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Be it resolved to quit ….

By KAREN HERZOG, Bismarck Tribune
It’s safe to say that “lose weight” and “quit smoking” are at the top of many a New Year’s resolution list. And they, sadly, top the failure list every year as well.
Not that it’s a contest, but some say weight loss is harder, because people can’t just “quit” eating. Others say quitting cigarettes is harder because it’s so physically addictive.
Either way, when you hear people say, about giving up unhealthy physical or mental habits, “I could never …” they truly believe it.
“Never” is not literally true, of course. If somebody were stranded on the South Pole without smokes or sweets, they would give them up. They’d have to. Or if somebody put a gun to their head and said, “eat that doughnut or smoke that cigarette, and I’ll shoot,” I’ll bet they could stop.
People can do it. They just really, really don’t want to.
Resolutions fail oftentimes because people are aiming at the wrong target — they fixate on the end product instead of resolving to follow a process. Because imagining the daily slog required for success is so less enjoyable than hazy fantasizing about the prize.
“Quit smoking” is tough, no doubt about it.
The idea that they can’t ever smoke another cigarette empowers some people and terrifies others.
That’s because there are cold turkey people and baby steps people.
Cold turkey people tend to be dramatic and competitive. These folks are the ones who will make the operatic gesture of ceremonially tossing out their last pack. This signals to the world that the gauntlet has been thrown. They have challenged the cigarette lover within them. Since they hate to lose, the next weeks will be a bloody spectacle. These are black-and-white folks — they will never have another cigarette or lapse back to two packs a day.
Baby steps people prefer stealth. They don’t appreciate commentary from the peanut gallery. It makes them uneasy to have others watch them sweat and struggle. They want to grind through the process alone to emerge one day quietly smoke-free.
Baby steps people can accept shades of gray, admitting that backsliding a few times will be part of the process.
But they persist, gradually narrowing their window for smoking — first the house is off-limits, then the car, then certain times of day. They sneak quietly away from cigarettes like a mom tiptoeing away from a baby who has finally fallen asleep.
Whichever type you are, one realization can boost your chance of success.
“Self-talk” matters.
When you’re already struggling to do something hard, coming down even harder on yourself when you falter or fail doesn’t necessary spur you on to greater commitment — it just adds another level of frustration and disappointment to carry. Then the temptation arises to just chuck it all and give up.
Instead of flogging yourself for setbacks, turn a 180 and praise yourself for making the effort. Applaud your spirit.
Despite your own resistance and those who want to sabotage your process, you have an intimate friend who supports your will to live healthier.
It’s yourself.
(Karen Herzog feels your pain. She had her last cigarette 39 years ago and still sometimes feels nostalgic for them.)
(Reach Karen Herzog at kherzogcolumn@gmail.com.)
http://bismarcktribune.com/news/columnists/karen-herzog/be-it-resolved-to-quit/article_de7c7e1e-717f-11e3-baf9-0019bb2963f4.html

