I hate pharmacies. I hate them because the only time I go in one, is when either I or a member of my family is sick. Plus, there were pharmacies all over the city in which I have lived for the last 25 years. It seemed like a new Walgreens was popping up across the street from the new CVS, which popped up across the street from old Rite Aid. Do we really need that many pharmacies?
Well, new data gives us some very interesting information regarding pharmacies and their impact on smoking and smoking cessation in America. I just wrote a post about how pharmacists have numerous occasions to talk to their clients about smoking cessation. It can be a tangible and potentially opportunistic conversation to kick start a customers quit attempt. After all, they've got all the NRT right there and can work with their MD to get a script for Zyban or Chantix. Makes perfect sense.
But here's the little dark secret that hides in the shadows. Did you know that by the year 2020, pharmacies (places we go to get healthier) will be responsible for almost 15% of all cigarette sales in the US? Does that blow your mind? But look behind the counter when you check out. What is in all those little rectangular packages? Yep, that's right - cigarettes. You know, I never put the two and two together before. I guess I just viewed the local neighborhood Walgreens as a cross between a grocery store and a five-and-dime.
This study, published in Tobacco Control, really shed the light on a rather ironic relationship. Who would have thunk it, huh? That's like going to the dentist to get a bag full of hard candy. What's even more weird, is that the national consumption for cigarettes has slightly declined overall. Meaning fewer people are buying cigarettes, but those who are still smoking, are getting them at the pharmacy with more frequency.
So next time you go to a pharmacy, look to see if they sell cigarettes. If they do, ask the manager if that represents some kind of conflict of interest. I'm not sure what kind of oath pharmacists take, if any, but it just doesn't seem like it passes the sniff test. Something about it just seems wrong.
Showing posts with label cigarettes. Show all posts
Showing posts with label cigarettes. Show all posts
Smoking a Cigarette
I wonder what goes through the minds of people when they are smoking a cigarette. Do they really think it's accomplishing some great goal, do they feel cool or accepted when they are smoking, or are they just chasing that elusive sense of satisfaction that comes with addiction?
If you really think about smoking a cigarette, doesn't it take on a gross quality. I mean, you're setting this paper and plant material on fire. Then you're putting it in your mouth, even though smoke is coming out of it. But that isn't good enough, now you have to inhale the smoke. You cough because it burns your throat, but that's okay because you've convinced yourself that if you repeat the process, you'll get used to it. People are smart (for the most part), so how does this make sense to them?
I'm trying to think of the best analogy that compares to smoking a cigarette. The only one I can come up with is going over to a campfire and inhaling the smoke deeply into your lungs. Nobody does that. It burns your eyes and your throat; the ashes are flying all over the place. Most people try to strategically place their folding chairs upwind from the fire so it won't blow in their faces. Yet, they'll sit there drinking a beer and smoking a cigarette. It just boggles the mind.
So if you are intellectually minded, think of this the next time you find yourself smoking a cigarette. Have a little chuckle and put it out.
If you really think about smoking a cigarette, doesn't it take on a gross quality. I mean, you're setting this paper and plant material on fire. Then you're putting it in your mouth, even though smoke is coming out of it. But that isn't good enough, now you have to inhale the smoke. You cough because it burns your throat, but that's okay because you've convinced yourself that if you repeat the process, you'll get used to it. People are smart (for the most part), so how does this make sense to them?
I'm trying to think of the best analogy that compares to smoking a cigarette. The only one I can come up with is going over to a campfire and inhaling the smoke deeply into your lungs. Nobody does that. It burns your eyes and your throat; the ashes are flying all over the place. Most people try to strategically place their folding chairs upwind from the fire so it won't blow in their faces. Yet, they'll sit there drinking a beer and smoking a cigarette. It just boggles the mind.
So if you are intellectually minded, think of this the next time you find yourself smoking a cigarette. Have a little chuckle and put it out.
Nicotine Free Inhalators
Smoking cessation rates are not where people would like them to be. There are a number of reasons for this. Let's face it, smoking is addictive. Many people are predisposed to the addiction which makes it harder for them to quit. Others face pressures in their life and feel like smoking is a crutch for them, a type of coping mechanism. But whatever the cause of a person's failed quit attempt, the person should not stop trying. Each relapse should be followed by a period of evaluation. The smoker should ask the question, "Why did I relapse?". This learning experience can then be logged away for future quit attempts. Studies say that it can take up to 7 quit attempts before someone is successful.
There are few smoking cessation methods which focus on the behavioral component of the nicotine addiction. Support groups try to get to this, but few methods actually help with the day to day ritual of smoking cigarettes. Nicotine free inhalators are one stop smoking aid which tries to address this component of smoking. They are plastic devices that may be used as a substitute coping mechanism for the triggers which cue the smoking ritual.
A recent study looked at how these nicotine free inhalators may improve the quit attempt. It was published in the European Respiratory Journal by Capponnetto and others and is entitled, "Effect of a Nicotine Free Inhalator as Part of a Smoking Cessation Program" [May 2011].
They looked at 120 healthy smokers who were attending a smoking cessation program. They assessed numerous factors like physical dependence, depression, behavioral dependence and motivation. The study participants were put into two groups: 1) received a nicotine free inhalator and 2) reference group. THey were followed up at week 4 and 24.
Overall, they found no significant difference in the quit rates between those who received the inhalator and those who did not. But, for those with a high behavioral dependence, the quit rate was much higher in the inhalator group (67%) compared to the reference group (19%).
The researchers conclude that nicotine free inhalators may be a helpful tool for those trying to quit who have a strong behavioral or ritualistic manipulation/handling of the cigarette. So check them out if you think you have a strong tie to the handling of the cigarette. They just might help you quit.
There are few smoking cessation methods which focus on the behavioral component of the nicotine addiction. Support groups try to get to this, but few methods actually help with the day to day ritual of smoking cigarettes. Nicotine free inhalators are one stop smoking aid which tries to address this component of smoking. They are plastic devices that may be used as a substitute coping mechanism for the triggers which cue the smoking ritual.
A recent study looked at how these nicotine free inhalators may improve the quit attempt. It was published in the European Respiratory Journal by Capponnetto and others and is entitled, "Effect of a Nicotine Free Inhalator as Part of a Smoking Cessation Program" [May 2011].
They looked at 120 healthy smokers who were attending a smoking cessation program. They assessed numerous factors like physical dependence, depression, behavioral dependence and motivation. The study participants were put into two groups: 1) received a nicotine free inhalator and 2) reference group. THey were followed up at week 4 and 24.
Overall, they found no significant difference in the quit rates between those who received the inhalator and those who did not. But, for those with a high behavioral dependence, the quit rate was much higher in the inhalator group (67%) compared to the reference group (19%).
The researchers conclude that nicotine free inhalators may be a helpful tool for those trying to quit who have a strong behavioral or ritualistic manipulation/handling of the cigarette. So check them out if you think you have a strong tie to the handling of the cigarette. They just might help you quit.
Respiratory Case Study
Here's another case study from the archive vault at the hospital I worked at for so many years. Again, I want to stress these are typical for people who smoke for several years. I saw thousands of patients just like this one.
