How Can I Stop Smoking?


Not what we have, but what we use;
Not what we see, but what we choose;
These are the things that mar or bless
the sum of human happiness.
-Joseph Fort Newton

Recently, I was pleased to read that Premier Ralph Klein is planning to quit smoking. He says his grandchildren want him to give up the bad habit.

As we know, Klein is a determined man. Once he decides do something, he does it. He stopped drinking and he received praise from all over Canada. He set a good example.

Klein may be aware that tomorrow is the first day of National Non-smoking Week. And next Wednesday is Weedless Wednesday. Wouldn’t it be nice, if during the next seven days, Klein goes public with a statement that he has given up smoking?

Klein is a very respected and successful politician. And I know one of these days, when he is ready, we will here the good news. And it will be a good present for his grandchildren.

Why it is so difficult for Klein and millions of others to quit smoking?

Nicotine is an addictive drug. It causes dependence and tolerance. Once you are hooked on it, it takes control of your mind and body. There is craving for more and more nicotine.

If you try to deprive your mind and body of nicotine then you get very unpleasant withdrawal symptoms. These are: irritability, anger, impatience, restlessness, difficulty concentrating, insomnia, increased appetite, anxiety and depression.

Smoking is also habit forming. It becomes part of our routine – cigarette on waking up, cigarette after a meal, cigarette with a drink, cigarette with coffee, cigarette before a bowel movement, cigarette after sex (remember Austin Power joke?), cigarette to relieve stress and so on.

Is there help for people who want to quit smoking?

Sure, there is help. The world does not come to an end the day you stop smoking. In fact, a whole new world opens up.

One can successfully quit smoking:

1. If the person is motivated.
2. If the person seeks counseling.
3. If the person goes on nicotine replacement therapy.

As a caring society, we can only create awareness and support system to help people quit smoking. But in the end, the success or the failure depends on personal motivation.

What motivates people to quit smoking?

There is fear of disability and death due to cancer or heart disease. There is desire to be healthy. There is a desire to have better old age, desire to be a role model for one’s family, desire to save money and use it for healthier activities, and desire to prevent damage to the environment and one’s family from second hand smoke.

What really works?

Studies have shown that self-motivation, counseling and nicotine replacement therapy achieves the highest rate of success, 40-60 percent in the initial phase and about 30 percent at the end of one year.

Nicotine replacement therapy is available in different preparations – gum, skin patch, nasal spray and vapor inhaler.

We also need to create a good support system – at home, at school and in the community.

We know that smoking is harmful. But people do start smoking and continue to smoke. Most smokers start before the age of 20, out of curiosity and from peer pressure (to look cool!).

Unfortunately, 50 percent of smokers will die prematurely due to smoke related disease. They will certainly be missed by their friends and families.

But it is never too late. You can quit smoking and reverse the damage. Help is only a phone call away.

You can see your family physician. He can help. You can also contact Rita at Freedom from Smoking (phone: 502-8224). She has plenty of tricks to share with you. But first, you should have the motivation and desire to quit smoking! Then make the phone call.

National non-smoking Week (January 18-24) is a good week to call. Good luck!

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Ten reasons for Klein to butt out!

Ten reasons for Klein to butt out!

An open letter was sent to Mr. Klein and it was published in the Medicine Hat News on Monday, August 25th, 2003, Page B4.

From: Dr. Noorali Bharwani [mailto:bharwani@monarch.net]
Sent: Friday August 22,2003 12:17 PM
To: premier@gov.ab.ca
Cc: Letters- Medicine Hat News
Subject: Open letter to Premier Klein – time to stop smoking!

Dear Mr. Klein:

I am shocked and disappointed to read in to-day’s Medicine Hat News (Klein slams butt bylaw) that you smoke. I was very proud of you when you publicly accepted that you were addicted to alcohol and took action to rid yourself of that evil. Now it is time for you to go public and say smoking is an evil which not only destroys your health but drains our health care system of precious dollars which can be put to better use.

