Smoking is known to harm nearly all cells and organs of the body and is a leading cause of preventable disease, disability, and death in the US. Smoking can be costly for individuals and the United States government, which spends hundreds of billions of dollars annually.
Over 10% of the US adult population smokes, with more male than female smokers, but, encouragingly, this is a nearly 50% decline since 2005. Fortunately, most adult cigarette smokers express a desire to quit.
Keep reading to learn about the health risks associated with smoking, a timeline of health benefits that may occur after quitting, and resources and tips to assist you with smoking cessation.
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How Does Smoking Affect Our Health?
Smoking has a wide range of negative health effects, including:
Cancer
Smoking greatly increases lung cancer risk with a dose-response relationship (e.g., the risk increases as the number of cigarettes smoked increases). Those exposed to secondhand smoke have an increased lung cancer risk of about 20%.
In addition to lung cancer, smoking is linked to many cancers that can occur in various parts of the body.
It is recommended that adults aged 50 to 80 years who have at least a 20-pack-year smoking history and currently smoke (or have quit within the past 15 years) get an annual CT scan to screen for lung cancer.
Cardiovascular Disease
Although lung cancer might be what comes to mind when thinking about the risks of smoking, cardiovascular disease is strongly associated with smoking.
Smoking can damage the endothelial cells that line our blood vessels, and this damage may contribute to a variety of cardiovascular diseases:
Coronary Artery Disease
When plaque is deposited in the blood vessels that supply the heart, it can lead to chest pain or 'angina' and may progress to a heart attack and death.
Carotid Artery Stenosis
This condition is similar to coronary artery disease, but the plaque blockage is instead in the carotid artery, which supplies the brain with blood. Carotid artery stenosis can cause a transient ischemic attack (TIA or 'mini-stroke') or a stroke.
Peripheral Arterial Disease
Blood vessel damage and plaque build-up can happen anywhere in our body, not just in the coronary or carotid arteries. The arteries supplying our limbs, hands, and feet can also be impacted by smoking. When peripheral arterial disease is present, the affected body part may not receive adequate blood supply and can become pale, cold, pulseless, or have intermittent pain called claudication. The most severe outcome of peripheral arterial disease is amputation of the affected body part.
Abdominal Aortic Aneurysm (AAA)
The abdominal aorta is the largest blood vessel in the abdomen and delivers blood to our legs, feet, and many organs. In a healthy state, the abdominal aorta has a diameter of about 2 cm. However, when the aorta wall becomes weakened and diseased, it can enlarge, forming an aneurysm. If the aneurysm gets so large that it ruptures, emergency surgery is required, and the prognosis can be very poor. Smoking is one of the major risk factors for developing an AAA.
It is recommended that men aged 65 to 75 who have ever smoked get an ultrasound to screen for an AAA.
Respiratory Disease
Smoking is a leading cause of emphysema and chronic bronchitis, known collectively as chronic obstructive pulmonary disease (COPD). This condition can cause inflation of the lungs, difficulties exhaling breath, mucus production, inflammation of the bronchi and smaller airways, and destruction of the tiny air sacs in the lung called alveoli. In addition to causing breathing difficulties, COPD may also lead to recurrent infections, the need for multiple inhalers and medications to alleviate symptoms, and sometimes home oxygen use.
Carbon Monoxide Exposure
When we think of carbon monoxide, we likely think of the detectors installed in our homes to protect us against exposure to this odorless gas produced by furnaces, vehicle exhaust, wood stoves, and other sources.
However, many are surprised to learn that smokers inhale carbon monoxide from tobacco smoke. This carbon monoxide is easily measurable in exhaled breath and can lead to carbon monoxide exposure if the levels are high enough. The average exhaled carbon monoxide level for nonsmokers is 1.26 parts per million, while the average level for smokers is significantly higher.
Secondhand smoke also contains carbon monoxide.
The FDA has recently approved a smartphone-compatible carbon monoxide detector as an "educational and motivational tool to inform the user about how breath carbon monoxide levels are affected by smoking behavior."
Sexual and Reproductive Health
Smoking is associated with damage to blood vessels. One of the ways this may manifest is as erectile dysfunction. According to one study, males who smoke more than a pack daily have a 60% higher risk of developing erectile dysfunction.