We had a 62 year-old male present with coronary artery disease. He had just returned from the OR where he had coronary artery bypass surgery (CABG) X 4 arteries. We weaned him off the ventilator within a few hours of arriving to the ICU. He had no family history of heart disease, led an active lifestyle but became fatigued with exertion in the last couple of years, and smoked about a pack of cigarettes per day for 40 years.
Once he came off life-support, we began therapy designed to help his chest get used to taking deep breaths. It's important for the post-op patient to take deep breaths, otherwise they can get a nasty case of pneumonia. This patient did fairly well, he could take a pretty deep breath for someone who just had his chest completely opened up a few hours earlier.
He was eventually discharged to the cardiac ward. However, the next day, his oxygen requirements increased greatly. He began to wheeze and became short of breath. We realized his heart was in some kind of failure, so we put him on a breathing machine that would help him breathe during the day and night, but it didn't require a breathing tube. It fit on his face via tight fitting mask. This is called "bipap" therapy.
After about 4 days, things started to normalize. But not before he had utilized $100,000's in cardiopulmonary services, pharmaceuticals, physican expenses, hospital procedures and the like. What was supposed to be a non-complicated bypass surgery had turned into a nightmare for him and his family.
So why was he in this boat to begin with? What was the initial cause of his coronary artery disease? You guessed it, his smoking. He had no other contributing risk factors, no family history, no high cholesterol, nothing. He just smoked.
Think of it this way. Lets say each pack of cigarettes cost him on average $2.50 over that 40 year time period. Now multiply that by 356 days and then by 40 years. You get $35,600. Now add in the $300,000 in hospital expenses that were incurred and you get an average price per pack of $23.00. If smoking were that expensive would people buy them? Sure some would, but not as many. That is what you call the hidden cost of cigarettes. Now add in the lost productivity, pre-surgical testing and physician office visits, along with the post-surgical rehab he had to go through and the cost goes up even more.
Again, this isn't a fringe example of how smoking affects a person's health. It is very common place, albeit, most bypass surgeries aren't complicated. Despite this, even the uncomplicated bypass surgeries are costly and carry with them great risk. Why add that risk to your health profile? Better to just quit now and not take any further chances.
We had a 62 year-old male present with coronary artery disease. He had just returned from the OR where he had coronary artery bypass surgery (CABG) X 4 arteries. We weaned him off the ventilator within a few hours of arriving to the ICU. He had no family history of heart disease, led an active lifestyle but became fatigued with exertion in the last couple of years, and smoked about a pack of cigarettes per day for 40 years.
Once he came off life-support, we began therapy designed to help his chest get used to taking deep breaths. It's important for the post-op patient to take deep breaths, otherwise they can get a nasty case of pneumonia. This patient did fairly well, he could take a pretty deep breath for someone who just had his chest completely opened up a few hours earlier.
He was eventually discharged to the cardiac ward. However, the next day, his oxygen requirements increased greatly. He began to wheeze and became short of breath. We realized his heart was in some kind of failure, so we put him on a breathing machine that would help him breathe during the day and night, but it didn't require a breathing tube. It fit on his face via tight fitting mask. This is called "bipap" therapy.
After about 4 days, things started to normalize. But not before he had utilized $100,000's in cardiopulmonary services, pharmaceuticals, physican expenses, hospital procedures and the like. What was supposed to be a non-complicated bypass surgery had turned into a nightmare for him and his family.
So why was he in this boat to begin with? What was the initial cause of his coronary artery disease? You guessed it, his smoking. He had no other contributing risk factors, no family history, no high cholesterol, nothing. He just smoked.
Think of it this way. Lets say each pack of cigarettes cost him on average $2.50 over that 40 year time period. Now multiply that by 356 days and then by 40 years. You get $35,600. Now add in the $300,000 in hospital expenses that were incurred and you get an average price per pack of $23.00. If smoking were that expensive would people buy them? Sure some would, but not as many. That is what you call the hidden cost of cigarettes. Now add in the lost productivity, pre-surgical testing and physician office visits, along with the post-surgical rehab he had to go through and the cost goes up even more.
Again, this isn't a fringe example of how smoking affects a person's health. It is very common place, albeit, most bypass surgeries aren't complicated. Despite this, even the uncomplicated bypass surgeries are costly and carry with them great risk. Why add that risk to your health profile? Better to just quit now and not take any further chances.
Hiring Freeze on Smokers
A recent NY Times article pointed out that many hospitals are no longer considering smokers as appropriate job applicants for their businesses. The article states that job applications have been changed to provide warnings which outline their "smoke-free hiring" practices. In fact, they go on to say that employees caught smoking or having positive laboratory tests for nicotine, will face termination. Apparently, the job of maintaining a smoke-free workplace is challenging for these entities.
From my own experience, my former hospital became a smoke-free campus. This required employees to clock-out and walk off campus to smoke. When this occurs, their services are no longer available for their job of taking care of patients. I was always troubled by the potential for a poor response time to a patient's need because their nurse, tech or therapist was off campus smoking. As a manager, I was also troubled by the fact that many of the employees did not clock-out to smoke their cigarettes off campus.
As a result of this new hospital policy, many of the smoking employees simply found little hideaways on campus to do their business. So, I can see why some hospitals would move on to the next level, which is to not even hire employees who smoke.
However, does this cause hiring discrimination. After all, tobacco is not a banned substance. It is not an illegal narcotic that will put you behind bars. I would think these policies will be vetted out in the courts. But it does lead to a good question, which is "Why are some drugs illegal, while others are legal?".
Lets look at illicit drugs. Why are they illegal? Is it because they kill people and cause great physical and mental harm? Sure, probably. Is it because they cause great financial harm to people and society? Again, probably.
Okay then, lets look at tobacco. Does it kill people and cause great physical and mental harm? You bet. I would argue it creates even more than all the illicit drugs put together. Does tobacco cause great financial harm to people and society? Again, the answer is absolutely yes! The healthcare costs are in the billions every year. Not to mention all the lost productivity due to illness.
So can someone explain to me why tobacco is a legal substance? Don't worry, I already know the answer. It has been grandfathered into our culture because it was a primary cash crop when our country was founded. So it gets a free ride. If we were to follow the example of alcohol and prohibition, we can see what would possibly happen if it were made illegal. There would be an explosive black market and crime would likely increase more than one hundred-fold.
So, we're left with a less than perfect system of lost productivity, disease and financial strain on our economy - all thanks to our founding fathers.
From my own experience, my former hospital became a smoke-free campus. This required employees to clock-out and walk off campus to smoke. When this occurs, their services are no longer available for their job of taking care of patients. I was always troubled by the potential for a poor response time to a patient's need because their nurse, tech or therapist was off campus smoking. As a manager, I was also troubled by the fact that many of the employees did not clock-out to smoke their cigarettes off campus.
As a result of this new hospital policy, many of the smoking employees simply found little hideaways on campus to do their business. So, I can see why some hospitals would move on to the next level, which is to not even hire employees who smoke.
However, does this cause hiring discrimination. After all, tobacco is not a banned substance. It is not an illegal narcotic that will put you behind bars. I would think these policies will be vetted out in the courts. But it does lead to a good question, which is "Why are some drugs illegal, while others are legal?".
Lets look at illicit drugs. Why are they illegal? Is it because they kill people and cause great physical and mental harm? Sure, probably. Is it because they cause great financial harm to people and society? Again, probably.