Quiet Anniversaries That Resound Loudly with North Dakotans

By: Erin Hill-Oban
Submitted to: ND Physician, December 2013 publication from the North Dakota Medical Association – pg. 30
With all the chaos and busy-ness in our everyday lives, milestones like birthdays and anniversaries pass by so quickly that, once in a while, we forget
to celebrate the day itself, let alone the importance that occasion brought to our lives. There were two anniversaries that just passed on the calendar, and while we are not upset, as a spouse or child might be upon being forgotten, we thought the occasions provided a great opportunity to remind NDMA members of the progress North Dakota has made in the past five years in tobacco prevention and control.
November 4 and November 6 marked, respectively, the anniversaries of the passages of Measure #3 in 2008 and Measure #4 in 2012. Measure #3 received 54% of the vote and thus implemented and fully funded North Dakota’s comprehensive tobacco prevention and control program. Measure #4 earned 67% approval at the polls and created the strongest statewide smoke-free law in the nation.
These publicly (rather than legislatively) initiated and passed measures have a direct impact on the health of North Dakotans and support for each has only grown stronger since their passages.
In February of 2013, Tobacco Free North Dakota (TFND) commissioned a public poll of North Dakota voters, conducted by Keating Research, Inc., to gauge the public’s feelings toward the aforementioned measures. Results showed support for continuing to fund a comprehensive program had grown from 54% of the voters in 2008 to 89% of those polled, and the statewide smoke-free law, just three months into its implementation, had already reached 72% support, up from 67% of voter support. It is difficult to argue with numbers like that, and it is even more difficult to argue with the effects produced by policies like these.
Medical professionals know of, and many educate, about the harmful role tobacco use plays in the health of their patients and future patients. TFND
has great respect and overwhelming appreciation for the tobacco prevention and cessation efforts our medical professionals practice in their offices. In fact, a recent study showed that physicians and other medical professionals are the best and most effective messengers for advising individuals to quit tobacco use. Though obesity has climbed the ranks, tobacco use still remains one of the leading causes of preventable disease and death, contributing to more than 800 deaths each year right here in North Dakota. Reducing, and even better yet, preventing, tobacco use provides the greatest benefits in reducing the incidences of so many chronic diseases – from lung cancer and diabetes to heart disease and stroke.
While the health benefits of reducing and preventing tobacco use are fairly obvious, a topic often overlooked when discussing the impacts of successful tobacco prevention is the potential savings in annual health care costs. In North Dakota, annual health care costs directly caused by smoking alone is estimated at $247 million, and smoking- related costs covered by the state Medicaid program total $47 million annually. If we, as a nation, and in North Dakota, as a fiscally conservative state, are truly concerned with bringing down our health care costs, we would double- down on tobacco prevention efforts.
According to the Centers for Disease Control (CDC), best practices for comprehensive tobacco control programs is a three-legged stool: 1.) fully-funding the program at CDC recommendations; 2.) implementing strong smoke-free laws; and 3.) passing high tobacco tax rates. North Dakota is one of very few states to successfully enact two of the three, but with a dangerously low tobacco tax, ranking 46th lowest in the nation, North Dakota will struggle to bring tobacco use down much further. Although an obvious source of revenue, we view tobacco tax as a public health measure to reduce tobacco use and save millions in future health care costs. Proven as one of the most effective ways to prevent young people from ever starting and to encourage current users to quit or reduce use, raising the tobacco tax is a lofty, yet achievable goal that organizations like TFND are dedicated to addressing through legislative action in 2015.
Years of research show time and time again the indisputable effects that tobacco prevention and control policy has on public health, so your work in the doctor’s office, combined with TFND and NDMA’s efforts on statewide policy, are certainly making a difference. We are grateful to your organization for your past support, commend you for going on record with us by adopting a resolution of support to raise North Dakota’s tobacco tax, and look forward to opportunities to provide information and education to your members, the public, and policymakers throughout the coming year.
http://www.ndmed.org/
http://tfnd.stewsites.com/wp-content/uploads/sites/26/2013/06/ND_Physician_Dec._2013.pdf

U.S. Cancer Death Rates Continue to Decline: Report

WebMD News from HealthDay
By Dennis Thompson, HealthDay Reporter
Cancer death rates continue to decline in the United States, mainly because anti-smoking efforts have caused a drop in lung cancer deaths, researchers report.
From 2001 through 2010, death rates for all cancers combined decreased by 1.8 percent a year among men and by 1.4 percent a year among women, according to a joint report from four of the nation’s top cancer institutions, published Dec. 16 in the journal Cancer.
“The four major cancers — lung, colorectal, breast and prostate — represent over two-thirds of the decline,” said study author Brenda Edwards, a senior advisor for cancer surveillance at the U.S. National Cancer Institute.
The report also found that one-third of cancer patients over 65 have other health conditions that can lower their chances of survival. Diabetes, chronic obstructive pulmonary disease (COPD), congestive heart failure and cerebrovascular disease, which impedes blood flow to the brain, are the most common ailments that complicate cancer treatment and survival odds, the researchers said.

“It’s good to see a report of this prominence focus on this,” said Dr. Tomasz Beer, deputy director of the Knight Cancer Institute at Oregon Health & Science University. “The general health of patients is important, and it impacts on cancer outcomes.”

