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Richmond Family Magazine
Home
Health

Still Smoking?

David Wu-PongBy David Wu-PongMarch 20, 2010
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According to a recent report from the Centers for Disease Control, the adverse health effects of smoking account for an estimated 443,000 deaths, or nearly one of every five deaths annually in the United States. The report went on to say that tobacco use causes more deaths each year than HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.

“If the threat of cancer can’t persuade you to quit smoking, maybe the prospect of poverty will,” wrote Hilary Smith in her MSN article, “The High Cost of Smoking.” The costs add up: cigarettes, dry cleaning, insurance premiums – you can even lose your job. On the savings side, according to the article, a 40-yearold who quits smoking and puts the money into a 401(k) aould save almost $250,000 by age 70. With cigarettes costing about $4 a pack, if one smokes only half a pack per day, the direct savings amount to $730 a year. As the effects of the global recession linger, this may be the best time ever to quit smoking.

Those of you who have tried to quit smoking know the single most important factor is deciding that you want to stop smoking. People come to this important decision for many different reasons. It helps to know your reasons for quitting smoking. Write them down. Review the list frequently, and especially when you feel the urge to smoke again.

That urge is important. It comes from two primary sources. The first source is neuro-chemical, and it occurs because of nicotine’s effect on our brain. When we smoke, the nicotine causes the rapid release of dopamine into many areas of the brain. Dopamine is a neuro-transmitter intimately involved in our experience of pleasurable feelings. If a rat is surgically linked to a device which injects small amounts of dopamine into the pleasure centers of its brain in response to pressing a lever, the rat will forgo all other activities and die pressing the lever. The release of dopamine is also connected to cocaine, methamphetamine, and diets high in simple sugars. Thankfully, vigorous exercise and dark chocolate can also be good dopamine triggers. Two popular products prescribed for smoking cessation are bupropion (Zyban) and varenicline (Chantix). These medications significantly reduce nicotine’s ability to alter the normal function of the dopamine pathways in the brain.

The second source of the urge is psychological, and is reinforced over time because people come to experience smoking as an emotionally comforting activity. Smoking provides a set of ritualistic and repetitive behaviors which become associated with taking a break from work and stress and at the same time provide a rewarding hit of dopamine. Getting support from your family, friends, and coworkers can help address the psychological urges we feel to smoke and help us find new, healthier ways to find that comfort.

So, if you are contemplating quitting – CONGRATULATIONS! The health and fiscal benefits can be huge. Your chances for success can increase dramatically if you clearly identify why you are quitting, involve friends and family in the process, and consult your physician for counseling and/or smoking cessation tools.

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David Wu-Pong

David Wu-Pong, MD, a family physician in the Richmond area since 1993, provides patient-centered healthcare at PartnerMD in the West End. He is the father of two teenage sons.

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