The Call-On-Doc Guide to Smoking Cessation

While many assume that smoking and tobacco only affect the lungs, there are actually many other body parts that suffer from regular and long-term use.

Brain: Smoking has detrimental effects on the brain due to various factors, particularly in many brain functions. The nicotine present in cigarettes acts as a highly addictive substance, altering the brain's reward system and leading to dependence. It can cause changes in neurotransmitter levels, particularly dopamine, which affects mood, motivation, and pleasure. Smoking also compromises blood flow to the brain by constricting blood vessels, reducing oxygen supply, and increasing the risk of stroke. The toxic chemicals in tobacco smoke contribute to oxidative stress and inflammation, damaging brain cells and potentially leading to cognitive decline, memory problems, and an increased risk of neurodegenerative disorders. (4)

Eyes: Smoking has detrimental effects on the eyes and is associated with several eye conditions. The toxic chemicals in cigarette smoke can damage the blood vessels in the eyes, leading to an increased risk of eye diseases such as cataracts, age-related macular degeneration (AMD), and diabetic retinopathy. Smoking also contributes to oxidative stress and inflammation in the eyes, which can further exacerbate these conditions. Additionally, smoking reduces the amount of oxygen reaching the eye tissues, which can negatively impact visual function and overall eye health. Quitting smoking can help reduce the risk of developing or worsening these eye conditions and promote better eye health in the long run. (5)

Gums: Smoking has detrimental effects on gum health and is a significant risk factor for gum disease. The toxic chemicals in cigarette smoke irritate and inflame the gum tissues, leading to a condition called gingivitis, which is characterized by red, swollen, and bleeding gums. Smoking also impairs blood flow to the gums, reducing their ability to heal and fight off infections, and can contribute to the progression of gum disease to a more severe form known as periodontitis. (6) Additionally, using cigarettes and similar products are known to stain teeth. 

Heart: Smoking has a detrimental impact on cardiovascular health and is a major risk factor for various heart conditions. The toxic chemicals in cigarette smoke, including nicotine and carbon monoxide, increase heart rate, constrict blood vessels, and elevate blood pressure, putting additional stress on the cardiovascular system. These effects can lead to the development of atherosclerosis, a condition characterized by the buildup of plaque in the arteries, which narrows and hardens them, reducing blood flow and increasing the risk of heart attacks and strokes. Smoking also promotes the formation of blood clots, further increasing the likelihood of cardiovascular events. (7)

Lungs: Smoking has severe consequences for lung health and is a leading cause of various lung diseases. The toxic chemicals in cigarette smoke, such as tar and carbon monoxide, irritate and damage delicate lung tissues. Smoking increases the risk of chronic bronchitis and emphysema, collectively known as chronic obstructive pulmonary disease (COPD), which results in persistent coughing, shortness of breath, and reduced lung function. Moreover, smoking is a primary cause of lung cancer, as the carcinogens in tobacco smoke can lead to the development of malignant tumors in the lungs. (8)

Blood Vessels: Smoking has significant negative effects on blood vessels throughout the body. The toxic chemicals in cigarette smoke, particularly nicotine, cause blood vessels to constrict, leading to a decrease in blood flow and oxygen supply to various organs and tissues. This constriction increases the workload on the heart and elevates blood pressure, increasing the risk of cardiovascular diseases such as heart attacks, strokes, and peripheral vascular disease. Smoking also damages the inner lining of blood vessels, promoting the development of fatty deposits (plaques) that can lead to atherosclerosis, a condition where the arteries become narrowed and hardened, further impairing blood flow and increasing the risk of cardiovascular complications. (7)

Bones: Smoking negatively impacts bone health in several ways. Firstly, smoking reduces bone density by interfering with the normal process of bone remodeling. The toxic chemicals in cigarette smoke, such as nicotine, inhibit the absorption of calcium and impair the production of new bone cells, leading to a higher risk of osteoporosis and fractures. Additionally, smoking compromises blood circulation, which is essential for delivering nutrients and oxygen to bone tissues, impairing the body's ability to repair and maintain healthy bones. (9)