Okay then, lets look at tobacco. Does it kill people and cause great physical and mental harm? You bet. I would argue it creates even more than all the illicit drugs put together. Does tobacco cause great financial harm to people and society? Again, the answer is absolutely yes! The healthcare costs are in the billions every year. Not to mention all the lost productivity due to illness.
So can someone explain to me why tobacco is a legal substance? Don't worry, I already know the answer. It has been grandfathered into our culture because it was a primary cash crop when our country was founded. So it gets a free ride. If we were to follow the example of alcohol and prohibition, we can see what would possibly happen if it were made illegal. There would be an explosive black market and crime would likely increase more than one hundred-fold.
So, we're left with a less than perfect system of lost productivity, disease and financial strain on our economy - all thanks to our founding fathers.
Is Smoking a Pain in Your Back?
Lots of people suffer from lower back pain. In fact, I have a tear in my disk at L4-L5 which makes my back ache most days. But as the population becomes heavier and heavier, and more sedentary, we can expect lower back pain to remain a problem. But is there something more to lower back pain than inactivity, weight-gain, etc.?
A new study from the Journal of Pain Research looked at how smoking might be a player in the world of chronic lower back pain. They reviewed the Canadian Community Health Survey (cycle 3.1) which looked at 73,507 Canadians, in that so important demographic, of people between the ages of 20 and 59. The researchers considered age, sex, level of education, body mass index (BMI), smoking level, lower back pain and level of activity.
Interestingly, they found a statistically significant prevalence of lower back pain among daily smokers (23.3%) versus non-smokers (15.7%). They were also able to uncover a positive correlation between smoking dose and the risk of lower back pain. Now, I'm not sure what possessed the researchers to look at this data stratification, but I have to say, it is an interesting finding.
Who would have thought that lower back pain might be some how correlated to the person's smoking habit. Could it be something physiological? Perhaps, something in the behavioral act of smoking that causes lower back pain? But regardless of why, it does appear to be a variable.
So if your back hurts and you smoke, try quitting cigarettes and see if your back pain doesn't improve. Hey, when you're looking for reasons to quit smoking, get as many as you can. Then hopefully, you'll get so many reasons to quit, that you'll just do it.
A new study from the Journal of Pain Research looked at how smoking might be a player in the world of chronic lower back pain. They reviewed the Canadian Community Health Survey (cycle 3.1) which looked at 73,507 Canadians, in that so important demographic, of people between the ages of 20 and 59. The researchers considered age, sex, level of education, body mass index (BMI), smoking level, lower back pain and level of activity.
Interestingly, they found a statistically significant prevalence of lower back pain among daily smokers (23.3%) versus non-smokers (15.7%). They were also able to uncover a positive correlation between smoking dose and the risk of lower back pain. Now, I'm not sure what possessed the researchers to look at this data stratification, but I have to say, it is an interesting finding.
Who would have thought that lower back pain might be some how correlated to the person's smoking habit. Could it be something physiological? Perhaps, something in the behavioral act of smoking that causes lower back pain? But regardless of why, it does appear to be a variable.
So if your back hurts and you smoke, try quitting cigarettes and see if your back pain doesn't improve. Hey, when you're looking for reasons to quit smoking, get as many as you can. Then hopefully, you'll get so many reasons to quit, that you'll just do it.
The Cost of a Pack of Cigarettes and Smoking Rates
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| What are you willing to pay? |
There was a recent article in the NY Post that detailed how a pack of cigarettes was now selling for $14.50 thanks to an abrupt increase in the tax. One smoker interviewed said she realized it was something tatamount to an idiot tax, but she'd have to go right on paying it. Another commenter said the tax hike was outrageous and how dare the government demand more money for cigarettes.
Tobacco friendly states add very little in the way of tax, for instance, Virginia adds only $0.30 to their packs of cigarettes while New York adds a hefty $4.35 on average to a pack. This is quite a wide range and points to the political pressure that Big Tobacco can exert on local state representatives.
So how does the price of cigarettes effect smoking cessation? Do people eventually hit a point where the immediate cost of smoking becomes too great and they are finally "forced" to quit? The journal Addiction published an article that looked at this very issue. The researchers looked at 2000 smokers and evaluated their motivation to quit, cigarette prices, nicotine dependence and health knowledge. The title of the article is "Do cigarette prices motivate smokers to quit? New evidence from the ITC survey."
Ross and others, found that higher cigarette prices increased the likelihood that smokers would quit, however, they achieved statistically significant results in only 1 of the 2 models evaluated. They also discovered that having access to cheaper cigarette sources did not slow down smoking cessation. But they did say current smokers would be more responsive to quitting if these cheaper sources were not available. Still though, they concluded that smoking cessation was associated with higher cigarette prices; even when there were cheaper sources of cigarettes available.
One last little caveat, in preparing for this blog post, I ran across a newspaper article out of Spain where researchers tried to find the real cost of a pack of cigarettes that was inclusive of the health costs. Their cost was $149 per pack. Now multiply that by 365 days and you get a "real cost" equal to $54,385 per year per smoker.
Hum...I wonder what would happen to our Medicare tax spending if nobody smoked?
FDA Proposes new Tobacco Health Warnings Changes to Cigarette Packages
The FDA proposes new tobacco packaging that will tell or show a more graphic health warning for those who want to buy these kinds of products. Read here to see more on the proposed changes.
Academic Failure and Tobacco Use
There are lots of scientific studies out there to support the notion that the more poorly educated in the world are more likely to smoke. It seems the more education you have, the less likely you are to be a smoker. Therefore, it seemed only natural to research how smoking adolescents fair in school compared to their non-smoking counterparts.
The Journal of School Health published a study that looked at academic success (or failure) of 10 to 16 year old government school students in India. They defined academic failure as having to repeat the same grade level once or twice. The study included over 6,300 students between 2004 and 2006.
The researchers found a significantly greater failure rate amongs students who used tobacco versus those who were nonusers. Tobacco users included those who chewed tobacco and smoked cigarettes and/or bidis. So students who reported tobacco use in 2004 were much more likely to fail a grade by the year 2006, than those who did not use tobacco products.
This brings up the question: does smoking make you more likely to fail academically or do poor performing students just so happen to smoke? Very much a chicken or the egg argument, I know. But certainly a matter that needs further investigation. While we're thinking about this, ponder these smoking facts.
The Journal of School Health published a study that looked at academic success (or failure) of 10 to 16 year old government school students in India. They defined academic failure as having to repeat the same grade level once or twice. The study included over 6,300 students between 2004 and 2006.
The researchers found a significantly greater failure rate amongs students who used tobacco versus those who were nonusers. Tobacco users included those who chewed tobacco and smoked cigarettes and/or bidis. So students who reported tobacco use in 2004 were much more likely to fail a grade by the year 2006, than those who did not use tobacco products.
This brings up the question: does smoking make you more likely to fail academically or do poor performing students just so happen to smoke? Very much a chicken or the egg argument, I know. But certainly a matter that needs further investigation. While we're thinking about this, ponder these smoking facts.
Cigarette Smoke
As if we needed proof that tobacco companies could care less about their customers. First, we learn they controlled the levels of nicotine in cigarettes to keep their customers coming back for more. Lawsuits were everywhere and "big tobacco" became associated with the dark underbelly of big business.
