Diseases

Users of nicotine-containing products should understand that all of these products have side effects as well as effects on other underlying medical conditions such as diabetes, high blood pressure, asthma, and heart disease. Furthermore, these products can have interactions with other prescribed medications such as pain relievers, blood thinners, and high blood pressure medications. And finally, they do have their limitations. The following guidelines are to help you safely use these products to achieve your goal of quitting smoking.

1. Always read the labels and know the ingredients in the products. Never take more than the recommended dose without checking with your doctor first.
2. If you are pregnant or nursing a baby, seek the advice of a health professional before using any nicotine-containing product.
3. Do not use a nicotine-containing product if you continue to smoke, chew tobacco, use snuff, or other nicotine-containing products.
4. Consult a physician before using nicotine-containing products if you are under 18 years of age and:

• Have heart disease, an irregular heartbeat, or have had a recent heart attack (Nicotine can increase your heart rate.)
• Have high blood pressure that is not controlled with medication (Nicotine can increase your blood pressure.)
• Have a history of, or currently have, inflammation of the esophagus (esophagitis) or ulcers of the stomach or duodenum (peptic ulcer disease)
• Take insulin for diabetes.
• Take any prescription medications (Nicotine interacts with some medications, such as aspirin, some medications for the heart, and female hormones to decrease their levels in the blood.)
• Have a skin disorder, such as dermatitis, which may increase the likelihood of skin reactions by the skin to the patch

5. People should stop using nicotine-containing products and see their physician if they have or develop:

• Mouth, tooth, or jaw problems (applies to Nicorette gum)
• Irregular heartbeats or palpitations
• Symptoms of nicotine overdose, such as nausea, vomiting, dizziness, weakness, and rapid heartbeat
• Severe rash, redness, swelling, burning, or itching at the site of the patch

There is little scientific information that determines how safe or unsafe e-cigarettes may be. Nicotine in any form is known to be addictive, and nicotine addiction can develop from using e-cigarettes. Nicotine has been shown to cause adverse health effects including:

• nausea,
• vomiting,
• abdominal pain, and
• eye irritation.

More serious effects can occur with high doses of nicotine, such as:

• increased heart rate,
• high blood pressure,
• seizures,
• coma, and
• even death.

The US Food and Drug Administration has reported that cancer-causing nitrosamines have been detected in some e-cigarettes. Further, poison centers have reported numerous cases of poisonings of small children from consuming the liquid in the cartridges of e-cigarettes.

e-Cigarettes expel vapors that contain nicotine, which is known to be addictive. Depending on the composition of the fluid in the cartridge, nitrosamines or other dangerous chemicals may also be expelled. It is not known at this time how significant the risk is to the health of those who breathe secondhand vapors from e-cigarettes. Are e-cigarettes safe to use during pregnancy? Little is known about the long-term health effects of e-cigarettes, but nicotine has been shown to be harmful to the developing fetus. Nicotine narrows blood vessels and interferes with circulation of blood to the fetus. It can interfere with development of the fetal brain and may harm fetal lung function. It also increases the risk for sudden infant death syndrome (SIDS). Doctors recommend that pregnant women abstain from both smoking and e-cigarette use.

e-Cigarettes are smokable, refillable containers or cartridges that contain fluid consisting of solvents, flavors, and varying amounts of nicotine. Inhaling from the devices is known as "vaping." Negative pressure on the cartridge created by inhaling triggers a battery-powered heating and vaporization of the solution. The composition of the fluid in e-cigarettes varies depending upon the manufacturer.

First, one can do certain things to get ready to quit. Then, there are other things to do on the day of quitting. Finally, one can do things to help oneself to remain abstinent. (This is the hardest part.)

The signs of addiction to cigarettes include:

• Smoking more than seven cigarettes per day
• Inhaling deeply and frequently
• Smoking cigarettes containing nicotine levels more than 0.9mg
• Smoking within 30 minutes of awakening in the morning
• Finding it difficult to eliminate the first cigarette in the morning
• Smoking frequently during the morning
• Finding it difficult to avoid smoking in smoking-restricted areas
• Needing to smoke even if sick and in bed

