New beginnings

Feature

Feature

Your health may be your wealth but both are set to significantly improve if you can manage to give up smoking
There are more than 7,000 smokingrelated deaths in Ireland every year, chiefly due to illnesses such as lung cancer, heart disease, stroke and emphysema, while thousands more are living with tobaccorelated illness. results of a study into smoking prevalence among nurses in Cork University hospital published earlier this year found that 21% of respondents were smokers and 23% ex-smokers, confirming that rates among nurses mirror those of the general population.1 With approximately 45% of these smokers being under the age of 30, smoking is something of an issue in a profession that really does know better. Nurses and midwives are in a position to encourage and suppor t patients who may be open to quitting but the research from Cork has shown that those who smoke are less likely to make such an intervention so the fewer smokers there are in the health profession the better it is for everybody. It is estimated that about two in three smokers would like to quit but without help many will not succeed. So, now that the pressure of January and the New Year has passed, it is as good a time as any for smokers to kick the habit. Not only will it benefit health but also the wallet, which is becoming an increasingly prominent consideration in the current economic circumstances. Giving up smoking is a challenge and willpower is required but there is a range of products on the market designed to help the quitting process. While no product alone can make you quit many of those available to assist smoking cessation really can boost the chance of success. Your doctor can help The first step is to make an appointment with your GP who will help you chose the appropriate strategy for giving up. They can also offer support and advice along the way to help you deal with the inevitable challenges to be faced along the way. Developing and maintaining your willpower, whether in conjunction with medication or not, remains the most important element of kicking the habit for good. Many people may make a snap decision to quit at New Year and find they are back smoking within days or weeks. In truth, all the experts stress that you really have to think about giving up smoking as more of a new life resolution. If you smoke, then you know the damage that it is doing to you. The health risks are well publicised but in case you need to be reminded, here are a few reasons to kick the habit: Smokers will lose on average between 10 to 15 years of their potential life span Smoking is a principal cause of both lung cancer and heart disease, two of Irelands biggest killers Smoking causes ulcers, which bleed in your stomach and can make eating painful, as well as being potentially lifethreatening, it also causes bronchitis, COPD Smoking can lead to vascular disease and ultimately to limb amputation If you smoke while pregnant, you are more likely to miscarry, or have a stillborn baby Smoking is expensive. If you smoke 20 cigarettes a day and multiply the cost of a

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pack by 365, youll save around 3,000 at current prices over the next year alone. Smoking affects the health of those around you. Everyone you live with is one-third more likely to contract lung cancer or heart disease Your taste buds dont work as well Your sense of smell is reduced. In one way, that might be for the best, because you probably wouldnt want to smell the stink emanating from your breath, clothes and hair There are more than 4,000 chemicals in tobacco, many of them deliberately added by tobacco companies. At least 43 of them are known to cause cancer in humans. The rest arent particularly good for you either. The list of reasons to quit is virtually endless. There is no single thing that you can possibly do that will have such profound health benefits as giving up smoking. Just flick through any medical book and youll find that right at the top of every medics wish list is for patients to stop smoking. This single step alone would do more to improve the health of the nation than anything else. It would also free up thousands of hospital beds, shorten waiting lists, and save the Irish taxpayer the one billion euro the Department of Health spends on treating smokers every year. According to lobby group Action on Smoking and Health (ASH) there are four stages in quitting. These are: Thinking about the reasons for stopping Preparing to stop Stopping Working on staying stopped. Stage one can take anything from a few days to a few years. Stages two and three can be over hours or may take weeks. Stage four is vital it may take some months before you can be confident that you will never want another cigarette. ASH believes that the big question in giving up smoking is whether you really want to stop. If you make up your mind that you are going to stop, then you will. Many people have been surprised how easy it was to stop once they had really made up their mind. Initially, it can be helpful to use nicotine replacement therapy (NRT) products like nicotine gum and

patches or products that work in the brain by interfering with the receptors that nicotine stimulates. These help to reduce the cravings that quitters experience initially. In the longer term, vigilance is important, as a single cigarette can be enough to kickstart the habit all over again. Challenge When you think of all the reasons not to smoke, it seems bizarre why anyone would continue with such a habit. Only one reason, perhaps, could possibly override all the good reasons to quit, and that is addiction. Nicotine is one of the most addictive substances a human can take into their system. Nicotine works by stimulating the central nervous system, increasing the bodys heart rate, blood pressure and metabolism. When you inhale cigarette smoke you will experience the effects of nicotine in less than eight seconds. When inhaled, it also briefly releases the body from craving, while reinforcing the need to smoke. Each cigarette smoked reinforces the craving for the next one. Its a vicious circle, but it can be broken.

Nicotine is known to alter moods, especially when you try to give up. Nicotine withdrawal can cause everything from restlessness and irritability to anger, anxiety and depression. People giving up find that they cough more mucus and phlegm than they ever did before. This is the body trying to clear the lungs of the tarry deposits left there by cigarettes. Set a date When youve made your decision to quit, set a date for stopping and prepare to quit. Think about where and when you usually have a cigarette. These are the times that you are likely to have cravings after you stop smoking. You may have to change your routine, and find things to do with your hands. The important thing is to break the habit not just the smoking habit, but any habits that lead you to smoke. Decide how you will cope being around other smokers. Know how to refuse if you are offered a cigarette. Dont be tempted to take even one drag of a cigarette as the nicotine will stimulate the old craving. Remember that everyone will help. Your GP can give you advice on how to alter your habitual behaviour, and can encourage you by monitoring the improvement in your health as you stay off cigarettes. Your pharmacist can also offer advice on which NRT would suit you best. If you ask, your family and friends will help you maintain your willpower. There are even some apps for the iPhone to support you on the journey to becoming a non-smoker! Take it one day at a time. Every day you do not smoke improves your health, just as every cigarette damages it. While you may fail at the initial attempt and find yourself smoking again, most smokers who quit have to try more than once before they are successful, so do not be downhearted. Give it another go. It is never too late to stop smoking, and there are always benefits to be gained by quitting. Your risk of contracting heart disease starts falling immediately, and after a few years of not smoking your chances of getting lung cancer will have fallen to the levels of a person who never smoked. For more information contact the HSEs National Smokers Quitline at Tel: 1850 201 203. Alison Moore
1. ODonovan G. Int Nurs Rev. 2009 Jun;56(2):230-6

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