There has been speculation for some time now, that smoking has become predominantly a poor man's habit. Oh sure, there are lots of rich people who smoke, but the lionshare of their customer base are of lower socio-economic means. In fact, this could be directly correlated with the level of education achieved by the worldwide smoking community, which is pretty low.
For a long time now, we've known that the more education a person has, the less likely they are to either smoke in the first place or continue to smoke without attempting a cessation program. The journal Public Health evaluated cigarette emissions from a variety of cigarettes which could be purchased in 10 different countries. They wanted to see if the tobacco producers modified their products based on the overall economic standing of the country and its residents. The study showed what you would expect: the higher a country's income, the better and cleaner engineered the cigarettes were and hence, the poorer and less educated you were, the more toxic the cigarette.
So before you buy that pack of cigarettes from a poor country, you might want to think twice. It very likely has many times more the cancer causing agents than your standard US pack.
It's a shame smoking has become such a curse on the lower socio-economic citizens of this world. The poor and uneducated just don't seem to have a chance. Add to this that smoking is such a vital part of their culture, passed on from parents to children. I'm not a real advocate for government telling business what to do, but in this case of the public health, why wouldn't they step into the fight and require more from the producers or at least help educate the poor? If for no other reason than so they can sleep at night.
To keep this from becoming a political conversation, I'll stop there. For those who dislike tobacco control programs, remember this blog entry and ask yourself who is looking out for the little guy?
There has been speculation for some time now, that smoking has become predominantly a poor man's habit. Oh sure, there are lots of rich people who smoke, but the lionshare of their customer base are of lower socio-economic means. In fact, this could be directly correlated with the level of education achieved by the worldwide smoking community, which is pretty low.
For a long time now, we've known that the more education a person has, the less likely they are to either smoke in the first place or continue to smoke without attempting a cessation program. The journal Public Health evaluated cigarette emissions from a variety of cigarettes which could be purchased in 10 different countries. They wanted to see if the tobacco producers modified their products based on the overall economic standing of the country and its residents. The study showed what you would expect: the higher a country's income, the better and cleaner engineered the cigarettes were and hence, the poorer and less educated you were, the more toxic the cigarette.
So before you buy that pack of cigarettes from a poor country, you might want to think twice. It very likely has many times more the cancer causing agents than your standard US pack.
It's a shame smoking has become such a curse on the lower socio-economic citizens of this world. The poor and uneducated just don't seem to have a chance. Add to this that smoking is such a vital part of their culture, passed on from parents to children. I'm not a real advocate for government telling business what to do, but in this case of the public health, why wouldn't they step into the fight and require more from the producers or at least help educate the poor? If for no other reason than so they can sleep at night.
To keep this from becoming a political conversation, I'll stop there. For those who dislike tobacco control programs, remember this blog entry and ask yourself who is looking out for the little guy?
Is Pipe Smoking Safer?
When I was a kid, my dad smoked Kent brand cigarettes. I remember seeing them on top of the refrigerator, right behind the Hostess Cupcakes. My parents always put the stuff we weren't supposed to get into on top of the frig. But we kids had a way to get into the cupcakes. One swift slide of the kitchen chair across the linoleum and our treasure was secured. But we knew better than to get into Dad's cigarettes. They were simply "not for the kiddos" and everyone in my family knew that. There was a time though, for about 4 years in the late 1970's, when my dad began to dabble in the pipe smoking world. I'm not sure why, other than he probably thought it was sophisticated. I'm not sure why half the stuff done in the seventies was done, but I guess that's for historians to figure out.
Anyway, he kept the pipe paraphernalia in the den near the liquor cabinet (another seventies iconic image). This was much easier to get around. My sister and I would open the package of tobacco and fill our senses. It felt kind of strange but smelled really good. We then took the pipe apart to see if we could put it back together again. We would even break out the pipe cleaners and get that thing sparkling inside and out. It was an odd attraction we had, but we knew not to light it up. I once asked my dad why he smoked it. He gave two responses. For one, he said the taste was better than the cigarettes and two, he said it wasn't as bad for him.
The novelty of the pipe eventually wore off, like the lime green liesure suits, and it started to collect dust in the corner of the den. Forty years later, we now have an interesting study in Tobacco Control that evaluated the health consequences of pipe smoking. They looked at the risk of dying from all smoking-related illnesses in men who daily and exclusively smoked a pipe. They also looked at a group of people who were converted to exclusive pipe smoking away from cigarette smoking. They compared these groups to a reference group of never smokers.
I wonder if you, the reader, can guess what researchers found? I'm sure you can. As you'd expect, their conclusions were that no significant differences in mortality were found between pipe and cigarette smokers. Those who switched from cigarette to pipe smoking, had the same risk as cigarette smokers for any cause mortality and the specified smoking-related diseases.
So as it turns out, I guess my dad smoked a pipe for only one reason, the taste. I wish he were still alive so I could tell him. Now there may be someone out there saying, well, what about water pipes? Doesn't the water filter out the bad stuff? I don't have the time to go into this now, but trust me, water pipes are not safer. This is a case where the equipment looks real cool and the process of smoking it looks cool, even a little taboo or exotic, but the consequences are the same.
Moral of this story, and if I may paraphrase from SNL's Frankenstein's monster, "Smoking Baaaaaaaad!"
Healthy Teeth
Show me that winning smile! All of us want a great looking toothy grin. But if you're like me, your teeth aren't quite Hollywood perfect, but hey, they're natural. As a child and young adult, my dentists always told me I had healthy teeth. Strong enamel, good roots, the whole nine yards. Except for a couple of cavities, my teeth are in pretty good shape, although years of drinking sodas has caused them to be slightly yellowed over time.
I have treated lots of patients who just had flat out, horrible teeth. As a respiratory therapist, you notice things like this, because you have to administer inhalers, breathing treatments, manage breathing tubes that stick out of the patient's mouth, etc. So I'm here to tell you, I know what bad looks like.We once had a patient that came up out of the OR with an oral endotracheal tube that needed adjustment. Well, first of all, he had what we called "ortho-breath". Now I can't really explain what that is, you just have to experience it for yourself. It seemed like all patients that had hip or knee replacement surgery, had this funky odor. Anyway, as I retaped the breathing tube, I saw the patient had a few teeth missing and the rest didn't look very good.
Anyway, I didn't think much more about it until I read his chart. He seemed to have had a fairly normal background and history. He lived in the suburbs and had normal looking family members. No degenerate looking folks in the bunch. His only problems were arthritis in his hips and he was a smoker. There was nothing there that said he should be having rotten teeth. Now we may have our answer as to what the problem was.
It seems that a new study out of Australia tells us why he was losing his teeth. We all know that smoking is bad for the lungs and heart. It causes numerous types of cancer. It exacerbates many other diseases. Now we know it has a strong correlation to tooth loss. Apparently, smokers and former smokers have a significantly higher odds of losing their teeth than do nonsmokers. This risk declines once the smoker quits smoking, however, the risk for tooth loss continues for at least 30 years after cessation. They also noted that people who were exposed to environmental tobacco smoke for six or more hours also had a higher risk than those who were not exposed.
So here is yet another stop smoking benefit for us to chew on (sorry for the pun). It's funny to see all those celebrities with their bright white smiles puffing away on cigarettes. They really seem to make us feel like they can have it all. Prestige, good looks, good health and so on, but what most don't realize is how much money it probably costs to keep the Hollywood image alive. Sadly, too many people waste their money buying cigarettes and then start spending even more money on the lasting, chronic side-effects that follow.
