When it comes to smoking, we have both some good news and some bad news to discuss.
Let’s start with the bad news: 42.1 million Americans still smoke regularly.1 Tobacco use remains the largest preventable cause of disease, disability, and death in the United States, and there are over 480,000 premature deaths annually that are related to tobacco use. This means that around one out of every five deaths that occur each year in the United States is related to smoking.2
Now for some good news: people are smoking less and less all the time. Between 2005 and 2016, the percentage of US adults who smoke has decreased from 20.9% to 15.5%.3 In adults who have ever used cigarettes, 59% have quit as of 2016, which has increased from 50.8% in 2005. Going back even further in time, there were more than twice as many smokers (as a percentage) in 1965 compared to today.3
Although the change is happening gradually and slowly, this is a war that we appear to be winning. This is partly because of greater public awareness of the harms of smoking, but is also attributable to improvements in treatments. Doctors are recommended to consistently ask patients about tobacco use, and encourage and assist patients in their attempts to quit.4 Studies have shown that this campaign of identifying and supporting tobacco users is effective. Frequently, explaining treatment options is a good way to get patients "over the hump" and into a mindset of actively quitting.
This is the desired mindset; the mindset that doctors hope all tobacco users develop. The rewards of quitting smoking are real, and dramatic. Quitting tobacco decreases the risk for cardiovascular diseases, pulmonary diseases, and many types of cancer.5 Not only this, but quitting saves former smokers tons of money. If a person smokes a pack of cigarettes per day, they save more than $2000 per year after quitting. For those who quit, their sense of smell improves, and food tastes better. The staining of teeth and fingernails ceases, and skin and hair has a younger, healthier appearance. Clothes and breath don’t smell like smoke anymore. In short, there are a great deal of desirable benefits that can be achieved by quitting tobacco.
The truth is, many smokers would like to quit, but they predictably run into a number of roadblocks. For example, sometimes people who are motivated to quit live with a smoker who does not share the same motivation. This lack of support and constant exposure to temptation can be quite a barrier. Others suffer from mental illness, poor motivation, or stress, all of which hamper efforts to quit. Sometimes people are worried about the withdrawal symptoms, or have attempted to quit in the past and feel frustrated and ashamed of past failures.6 But whatever the reasons may be, they should absolutely be viewed as surmountable challenges as opposed to rigid impasses.
People who struggle with tobacco use tend to go through a handful of stages in their attitude towards quitting:
To help improve the smokers chance of successful abstinence, there are a number of medications that have proven to be of significant benefit:
Additionally, there are interventions that don’t involve medication and have proven effective as well. One of these is behavioral counseling by a trained therapist.13 This treatment isn’t as effective as the discussed medications, but may be a good option for those who are hesitant to take pharmaceuticals or for pregnant patients. Another support system that can improve success is the telephone “quitline”. This allows individuals attempting to quit access by phone to trained counselors. The number is 1-800-QUIT-NOW (1-800-784-8669). People who access this counseling by phone or twice as likely to successfully quit then those who do not.14
In summary, it’s very gratifying when a trend is moving in the right direction, and smoking cessation appears to be one of these trends. More and more people are quitting, and along with the cigarettes leave behind diseases, expenses, and death. As we have discussed, pharmacotherapy (medications) are very effective at helping people quit. Other interventions such as the telephone quitline, behavioral counseling, and establishment of support systems are effective as well. If you are a smoker, don’t hesitate. Start planning, get a healthcare professional on your side, develop a strategy, put forth the effort, and become another success story!
Lastly, if you are not a smoker, but know and love someone who is, make sure to pass this information along to them!
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