The report produced by the National Cancer Institute, the American Cancer Society, the U.S. Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.
Researchers found that lung cancer death rates for men fell by 2.9 percent a year between 2005 and 2010, a much faster rate than the 1.9 percent-per-year decline during the period 1993 to 2005.
For women, rates declined 1.4 percent annually from 2004 to 2010, which was a turnaround from an increase of 0.3 percent a year during the period 1995 to 2004.
The researchers attributed these overall decreases to the decline in cigarette smoking in the United States. Since lung cancer accounts for more than one in four cancer deaths, these declines are fueling the overall reduction in cancer deaths.
Beer said new targeted therapies for lung cancer have also helped improve survival chances. He expects lung cancer death rates to fall even further with the advent of new standards for lung cancer screening using low-dose CT scans.
“I was particularly struck by the overall decline in cancer death rates,” Beer said of the study. “It’s modest but real, and the fact that it’s annual is encouraging in the sense that even though these gains are modest, they compound over time.”
Death rates among men decreased for 11 of the 17 most common cancers, increasing only for melanoma, soft tissue cancers and cancers of the pancreas and liver. Death rates among women decreased for 15 of the 18 most common cancers, increasing for cancers of the uterus, pancreas and liver.
Researchers compared National Cancer Institute data with Medicare claims data to investigate other health problems that can complicate cancer treatment and survival.
Diabetes and its associated complications is the most common health problem affecting cancer patients. It was found in 16 percent of people older than 65 diagnosed with cancer between 1992 and 2005, the researchers said.
“There are a number of issues with diabetes,” Beer said. “Some data even suggests insulin can accelerate the growth of cancer.” (Many diabetics take insulin, a hormone needed to turn food into fuel for the body).
Patients with diabetes also have to struggle with the effect that cancer medications can have on their blood sugar, Beer added. They may end up receiving a lower dosage or stopping a treatment regimen early because of the conflict between their diabetes control and their cancer therapy.
COPD affects more than 15 percent of older cancer patients, while congestiveheart failure affects about 10 percent of patients. About 6 percent are affected by cerebrovascular disease, which can include stroke and aneurysms.

Lung and colorectal cancer patients tended to have other health problems more often than people with other cancers. People with breast and prostate cancers tended to have other health problems at the same rate as people without any cancer.
“The general strength and wellness of patients makes a huge difference in cancer outcomes,” Beer said. “People who are capable of going on a hike, jogging, running and eating healthy do a heck of a lot better than people who are sedentary and in poor physical condition.”

http://www.webmd.com/cancer/news/20131216/us-cancer-death-rates-continue-to-decline-report

Nicotine in e-cigs, tobacco linked to heart disease

By Jen Christensen, CNN
(CNN) — The nicotine delivered by cigarettes — even the electronic versions — may still contribute to heart disease, a new study suggests.
A new paper delivered at the American Society of Cell Biologyannual meeting in New Orleans on Sunday suggests that nicotine can cause direct harm to cells in the heart.
Nicotine is an highly addictive substance found in tobacco and is also found in vegetables in the nightshade family like eggplant and tomatoes.
The substance itself has a powerful impact on the body. It elevates your mood, suppresses your appetite and stimulates your memory; however, it also speeds up your heart rate and blood pressure.
E-cigarettes satisfy a smoker’s craving for nicotine and mimic the physical movements of smoking, but were viewed as a healthier alternative by some since they don’t contain the cancer-causing toxins of regular cigarettes.
Previous studies, such as one published in the journal The Lancet in September, have suggested e-cigarettes may be a more effective way for smokers to quit than nicotine patches or the “cold turkey” method.
In 2007, the Royal College of Physicians concluded, “If nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”
Smoking is the leading preventable cause of premature death, according to the American Heart Association.
For years, doctors have also known that smokers often develop heart problems in addition to lung problems.
Smoking increases a person’s risk of developing atherosclerosis, a disease in which plaque, a waxy substance, builds up in the arteries, narrowing and hardening them over time and limiting blood flow.
Atherosclerosis can cause heart attacks, strokes, and can even lead to death. The connection between smoking and atherosclerosis has been unclear, but scientist Chi Ming Hai may have discovered the root cause of the problem in the new study.
The molecular pharmacology professor at Brown Universityexposed cells found in the heart to nicotine. After only six hours, a kind of cellular drill, called podosome rosettes formed and ate through tissue.
When this happens in the vascular smooth muscle cells which are in the middle layer of the arterial wall to the inner layer, this can cause plaque to form in atherosclerosis. This happened when Hai exposed human and rat cells to nicotine.
What that means is that the nicotine is acting like “a kind of cancer of the blood vessel which is waking up these cells and breaking them away from their surrounding matric and then migrating having an effect like it is almost like digging a hole through the wall,” Hai said. “I think this is potentially very interesting and significant.”
It also means that the nicotine substitute of an e-cigarette may reduce a person’s chance of having lung cancer, but it does not mean that their risk of heart disease will go away.
Research is still in the very early stages, Hai said, but he believes it would be a good area for the government to invest in to better understand the connection between smoking and heart disease.
“We have certain pillars in this data that shows something significant is going on here and we need to understand it better,” Hai said.
http://www.cnn.com/2013/12/16/health/nicotine-e-cigarettes/