Why should someone quit smoking? Quitting smoking makes a difference right away in the way you feel. You can taste and smell food better. Your breath smells better. Your cough goes away. These benefits happen for men and women of all ages, even those who are older. They happen for healthy people as well as those who already have a disease or condition caused by smoking.Even more importantly, in the long run, quitting smoking cuts the risk of lung cancer, many other cancers (including laryngeal, oral cavity, stomach, esophageal, cervical, kidney, bladder, and colon cancers), heart disease, stroke, and other lung or breathing (respiratory) diseases (for example, chronic bronchitis, pneumonia, and emphysema). Smoking also increases the risk of peripheral vascular disease and abdominal aortic aneurysms. Moreover, ex-smokers have better health than current smokers. For example, ex-smokers have fewer days of illness, fewer health complaints, and less frequent bouts with chronic bronchitis and pneumonia than current smokers. People who quit smoking can actually reduce their risk of developing lung cancer or other smoking-related diseases.Finally, quitting smoking saves money. The average cost of a pack of cigarettes is approximately $6.28 a pack (depending on where you live). A smoker with a pack a day habit spends approximately $44.00 per week ($2,288 per year).

Health care workers have become extremely active in publicizing the negative effects of smoking. In fact, health care workers have been instrumental in passing various legislation to limit smoking in public. As a result, the proportion of people in the US who smoke has dropped from 40.4% in 1965 to around 17% in 2013 (data from the US Department of Health).This reduction in the percent of people who smoke has been significantly less in women than in men. From 1965 to 2010, smoking among men dropped from 50.2% to 20.5% while during the same period, smoking among women dropped from 31.9% to 15.3%. So, in the future, efforts need to be made to understand and eliminate this difference between the genders.One interesting area of the current research on smoking is the study of the population distribution of the genes for smoking (genetic epidemiology). (Genes determine an individual's inherited characteristics.) Only a small fraction of individuals who start smoking as an adolescent will actually become nicotine dependent. So, what determines which individuals will become nicotine-dependent? Investigators have found that smoking initiation (the obligatory first step) and the development of nicotine dependence are both influenced by genetic factors. The genetic factors appear to play a larger role in nicotine dependence than in smoking initiation. The next step will be to identify these genes and learn how they work in order to facilitate the development of effective prevention and treatment strategies for tobacco addiction.Teen smoking rates remain of concern. In 2011 19% of high school girls and 28% of boys had used some form of tobacco in the prior month.. According to the American Cancer Society, the majority of cigarette use- in almost 90% of people who smoke- begins before a person reaches 18 years of age. Very few people start smoking after age 25. Statistics show that 99% of adult smokers had started by age 26. Education of the at-risk teen population is therefore critical for prevention of tobacco use. Various celebrities and activist groups actively promote campaigns aimed at a teen audience that educate about the consequences of smoking and offer advice on smoking cessation and prevention. While teen smoking rates increased during the 1990s (36% of teens smoked in 1997), prevention and education campaigns have brought about a decrease in teen smoking in recent years.

Several methods are available to assist those who decide to quit smoking. The main categories of methods are:

• Behavior modification and self help-literature to quit smoking
• Self-help literature
• Nicotine replacement therapy
• Prescription smoking cessation aids

Each method actually offers several different options. Moreover, combinations of the methods usually are necessary, and no one combination will work for everyone. In fact, it may be necessary to try several different methods or combinations of methods before success is achieved. Behavioral modification and self-help literature to quit smoking Due to the addictive nature of nicotine, some form of behavioral modification is often necessary for successful cessation of smoking. Educational programs, hypnosis, and aversion therapy (learning how to avoid cigarettes) are a few options. Smokers may be counseled to avoid specific triggers or situations that lead to smoking. For example, instead of awakening and grabbing a cigarette at the bedside or smoking immediately after a meal, people may be encouraged to replace the urge to smoke with another activity, such as, taking a walk or reading a book. Numerous medical associations and societies, for example, the American Cancer Society, American Heart Association, and the American Lung Association, have developed brochures to help smokers quit smoking.

There are products for cessation of smoking that are available by prescription only. Nicotine for nicotine replacement therapy is available by prescription as an inhaler or nasal spray (Nicotrol Inhaler and Nicotrol NS).These other forms of delivery of nicotine seem to work as well as the nicotine patches or gum. Prescription nicotine replacement products are more expensive than over-the-counter products. Varenicline (Chantix) Varenicline (Chantix) is a prescription drug approved by the U.S. FDA to help adults quit smoking. Chantix does not contain nicotine, but is believed to act on the same receptors (the sites where nicotine acts to produce its effects) in the brain as nicotine, resulting in activation (stimulation) of these receptors and blocking the ability of nicotine to attach to these receptors. Chantix should be taken seven days prior to the date an individual desires to quit smoking, and most people will keep taking Chantix for up to 12 weeks. Side effects of the Chantix may include:

• nausea,
• vomiting,
• gas,
• constipation, and
• changes in dreaming.