Do Patients with COPD Want to Stop Smoking?
A recent study in the Journal of Clinical Nursing (Wilson, et al) looked at the experience of tobacco/cigarette smokers who had been diagnosed with chronic obstructive pulmonary disease, better known as COPD. The lion-share of those with this diagnosis are people who suffer from emphysema. Perhaps many COPD diagnosed individuals think it is too late for them to quit smoking. Perhaps, they just don't care. It has been my experience that people with COPD fall into three categories: 1) they feel it's too late for them; 2) they already stopped smoking, but still suffer the consequences of COPD; or 3) they want to quit, but they're not yet convinced that they're really bad off yet.
In fact, previous studies show that people who have COPD are less likely to quit smoking, as their smoking cessation rates are fairly low compared to the remaining population at large. Interestingly, the number one treatment outlined in the GOLD guidelines is to remove the cause of the disease, or in other words, quit smoking. COPD is the single most preventable disease. Simply quit smoking and sit back and watch the disease rates melt to insignificance.
In the past, nobody really knew why their smoking cessation rates were so low. This study was a randomized controlled trial and evaluated the national smoking cessation guidelines and conducted interviews to distinguish why COPD patients were unsuccessful at quitting smoking. They questioned the participants and identified 6 themes listed as follows:
1 - Too late to stop now2 - Finding motivation
3 - Guilt about continued smoking
4 - Bargaining/contemplation
5 - Need to stop
6 - Reduced quality of life
What they found in this population is that a complex pattern of thought and behavior is at work, in spite of the rather obvious connection between cigarette smoking and poor or declining health. For many with COPD, cigarettes are regarded as "friends". It clearly helps us understand the old expression that says, "with friends like these, who needs enemies". Additionally, these people also avoid healthcare opportunities which contributes to their continuing disability.
So as we first said in the beginning, many with COPD associate smoking cessation with ambivalence. Sadly, this is all too prevalent a problem in many who smoke, regardless of their disease state(s). They either misunderstand the hazardous health affects of smoking or don't feel it will happen to them. As was demonstrated in this particular study, they may also feel it's simply too late for them. But the catch is, it isn't too late for many with COPD. Remember, COPD is a progressive disease that can be slowed through avoidance. The continuation of the disease will lessen once smoking cessation occurs.
We as healthcare workers need to get this message out to those with COPD. We need to let them know that they too can reap many benefits when they stop smoking - and the earlier the better.
Smoking is a Lifestyle
| Am I cool or what? |
A lot of that still goes on today, I imagine. The youth see prominent role models drinking alcohol or smoking a cigarette and think the same things I thought when I was their age. They begin to experiment with these items, casually at first, then with purpose second. I suppose they begin to believe that they too are now becoming like their heroes. They are living out what they see and enjoying it immensely.
The lifestyle of someone who is young can be awesome - living on the edge and rebelling against what they know is not in their best interest. But they're young and why should they stop smoking or stop whatever "bad habit" it is they've picked up? They have their whole life ahead of them. So if you ask them about their lifestyle as a young adult, they'll likely respond with an affirmation, "life is good". Now lets speed up the clock a little bit and see what their lifestyle looks like in 40 years. Now they are in their sixties and have smoked for 30 or 40 years.
A new study examined the effects of middle aged smoking on long term risk of impaired activities of daily living (ADL). Lets first define ADL - these are things we do everyday, like bathing, brushing our teeth, urinating/having a bowel movement in the toilet, combing your hair, etc. Most of us think we'll be doing that without any problems well into 80's. Then we hope to have a cute, young nurse change our Depends. The study looked at 2,200 people in 1980, then again in 1999. They found that smokers had a much higher risk for impairment of ADLs. This means it was harder for them to do the simple things of just existing. The odds ratio (risk) was even higher for those who smoked greater than 20 cigarettes per day.
That's the problem with smoking. When you're young and invincible, smoking only creates silent changes in your body. But the repeated affect of smoking every day for years on end, transform these previously unknown physiological changes into a stark ubiquitous reality. Breathing becomes labored, chest pains are present, infections simply come in waves, and you get on a first name basis with your emergency room charge nurse. Sure, some people are physiologically wired to be less affected by smoking, but as a general rule of statistics and experience, smoking does not improve your lifestyle.
Imagine for a moment. You're 62 years old. You wake up at 4:00 am to take a breathing treatment. You go back to bed where you can only sleep with 2-3 pillows stacked up, otherwise you can't breathe. You turn up the oxygen concentrator located by your bed because you're a little more short of breath than usual. Eventually you doze off, only to awaken 3 hours later feeling very anxious. You use your inhaler which you keep in your bedside drawer. You reach over to your walker and move toward the bathroom. Half way there, you sit back down to catch your breath. A few minutes later, you get back up and use the facilities. You return to your bed where you take another puff from your inhaler. You decide that you'll just keep your pajamas on because you don't feel like getting dressed today. Now you go into the kitchen to get your coffee. When you arrive ten minutes later, you pour a cup and start to feel a little bit better. You call your spouse over and ask them to get your nebulizer and meds from the kitchen counter.
It's too difficult to go back to the bathroom to brush your teeth and shower, so you move over to the easy chair and sit down. You ask your spouse to move the oxygen tubing so it doesn't get caught under the easy chair when you recline. Next, you read the newspaper, comb your hair and think about what you'll do today. After talking it over, you call your grandkids up (if they're in town) and ask them to come over for a visit. It is simply too hard for you to make it over to their place. Plus, they haven't made the front door wheelchair accessible yet. But they did get an oxygen tank delivered to their house, so they'll be ready for you when the ramp gets built.
Now, it's time for another breathing treatment, except you need a new box of facial tissue, because you used up the last box in the morning. The decision is made to get a second tissue box to save time tomorrow, when you'll be finished with this one. The rest of your day is spent reading, watching t.v., doing crossword puzzles or whatever other activity you've decided to "enjoy" during your retirement.
Lets skip to nighttime. Since you've still got your pajamas on, all you have to do is brush your teeth, take your pills and last breathing treatment. Finally, you collapse in bed after a stressful and physiologically challenging day. While you lay their on your 3 pillows trying to get comfortable, you think about how you idolized James Dean. It's then you wish you could go back to that 24 year old kid and tell him to not smoke.
Stop Smoking Anytime and Reap the Benefits
As a respiratory therapist, I get to have lots of conversations with patients about their smoking habits. They ask me all sorts of questions. 1. Am I too old to quit smoking?
2. I already have a smoking disease, so why should I quit?
3. It's too late for me, isn't it?
When patients are in the hospital because they smoked, it's hard to be brutally honest with them, because they already feel bad. The last thing they need is a guilt trip from some young whipper-snapper in a white lab jacket about their smoking habit. So I carefully answer their questions as best I can without making them feel too bad about their poor choices in life.
But they do ask some good questions, don't they? Are they too old or sick to even think about quitting? Lets look at these for a moment.
Stop smoking benefits are great. They're even greater if you stop smoking at a young age. But just because you are getting a little long in the tooth, doesn't mean there are no benefits for you. Consider this for a moment.
