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Category Archives: Tobacco Cessation

What smoking does to our lungs – in graphic detail

All of you are aware that smoking damages most of the body, especially the lungs. An experiment loaded to the Internet by Devon Arbelo graphically depicts that damage.

On one side are a set of healthy pinkish lungs from a nonsmoker. As air is introduced, the lungs expand very nicely. On the other side are the blackened lungs from a long-time smoker. First of all, the color itself is off-putting. Secondly, you can see how poorly these lungs expand compared to the lungs from the nonsmoker.

At the bottom of the article are pictures of lungs posted by Ryan Au, a Hong Kong teacher. Again, you can see the color difference between the pink lungs from the nonsmoker compared to the brownish lungs from the smoker. What’s disturbing is that the brown lungs took on this appearance after only 60 cigarettes.

So next time you light up, form a mental image of the video clip and the photos from the above article.


Cigarettes today are more harmful than 50 years ago

A new study published by the Campaign for Tobacco-Free Kids explains the disturbing findings that came out last year in the Surgeon General’s Report on smoking. The report stated that in spite of the fact that the average smoker is smoking fewer cigarettes today, they’re at a higher risk of developing lung cancer and emphysema!

Why would that be? It seems that Big Tobacco has over the years engineered cigarettes into more palatable, more addictive products in a bid to get new smokers hooked. Since over the decades smoking has become less attractive and the industry has faced more regulation (e.g. warning labels on packs, a ban on advertising on TV), it’s essential for the tobacco companies to find other ways to reel in and keep new smokers.

Among the alterations in today’s smokes:

  • Increased nicotine levels to make the cigarette more addictive.
  • Increased ammonia levels which makes the cigarettes “smoother” as well increase the absorption of nicotine.
  • Increased sugar levels, which again, makes the cigarette easier to smoke as well as increases the absorption of nicotine through a byproduct of the burnt sugar called aldehyde.
  • Levulinic acid which once again makes the cigarettes easier to inhale through decreasing their harshness.
  • Bronchodilators which are chemicals that open up the airways, making it easier to inhale the tobacco deep into the lungs.
  • Menthol found in menthol cigarettes which cools the throat making it easier to smoke.
  • Increased nitrosamine levels which cause cancer. This is due to the specific tobacco blends being used in the U.S.
  • Ventilation holes in the cigarette filter which causes smokers to inhale more deeply, resulting in the tobacco smoke ending up deeper in the lungs.

There you have it – a more carcinogenic cigarette that’s inhaled deeper and is more addictive.

– Tamir


Are e-cigarettes really going to help you quit smoking?

Disposable E-Cigarette

As the debate rages on regarding what if any role e-cigarettes have in smoking cessation, a new study, published in JAMA Internal Medicine casts doubts on their efficacy.

The authors looked at over 900 people who participated in an online survey regarding smoking behavior. 88 of those people had used e-cigarettes, most in the hopes that it would help them to quit. After a year, the e-cigarette users were no more likely to have quit or cut down on smoking than non-users. The study quotes a couple of other studies showing similar results, including a study done on quit-line users which found that those using e-cigarettes were less likely to have quit at 7 months.

The bottom line is that as of this writing, it’s probably best to stick to smoking cessation modalities that have been proven to work instead of turning to e-cigarettes. If nothing else is effective, then perhaps there’s room for further discussion about e-cigarettes.

– Tamir

(Image links to source, under this license.)


What’s in a cigarette?

Although all of us conceptually know that smoking is harmful, it’s hard to imagine the damage done to the body when you’re in good health and seem to be experiencing no ill effects from your cigarette habit.

A brilliant new graphic from Smoke-Free Forsyth, a webpage advocating smoking cessation for residents of Forsyth County, North Carolina, breaks down many of the harmful chemicals and substances in a cigarette in terms we can understand and relate to. Many of us have heard of these noxious chemicals in other contexts. Click on the link for the full list, but among the worst things found in cigarettes (quoted verbatim from the site):

Arsenic – used in rat poisons
Carbon monoxide – poisonous gas
Cyanide – deadly poison
DDT – a banned insecticide
Formaldehyde – used to preserve dead specimens
Lead – poisonous in high doses

Perhaps if you’re trying to quit, the next time you take a long drag on a cigarette, close your eyes and visualize the above ingredients making their way into your lungs and from there permeating your entire body and destroying it.

– Tamir


E-cigarette Poisoning

The jury is still out as to what role (if any) e-cigarettes have in smoking cessation. However, it’s clear that their use has skyrocketed in the past few years. With the increased use, a new problem has surfaced – nicotine poisoning.

