Smoking kills. Yet about one in five U.S. adults lights up anyway. Quit now, or help a family member quit now, in the spirit of the American Cancer Society's Great American Smokeout on Nov. 15.
To find out how you can help loved ones kick the habit, Family Goes Strong talked with Dr. Jonathan Whiteson, director of the cardiac and pulmonary wellness program at New York University Langone Medical Center. Excerpts:
People know smoking is unhealthy, but just how bad is it?
Smoking causes cancer of almost every organ system in the body, from the mouth, throughout the GI [gastrointestinal] tract, the lungs — every organ system can develop cancer through smoking. Also heart disease, stroke, COPD [chronic obstructive pulmonary disease] — it's emphysema and chronic bronchitis.
So why do so many Americans still start smoking?
I personally don't believe it's a lack of knowledge. A lot of teenagers feel they're invincible, that they're not going to get sick. Many times they consider social smoking as harmless. "If I only have one or two a day or I only have half a pack a weekend, that's OK. It doesn't cause any long-lasting damage." That's not true. Any puff of any cigarette is dangerous. It's a cumulative effect. It's not, "If I wait 10 minutes between each puff, it's OK." There's also a culture of coolness. Look at the way cigarettes have been advertised.
How can parents raise teens who don't smoke?
Ten years old is not too early to start talking to your kids about the dangers of smoking. Model the right behavior.
What are some good ways to stop smoking?
A lot of people who smoke feel that if they smoke, they can't be active. Actually taking up exercise is a great way to get people to believe in their own health and can work as a catalyst to help people stop smoking.
What if family members worry that they'll gain weight if they quit?
In all honestly, you have to gain 50 pounds, or even 75 or 100 pounds, in order to have the same negative [health] consequences as you do from smoking.
So it's better to be a little chubbier than to smoke?
Right, absolutely. So you eat a little bit more, you may gain a few pounds. You'll kick a terribly dangerous habit. We can build in exercise and teach you healthy eating habits. Instead of going for a New York-size bagel with full-fat cream cheese, maybe you can go for a healthier snack.
What else can smokers do with their hands? Knit?
A lot of people do find they need to hold something — a pen or something to turn in the fingers, a little ball.
How can family members help out?
A lot of smokers feel isolated. More and more, our culture is isolating smokers. Smokers, certainly they worry about their spouse or anyone else who's living with them. There's a degree of guilt that goes along with smoking. Family support is very important. Everyone can be around the smoker and support the smoker. We need to clean our apartment and our car to get rid of the smell of cigarettes. Sometimes the odor can drive someone back to smoking. We need to move the furniture. Instead of having a cigarette after dinner, take a walk with family. Some smoking-cessation programs, spouses, loved ones, children, can go along to these activities. The eating problem, we'll all change from the full-fat cream cheese to the low-fat cream cheese. It's like the whole family's involved. It's a journey that once traveled, everyone feels good.
What about nagging?
We don't want to alienate our loved ones and the people we care for even if they are smoking. We want to show understanding and insight. "I'm here to help you in any way I can. I'll do whatever it takes." Rather than, "Don't smoke," why don't you say, "Let's go for a walk," in a productive way? Sometimes people go back and start smoking again, especially on the anniversary of a death or a stressful time like 9/11. It drives people to smoke again because it's a comfort. Especially on those days, you can say, "I've got this wonderful thing planned for us on this day." We can predict the stresses and try to do something that's a little bit distracting. Focus on the positive of it. "You're going to set an example for your children." That's the way to reinforce it.
Should you hide a family member's cigarettes?
That's just going to frustrate someone. The last thing you want is to alienate someone. You want to maintain a dialog with them. As an adult to a child, if they're legally still under your care, there can be a conversation with a physician.
It's ok to call?
Let the pediatrician know. This is not breaking any privacy rules. You're still the parent. You can call in advance or when you're there, you can bring it up. The consultation, it can be brought up. "I'm concerned that Amanda is smoking. She smells of smoke."
What about smoking anything other than cigarettes?
Anything you inhale into your lungs is dangerous, whether it's smoke or soot from the atmosphere, whether it's a hookah fumes, whether it's an aromatic cigarette, whether it's pot.
What else can family members do?
Get your kids involved with after-school sports or an athletic program. There's strong evidence that says kids who are involved at an early age in sports programs are much less likely to start smoking. 2011 was a significant increase in tobacco placement [in films]. I'm not saying you can go and see all the movies before your kids do. But it's something parents need to be concerned about and speak out about.
You're also concerned about electronic cigarettes?
Electronic cigarettes can be dangerous because we're not quite sure of the temperature of the fumes that are going into the lungs. They also contain a lot of chemicals, fewer than cigarettes, but ethylene glycol, which is part of the product of antifreeze. This is being inhaled into the lungs.
You treat smokers.
My world is the wellness, the health and the rehabilitation of people with heart and lung problems. Every single person I see has been or is a smoker. The average number of quit attempts before someone is successful is about seven times. Just because you fail the first or second time doesn't mean it isn't going to work in the future. [Try] a more comprehensive approach, with counseling and behavioral change and also nicotine replacement so people don't go through withdrawal.
What is the withdrawal like?
They feel agitated and angry and nervous. Some people it can last days if not weeks. It's because of the chemical dependence on nicotine. To enhance the success, we give nicotine replacement. You reduce the dosage of the patch over a course of weeks or months and use either a gum or a lozenge if you're having a craving. It's just like a booster. It's very important that it's used correctly and tapered off. With electronic cigarettes, the amount of nicotine taken in is not predictable. They're marketed through fancy flavors, raspberry and mint, and fancy colors, pinks and purples and greens and purples. Nicotine causes high blood pressure, it causes constriction of blood vessels. People who overdose on nicotine can have acute cardiac events. When we give nicotine replacement, we're telling people you must not smoke. They can have heart attacks. It can cause constriction of blood vessels in the heart.
Did you ever smoke?
Never. [But] my father's father and his 12 brothers and one sister all died from cigarette related diseases – through stroke, through cancer, through emphysema. My father instilled in me, "Don't smoke."
The Smokeout is just one day. Is that enough?
One second can do it. Any time we have an opportunity to get people talking about the health benefits of not smoking, any opportunity is wonderful. I wish we had the Great American Smokeout 365 days a year! We don't have to wait for New Year's Eve to make our resolutions. We can do it right now.
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