Women who take oral contraceptives ("the pill") may be at a greater risk of developing blood clots if they smoke.
Maternal and Infant Concerns
Smoking can affect all stages of pregnancy, including fertility, and may increase the risk of an ectopic pregnancy, miscarriage, preterm delivery, low birth weight, and sudden infant death syndrome (SIDS).
Mortality
The CDC has established that cigarette smoking is a leading cause of preventable death in the United States. Smoking is responsible for nearly one in five deaths, representing over 480,000 deaths annually.
Smoking is associated with nearly double the number of deaths as motor vehicle accidents, firearms, illicit drugs, alcohol, and infections combined.
What Happens When You Quit Smoking:
A Timeline Provided by the American Lung Association:
20 Minutes After Quitting:
- Your previously elevated heart rate may return to normal.
12 to 24 Hours After Quitting:
- The previously elevated carbon monoxide level in your blood may return to normal.
- The risk of a heart attack may be greatly reduced.
2 Weeks to 3 Months After Quitting:
- Your risk of having a heart attack may further decrease.
- Your lung function may begin to improve.
1 to 9 Months After Quitting:
- Your coughing and shortness of breath may decrease.
1 Year After Quitting:
- Your added risk of coronary heart disease may be half that of a smoker.
5 to 15 Years After Quitting:
- Your stroke risk may be reduced to that of a nonsmoker.
- Your chance of getting mouth, throat, or esophagus cancer may be half that of a smoker.
10 Years After Quitting:
- Your risk of dying from lung cancer may be about half that of a smoker.
- Your chance of getting bladder cancer may be half that of a smoker.
- Your risk of getting cervical cancer or cancer of the larynx, kidney, or pancreas may decrease.
15 Years After Quitting:
- Your risk of coronary heart disease may be the same as that of a nonsmoker.
In addition to the health benefits of quitting smoking, your skin, teeth, hair, and nails may show improvements in appearance.
How to Quit Smoking
There are a variety of tips, practices, and medications that smokers can use alone or in combination to assist with quitting.
Nicotine replacement therapy (NRT)
The most familiar form of NRT is "the nicotine patch," but there are other forms like gum, lozenges, nasal sprays, and inhalers. A prescription is required for some forms of NRT, but patches, gum, and lozenges are usually available over-the-counter.
Electronic cigarettes have been used as a replacement for smoking cigarettes. However, there is no evidence that these are safer or more effective than NRT.
Other Medications
Two FDA-approved medications for smoking cessation (not nicotine-based) are bupropion and varenicline. These require a doctor's prescription and close monitoring for evaluation and management of any side effects.
Avoid Triggers
Cravings are likely to be strongest at places or during events associated with smoking. Common examples include driving, the morning cup of coffee, social gatherings, having an alcoholic beverage, and stressful situations. Being prepared with a plan for how to avoid triggers or manage them when they arise can increase your chances of success in quitting smoking.
Keep your Mouth Busy
Chewing gum, eating a mint, or nibbling on crunchy vegetables and seeds can help to resist a tobacco craving.
Physical Activity
Being active can help as a distraction from tobacco cravings. Even short periods of activity may help a tobacco craving go away.
Relaxation Techniques
Smoking is commonly used to provide relaxation during stressful periods in our lives. Figuring out ways to become relaxed without smoking can be helpful. Things to try include deep breathing, muscle relaxation, visualization, yoga, massage, or listening to calming music.
Acupuncture
A recent study examined the effect of acupuncture alone and in combination with education on smoking cessation and cigarette consumption in 141 adults. All groups showed significant reductions in smoking and post-treatment cigarette consumption, with the combined acupuncture–education group showing the greatest effect from treatment. The investigators concluded that acupuncture and education, alone and in combination, may significantly reduce smoking.
Apps
Smartphone users can look for apps designed to help with quitting smoking.
Remember the Benefits
If all else fails, try remembering all the reasons for quitting smoking that are important to you:
- boosting your mental health and well-being
- protecting your loved ones from secondhand smoke
- saving money
- improving your physical health
Summary
It's never too late to quit smoking. The sooner it happens, the sooner you may reduce your risk of many adverse health consequences. The benefits may start as quickly as 20 minutes after your last cigarette. Options to assist you with quitting include medications, stress management, apps, and acupuncture.
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