E-cigarettes contain liquid nicotine, which can be ingested. (Of course inhalation can also result in poisoning.) In 2010 it was rare to have a case of nicotine poisoning from e-cigarettes. Most cases were from accidental ingestion of cigarettes by children. Today, over 40% of the cases are caused by e-cigarettes with more than half the cases occurring in children under 5. Since e-cigarettes come in different shapes and colors, they can often seem appealing to little kids.

Symptoms of nicotine poisoning include nausea, vomiting, malaise, headache, rapid heart rate, elevated blood pressure, and sweats, but in severe cases can result in seizures and even death.

So if you’re currently using e-cigarettes, especially if you have children, keep them in a secure location. Better yet, quit altogether. There’s still no good evidence that they help people quit smoking.

– Tamir


Are e-cigarettes encouraging teenagers to smoke?

As many of you are aware, e-cigarettes are becoming more and more popular. Celebrities have been seen smoking them, and they’re touted as a cool and safe alternative to regular cigarettes.

e-cigarette image

Almost everyone would agree that if it came down to smoking a regular cigarette or an e-cigarette, the e-cigarette would probably be safer. The big controversy exists due to the idea that e-cigarettes encourage teens and young adults who never would have smoked to start using them. Once hooked on the nicotine from the e-cigarettes, many go on to smoke regular cigarettes. This is especially true since there’s an eerie similarity between how cigarettes were marketed back in the 1950s and 1960s to how companies heavily market e-cigarettes today to the young population. E-cigarettes come in different flavors, shapes, styles, etc.

A new study from JAMA Pediatrics seems to confirm the fears that e-cigarettes are acting as a bridge to regular cigarettes.

The study surveyed around 40,000 teens in 2011 and 2012, and found many disconcerting results. First of all, amongst teens who were experimental smokers, those who had ever used e-cigarettes were roughly 6 times more likely to have ever been smokers (defined as smoking >100 cigarettes) as well as over 6 times as likely to be current smokers compared to those who had not used e-cigarettes. Amongst current e-cigarette users, the rates were even higher – 7.4 times the risk of ever having smoked regular cigarettes, and close to 8 times the risk of currently smoking cigarettes. Finally, for those who were current smokers, current or past e-cigarette use made it much less likely that they would abstain from smoking over the next 30 days, 6 months, and a year (up to 90% less likely!).

The only possible positive spin was that current smokers who had ever used e-cigarettes were about 50% more likely to intend to quit over the next year. However, as the above data shows, most were unable to quit.

The bottom line is that e-cigarettes seem more and more to be a wolf in sheep’s clothing. Although “fun” and “safe” on the surface, it seems that the sum of the evidence is that they are getting young people addicted to nicotine and down the line to regular cigarettes.

– Tamir


Another reason to quit smoking: Your kids’ carotids

Secondhand smoke exposure is a controversial subject. On the one hand, there are those who make it out to be almost as bad as smoking (I’ve even heard people who claim that it’s worse than smoking!). On the other hand, there are those, mostly from pro-smoking groups, who completely minimize any possible danger from secondhand smoke.

The truth is somewhere in between. There’s no doubt that secondhand smoke is nowhere near as harmful to one’s health as actual smoking. However, there are studies that link it to several adverse health outcomes.

A recent study published in the European Heart Journal checked the thickness of the carotid arteries (the main blood vessel supplying blood to the brain) in over 2,000 people. Thicker vessels mean that they’re more diseased with unhealthy plaque that’s clogging them; it’s also a marker for blood vessel health in the rest of the body, including the vessels that supply blood to the heart.

On average, people whose parents both smoked when they were children had blood vessels that were over 3 years older than their peers who grew up in nonsmoking homes. In homes with one parent smoker, the study authors were unable to discern a difference. Perhaps when only one parent is smoking, he or she goes outside or away from others who don’t enjoy the smoke; in contrast, when both parents are smoking they’re likely to both be sitting around the house, such that the children are inhaling more smoke.

Again, if you have children and smoke around them, you’re causing serious harm to their health. It’s already known that children of smokers suffer more asthma, respiratory and ear infections, and are at increased risk of Sudden Infant Death Syndrome. This study adds further damning evidence. So if you’re cool with what cigarettes are doing to you, then fine, continue to smoke. But at least do it in a way that isn’t harming your kids. Then again, even if you smoke away from your young ones, but end up dying at a young age because you smoked, that would devastate your family as well.

– Tamir


Even one a day is bad

As we’ve discussed in our book and blog, there’s a misconception that light smoking (smoking a few cigarettes a day) isn’t too bad. After all, many other unhealthy things we do in moderation are probably not too bad. For instance, if someone who has an otherwise healthy diet and is physically active indulges their sweet tooth a little with a cookie or a candy bar here and there, for the most part, it probably won’t affect their health too much.

