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Women's Health

Don't Light Up No ifs, ands or butts for cigarette smoking. By Dr. Lisa Karamardian Published: November, 2003

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Why am I writing an article about how to quit cigarette smoking? The unfortunate answer is that today, despite vast evidence that smoking is harmful to one's health, about 22 percent of adult women consider themselves smokers. Even more disheartening is that 30 percent of high school girls report having smoked in the past 30 days. Evidence shows that tobacco use is the single most preventable cause of death in the United States. Cigarette smoking is responsible for at least one-third of all cancer deaths and contributes to the development of hardening of the arteries, blood clots, coronary artery spasm and disturbances of the heart rhythm, and numerous other circulatory, lung and breathing disorders. Despite these dangers, millions of people continue to smoke. Cigarette smoking doubles a woman's risk of heart disease and cervical cancer. Here's the fact: A woman who smokes cigarettes shortens her life by 5 to 8 years. Unfortunately, the issue of women and smoking is complicated even more by pregnant smokers. Many women quit smoking before getting pregnant, but as many as 22 percent continue to smoke during their pregnancy. Smoking by women during and after pregnancy dramatically increases the risk for a range of health problems for themselves and their babies. According to the U.S. Surgeon General, cigarette smoking is the most important modifiable cause of poor pregnancy outcome. The risks include an increased rate of miscarriage, sudden infant death syndrome, infertility, ectopic pregnancy, premature delivery, low birth weight, growth retardation, stillbirth and infant mortality. In fact, it is reported that eliminating smoking during pregnancy could prevent 10 percent of all infant deaths and 12 percent of all deaths due to perinatal conditions. What an impact! You CAN quit More than 3 million Americans quit smoking every year. You can be one of them. The good news is that after only one year of quitting cigarettes, your risk of heart disease is cut in half. Even better news is that after 15 years of abstinence, your risk of heart disease is reduced to the same level as someone who has never smoked at all. Prepare yourself to quit, and if you feel you need help, ask for it. Your doctor can offer support and medical advice. Understand that cigarette smoking is not a habit, it is a chronic medical disease that requires long-term medical management. Cigarette smoking is more addictive than some illegal drugs. When you quit, be aware that there are withdrawal symptoms. Physically caused nicotine withdrawal symptoms can include anxiety, restlessness, irritability, difficulty concentrating, depressed mood, insomnia, headaches, craving for cigarettes and increased appetite. Withdrawal symptoms will go away after about one or two weeks. All of these symptoms can be suppressed by medication. Nicotine replacement therapy (in the form of a patch or chewing gum) and other medications can increase the success of nonsmoking programs by 50 percent. The first thing that needs to be done is to establish a Target Quit Date (TQD). Certain antidepressant drugs (such as Zyban or buproprion) work very well at reducing the craving and increasing success rates. The usual regimen involves starting the medication one to two weeks before the TQD. Another option is to prescribe a 15-mg nicotine patch on the TQD for 16 hours per day and remove it at bedtime. Nicotine nasal sprays, oral inhalers, gum and/or lozenges can be used as "rescue" medications. The important thing to understand is that therapy must be continued for two to three months after you become abstinent. Patients with high nicotine dependence may require therapy for six months and a rare few will require therapy for life. If you slip, don't be too hard on yourself. It takes time and patience to quit any habit. Many people have to try more than once, and try more than one method, before they become successful. Don't give up. Mistakenly, 80 percent of women think that breast cancer rather than lung cancer is the leading cause of cancer deaths among women. In reality, lung cancer kills about 65 percent more women per year than breast cancer. What are you going to do to change that statistic? For more information, contact the American Cancer Society at 800.ACS.2345; the National Cancer Institute at 800.422.6237; and Nicotine Anonymous at www.nicotine-anonymous.org.  Dr. Lisa M. Karamardian is a board-certified OB/GYN and Fellow of the American College of Obstetricians and Gynecologists. She can be reached at 949.644.2722.

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