Roughly 90% of all lung cancers are brought on by smoking. Let that sink in for a moment. If people stopped smoking, 90% of all lung cancers would just go extinct, like the dinosaurs. But how long do you run the risk of lung cancer after you stop smoking? For those who quit smoking for 10 years, the risk is 30-50% less than current smokers. Also, if you have quit for 15 years, the risk may be 80-90% less than current smokers. What does this mean in real terms? Lets say you quit at age 55. That mean by age 70, you have approximately the same risk of lung cancer as a non-smoker. So when you are about to enjoy those grandchildren, you'll have a greater chance to do so. What if you quit when you're 40? Then you can enjoy your retirement without as much concern for that dreaded disease.
Now we turn our attention to COPD, popularly known as emphysema. Many smokers have some sort of COPD as they age. They simply can't help it. Smoking does what smoking does, it damages the lungs. So people more, some less, but the damage is there. The question is, how much damage do you want to risk? So when my patients ask me if stopping smoking will help their COPD, the answer is of course it will. The less you smoke the less damage you have. Studies show the progression of COPD slows after smoking cessation. The amount of obstruction in the airways to airflow continues to occur, but at slower rates of decline.
So "yes Virginia, their are benefits for the elderly and sick who want to stop smoking". We haven't even touched on the other health benefits seen in people when they stop smoking. There is an even more comprehensive list of stop smoking benefits available. There are also many more risks that smokers expose themselves to by continuing to smoke.
Is Smoking Addictive
For over fifty years now, people have been telling us that smoking is addictive. The nicotine is said to increase the levels of dopamine in your brain which gives the smoker that "pleasure sensation" everytime they inhale. In fact, the brain produces more receptors to accommodate more and more nicotine, in an effort to get more of that feeling. Researchers state that over 85% of all smokers are addicted to nicotine. Given the low success rates associated with smoking cessation aids, it is easy to see how one could come to the conclusion that nicotine is addictive and is often compared to the addictive properties of opium and cocaine.
The second part of habitual smoking is the behavioral side. We humans are creatures of habit and tend to associate certain activities together. We all know people who smoke only when they drink. Those two behaviors are said to be associated. In addition, many smokers take cues from their environment which trigger the smoking response. Often times these are simple cues like finishing a meal, driving to work, or some other basic, repeated cue that occurs throughout the day. This one-two punch makes stopping smoking very difficult.
However, new research from Tel Aviv is challenging the assumption that smoking causes a physiological addiction, like heroin. Dr. Dar's study examines the idea that smoking may be a simple case of mind over matter. His premise states that smoking's primary driver is behavioral. He feels these triggers are so strong they cause the appearance of physiological addiction. His study looked at craving intensity on regular smoking days, a voluntary day of abstinence and the required smoking cessation on the Sabbath. His findings show that cravings on the Sabbath were less intense when the smoker knew they couldn't smoke. The cravings on the day of abstinence were just as strong as the regular smoking days. This lead Dr. Dar to conclude that when the individual knew they couldn't smoke, they were not showing the addictive calling card, intense cravings, that were present on every other day; in essence, mind over matter.
There may be something to Dr. Dar's research. After treating thousands of patients in the hospital, it is my experience that once the patient had made up their mind to stop smoking, it didn't really matter what method they used, they simply stopped. And they stopped without any trouble.
Skeptics will argue this mind over matter concept. Research is still warranted to determine just which side of the addiction represents the most influencing motivation to smoke. In fact, there is also new research pointing to a smoking gene which, when present, can predict how successful a person will be when trying to quit. However, this genome testing is very expensive and still in it's infancy.
What it boils down to is this, the mind is extremely powerful. If you've finally had it with smoking and you're ready to quit, find what stop smoking aid best fits your personality and is something you can stick with. Then follow the stop smoking help guidelines and quit smoking.
If you're not serious about stopping, or you feel like you can quit just as easy as you started, then you're fooling yourself. It does take a decision followed by another decision and another. Each day, you have to resolve to quit smoking. Because whether it's environmental cues or a true physical addiction, you need to be prepared mentally for what you're trying to do.
The Smoker's Poem
If you like this poem, then please go to my website for sound, unbiased stop smoking help.
There was a man who liked to smoke; "I’ll quit some day", he used to joke.
He took them with him where ever he went; and out of his wallet the money was spent.
He needed them more and so more he would pay; just to get through the pressures of his day.
Once he was home, it didn’t slow down; he needed a puff and searched all around.
Finding them on the table, he gave a deep sigh; relieved that his brain would soon be on high.
Feeling able to handle almost all things with peace; he went to lie down to relax and to cease
thinking about the stuff that clouded his mind; drifting to sleep, putting the day behind.
Then waking in the morning, fumble he did; looking for those cigs, with an open eye-lid.
Finding them not, he yelled aloud; everyone could hear him, even those in a crowd.
Then clutching his chest, he gave a loud wheeze; breathing his last, he fell down with a seize.
When they found him, they said he was holding a lighter; his other hand held, an empty pack even tighter.
What a sad end to his life, what a total disaster; as cigarettes laughed knowing they were his master.
“Stop?” he used to ask, flashing a smile that was quick; "Maybe one day when they start to make me sick.
Don’t judge me now, there’s no need to get rough; I’m healthy, I’m young, I don’t even cough".
But that day finally came when he did finally stop; his heart gave up and to the floor did he drop.
The moral of the story is simply to say; cigarettes do what they do, they have their own way.
You might think that you have plenty of time to play; but they cost you a dear price, it’s your life that you pay.
So don't put it off, don't make yourself wait, get stop smoking help before it's too late.
There was a man who liked to smoke; "I’ll quit some day", he used to joke.
He took them with him where ever he went; and out of his wallet the money was spent.
He needed them more and so more he would pay; just to get through the pressures of his day.
Once he was home, it didn’t slow down; he needed a puff and searched all around.
Finding them on the table, he gave a deep sigh; relieved that his brain would soon be on high.
Feeling able to handle almost all things with peace; he went to lie down to relax and to cease
thinking about the stuff that clouded his mind; drifting to sleep, putting the day behind.
Then waking in the morning, fumble he did; looking for those cigs, with an open eye-lid.
Finding them not, he yelled aloud; everyone could hear him, even those in a crowd.
Then clutching his chest, he gave a loud wheeze; breathing his last, he fell down with a seize.
When they found him, they said he was holding a lighter; his other hand held, an empty pack even tighter.
What a sad end to his life, what a total disaster; as cigarettes laughed knowing they were his master.
“Stop?” he used to ask, flashing a smile that was quick; "Maybe one day when they start to make me sick.
Don’t judge me now, there’s no need to get rough; I’m healthy, I’m young, I don’t even cough".
But that day finally came when he did finally stop; his heart gave up and to the floor did he drop.
The moral of the story is simply to say; cigarettes do what they do, they have their own way.
You might think that you have plenty of time to play; but they cost you a dear price, it’s your life that you pay.
So don't put it off, don't make yourself wait, get stop smoking help before it's too late.
What's the Deal with Electric Cigarettes?
Electric cigarette ads are everywhere. They really seem to be building momentum on the internet article directories and websites are popping up all over the place claiming terrific results when using them as a smoking cessation tool. I'm a little curious about these because I haven't read or seen any research studies detailing the outcomes (either positive or negative) of this new device. The official manufacturer advertisements themselves, don't brand it as a smoking cessation method, but rather an "alternative" to smoking regular cigarettes. So what is an electric cigarette anyway?
