Smoking: Ten reasons to quit

There are 50 million smokers in the United States, and 70 percent of them have tried to quit at least once.

For most smokers it takes a number of attempts before they are able to quit for good. One quitting strategy is to set a date and begin preparing psychologically for the attempt.

The following 10 reasons to quit are only a start. Smokers and their families undoubtedly can tack on many more.

1. Heart disease is far more common among smokers than nonsmokers and causes far more deaths than lung cancer. One reason is that smoking damages the inner walls of arteries, constricting them and making them less elastic.

Smoking also increases levels of LDL cholesterol and lowers levels of HDL (the "good" cholesterol). And smoking makes it possible for blood to clot more easily, setting the stage for a heart attack or stroke.

When a smoker quits, the risk of heart disease drops to half that of active smokers within a year. After five years the risk is close to that of nonsmokers.

2. Lung cancer risk is greatly increased for smokers, often for many years after they quit smoking. The recent diagnosis of newscaster Peter Jennings 20 years after he had quit smoking (except for a brief period after the events of Sept. 11) is a reminder of the lasting DNA damage smoking causes to lung cells.

For most smokers who quit, the risk of lung cancer drops close to that of nonsmokers after about 15 years, but research shows that former smokers are more vulnerable than others to the effects of secondhand smoke. Occupational exposure and exposure to air pollution can also play a role in lung cancer risk.

3. Emphysema is a chronic, progressive lung disorder common in people who have smoked for many years. It's common for aging smokers with emphysema to need supplemental oxygen as the lungs become flaccid and unable to supply the body's oxygen needs.

Emphysema has a direct and very negative effect on overall health and also on quality of life as patients find it increasingly difficult to work, be active or carry on daily living activities.

4. Age-related macular degeneration, a disease that affects central vision, is twice as common in older smokers compared with non-smokers. Smoking damages the macula, the part of the eye that discerns details. So a person with macular degeneration might be able to see that a person has come into the room, but not be able to distinguish facial features. Reading and watching television eventually become impossible.

Macular degeneration is the leading cause of blindness in the elderly, and there are few treatments. Preventive strategies include not smoking and eating a diet rich in antioxidants including leafy green vegetables.

Quitting cuts your risk of developing AMD, however. One study found that 20 years after quitting, former smokers had no increased risk for AMD.

5. Second-hand smoke and the negative impact it has on fellow workers and family members is enough to prompt some smokers to quit. Infants and toddlers exposed to second-hand smoke have a higher risk of developing respiratory problems.

One study found a direct association between environmental tobacco smoke and cognitive deficits in children. An estimated 17 percent of lung cancers occur in people who never smoked but who were subjected to second-hand smoke during childhood.

6. Smoking during pregnancy is a recognized risk factor for multiple problems related to both the pregnancy and the developing infant. A JAMA study found a fourfold risk of damage to a baby's DNA when the mother smoked.

Prenatal exposure to cigarette smoke increases the risk of childhood asthma by 15 percent. Smoking is blamed for 40 percent of low birth-weight babies, and research now shows that children who are exposed to cigarette smoke in utero have a greater likelihood of becoming addicted to smoking as teenagers.

7. Workplace restrictions against smoking are becoming increasingly strict, in part fueled by employer concerns about the escalating costs of health care.

One Michigan company, Weyco, recently issued a ban on all smoking by employees, even when they are away from the job. Four company employees who refused to take a nicotine test were fired in January of 2005. The firings are being challenged in court by employees who assert their right to engage in a legal activity on their own time.

Although the Weyco example is extreme, a Michigan community college recently cited a new policy which bans smoking on its campus and says it will not promote employees who continue to smoke away from work.

Clearly the workplace is becoming increasingly hostile to smokers.

8. Social barriers. As more people worry about the effects of second-hand smoke, smoking in other people's cars and houses has become increasingly unacceptable.

Not only do most workplaces ban smoking but a growing number of cities, and even entire nations, have banned smoking in certain public places. In Ireland, it is no longer permitted to smoke in any bar or pub.

That's also true in Bloomington, Ind. and many other communities in the United States.

9. Longevity is compromised by smoking and much improved by quitting.

A 30-year-old woman who smokes can take seven years off her life expectancy. A man of the same age will lose fiveand-a-half years.

A 60-year-old woman who smokes can expect to live to be 81. If she didn't smoke, she could expect to live until 87. For a 60-year-old man who smokes, life expectancy is 79. If he didn't smoke, he could expect to live to 84.

10. There's help. No one is suggesting that quitting is easy, but quitters should take advantage of the help that's out there. Nicotine patches and gum can help overcome the acute physical withdrawal. But for many smokers, the cravings that can occur weeks and months later can be more difficult to deal with. Behavioral counseling, being prepared with a plan and the support of friends and family can help you fight through these difficult phases.

Each year 46 percent of smokers try to quit. Some succeed, and most fail. But the important thing for smokers to understand is that it usually takes more than one attempt to successfully quit.

Analyze what went well and what didn't and create a better plan for your next attempt. Then set a new quit date to work toward. Millions of smokers quit each year.

Make this your year to quit for good.

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