Homeless North Texans being weaned from tobacco

ARLINGTON, Texas (AP) — When he was sent to Vietnam in 1970, Travis Dorsey quickly picked up a smoking habit.
As the stress of being in a war zone took its toll, Dorsey found comfort in cigarettes.
“They started giving them to us with our meals, they called them C-rations, and the next thing you know I was buying them,” Dorsey told the Fort Worth Star-Telegram (http://bit.ly/1cXO5HL). “I didn’t drink. I didn’t do drugs. The cigarette helped me deal with the stress during the day.”
Life hasn’t been easy for Dorsey since returning, and through it all he has continued to smoke.
Sixteen years ago, he was diagnosed with post-traumatic stress disorder and lost his job as an aircraft mechanic. Two years ago, his wife died from breast cancer, triggering a downward spiral.
“I tried to commit suicide here about three months ago,” Dorsey said. “I ran off the cliff and tore up my truck. I was in the hospital about 2½ months.”
Dorsey, 62, who is now staying at the Arlington Life Shelter, says he’s beginning to turn his life around. He’s resumed taking insulin for his diabetes, received counseling to cope with his wife’s loss and found a church in Arlington where he feels at home.
And he’s now looking at quitting smoking through a program started in November by Tarrant County Public Health at the Arlington Life Shelter.
“I know it’s easier to quit now because I’m not under the stress I’ve been under the last two years,” Dorsey said. “I’m laying down at night and I’m not afraid.”
The county health department plans to eventually expand the program to other homeless shelters across Tarrant County, including the Patriot House, a shelter for homeless veterans.
“I wanted to reach an audience that wasn’t already being reached,” said Vanessa Ayala, a community health worker with the department. “We try to help them manage the stress from quitting smoking and understand the effects of nicotine withdrawal and dealing with weight gain.”
Michael Businelle, an assistant professor at the University of Texas School of Public Health in Dallas, said more should be done to encourage those who are homeless to quit smoking.
Tobacco-related deaths in the U.S. are about 440,000 annually, which include deaths from secondhand smoke, according to the federal Centers for Disease Control and Prevention.
“These tobacco cessation services are generally not offered at homeless shelters while substance abuse programs are generally ubiquitous,” Businelle said. “Smokers don’t go and rob their neighbors or sell their VCRs for cigarettes like someone would do for crack, but smoking is responsible for way more deaths than drugs and alcohol combined.”
Businelle helped conduct a study with several other researchers for publication in the American Journal of Public Health, comparing homeless smokers with economically disadvantaged smokers who have a home. The study, conducted from August 2011 to November 2012, found that the homeless smoking rate of 70 percent was twice that of those living in poverty (34.7 percent).
One of the challenges Businelle found was that homeless people were exposed to as many 40 smokers a day compared with three or four among those who are not homeless.
Those who run area shelters agree that efforts to curb smoking among homeless people are needed.
“The majority of the homeless population does smoke,” said Toby Owen, executive director of the Presbyterian Night Shelter. “Offering programs would certainly be most beneficial but it’s going to have to provide more than just going cold turkey.”
In Businelle’s study, 10 participants received small incentives — gift cards — and their carbon monoxide levels were tested to see whether they had actually quit. A larger group of 58 homeless people did not receive gift cards.
The quit rate four weeks after stopping smoking was 30 percent among the group that got gift cards versus 1.7 percent among those who didn’t receive gift cards.
“The findings of this pilot study are important because smoking cessation interventions that have worked in the general population are not as effective in homeless smokers,” Businelle said. “Offering small financial incentives for smoking cessation may be a novel way to have an impact on smoking in this vulnerable population.”
Businelle has applied for a National Institutes of Health grant that would pay for a five-year study and is still waiting to see whether it gets approved. The most recent study didn’t cover enough time to draw definitive conclusions. But Businelle said it is worth exploring because of the extensive costs associated with tobacco-related illnesses.
“The study is so small you can’t really make any broad generalizations,” Businelle said. “It is a pilot study that shows there is potential.”
The Bridge homeless recovery center in Dallas has been offering smoking cessation classes and modified its courtyard this summer to include a nonsmoking area for those who want to quit. With a day shelter that brings in as many as 1,200 people daily, along with a transitional shelter and an emergency shelter, the Bridge is trying to find ways to reach as many people as possible, President and CEO Jay Dunn said.
“We’re learning about the need for smoking cessation medication and brainstorming about how to make that more accessible,” Dunn said.
At the Arlington Life Shelter, Dorsey can get nicotine replacement medication through the Veterans Administration Hospital in Dallas.
Another shelter resident, Dennis Bell, said he can get a prescription through the JPS Connection Program if he needs one.
“I don’t know that I’ll need the medication,” Bell said. “I think I can do it with just the knowledge I’ve learned in the classes. That’s my goal. Now if my body says otherwise, that’s another thing.”
Bell, 45, ended up at the Arlington Life Shelter after his home was foreclosed on and he went through a difficult divorce.
But he said he was receptive to quitting smoking after Ayala pointed out how much money it would save him.
“I knew some of the health issues but the cost of smoking wasn’t something I had really thought about,” Bell said. “It was good information.”
Bell started smoking at 19 to fit in with his friends.
“To be honest with you, it was peer pressure,” Bell said. “I guess I wanted to be in the cool crowd.”
Karen Caston, director of shelter operations at the Arlington Life Shelter, said the classes can have an impact.
“They come here to become self-sufficient,” Caston said. “Anything that helps their health, their mental state and their financial state, can’t help but be a good thing.”
http://www.fosters.com/apps/pbcs.dll/article?AID=/20131216/GJLIFESTYLES/131209301/-1/SANNEWS

