Smoking and Vaping - What It Does and How to Quit
- Victoria Wermers, RN,MSN,FNP, PMHNP
- Dec 21, 2024
- 10 min read
Updated: Jun 13
ITS GOT YOU. IT OWNS YOU.
Smoking - What it Does and How to Quit
I remember when healthcare providers used to smoke in the hospital. In a postpartum unit, a doctor sauntered in and put his cigarette on the edge of the sink while he went to check on a woman who had just delivered a baby. Just crazy. In the ICU, many of the nurses would all gather in the break room to smoke. We might have been caring for very sick patients in the unit, but we had to have that cigarette. They obviously don't do that anymore, but how foolish we were. "We've come a long way (baby)."
I don't lecture my smoking patients much because, as an ex-smoker, I know most smokers lecture themselves. If you are a smoker, you know you need to quit. You know the cost, you know the filth, you know it can hurt you (and most likely will if you keep smoking), and it will hurt others around you - directly or indirectly. But, even knowing that you keep smoking anyway, and you know why. Because cigarettes are as addictive as heroin, cocaine, and alcohol, maybe it is self-medication, but there are better ways.
As in most addictions, chemicals (in this case, nicotine) stimulate the neurons in the reward/emotion center in the brain, the nucleus accumbens. When neurotransmitters of the brain - the nucleus accumbens is stimulated, it releases dopamine - one of the "feel good" neurotransmitters. This is the same area where drugs, alcohol, and gambling work to produce a "high" feeling. It temporarily enhances thinking, attention, memory function, and fine motor skills; it feels so "good" that the brain wants more. It creates an addiction.
Most nicotine gets metabolized out of your body after about two hours; the "happy" effect on your brain wears off. Thirty minutes after a cigarette, your brain's reward center wants more. So you light up again. If you do not light up, your craving will last about 3-4 minutes, go away and usually come back about 30 minutes later, depending on whether you are a die-hard smoker.
Yes, there are some mental "rewards" when you smoke, BUT the negative impacts on your body far outweigh the good things. "If I knew then what I know now."
HERE ARE SOME THINGS TO CONSIDER THAT MAY HELP YOU QUIT
WHAT POTENTIAL HEALTH PROBLEMS CAN SMOKING AND VAPING CAUSE? WHY QUIT???
According to the NIH, one cigarette reduces your life by 11 minutes. Do the math.
CANCER
Back in the day, before they knew it was unhealthy, it was glamorous to smoke cigarettes. People like Paul Newman, Walt Disney, George Harrison, and John Wayne - just to name a few - were die-hard smokers who died of lung cancer, and Patrick Swayze died of pancreatic cancer; smoking can cause bladder, kidney, liver, and stomach cancer as well. Smoking puts people at risk for all kinds of cancers.
In terms of the lungs, smoking causes chronic lung inflammation: The immune cells in your lungs become overworked trying to protect your lungs from foreign particles. The process of chronic inflammation can cause changes in the way lung cells function. Sometimes, the chemicals and inflammation from smoking change the DNA in a cell (DNA basically communicates to new cells how to "behave"). The new cells get an erroneous code and start to create cancerous cells instead of normal ones; they multiply and spread, morphing into cancer.
Battling cancer is not a nice way to live out your years on earth for you or the people around you.
BRAIN FUNCTION
Smoking shrinks parts of your brain that help you think and remember things. It narrows blood vessels in your brain, and it definitely raises your risk of stroke, which can damage the brain and leave you in a bad way. These changes can also cause dementia, a sad state of affairs for you and your family and friends. Yes, they will take away your car keys.
CHRONIC BRONCHITIS/COPD/EMPHYSEMA
Another common hazard of smoking is chronic/long-term lung disease. This is a miserable disease as it progresses, which I liken to "feeling like a fish out of water": You just can't breathe. People with chronic lung disease like this tend to progress: They get chronically "crabby" and mean because they can't breathe. Long-term smokers with lung disease are called "pink puffers" because their faces look red, and they often develop a rounded "barrel chest."
If you are a non-smoker or ex-smoker trying to convince a loved one to quit, you could try something like this: "If you get nasty or have a stroke because you won't quit smoking...I am going to send you to a nursing home where someone will change your diapers!" Barrel chest "pink puffer"
EYES
As smokers age, they are more likely to develop cataracts and macular degeneration than non-smokers.
