Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Several methods are available to assist those
who decide to quit smoking. The main categories
of methods are:
Prescription smoking cessation aids: varenicline (Chantix), Nicotrol Inhaler and Nicotrol NS, and bupropion hydrochloride (Zyban, Wellbutrin) are available smoking cessation prescription aids. Antihypertensive drugs such as Clonidine (Catapres) and calcium channel blockers have also been prescribed to assist in quitting smoking; however, they have been less effective than
other aids to smoking cessation.
Behavioral modification and self-help literature to quit smoking: Due to the addictive nature of nicotine, some form of behavioral modification is often necessary for successful cessation of smoking. Educational programs, hypnosis, and aversion therapy (learning how to avoid cigarettes) are a few options.
Nicotine replacement therapy (NRT): The purpose of nicotine replacement therapy is to substitute another source of nicotine while cigarettes are discontinued. By this means, the habit of smoking is eliminated, even though the addiction to nicotine remains intact. But at the same time, nicotine replacement therapy eliminates the symptoms of withdrawal that can trigger more smoking.
Smoking and quitting smoking facts
Although smoking is an addiction, people can quit
smoking.
Secondhand smoke is harmful to the health of
children, unborn children, family members, and coworkers.
The steps in quitting, each of which
requires special attention and efforts by the smoker, are getting ready to
quit, quitting, and staying quit.
A number of techniques are available to assist people
who want to quit, including nicotine replacement therapy (NRT), behavioral
modification, self-help literature, and prescription medications.
In nicotine replacement therapy, which is the
cornerstone of most smoking cessation programs, another source of nicotine is
substituted while the cigarettes are stopped. (The idea of nicotine replacement
therapy is to eliminate
both the smoking habit - although the addiction remains - and the symptoms of
withdrawal. Then, the replacement nicotine is gradually stopped.)
Currently, three forms of nicotine replacement therapy are available over the
counter: nicotine patches, nicotine gum, and nicotine lozenges, while two
forms are available by prescription, an inhaler and a nasal spray.
Nicotine replacement therapy has about a 25% success rate, which increases to
35% or 40% when nicotine replacement therapy is combined with intensive behavioral counseling.
Nicotine-containing substances have side effects,
interactions with other medications, effects on other medical conditions, and
limitations in their use.
Varenicline (Chantix) is a prescription drug that can help adults quit smoking. It is believed to act on the same receptors (the sites where nicotine acts to produce its effects) in the brain as nicotine, resulting in activation (stimulation) of these receptors and blocking the ability of nicotine to attach to these receptors.
A prescription drug called bupropion (Zyban,
Wellbutrin) has also been found to be effective in helping people to stop smoking.
What problems are caused by smoking?
By smoking, you can cause health problems not only for yourself but also for
those around you.
Hurting Yourself
Smoking is an addiction. Tobacco contains
nicotine, a drug that
is addictive. The nicotine, therefore, makes it very difficult (although not
impossible) to quit. In fact, since the U.S. Surgeon General's 1964 report on
the dangers of smoking, millions of Americans have quit. Still, approximately
440,000 deaths occur in the U.S. each year from smoking-related illnesses; this
represents almost 1 out of every 5 deaths. The
reason for these deaths is that smoking greatly increases the risk of getting
lung cancer, heart attack, chronic lung disease, stroke, and many other cancers.
Smoking is the most preventable cause of death. In addition, smoking is perhaps the most preventable cause of breathing
(respiratory) diseases within
the USA.
Hurting Others
Smoking harms not just the smoker, but also family
members, coworkers, and
others who breathe the smoker's cigarette smoke, called
secondhand smoke or
passive smoke. Among infants up to 18 months of age, secondhand smoke is
associated with as many as 300,000 cases of
chronic bronchitis and pneumonia each year.
In addition, secondhand smoke from a parent's cigarette increases a child's
chances for middle ear problems, causes
coughing and wheezing, worsens
asthma, and increases an infant's risk of dying from
sudden infant death
syndrome (SIDS).
Smoking is also harmful to the unborn fetus. If a
pregnant woman smokes, her fetus is at an increased risk of
miscarriage, early delivery (prematurity), stillbirth, infant death, and low birth weight. In fact, it has been estimated that if all women quit smoking during pregnancy, about 4,000 new babies would not die each year.
Exposure to passive smoke can also cause cancer. Research has shown that
non-smokers who reside with a smoker have a 24% increase in risk for developing
lung cancer when compared with other non-smokers. An estimated 3,000 lung cancer
deaths occur each year in the U.S. that are attributable to passive smoking.
Secondhand smoke also increases the risk of stroke and
heart disease. If both
parents smoke, a teenager is more than twice as likely to smoke as a teenager
whose parents are both nonsmokers. Even in households where only one parent
smokes, young people are more likely to start smoking.
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due
to tobacco smoke. Lung cancers are classified as either small cell or non-small
cell cancers.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
In the U.S., more than 2,000 people are diagnosed with bone cancer every year. There are many types of bone cancer. The most common forms of bone cancer are osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma. Pain is the most common symptom. Treatment usually involves surgery, chemotherapy, and radiation therapy.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Rosacea is a skin disease that causes redness of the forehead, chin, and lower half of the nose. In addition to inflammation of the facial skin, symptoms include dilation of the blood vessels and pimples (acne rosacea) in the middle third of the face. Oral and topical antibiotics are treatments for rosacea. If left untreated, rhinophyma (a disfiguring nose condition) may result.