Muscles: Smoking negatively impacts bone health in several ways. Firstly, smoking reduces bone density by interfering with the normal process of bone remodeling. The toxic chemicals in cigarette smoke, such as nicotine, inhibit the absorption of calcium and impair the production of new bone cells, leading to a higher risk of osteoporosis and fractures. Additionally, smoking compromises blood circulation, which is essential for delivering nutrients and oxygen to bone tissues, impairing the body's ability to repair and maintain healthy bones. (10)

While the most successful method of smoking cessation is dependent on the individual, current research shows that going “cold turkey” has proven to be successful in more cases. For those looking to try, it might be best to consult your healthcare provider, as withdrawal symptoms are known to be more severe in such cases. In either case, it is most recommended that the person practicing smoking cessation plan the entire process. Clearing out all nicotine-related products from your personal environments, building a support group, setting plans that avoid smoking, and most importantly, finding healthy replacements for cigarettes and related products, 

Smoking cessation treatment refers to various strategies and interventions aimed at helping individuals quit smoking and overcome nicotine addiction. These treatments are designed to address both the physical and psychological aspects of tobacco dependence. Here are some common components of smoking cessation treatment:

• Behavioral support: This includes counseling, support groups, or behavioral therapy sessions where individuals receive guidance and develop coping strategies to deal with cravings, triggers, and nicotine withdrawal symptoms. Behavioral support helps individuals identify their smoking patterns, understand the reasons behind their smoking behavior, and develop healthier habits and coping mechanisms.
• Medications: Several medications are available to aid in smoking cessation. Nicotine replacement therapy (NRT) is commonly used, which involves using nicotine patches, gum, lozenges, nasal sprays, or inhalers to gradually reduce nicotine dependence. Other prescription medications, such as bupropion or varenicline, can also help reduce cravings and withdrawal symptoms.
• Combination therapy: Combining behavioral support and medication has been shown to be highly effective in increasing quit rates. The combination of counseling or behavioral therapy with medications offers a comprehensive approach to address both the physical addiction and psychological factors associated with smoking.
• Digital tools and mobile applications: With advancements in technology, various digital tools and mobile applications are available to support smoking cessation efforts. These tools provide personalized support, forums, tracking features, reminders, and more to help individuals stay motivated and track their progress.
• Follow-up and support: Smoking cessation treatment often involves regular follow-up appointments or support sessions to monitor progress, address challenges, and provide ongoing encouragement. Continued support is crucial for long-term success and to prevent relapse.

When a person stops smoking or significantly reduces their nicotine intake, they may experience withdrawal symptoms as the body adjusts to the absence of nicotine. Withdrawal symptoms can vary in intensity and duration depending on the individual and their smoking history. Common withdrawal symptoms of smoking include:

• Nicotine cravings: Strong urges or desires to smoke can be one of the most challenging withdrawal symptoms. Cravings are typically strongest in the initial days and weeks after quitting.
• Irritability and mood changes: Many individuals experience irritability, restlessness, anxiety, or mood swings during nicotine withdrawal. These symptoms are partly due to the impact of nicotine on neurotransmitters in the brain.
• Difficulty concentrating: Some people may find it harder to concentrate or experience a foggy mental state during withdrawal.
• Increased appetite and weight gain: Nicotine is known to suppress appetite, so when a person quits smoking, they may experience increased hunger. This can lead to temporary weight gain, although it is typically modest and manageable.
• Sleep disturbances: Insomnia, difficulty falling asleep, or disrupted sleep patterns can occur during nicotine withdrawal. Some individuals may also experience vivid dreams.
• Fatigue and lack of energy: Many people report feeling tired or having low energy levels during the initial withdrawal period.
• Headaches: Nicotine withdrawal can trigger headaches or migraines in some individuals.

The exact time span differs from person to person, with losing symptoms within two weeks and some lasting longer than four weeks. Some cases additionally report that symptoms are at their worst within the first week, growing lesser and more manageable from then. 