Chantix is not appropriate for use by pregnant and breast-feeding women and people with certain chronic medical conditions. bupropion (Zyban) Bupropion (Zyban) is a medication that is used primarily for treating depression. This drug, however, also has been found to be effective in helping people to quit smoking, and has been approved by the U.S. FDA for use in smoking cessation in adults. Other agents that have been tried for cessation of smoking include serotonin reuptake antagonists (drugs also used for depression) and the anti-hypertensive drugs clonidine (Catapres) and calcium channel blockers. Although these agents appear to be less effective than nicotine replacement therapy, they may be effective for some people.

By smoking, you can cause health problems not only for yourself but also for those around you.Hurting YourselfSmoking is an addiction. Tobacco contains nicotine, a drug that is addictive. The nicotine, therefore, makes it very difficult (although not impossible) to quit. In fact, since the U.S. Surgeon General's 1964 report on the dangers of smoking, millions of Americans have quit. Still, approximately 484,000 deaths occur in the U.S. each year from smoking-related illnesses. This represents almost 1 out of every 5 deaths. The reason for these deaths is that smoking greatly increases the risk of getting lung cancer, heart attack, chronic lung disease, stroke, and many other cancers. Smokers die an average of 10 years earlier than nonsmokers. Smoking is the most preventable cause of death. In addition, smoking is perhaps the most preventable cause of breathing (respiratory) diseases within the USA.Hurting OthersSmoking harms not just the smoker, but also family members, coworkers, and others who breathe the smoker's cigarette smoke, called secondhand smoke or passive smoke. Among infants up to 18 months of age, secondhand smoke is associated with as many as 300,000 cases of chronic bronchitis and pneumonia each year. In addition, secondhand smoke from a parent's cigarette increases a child's chances for middle ear problems, causes coughing and wheezing, worsens asthma, and increases an infant's risk of dying from sudden infant death syndrome (SIDS).Smoking is also harmful to the unborn fetus. If a pregnant woman smokes, her fetus is at an increased risk of miscarriage, early delivery (prematurity), stillbirth, infant death, and low birth weight. In fact, it has been estimated that if all women quit smoking during pregnancy, about 4,000 new babies would not die each year.Exposure to passive smoke can also cause cancer. Research has shown that non-smokers who reside with a smoker have a 24% increase in risk for developing lung cancer when compared with other non-smokers. An estimated 3,000 lung cancer deaths occur each year in the U.S. that are attributable to passive smoking, and an estimated 49,000 deaths each year in total from all smoking-related conditions occur as a result of secondhand smoke. Secondhand smoke also increases the risk of stroke and heart disease. If both parents smoke, a teenager is more than twice as likely to smoke as a teenager whose parents are both nonsmokers. Even in households where only one parent smokes, young people are more likely to start smoking. What is addictive disease and why is smoking considered an addictive disease? The term addictive disease or addiction describes a persistent habit that is harmful to the person. Thus, addiction is a chronic (long duration) disease with reliance on the substance causing the addiction. The addictive substance also causes the accompanying deterioration of a person's physical and psychological health.Psychologically, an individual's behavior pattern establishes how the addictive substance is used. One type of behavior is compulsive behavior, which is an overwhelming and irresistible interest in use of the substance. For example, the compulsive addict makes sure that the substance is always available. Another type of behavior is habitual behavior, which is using the substance regularly or occasionally for the desirable effects. Physically, continuous use of the substance leads to dependence on the drug by the body. This dependence means that when the drug is discontinued, symptoms of withdrawal or distress occur.Nicotine is the component of cigarettes that addicts. Almost immediately upon inhalation, the body responds to the nicotine. An individual feels relaxed, calmer, and happier than before the inhalation. These pleasant feelings reflect the physical side of addiction, but then, not smoking cigarettes causes a craving for more cigarettes, irritability, impatience, anxiety, and other unpleasant symptoms. Indeed, these symptoms are the symptoms of withdrawal from cigarettes. Moreover, with time, more and more nicotine is desired to produce the favorable effects and to avoid the symptoms of withdrawal.