Forum editorial: Progress in tobacco cessation

North Dakota was recognized last week as leader among states meeting national standards for funding anti-smoking programs. It’s a welcome designation. Moreover, it’s more evidence the state is doing an excellent job with the resources it has to educate about the risks of smoking and secondhand smoke and provide programs to help smokers quit.
No thanks to the Legislature.
At nearly every turn in the smoking debate during the last decade, lawmakers, particularly those in the Republican majority, have done the bidding of the smoking lobby and hospitality industry. Lobbyists worked to scuttle statewide smoking curbs, and their legislative allies fell into line, despite clear indications that a majority of North Dakotans wanted a smoking ban. Indeed, several cities, large and small, were ahead of the Legislature in imposing smoking restrictions, most of them via the ballot.
As in the cities, it took the ballot box to spank the Legislature. Two measures did what the legislators refused to do. The first in 2008 established a tobacco prevention and cessation program funded in large part by tobacco lawsuit settlement money. The second passed by a landslide in 2012 with every county voting “yes.” It made all public places 100 percent smoke free.
Despite dire predictions from fans of poisoning their customers (it’s their “right,” you know), the sky did not fall on the bar scene or the hospitality sector. Instead, smoking levels among adults are down significantly. There is more work to do among the state’s youth, and that’s where education programs are focused.
It’s good news. It’s good for the state’s long term public health, which, in turn, is a plus for everything else in North Dakota.
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Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/event/article/id/421219/

Smoke from E-Cigs Still Poses Some Second-Hand Risk

By  @acsifferlin , TIME Health & Family
It’s not real tobacco smoke, but the emissions from electronic cigarettes can still contain harmful ingredients.
A new study published in the journal Nicotine and Tobacco Research shows that e-cigarettes generate enough nicotine emissions that they can be inhaled by those near a smoker. The researchers conducted two studies on three brands of e-cigarettes that investigated what the devices emitted into the surrounding air.
In the first study, the scientists used a smoke machine to “smoke” the cigarettes and then measure the concentrations of nicotine and other volatile organic compounds such as carbon monoxide released. They compared these emissions to those of standard cigarettes. Then, the team asked five male participants to smoke both tobacco and e-cigarettes in a room that measured contaminant exposure.
The found that e-cigarettes are a source of second-hand exposure to nicotine, but not of other compounds released when tobacco is burned. And the nicotine exposure was 10 times less than that from tobacco smoke.
However, another recent study from New York University researchers reported that e-cigarette smokers may not be spared such exposures. They inhale more nicotine because they puff more often and tend to breathe in more deeply than regular cigarette smokers. So higher nicotine consumption may be a risk for e-cig smokers.
Both studies suggest there’s much still to be learned about the health risks of e-cigarettes, including their effect not just on smokers but on those around them. The Food and Drug Administration currently does not regulate e-cigarettes, but has proposed a rule that would give the agency more regulatory power over the devices.
http://healthland.time.com/2013/12/13/smoke-from-e-cigs-still-poses-some-second-hand-risk/#ixzz2nfw3Jckr