Woman smoking

Not so with smoking. I’m not going to suggest that smoking 1 or 2 cigarettes a day is as bad as smoking 2 packs, but its harmful effects are proportionally much worse than almost any other unhealthy habit. New research from University College London shows that people who smoke as little as 1-4 cigarettes daily TRIPLE their risk of having a heart attack.

Only 1 in 7 light smokers felt that they were addicted, but only a quarter believed that light smoking significantly impacts one’s health.

So, if you’re a social smoker, or like to have one in the evening with a beer (or one in the morning with your coffee), then at the very least know that it’s harming your body much more than you may realize. Maybe this will spur you to quit completely. Because you smoke so little right now, it will probably be much easier to quit than if you were puffing away on one or two packs a day. Furthermore, many light smokers only do it for social reasons, such as when they go out with friends. Otherwise, smoking isn’t a part of their daily routine. If this describes you, then by tweaking your social life a bit (e.g. hanging out in smoke-free areas), quitting should really be no big deal.

– Tamir

(Image links to source: Wikimedia Commons.)


CVS stops selling cigarettes: Will this help people who want to quit?

Let me preface this post by stating that I don’t have any commercial, personal, financial, or any other ties to CVS.

As most of you who’ve entered the major pharmacy chains such as CVS, Walgreen’s, and Rite Aid know, right behind the counter is a very large wall of cigarettes. All different brands. Different deals (buy 2 packs, get a third free). Stores are known to stock products that people will buy on a whim by the check-out counter. That’s why you’ll also notice gum, candy, popular magazines, and other miscellaneous items in the front too. People who smoke, or even used to smoke, have the unfortunate experience of being seduced by the cigarettes while waiting to pay for other items. “Hey, Marlboro is on sale this week. Let me get a carton or two!” “I haven’t smoked in a few weeks, but I’m under a crazy amount of stress. Discounted cigarettes! What the heck – I’ll get a pack or two . . . .”

Many people over the years have challenged pharmacies, claiming that they have some chutzpah selling cigarettes. After all, most of us use pharmacies to purchase products pertaining to our health such as medications, skin care products, first aid items, etc. It’s almost as if having cigarettes in the same vicinity somewhat makes them okay or not so bad.

Most pharmacies will state that they also sell nicotine replacement products and other smoking cessation products. Indeed, pharmacists are a great resource for people trying to quit. Nevertheless, the idea of pharmacies selling cigarettes leaves a bad taste in our mouths. In a way, it’s analogous to seeing a cigarette machine in the waiting room of your doctor’s office.

CVS recently decided to stop selling cigarettes by October of this year. This unexpected decision, which is going to cost them $2 billion in annual revenue (according to one article I saw) has been lauded by doctors, medical associations, and politicians.

Yes, I’m sure it’s true that there’s a financial motive as well. Maybe they want to rebrand themselves as the pharmacy that cares about people’s health in the hopes that this will attract a certain type of consumer. It’s still a pretty bold move. With the popularity of smoking decreasing overall, maybe other large retail pharmacies will follow suit.

Almost all of us visit retail pharmacies, at least from time to time. Limiting tobacco purchases to tobacco stores and other less accessible areas may end up helping people quit and help those who quit stay tobacco free.

– Tamir


Quitting smoking when you have mental health issues: New research

As we discuss in our book and blog, there’s a widespread misconception that smoking helps people deal with mental health problems such as anxiety. In many cases, smokers who have psychiatric/psychological illnesses or problems with drug or alcohol abuse are treated for the disorder or substance abuse, but the doctor will often hold off on smoking cessation due to the mistaken notion that patients need to deal with their more serious issues first.


Well, a new study published in Psychological Medicine adds more evidence that not only is it not necessary to hold off on smoking cessation, but continuing to smoke actually makes people more likely to continue suffering from mental health problems as well as drug or alcohol abuse.

The authors of the study analyzed data from over 4,800 smokers who participated in 2 surveys spaced 3 years apart. They found that those who initially reported mood/anxiety disorders, or drug or alcohol abuse in the first survey were much less likely to report those problems in the second survey if they quit in the interim. The numbers were quite impressive.

64% of the people in the initial survey reported mood/anxiety disorders, 33% had problems with alcohol, and 23% with drugs. At the follow up survey, those who had quit smoking were 40% less likely to suffer from anxiety, 30% less likely to have a problem with alcohol, and 70% less likely to have issues with drug abuse!

Although this study doesn’t definitively prove that smoking cessation improve mental health, the drastic results are quite suggestive. The take home message is that if you currently smoke and suffer from mood/anxiety disorders, alcohol abuse, and or drug abuse, it seems that by quitting, you could increase your chances of successful outcomes with your other problems. Don’t buy into the assumption that cigarettes will help you deal with stress or anxiety.

– Tamir