Though the cause of stomach cancer is unknown, risk factors for stomach cancer include diet, H. pylori infection, smoking age, gastritis, stomach surgery, family history, and pernicious anemia. Symptoms include stomach discomfort, feeling full after a small meal, nausea and vomiting, and weight loss. Treatment depends upon staging and may involve surgery, radiation therapy, or chemotherapy.
An ectopic pregnancy is a pregnancy located outside the inner lining of the uterus. The majority of ectopic pregnancies occur in the Fallopian tube. Symptoms include abdominal pain, amenorrhea, and vaginal bleeding. Treatment options include observation, medication, or surgery.
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Thrush is an infection of the mouth caused by the candida fungus. Symptoms of Thrush include pain or difficulty swallowing, a feeling that food gets stuck in the throat, and fever.
Bronchitis is a disease of the respiratory system in which the bronchial passages become inflamed. There are two types of bronchitis, acute and chronic. Symptoms of acute bronchitis include frequent cough with mucus, lack of energy, wheezing, and possible fever. Treatment may require medication such as bronchial inhalers and predinsone. Supportive treatment is focused on relieving the symptoms with fever reducers, cough suppressants, and rest. Treatment may be more aggressive in patients with pre-existing conditions such as empyema, COPD, or cigarette smoking.
There are several types of kidney cancer, including renal cell cancer (renal adenocarcinoma or hypernephroma), transitional cell carcinoma, and Wilms tumor. Symptoms of kidney cancer include blood in the urine, an abdominal lump or mass, chronic pain in the side, and tiredness. Treatment of kidney cancer--which may include surgery, arterial embolization, radiation therapy, biological therapy or chemotherapy--depends upon the stage of the disease and the patient's overall health.
Treatment for bladder cancer depends on the stage of the disease, the grade of the tumor, and the type of bladder cancer. Options for treatment include surgery, radiation therapy, chemotherapy, and biological therapy.
Abdominal aortic aneurysm is a ballooning or widening of the main artery (the aorta) as it courses down through the abdomen. The most common cause of aortic aneurysms is
"hardening of the arteries" called arteriosclerosis.
The term oral cancer includes cancer of the mouth (oral cavity) and the back of the mouth (oropharynx). Red and white patches inside the mouth, bleeding, loose teeth, pain upon swallowing, a lump in the neck, earache, and a sore on your lip or in your mouth that won't heal are all symptoms of oral cancer. Treatment for oral cancer depends upon the staging of the disease and usually involves surgery, radiation therapy, or chemotherapy.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Esophageal cancer is a disease in which malignant cells form in the esophagus. Risk factors of cancer of the esophagus include smoking, heavy alcohol use, Barrett's esophagus, being male and being over age 60. Severe weight loss, vomiting, hoarseness, coughing up blood, painful swallowing, and pain in the throat or back are symptoms. Treatment depends upon the size, location and staging of the cancer and the health of the patient.
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Emphysema is a progressive disease of the lungs. The primary cause of emphysema is smoking. Alpha 1-antitrypsin deficiency is a rare disorder that has a genetic predisposition to emphysema. Aging, IV drug use, immune deficiencies, and connect tissue illnesses are also risk factors for emphysema. Emphysema is a subtype of COPD (chronic obstructive pulmonary disease, COLD). Symptoms include shortness of breath and wheezing. Management of symptoms may be achieved with medications, quitting smoking, pulmonary rehabilitation, or surgery.
COPD (chronic obstructive pulmonary disease) is a disorder that persistently obstructs bronchial airflow. COPD mainly involves three related conditions, chronic bronchitis, chronic asthma, and emphysema. Symptoms of COPD include chronic cough, shortness of breath, frequent respiratory infections, wheezing, morning headaches, and pulmonary hypertension. Treatment of COPD is focused on the related condition(s).
Dry eyes are caused by an imbalance in the tear-flow system of the eye, but also can be caused by the drying out of the tear film. This can be due to dry air created by air conditioning, heat, or other environmental conditions. Treatment may involve self-care measures, medications, or rarely, surgery.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
Anal cancer, cancer located at the end of the large intestine, has symptoms that include anal or rectal bleeding, anal pain or pressure, anal discharge or itching, a change in bowel movements, and/or a lump in the anal region. Treatment for anal cancer may involve radiation, chemotherapy, or surgery and depends upon the stage of the cancer, its location, whether cancer is eradicated after the first treatment, and whether the patient has HIV.
Impotence, also known as erectile dysfunction, is a common
problem among men characterized by the consistent inability to sustain an
erection sufficient for sexual intercourse or the inability to achieve
ejaculation, or both. Impotence can have emotional causes but most often it is
due to a physical problem.
Asthma is a common disorder in which
chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Signs and symptoms include shortness of breath, chest tightness,
cough and wheezing.
Porphyria is a group of disorders -- the porphyrias -- that affect the nervous system or skin, or both.
Each type of porphyria results from a deficiency of one of the enzymes needed to make heme.
Most porphyrias are inherited disorders, but porphyria cutanea tarda is usually an acquired disorder.
Cutaneous types of porphyria affect the skin, causing symptoms such as blistering, itching, and swelling.
Acute types of porphyria affect the nervous system, causing symptoms such as abdominal pain, vomiting, numbness, and mental disorders.
Each type of porphyria is treated differently.
What is porphyria?
Porphyria is a term that refers to a group of disorders -- the porphyrias -- that affect the nervous system or skin, or both. Each type of porphyria is due to the deficiency of one of the enzymes needed to make a substance in the body called heme. Enzymes are proteins ...