These devices were first used in China in 2004 and come in different "flavors". The body of the cigarette is made of stainless steel. Inside there are circuits, a smart chip and a lithium ion battery. Among these gadgets is an atomization chamber with connecting cartridge. The e-cigarette provides an inhaled dose of nicotine by delivering a vaporized propylene glycol/nicotine mixture. On the surface, this sounds great and in fact, the manufacturers claim in their advertisements that there is no more harsh smoke or odors to worry about. But they don't tell you what is in the vapor. Sure it may not smell bad, but is it good for you or those around you? They also don't tell you what's in the cartridge. The FDA looked at these last year and found several, oh let's call them, "impurities". Now to be honest, I couldn't tell you what these chemicals are or what they do to you once they're in your body. Of course, I could say the same thing about regular tobacco cigarettes too, but I can't imagine the electric cigarette is any safer than a regular tobacco cigarette.
For those who would like to argue this point, I would ask them to refer to the FDA document detailing this information. I would also ask them to provide any scientific data to support the safety of these devices. In my humble opinion, smoking cessation by using the e-cigarette is like deciding to loose weight by eating cake for dessert instead of pie. Sure it's different than the old way, but it's not necessarily better for you.
For it to be officially licensed or marketed as a stop smoking aid, it has to first gain FDA approval, who would then require it to be thoroughly investigated. Obviously, the manufacturers will never do this, so they rely on retailers and word of mouth (the internet) to get the word out.
In theory, an electric cigarette sounds like it would be a great idea. It could safely deliver nicotine replacement in a manner familiar with the smoker. It has already achieved social acceptance in places where smoking bans are in force. It just needs to do a better job of purifying it's ingredients, making sure what's in there is safe and find out what the possible side-effects might be. If you go to some of these websites, you'll not find a list of ingredients anywhere, nor will you find any safety warnings. Interestingly, the FDA did find nicotine in the cartridges labeled "nicotine-free", so I would suspect their quality control needs to be improved as well. Finally, in its current form, I don't think the electric cigarette is ready to offer any real stop smoking help, just yet.
These devices were first used in China in 2004 and come in different "flavors". The body of the cigarette is made of stainless steel. Inside there are circuits, a smart chip and a lithium ion battery. Among these gadgets is an atomization chamber with connecting cartridge. The e-cigarette provides an inhaled dose of nicotine by delivering a vaporized propylene glycol/nicotine mixture. On the surface, this sounds great and in fact, the manufacturers claim in their advertisements that there is no more harsh smoke or odors to worry about. But they don't tell you what is in the vapor. Sure it may not smell bad, but is it good for you or those around you? They also don't tell you what's in the cartridge. The FDA looked at these last year and found several, oh let's call them, "impurities". Now to be honest, I couldn't tell you what these chemicals are or what they do to you once they're in your body. Of course, I could say the same thing about regular tobacco cigarettes too, but I can't imagine the electric cigarette is any safer than a regular tobacco cigarette.
For those who would like to argue this point, I would ask them to refer to the FDA document detailing this information. I would also ask them to provide any scientific data to support the safety of these devices. In my humble opinion, smoking cessation by using the e-cigarette is like deciding to loose weight by eating cake for dessert instead of pie. Sure it's different than the old way, but it's not necessarily better for you.
For it to be officially licensed or marketed as a stop smoking aid, it has to first gain FDA approval, who would then require it to be thoroughly investigated. Obviously, the manufacturers will never do this, so they rely on retailers and word of mouth (the internet) to get the word out.
In theory, an electric cigarette sounds like it would be a great idea. It could safely deliver nicotine replacement in a manner familiar with the smoker. It has already achieved social acceptance in places where smoking bans are in force. It just needs to do a better job of purifying it's ingredients, making sure what's in there is safe and find out what the possible side-effects might be. If you go to some of these websites, you'll not find a list of ingredients anywhere, nor will you find any safety warnings. Interestingly, the FDA did find nicotine in the cartridges labeled "nicotine-free", so I would suspect their quality control needs to be improved as well. Finally, in its current form, I don't think the electric cigarette is ready to offer any real stop smoking help, just yet.
Similar Stories, Similar Results
After 20+ years experience in healthcare, I've come across what could only be described as some very nice case studies for why people shouldn't smoke. I'd like to say these case studies are few and far between, but in fact, they're all too commonplace. Everyday in the hospital, I was one of about 10 therapists who would see on average 30 patients in 12 hours. Of these 30 patients, more than 20 were there due to a smoking related illness.
Now multiply this scenario out by the other 20-30 metropolitan hospitals in the metroplex and then again by all the long term care facilities and nursing homes found in our fair city. Now multiply this number by everyday of the year, year after year, after year. So it's safe to say, I've seen my share of pain that smoking can cause. I would like to talk about one such case today.
This was a 68 year old man who smoked on average one and a half packs of cigarettes per day for over 30 years, but he quit when he was 49. He first came to our hospital when he was 53 years old, 4 years after he stopped smoking. His symptoms began with shortness of breath and a cough that wouldn't go away with over the counter medications. Over the 15 years he spent coming to our hospital, he was diagnosed with the following diseases: emphysema (COPD), respiratory failure requiring mechanical ventilation (life support machine) three times, congestive heart failure (CHF), pneumonia (multiple times), coronary artery disease, CVA (stroke), renal insufficiency, chronic bronchitis, acute myocardial infarction (heart attack) and several more maladies related to the above diseases.
He was prescribed home oxygen at age 58 and was dependent on respiratory inhalers and cardiac medications for the duration of the time he first came to us at age 53. He eventually died at the ripe old age of 68 in our emergency room from respiratory failure. The wife decided he had been through enough and chose not to revive him.
This is just one example out of literally millions, of what smoking can do. I did not add any hype to this story for dramatic affect, it simply is what it is. I shudder to think what his life would have been like if he hadn't stopped smoking when he did. But, imagine what would have happened if he had quit when he was 30 years old. He might have been able to enjoy life a little more, maybe travel and see the world. He might have been able to see his grandchildren and his friends more frequently, but as it turns out, he couldn't. You see, he couldn't leave his house. He would simply get too short of breath.
This tragic tale plays out everyday in every city. Hey, I know the world is made up of a million other sad stories. My mom has Alzheimer's disease, so I know that sadness comes in many forms, both within and out of our control. But the thing about smoking is, you can choose to stop. You can rewrite the ending of your life story. It doesn't have to end with a breathing tube stuck in your throat, attached to a ventilator pushing oxygen into your lungs until your family decides you've had enough.
You have so little control over what happens to you in life, but you can control whether you pick up that next cigarette - or does the nicotine have that control? Go ahead and fight back. Get some stop smoking help and take your life back. You won't regret it and neither will those who care most about you.
Now multiply this scenario out by the other 20-30 metropolitan hospitals in the metroplex and then again by all the long term care facilities and nursing homes found in our fair city. Now multiply this number by everyday of the year, year after year, after year. So it's safe to say, I've seen my share of pain that smoking can cause. I would like to talk about one such case today.