SKIN
Long-term smokers often develop features of premature aging, particularly wrinkling of the skin. You can spot them in a crowd.
IMMUNITY
Smoking decreases immunity. Long-term smokers generally get sick more often than non-smokers. If they get a lung infection, it can hang on...and on and on.
HIDDEN RISKS OF SECOND AND THIRD-HAND SMOKE
Smoke in the air given off by a nearby smoker is called second-hand smoke. The smoke residue that leaves a yellow film and smells all over everything, your car, your child, your clothes, skin, hair, and even your breath, is called third-hand smoke. Both the smoke itself and the residue contain dangerous toxins, including arsenic, cyanide, and lead.
When you smoke, everyone in the room or car in which you are riding is smoking right along with you. They are at an increased risk for asthma and other respiratory disorders like ear infections - and if the smoke exposure continues, those people who are exposed can develop various cancers just from smoking your smoke!
While still not ideal, I meet more and more people who smoke outdoors instead of in the house. This is awesome. It's not fair to make other people sick.
SMOKING CAN CHANGE LEVELS OF CERTAIN MEDICATIONS IN YOUR BODY
Smoking and vaping (specifically polycyclic aromatic hydrocarbons or "PAHS") can increase the rate at which you metabolize, inactivate, or basically "get rid" of a medication in your bloodstream. So if you start smoking, it may increase the concentration of certain medications and if you stop it can change levels to. See more information.
THE FINANCIAL COST OF SMOKING
According to USA TODAY, in 2015, the average person spent 1.1 million dollars on cigarettes in a lifetime. Imagine what you could do with 1.1 million dollars!
Health insurance and often life insurance policies cost more for a smoker. In fact,
Insurers can (and sometimes do) charge tobacco users up to 50% more than those who don’t use tobacco. Premiums for life insurance policies are also higher. We are looking at a yearly savings of thousands of dollars. You have better things to spend your money on.
HOW TO QUIT
First, remind yourself often of the risks (above). And always remember these benefits:
On average, for most middle-aged people, 20 minutes after your last cigarette, your blood pressure and heart rate go down to normal (don't be falsely reassured: if you are a smoker and your blood pressure is good now, it will assuredly go up as you get older and keep smoking).
When you quit, your hands and feet get warmer.
After 24 hours of the last cigarette, the chance of a heart attack goes down after two to three months, and lung function increases.
One to nine months later, coughing, sinus congestion, fatigue, and shortness of breath improve.
After one year, your risk of heart disease decreases to 50%
Five to fifteen years after you quit, your risk decreases by 50%
10 years after you quit, your lung cancer risk decreases to 1/2 that of smokers, and there is a reduced risk of other cancers like mouth, esophageal, pancreatic, kidney, and bladder
At 15 years - Risks of heart disease and death are nearly equal to nonsmokers.
After you quit, premature aging slows down (including premature skin wrinkling due to smoking).
(Above statistics from the CDC)
Going to quit? Great Ideas on What to Do Next
Make a plan-check out one of the options below.
Set a date to quit
Write down 10 reasons why you want to quit.
Close your eyes...Envision your life without smoking when there is no monkey on your back telling you what to do, when and where you do it (gotta find a place! Gotta smoke!). No more sense of urgency to smoke. That's freedom. Then, imagine your life in middle to old age if you KEEP smoking.
Identify your triggers and try to stay away from them for a while. The places you go to or people you hang out with to smoke. These trigger your brain (neurotransmitters and neurons) to want to smoke.
When you get a craving, quickly do something with your hands or your mouth (eat sunflower seeds, chew cloves or gum), sing, or do something to change your thoughts to get that craving out of your mind. Cravings usually come on about 20-30 minutes after your last cigarette and last only four to five minutes. So do SOMETHING for that three to five minutes until the thought leaves your mind. It will return frequently and is worse for the first two to three days. You just have to refuse that craving over and over again. They will become less frequent, and after about four to six weeks, they usually go away (with only a rare brief recurrence).
In general, keep your hands busy.
When you have an urge, relax and deep breathe. Enjoy your surroundings.
Contacts
There are numerous resources and apps available to help you quit:
The American Lung Association has some great resources.
Try an app: QuitStart app on your phone.
Call: 1-800-QUITNOW
These are often very helpful.
If You Can't Do It Yourself, Consider Medicine
Over-the-Counter
Nicorette Gum - is okay, but you may end up "chain chewing" (jaw ache), but it still beats smoking.
