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 Health & Beauty | April 2005 
Want To Quit Smoking? Here's Some Help
 Kelly Arthur Garrett - The Herald Mexico
A global anti-smoking treaty went into effect last February, committing member nations to take measures to reduce tobacco use and discourage youngsters from starting to smoke.
Mexico has signed and ratified the treaty, so the nation's future will no doubt see an increase in public service ads about smoking's dangers, and perhaps some sharper-toothed regulation of lighting up in public spaces.
But as welcome as increased government pressure may be from a public health point of view, giving up cigarettes comes down to the individual. And it's never easy.
The failure rate for would-be quitters is over 95 percent. In Mexico, it's estimated that on any given day, 50,000 people are trying to kick the habit. About 48,000 of them won't make it through a year without starting up again.
That discouraging statistic is a convincing testimonial to the addictive power of nicotine. But the growing awareness of smoking's link to the two top killer illnesses heart disease and several kinds of cancer is a powerful incentive to stop.
If you want to quit, you can. Many do it cold turkey. But, smoking cessation experts say, your best bet for success is to work with your doctor, seek support from friends or sympathetic strangers, and take advantage of the available quit-smoking aides.
Nicotine replacement devices, the most popular aides, have been available in Mexico since the 1980s. They work.
And they work for a simple reason. Quitting is hard because you're addicted to the nicotine component in tobacco. Replacement devices patches, gum or inhalers deliver smokeless nicotine to your bloodstream in metered doses, gradually weaning you off it.
(As an aside, studies are starting to accumulate showing cognition benefits from nicotine that's delivered patch-style. Researchers are already poking around for a safe and non-addictive way to use a nicotine derivative to enhance memory skills a "smart patch," if you will.)
Except for the gum and the lower-dose patches, nicotine replacement devices usually require a prescription in Mexico. The truth is, you should use them with your doctor's advice anyway, or the advice of a specialist recommended by your doctor. That way you'll have a better idea of the dosage level to choose, based on your medical history and an analysis of your smoking patterns. Basically, the more you smoked, the higher dose of nicotine you'll need at first to stave off cravings.
Which to choose between patch, gum and inhaler often comes down to trial-and-error. But a French study published in 2003 came up with some pretty strong evidence that inhalers may be the best nicotine replacement therapy for women.
The reason for that has to do with a fertile new field of smoking cessation research that looks at differences in the way men and women smoke. Women, generally experience less nicotine dependence than men, but a higher behavioral attraction. In other words, as they try to quit, what they miss most is the ritual of lighting up.
Inhalers, unlike gum or patches, mimic that ritual a bit. You fumble through your purse to find the thing and then actually bring it up to your mouth. "The nicotine inhaler may be a good tool for women," says lead study author Abraham Bohadana, M.D., of the French National Institute of Health. "It not only provides nicotine craving relief but also seems to satisfy the hand-to-mouth habit smokers are used to."
Other investigators, notably at the University of Pittsburgh, are finding more gender-specific factors that affect women's efforts to quit smoking. Most pregnant women, for example, consider it their duty to quit smoking, and usually do. "But," says University of Pittsburgh psychiatry professor Michele Levine, Ph.D., "a full two thirds of them relapse during the first year of the baby's life."
The message is clear: Don't expect your successful efforts during pregnancy to automatically continue through the notorious post-partum mood dips. In fact, mood swings in general are another quitting obstacle for men and women. One answer to the problem is an anti-depression drug that's often prescribed as a quit-smoking aide in the United States under the brand name Zyban. In Mexico, you'll know it by the generic name bupropion.
Why does an anti-depressant help you quit smoking? Well, what makes quitting hard is the withdrawal process, which is worse in the early stages. And what is withdrawal? Feeling bad. So combine a drug that makes you feel better with nicotine replacement therapy to smooth the transition, and you have a pretty good one-two punch.
The Pittsburgh researchers (and others) have found another women-only quirk. Their studies show a pretty clear connection between successful quitting and a quit-date (the day you swear off smoking) early in the menstrual cycle. They're not ready to claim a solid cause-and-effect, but the evidence is good enough to recommend setting your quit date early in your cycle, all other things being even.
Weight gain is another issue that's more prominent with women then men, though men are by no means immune to it. Fear of gaining weight is a major obstacle to quitting, and in one sense it's well-founded. Temporary weight gain is indeed common among smokers who are quitting. That's why, until recently, weight control measures were included in many smoking cessation programs.
But the Pittsburgh researchers found out something surprising in a study of 219 women smokers. Some of the women were put on a diet as they tried to quit smoking, and some were counseled to accept weight gain. Results? Those who surrendered to weight gain were not only more successful in their quitting efforts, they also gained less weight than the dieters.
The lesson? Quit smoking first, and take care of the weight afterwards. Smoking is even worse for your health than being overweight. And once you've experienced the healthy feeling of being smoke-free, it's easier to lose whatever weight you need to.
Finally, it's a given among smoking cessation experts that some kind of social support is a key to quitting. The difference between men and women here is a case of men living up to their stereotype. They prefer to go it alone. But even for them, just a buddy with a patient ear would be a huge plus.
A trend that has been remarkably successful is Internet-based stop-smoking groups. This is an especially attractive option for English-speaking Mexico residents, since it's easy to hook up with a site in your own language. You can ask your doctor for a recommended group, Google around to find something, or start with the well-known Quitnet.com.
Some are loose gatherings of would-be quitters, others are run by smoking-cessation professionals. Either way, the main idea is simply to have somebody to communicate with who's going through the same thing you are. It doesn't sound like much, but for many it's the difference between success and failure.
kellyg@prodigy.net.mx |
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