This was a 68 year old man who smoked on average one and a half packs of cigarettes per day for over 30 years, but he quit when he was 49. He first came to our hospital when he was 53 years old, 4 years after he stopped smoking. His symptoms began with shortness of breath and a cough that wouldn't go away with over the counter medications. Over the 15 years he spent coming to our hospital, he was diagnosed with the following diseases: emphysema (COPD), respiratory failure requiring mechanical ventilation (life support machine) three times, congestive heart failure (CHF), pneumonia (multiple times), coronary artery disease, CVA (stroke), renal insufficiency, chronic bronchitis, acute myocardial infarction (heart attack) and several more maladies related to the above diseases.
He was prescribed home oxygen at age 58 and was dependent on respiratory inhalers and cardiac medications for the duration of the time he first came to us at age 53. He eventually died at the ripe old age of 68 in our emergency room from respiratory failure. The wife decided he had been through enough and chose not to revive him.
This is just one example out of literally millions, of what smoking can do. I did not add any hype to this story for dramatic affect, it simply is what it is. I shudder to think what his life would have been like if he hadn't stopped smoking when he did. But, imagine what would have happened if he had quit when he was 30 years old. He might have been able to enjoy life a little more, maybe travel and see the world. He might have been able to see his grandchildren and his friends more frequently, but as it turns out, he couldn't. You see, he couldn't leave his house. He would simply get too short of breath.
This tragic tale plays out everyday in every city. Hey, I know the world is made up of a million other sad stories. My mom has Alzheimer's disease, so I know that sadness comes in many forms, both within and out of our control. But the thing about smoking is, you can choose to stop. You can rewrite the ending of your life story. It doesn't have to end with a breathing tube stuck in your throat, attached to a ventilator pushing oxygen into your lungs until your family decides you've had enough.
You have so little control over what happens to you in life, but you can control whether you pick up that next cigarette - or does the nicotine have that control? Go ahead and fight back. Get some stop smoking help and take your life back. You won't regret it and neither will those who care most about you.
Secondhand Smoke and Your Unborn Child
The topic of secondhand smoke (SHS) continues to receive much controversy. Smoking proponents (yes, there are some out there), actually deny the possibility that smoking may be dangerous to someone else. They say the studies detailing the dangers of SHS are flawed, bogus, or just bad science.
The scientific community would choose to differ in that opinion. Most studies are designed with a great attention to detail in hopes of deriving an outcome of scientific or medical merit. Either way, researchers hope to learn something from the experiment or study, even if it does not prove their supposition.
The smoking community does not bother to produce any study that may produce the outcome that smoking is safe for a particular subgroup of the population. Rather, they choose to deny the results brought to publication that say smoking is bad for just about everyone who gets exposed to it.
Given that background, enter in today's study which looked for a link between SHS and low birth weight (LBW) babies and preterm deliveries of babies. This is not breaking news, of course. This link has been known for quite some time and in fact, many resources report smoking as a primary risk factor for these two conditions. So it's not surprising to find a 6.5% higher incidence in the number of preterm deliveries for women who were exposed to SHS. There was also a 5% greater prevalence for LBW babies in women exposed to SHS. Both these results were statistically significant, meaning the difference between the control group and exposed group was not brought about by chance, but rather by something unique to the one group versus the other.
What does this mean for the child? Basically, it means the child will have a harder time of it. Many of the child's organ systems may not be fully developed, depending on when it was delivered. The lungs are the last organ to develop, so the baby may find itself on a respirator as it begins its fragile life. Once on the ventilator, the baby is exposed to infectious organisms and potentially dangerous intrathoracic pressures that can cause damage to their lungs and heart. Add bleeding and development of scar tissue to the equation, as these are always risk factors when being placed on a respirator. LBW babies also are at risk for many bad outcomes. Just imagine giving birth to a 3 pound child who should weigh 6 pounds. They will be markedly weaker and have greater difficulty overcoming infection and feeding challenges. Many of these babies may be born with physical deficits and abnormalities not easily outgrown.
So before you smoke around your pregnant wife, remember that your cigarette, cigar or pipe may be hurting your unborn child. Ask yourself if it is worth the risk. If you're not a real "touchy-feely" person then ask yourself if it's worth the expense. Trust me, you don't want to see the neonatal intensive care unit (ICU) bill when you leave, even with insurance. Not to mention, not everyone has a neonatal ICU in their local hospital. Many have to travel to the nearest metropolitan area for care. As we all know, hotel and restaurant bills are not covered by insurance.
The old saying goes, "Nobody is denying your right to smoke, just don't deny my right to breathe clean air". In this case, give your kid a hand and take the smokes outside. Better yet, get stop smoking help and finally kick the habit. Enjoy the added benefits of improved health in your older age and you'll have a better lifestyle when you get older; no inhalers or portable oxygen to carry around. Finally, you're setting a great example for your children to follow. It's a win-win for everybody.
The scientific community would choose to differ in that opinion. Most studies are designed with a great attention to detail in hopes of deriving an outcome of scientific or medical merit. Either way, researchers hope to learn something from the experiment or study, even if it does not prove their supposition.
The smoking community does not bother to produce any study that may produce the outcome that smoking is safe for a particular subgroup of the population. Rather, they choose to deny the results brought to publication that say smoking is bad for just about everyone who gets exposed to it.
Given that background, enter in today's study which looked for a link between SHS and low birth weight (LBW) babies and preterm deliveries of babies. This is not breaking news, of course. This link has been known for quite some time and in fact, many resources report smoking as a primary risk factor for these two conditions. So it's not surprising to find a 6.5% higher incidence in the number of preterm deliveries for women who were exposed to SHS. There was also a 5% greater prevalence for LBW babies in women exposed to SHS. Both these results were statistically significant, meaning the difference between the control group and exposed group was not brought about by chance, but rather by something unique to the one group versus the other.
What does this mean for the child? Basically, it means the child will have a harder time of it. Many of the child's organ systems may not be fully developed, depending on when it was delivered. The lungs are the last organ to develop, so the baby may find itself on a respirator as it begins its fragile life. Once on the ventilator, the baby is exposed to infectious organisms and potentially dangerous intrathoracic pressures that can cause damage to their lungs and heart. Add bleeding and development of scar tissue to the equation, as these are always risk factors when being placed on a respirator. LBW babies also are at risk for many bad outcomes. Just imagine giving birth to a 3 pound child who should weigh 6 pounds. They will be markedly weaker and have greater difficulty overcoming infection and feeding challenges. Many of these babies may be born with physical deficits and abnormalities not easily outgrown.
So before you smoke around your pregnant wife, remember that your cigarette, cigar or pipe may be hurting your unborn child. Ask yourself if it is worth the risk. If you're not a real "touchy-feely" person then ask yourself if it's worth the expense. Trust me, you don't want to see the neonatal intensive care unit (ICU) bill when you leave, even with insurance. Not to mention, not everyone has a neonatal ICU in their local hospital. Many have to travel to the nearest metropolitan area for care. As we all know, hotel and restaurant bills are not covered by insurance.
The old saying goes, "Nobody is denying your right to smoke, just don't deny my right to breathe clean air". In this case, give your kid a hand and take the smokes outside. Better yet, get stop smoking help and finally kick the habit. Enjoy the added benefits of improved health in your older age and you'll have a better lifestyle when you get older; no inhalers or portable oxygen to carry around. Finally, you're setting a great example for your children to follow. It's a win-win for everybody.
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