Nicorette Lozenges - Fair reviews
Nicoderm Patches - According to their reviews, these are the best over-the-counter products. They also have coupons and an extensive guide on how to quit on their website.
Nicotine Pouches (although one of these are recently been discovered to have some cancer causing chemicals)
Herbal Remedies
Black Pepper Essential Oil: Inhaling black pepper oil reportedly gives the respiratory tract the sensation of smoking. It is to be inhaled for two minutes each time a craving begins. Some people inhale vapors directly from the others, put a drop or two on a tissue, and inhale it.
Prescription
Bupropion (Zyban/Wellbutrin) - This is usually used as an antidepressant but works to decrease craving and withdrawal symptoms. It works pretty well. This is the least expensive prescription to help quit smoking (with a Good RX coupon)
The potential side effects of Wellbutrin include suicidal and homicidal thoughts. Keep these in mind, but do not use this as an excuse not to try the medicine (unless you have a history of this type of behavior). In reality, anyone who has ever tried to quit smoking with no support tends to feel a bit crabby and almost suicidal anyway (JK).
Varenicline (AKA past Chantix) - This is a series of pills used to quit smoking. Most courses last for about 11 weeks. From what I understand, this medicine works very well, but once you come off it, you are inclined to want to start smoking again. But, again, do not let that deter you from trying it. Like any medication, it has potential side effects. From what I understand, nightmares are kind of common (is trying to quit smoking a nightmare?). Be sure to read about the potential side effects and contraindications and discuss them with a healthcare provider.
Nicotrol Nasal Spray $$$$
REMINDERS
When you quit, expect to be uncomfortable for a little while.
Expect those thoughts to come into your head: "Oh, I need to smoke because I am gaining weight." "I need to smoke because I am anxious." This is THE ADDICTION TALKING AND TRYING TO MANIPULATE YOU. Put that voice away!
It takes just ONE cigarette to make you start up again. How often have I heard over a cup of coffee, "I am just going to have this one, and then I won't smoke anymore." This does NOT work for a person who has been a die-hard smoker. You have one, then another...and another, and before you know it, you are back where you were before.
Q&A
How many times does a person TRY to quit before they finally do quit?
According to most sources, about 12 times. (That does not mean that you quit one day, start smoking the next day, and say, "I have 11 more times"!). Try and try again if you have to, accept a relapse, and move on to the next try, but NEVER GIVE UP!
Good luck and don't stop until you quit for good!
Vaping
Vapes (e-cigarettes, vape pens) - So many people have turned to vaping. I hear about kids in middle school who even do this - kids from all walks of life. Many people - too many - like to vape. It seems a little bit less innocuous than smoking and is often used as a substitute for smoking. Initially, they do tend to help people quit smoking cigarettes however, given time, most people go back to smoking cigarettes again.
Relative to cigarettes, vapes range in the amount of nicotine they contain: They can have less, the same, or more than cigarettes. According to Johns Hopkins, vapes often contain toxic chemicals but less than those in cigarettes (still not great).
POTENTIAL HEALTH PROBLEMS
Keep in mind that vapes have not been around for very long, and the jury is still out on them - they do not know enough yet about their effects. However, studies are beginning to show that vaping may cause chronic lung disease and asthma. Vapers also tend to have some lower immunity to pathogens than non-vapers. But, again, research is still young in this area.
If you look at it logically, how can your lungs (and body) respond positively when you introduce any foreign substance into them? Our body is built for survival - to ward off foreign invaders. According to the Journal of Nuclear Medicine, there is more inflammation caused by e-cigarettes than from cigarettes (and nonsmokers, of course). Chronic inflammation typically causes problems - like cancer. So, it remains to be seen how vapers will fare.
Needless to say, most still contain the addictive substance nicotine (see smoking - above), which can cause some of the same untoward health problems that cigarettes do - like high blood pressure, cancer, stomach problems, ocular, renal, cardiovascular, and others. So, to say that vaping does little harm would be misleading at this point.
How to Quit
See: Going to quit vaping?
You can use some of the methods above, used for smoking cessation, to quit vaping.
In addition, because there are different nicotine strengths available, consider progressively lowering the nicotine content in your vape pens.
As mentioned above, there are numerous resources and apps available to help you quit:
-The American Lung Association has some great resources.
-Try a phone app: QuitStart
-Call: 1-800-QUITNOW