In your recent statement you gave several reasons why you think smoking is a lesser evil than alcohol. I beg to disagree. And I think many Albertans and Canadians are going to be disappointed that you chose to make a statement which will encourage people to justify their smoking. As a premier who cares about the health of Albertans and how every dollar is spent in the health care system, I would have expected that you would have given the following ten reasons (well publicized in Health Report to Albertans 2003; AADAC’s It’s time to tell the truth about tobacco; and Alberta Cancer Board’s Cancer in Alberta, January, 2003) why all Albertans should stop smoking and discourage others to start smoking:

1. Albertans smoke more than the national average.

2. In 2000-2001, 683,900 Albertans were smokers.

3. Tobacco causes one in five deaths in Alberta.

4. Tobacco use is the leading cause of preventable illness, disability and death in Alberta and Canada.

5. Tobacco is the cause of an average of 3,400 premature deaths each year in Alberta.

6. Smokers have two to four times the risk of heart attack and sudden death from coronary artery disease than non-smokers.

7. Smoking around children can negatively impact their health.

8. Smoking during pregnancy is associated with low birth weight and health problems in infancy and later on.

9. Exposure to second-hand smoke can increase non-smokers’ likelihood of developing asthma, heart disease and lung cancer and

10. Nicotine is addictive.

I hope these are ten good reasons to declare smoking a monstrous evil and call on all Albertans to quit smoking. And you may want to set an example by throwing all your cigarettes in the garbage. I am sure many Albertans and Canadians will be grateful to you and be proud of their premier who always sets a good example when it comes to self-discipline.

Yours Sincerely,

Dr. Noorali Bharwani
(A concerned citizen)
Medicine Hat, AB
www.nbharwani.com
bharwani@monarch.net

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Patients Who Smoke

Dr. Frederick Ross of Winnipeg must have become a household name. He has been extensively interviewed and quoted in the media. And his recent actions have rekindled the debate about individual’s responsibility to his own health and physician’s responsibility to educate his patients on preventive medicine.

What did Dr. Ross do?

Three months ago, he informed all his patients that he would not treat smokers who are unwilling to give up the deadly habit. They were given 90 days to quit. The deadline was last week. That’s when Dr. Ross hit the headlines. Some people complained that Dr. Ross’s action was unethical. Manitoba’s licensing body for Physicians thinks otherwise.

As we know, tobacco use is the leading preventable cause of death in Canada. It is responsible for one in five deaths. Half of regular smokers die prematurely of tobacco-related disease. Many patients continue to smoke although they have known or experienced ill health due to smoking.

What are the obstacles to quitting?

The main obstacle to quitting is the addictive nature of nicotine, says an article in the New England Journal of Medicine (NEJM).

Nicotine causes tolerance and physical dependence. If you quit smoking then expect withdrawal symptoms like irritability, anger, impatience, restlessness, difficulty concentrating, insomnia, increased appetite, anxiety, and depressed mood. These symptoms may vary widely in intensity and duration.

The withdrawal symptoms begin a few hours after the last cigarette, peak two to three days later, and wane over a period of several weeks or months.

The second obstacle to quitting is the psychological factor – tobacco use is a learned behaviour, cigarettes become part of a person’s daily routine, says the NEJM article.

It is associated with events, such as finishing a meal; handling stress and negative emotions such as anger or anxiety. To stop smoking, a smoker must learn new coping skills and break old patterns.

Smokers who have good intention to quit have two problems: staying free of cigarettes for a long period of time and putting on weight.

What is effective in encouraging smokers to quit?

A physician can do what Dr. Ross did. But scientifically, two approaches have been found to be effective: counselling and nicotine replacement therapy. Each is effective by itself, but the two in combination achieve the highest rates of smoking cessation, says the NEJM article.

