not mean it is not possible. Long term, our improved health and a long active life is what we are after here. If you want to accomplish either of these health improving goals, reach out to a caring professional who will empathize with this disorder and work diligently to assist you to overcome it.
The good news for both weight loss and smoking cessation is that benefits begin to accrue in our body within the first few hours of our lifestyle adjustment.
Think about it and choose a date to start on your journey to better health and vitality.