Forum editorial: Smokeout still has work to do

In 1976 a group of anti-smoking activists got the idea of having a national day when smokers would be urged to not smoke. From that modest beginning at the California Division of the American Cancer Society emerged The Great American Smokeout, which has been observed every year since then on the third Thursday of November. By any measure, it’s been a success. There is more work to do.
These days, the only people who deny the dire health effects of tobacco use are, well, not bright. Only those who cling to peculiar notions of “personal freedom” and business privilege sans business responsibility dismiss the damage to personal health and public health from tobacco use. They comprise a smaller minority every day, as more enlightened Americans favor laws and regulation to protect individual and public health.
It’s not a new concern. Efforts to restrict smoking in public places go back to 1908 in New York City, where the city council approved a ban on women from smoking anywhere except in their homes. The mayor vetoed the ordinance.
Since then, the nation, often led by states, has moved steadily toward smoke-free environments in public venues and private places that cater to the public, such as restaurants. Today only a handful of states do not have statewide smoking bans. Minnesota approved a ban in 2007. North Dakotans had to go to the polls in 2012 to secure a comprehensive ban after session after session of the Legislature capitulated to the tobacco lobby and refused to enact a statewide ban. Before the 2012 vote, voters in several cities, including Fargo and West Fargo, had pointed the way.
Smoking has not gone away. It won’t anytime soon. About 19 percent of Americans still light up, but that level is way down from the days when up to 60 percent of adults in many states used tobacco in its various forms. Progress has been steady and impressive, and it’s not always been a legislature or ballot measure that drove the issue. In many cities and states, private sector businesses were ahead of public policy in imposing smoking bans.
Credit must go to the American Cancer Society’s Great American Smokeout for keeping the issue in front of Americans. Together with a plethora of medical organizations, public health agencies, schools, attorneys general who were willing to challenge Big Tobacco (and win) and many other efforts, the message has been received. Even those people who smoke for reasons they believe to be legitimate understand what they are doing to themselves by smoking and to others via secondhand smoke. Given the unassailable science and medical evidence, how could they not know?
And so to that dwindling group, today’s Smokeout says: “Give it up for the day. Try to quit.” If a few do, that’s more progress.
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Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/event/article/id/418984/

Quitters are winners: The benefits of kicking the tobacco habit

By Richard A. Claiborne

We all know the bad news about smoking, including health risks, expense and even criticism from non-smokers. But, for many people, scare tactics are not helpful when it comes to quitting. To put a positive spin on smoking cessation, let’s look at the benefits of living tobacco-free and how to go about quitting.
The greatest benefit to kicking the habit is dramatically improving your health. According to a report from the Surgeon General, as soon as you take that last puff, your body is busy repairing itself. Just one day after stopping, the heart rate and blood pressure drop and the carbon monoxide level drops to normal. By nine months, coughing and shortness of breath decrease; lungs start to regain normal function, increasing the ability to handle mucus, clean the lungs and reduce the risk of infection. At one year, the risk of coronary heart disease is half that of a smoker, and by five years, the report says the risks of cancer of the mouth, throat, esophagus and bladder are cut in half. After 15 years of living smoke-free, the risk of coronary heart disease and many cancers is that of a non-smoker.
Other benefits of living nicotine-free include:
•  Feeling in charge of your actions.
•  Knowing you are not bothering others with your smoke.
•  Saving money (not to mention time looking for a place to smoke).
•  Smelling better! Your hair, clothes, breath, care, home and kids won’t smell like smoke.
•  Enjoying an increased sense of smell.
•  Having fewer worries – about health, money, having to make sure you have a cigarette supply.
•  Looking and feeling better! Your skin will look healthier.
•  Having more energy.