On top of nicotine cessation treatment, those looking to quit should have a plan that almost takes into consideration each day going forward until the process is complete. Identify Triggers and Plan Ahead: Take note of situations, people, or activities that tend to trigger the urge to smoke. Develop strategies to cope with these triggers, such as finding alternative ways to handle stress or seeking support from others. Additionally, many successful strategies our patients have deployed include:

• Build a Support System: Inform your family, friends, and coworkers about your decision to quit smoking. Surround yourself with supportive individuals who can offer encouragement, understanding, and accountability throughout the quitting process.
• Develop Coping Strategies: Identify healthy alternatives to smoking that can help manage cravings and cope with stress. This could include activities like exercise, deep breathing exercises, or engaging in hobbies that provide a distraction.
• Seek Professional Guidance: Consider joining a smoking cessation program or seeking counseling from healthcare professionals. They can provide personalized advice, support, and strategies to overcome challenges and maintain motivation.
• Make Lifestyle Changes: Adopt a healthy lifestyle by engaging in regular physical activity, eating a balanced diet, and managing stress effectively. These changes can support your overall well-being and help reduce the desire to smoke.
• Reward Yourself: Establish a system of rewards for achieving milestones in your smoke-free journey. Treat yourself to something enjoyable or meaningful as a way to celebrate your progress and stay motivated.
• Stay Positive and Persistent: Quitting smoking may have its ups and downs. Remember to be kind to yourself and maintain a positive mindset. If you experience a setback, don't give up. Learn from the experience and use it as motivation to keep moving forward.
• Stay Smoke-Free: Once you've quit smoking, commit to remaining smoke-free. Avoid situations or environments that may tempt you to smoke and focus on maintaining a healthy and smoke-free lifestyle.

The healing timeline after quitting smoking varies, but noticeable improvements begin within days. In the first 20 minutes, blood pressure and heart rate normalize. After 48 hours, carbon monoxide levels drop, enhancing oxygen levels. Within weeks, lung function improves, and circulation enhances. Over months, coughing and shortness of breath decrease, and lung cilia start regenerating. After a year, the risk of heart disease significantly drops. While many health benefits accrue quickly, the full healing process takes years, with reduced risks of cancer and other smoking-related illnesses over an extended period of abstinence. 

It is never too late to quit smoking, regardless of your age. Quitting smoking at any stage of life can have significant health benefits, such as improving your overall well-being and potentially adding additional years to your life. While quitting at a younger age may provide more long-term health advantages, quitting later in life can still have notable positive impacts.

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2. “Why Quitting Smoking Is Hard | Quit Smoking | Tips From Former Smokers | CDC.” Centers for Disease Control and Prevention, https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/quit-smoking-medications/why-quitting-smoking-is-hard/index.html.
3. “Smoking Cessation: Fast Facts | Smoking & Tobacco Use | CDC.” Centers for Disease Control and Prevention, https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/smoking-cessation-fast-facts/index.html.
4. “Smoking harms brain health, regardless of other health conditions.” Heart, American Heart Association, 3 February 2022, https://www.heart.org/en/news/2022/02/03/smoking-harms-brain-health-regardless-of-other-health-conditions.
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6. “Smoking and oral health.” Oral Health Foundation, https://www.dentalhealth.org/smoking-and-oral-health.
7. “How Smoking Affects the Heart and Blood Vessels.” NHLBI, 24 March 2022, https://www.nhlbi.nih.gov/health/heart/smoking.
8. “COPD - What Is COPD?” NHLBI, 24 March 2022, https://www.nhlbi.nih.gov/health/copd.
9. Germany, Judy. “Bad to the Bones | RUSH.” Rush University Medical Center, https://www.rush.edu/news/bad-bones.
10. Wiener, R Constance et al. “Relationship between smoking status and muscle strength in the United States older adults.” Epidemiology and Health vol. 42 (2020), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871150/.