Studies have shown that a physician’s advice to stop smoking increases the rates of smoking cessation among patients by approximately 30 percent.

One report in the Medical Post says that half the specialists surveyed never counselled patients on smoking cessation. That burden seemed to fall on the family physicians, who were eight times more likely to ask patients about a quit date than other physicians.

Nicotine replacement therapy comes in different forms: gum, skin patch, a nasal spray, and a vapour inhaler. Combination of counselling and drug therapy achieves typical rate of cessation at 40 to 60 percent at the end of drug treatment and 25 to 30 percent at one year.

Changing public behaviours is difficult. “The first reform is to stay healthy,” says Mazankowski report. We know that relatively small changes in our lifestyle can markedly reduce several major diseases. But are we ready to do that?

Through these columns and through CHAT TV’s “Medical Moments” we have tried to send the same message of self-help and improvement in once life-style. The slogans we have used are: help your doctor to keep you healthy and if you take care of ELMOSS then ELMOSS will take care of you!

So, what did you do today to keep yourself healthy?

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How To Quit Smoking

“Getting kids to butt out” was the topic of my column last week. We also discussed Medicine Hat School District No 76’s “Tobacco-free Environment” Policy A-38. Today, we will take the subject little further.

We know that no one starts smoking after the age of 20. Most smokers start smoking in their teens. We know that 91 percent of youth believe smoking is addictive. We know the two reasons why teens start smoking are: peer pressure (“be cool, man!”), and curiosity.

So, how can we stop teenagers from picking up this habit? And help smoking teenagers kick the habit?

Prevention programs depend on creating public awareness of the serious health consequences of tobacco use. But the Alberta Cancer Board says: “It is now recognized that awareness alone is not enough to alter behaviours. For example, it is ineffective to teach children that smoking is bad for you if the students then go home to parents who smoke, or go to the mall or other public places and see widespread social acceptance of tobacco use.”

To encourage and help people become and remain tobacco free, it is also necessary to create a supportive social environment, says the Cancer Board. Does our school system have such supportive social environment?

Ninety percent of everything we do is habit, says Kurt Hanks in “Motivating People”. Much of motivation involves changing someone’s habits. People are usually quite comfortable with their established patterns and routines. So how can we change them?

To change someone’s habit pattern, you have to substitute a better habit pattern. We have to show them that their time and money can be spent on better and healthier things. Besides that, personal motivation plays a big role.

Personal motivation is the single most important factor that determines a person’s success or failure in quitting cigarettes, says Dr. Edward Beattie, Jr., M.D. in “Toward the Conquest of Cancer.”

The man or woman who is highly motivated to stop smoking – for whatever reason – will be successful while those with weak or moderate motivation often do not succeed, says Dr. Beattie. Personal motivation also determines whether a smoker who has quit will backslide into smoking again.

The teenager does not fear cancer or other illness that may strike him in 20 to 30 years. But he does fear being “uncool”, not knowing how to handle a cigarette, and not being an “in” member of his social group, says Dr. Beattie.

It is never too late to quit smoking. The risk of death decreases soon after quitting and continues to do so for at least 10-15 years. After that, the overall risk is nearly the same level as for never-smokers.

Therefore, it is very important for schools to have programs that focus on prevention and elimination of smoking in and around schools. This should involve parents, teachers and students. We should also create a supportive social environment for teenagers to keep them away from this deadly disease.

The task is not easy. But the parents and teachers should get together and organize some serious preventative measures that we can all try and make it work. Does anybody talk to the kids who stand across from their schools and smoke? Do their parents know they smoke?

Finally, let us remember that cigarette smoking is the largest single preventable cause of cancer. It is also the largest single preventable cause of illness and premature death in Canada. Smoking accounts for almost 30 percent of all cancer deaths and kills almost 3,500 Albertans and 45,000 Canadians each year – more people than killed by heroin, cocaine, alcohol, AIDS, fires, murders, suicides and car crashes combined.

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