How to quit

Those most successful at quitting are those who make a firm commitment, have a plan and work hand in hand with their physician to tailor a program to meet their unique needs. So:
•  Make a commitment and pick a “quit day.” Mark it on your calendar, tell friends and family and seek out support systems so you will feel accountable to achieve your goal.
•  Prepare your surroundings. Get rid of cigarettes and remove smoking triggers, including inviting smoking areas.
•  Stock up on suckers and gum to satisfy oral cravings.
•  Create distractions and have plans for how you will stay busy. Make a list of friends to call.
•  Make an appointment with your doctor. Your doctor can help you decide if you would benefit from anti-smoking medication or a support group.

Nicotine replacement therapy

Nicotine replacement therapy involves replacing cigarettes with other nicotine substitutes. Therapies work by delivering small and steady doses of nicotine into the body to relieve some of the withdrawal symptoms without the tars and poisonous gases found in cigarettes. This helps smokers focus on breaking their psychological addiction and learn new behaviors and coping skills.
The U.S. Food and Drug Administration has approved five types of nicotine replacement therapies: gum, lozenges and patches, which can be purchased over the counter; and nasal sprays and inhalers, which require a prescription. These products can be very helpful in the initial stages of quitting and withdrawal. However, nicotine is addictive and a person can transfer their dependence from cigarettes to the other therapy, particularly the fast delivery of nasal spray. Use only as prescribed by your doctor.

Prescription medications

These oral medications help you stop smoking by reducing cravings and withdrawal symptoms without the use of nicotine. Some can be used along with nicotine replacement therapies, and some must be started before your planned quit day.
Varenicline (Chantix) is a prescription medicine developed to help people stop smoking by interfering with nicotine receptors in the brain. It has a duel effect: It reduces the pleasure a person gets from smoking, and reduces the symptoms of nicotine withdrawal. It is typically started before your quit date. Bupropion (Zyban) is another effective prescription smoking cessation medicine. Several studies have shown taking medication can more than double the chances of quitting compared to taking no medicines at all. Medications are most effective when used as part of a comprehensive cessation program monitored by your physician.

Alternative therapies

•  Hypnosis – Places you in a deeply relaxed state where you are open to suggestions that strengthen your resolve to quit smoking.
•  Behavioral therapy – Nicotine addiction is related to the habitual behaviors involved in smoking. Behavior therapy focuses on learning new coping skills and breaking those habits.
•  Counseling – Participating in individual or group counseling can be beneficial in the educational and motivational aspects of smoking cessation. According to the Centers for Disease Control and Prevention, the combination of medication and counseling is more effective for smoking cessation than either medication or counseling alone.
Kicking the habit is hard work but it can be done. With a plan tailored to your needs, you can break the addiction, manage your cravings and join the millions of people who have quit smoking for good. If you are ready to quit, talk to your physician.

Richard A. Claiborne practices in pulmonary medicine at Via Christi Clinic, 3311 E. Murdock. He may be reached at 316-689-9325.

http://www.kansas.com/2013/11/09/3106682/quitters-are-winners-the-benefits.html

Maryland cigarette sales down 17% since tobacco tax hike, report says

, Reporter-Baltimore Business Journal
The number of cigarette packs sold in Maryland has declined 17 percent since 2008, according to a new report released Wednesday by a health care advocacy group.
A total of 200 million packs of cigarettes were sold in Maryland in fiscal 2012, down from 243 million in 2008, according to data compiled by Maryland Citizens’ Health Initiative that analyzes data from the national Campaign for Tobacco-Free Kids. The report is intended to highlight improvements in combatting smoking among teens and adults since Maryland raised a tax on cigarette packs in 2008 to $2.
The report comes as the Citizens’ Health Initiative and other health care organizations prepare to lobby for another $1 increase on the cigarette tax. If successful in the Maryland General Assembly, the tax would rise to $3 a pack.
The total number of cigarette packs sold in Maryland has been declining for more than a decade, according to the report. Back in 1995, 389 million packs of cigarettes were sold in the state.
Maryland’s General Assembly in 2012 increased the tax on mini cigars (which come in fruit flavors and have become popular among teenagers) to 70 percent of wholesale price, up from 15 percent. The assembly also increased the tax on smokeless tobacco to 30 percent of wholesale price, up from 15 percent.
In the assembly’s next session, which starts in January, health advocates will also be seeking another increase to the tax on smokeless tobacco and mini cigars.