Monday, July 17, 2006

Smoking ban 'would have delighted Hitler' says Smith

Comedian and actor Mel Smith has threatened to flout Scotland's smoking ban by sparking up when he appears on stage this summer, it emerged today.

Smith told the Scotland on Sunday newspaper he refused to use a fake cigar for when he plays Winston Churchill in the play Allegiance at the Edinburgh Fringe Festival.

And the actor hit out at the Scottish Parliament, saying that the smoking ban would have delighted the wartime leader's arch-enemy Adolf Hitler.

The total ban on smoking in enclosed public spaces came into force in Scotland last March and has been hailed as a success by the Scottish Executive.

But not everyone is happy and Smith is not the only rebel threatening to flout the smoking ban at the Fringe.

Edinburgh's Hill Street Theatre manager Tomek Borkowy has vowed to literally stage a defiance of the ban during the arts festival, branding it "communist censorship".

Smith told Scotland on Sunday: "Who knows, maybe I'll light it [the cigar]. Maybe I won't. But maybe I will. I mean, what are they going to do to me? Are they going to extradite me?"

In a broadside at Holyrood, the comedian added: "The thing I would like to say about (the smoking ban) is that it would have delighted Adolf Hitler.

"Adolf Hitler, as you know, was anti-smoking. You couldn't smoke at Adolf Hitler's dining table, so he'd be pleased, wouldn't he? Congratulations Scotland."

Allegiance is inspired by the Irish independence leader Michael Collins' real-life visit to London in 1921.

The play, which will be staged at the Assembly Rooms, revolves around the fiction that over the course of one night, Collins and Churchill met and became friends.

An Executive spokesman said: "The smoking legislation applies equally to actors, as it does to other workers and members of the public.

"If smoking requires to be represented in film, TV and theatre performances, realistic alternatives can be used or developed."

Individuals face a fixed penalty of £50 while the manager of any premises who allows others to smoke there can be fined £200.

Sunday, July 16, 2006

Women are more likely than men to develop unhealthy habits such as smoking

Women are more likely than men to develop unhealthy habits such as smoking, snacking on high-sugar, high-fat snacks, and drinking caffeine when they work long hours, a British study finds.

However, working long hours does have one beneficial effect for both women and men: They drink less alcohol.

The findings are from a University of Leeds study focused on the effects of stress on eating. The study was funded by the Economic & Social Research Council in the United Kingdom.

"Stress disrupts people's normal eating habits," researcher Dr. Daryl O'Connor said in a prepared statement. "Stress causes people to opt for unhealthy high-fat and high-sugar snacks in preference to healthier food choices. Also, people under stress eat less than usual in their main meals, including their vegetable intake, but shift their preference to high-fat/high-sugar snacks instead."

He and his colleagues studied the effects of stress on the eating habits of 422 people. The stress was caused by minor work and non-work events, such as having an argument with a colleague or friend, losing keys, missing a deadline, or having to give a presentation.

People who experienced one or more of minor stressful events reported eating many more between-meal snacks than usual but fewer portions of vegetables and a smaller main meal. The study also found that mental stress was more likely to cause people to snack than physical stress.

"Those more at risk of snacking under stress are best described as 'emotional eaters'," O'Connor said. "These individuals have higher levels of vulnerability and tend to turn to food as an escape from self-awareness. In other words, when they feel anxious or emotionally aroused or negative about themselves, they try to avoid these negative feelings by turning their attention to food."

"Our findings are disturbing in that they show stress produces harmful changes in diet and leads to unhealthy eating behaviors," O'Connor said.

More information

The American Academy of Family Physicians has more about stress.

Friday, July 14, 2006

Smoking increases the risk of lung diseases.

Your Health

Health concerns usually top the list of reasons people give for quitting smoking. About half of all smokers who continue to smoke will end up dying from a smoking-related illness. Nearly everyone knows that smoking can cause lung cancer, but few people realize it is also a risk factor for many other kinds of cancer as well, including cancer of the mouth, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, cervix, stomach, and some leukemias.

Smoking increases the risk of lung diseases such as emphysema and chronic bronchitis. These progressive lung diseases – grouped under the term COPD (chronic obstructive pulmonary disease) – are usually diagnosed in current or former smokers in their 60s and 70s. COPD causes chronic illness and disability and is eventually fatal.

Smokers are twice as likely to die from heart attacks as are nonsmokers. And smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles, as well as cerebrovascular disease that can cause strokes.

Smoking also causes premature wrinkling of the skin, bad breath, bad smelling clothes and hair, and yellow fingernails and hair, yellow fingernails and increased risk of macular degeneration, one of the most common causes of blindness in the elderly.

For women, there are unique risks. Women over 35 who smoke and use birth control pills are in a high-risk group for heart attack, stroke, and blood clots of the legs. Women who smoke are more likely to have a miscarriage or a lower birth-weight baby. Low birth-weight babies are more likely to die or to be permanently impaired.

Based on data collected in the late 1990s, the US Centers for Disease Control (CDC) estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking.

No matter what your age or how long you've smoked, quitting will help you live longer. People who stop smoking before age 35 avoid 90% of the health risks attributable to tobacco. Even those who quit later in life can significantly reduce their risk of dying at a younger age.

Ex-smokers also enjoy a higher quality of life with fewer illnesses from cold and flu viruses, better self-reported health status, and reduced rates of bronchitis and pneumonia.

For decades the Surgeon General has reported the health risks associated with smoking. Regardless of your age or smoking history, there are advantages to quitting smoking. Benefits apply whether you are healthy or you already have smoking-related diseases. In 1990, the Surgeon General concluded:

Quitting smoking has major and immediate health benefits for men and women of all ages. Benefits apply to people with and without smoking-related disease.
Former smokers live longer than continuing smokers. For example, people who quit smoking before age 50 have one-half the risk of dying in the next 15 years compared with continuing smokers.
Quitting smoking decreases the risk of lung cancer, other cancers, heart attack, stroke, and chronic lung disease.
Women who stop smoking before pregnancy or during the first 3 to 4 months of pregnancy reduce their risk of having a low birth weight baby to that of women who never smoked.
The health benefits of quitting smoking far exceed any risks from the average 5-pound weight gain or any adverse psychological effects that may follow quitting.
When Smokers Quit – What Are the Benefits Over Time?

20 minutes after quitting: Your heart rate drops.
(US Surgeon General's Report, 1988, pp. 39, 202)

12 hours after quitting: The carbon monoxide level in your blood drops to normal.
(US Surgeon General's Report, 1988, p. 202)

2 weeks to 3 months after quitting: Your circulation improves and your lung function increases.
(US Surgeon General's Report, 1990, pp.193,194,196,285,323)

1 to 9 months after quitting: Coughing and shortness of breath decrease; cilia (tiny hair like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection.
(US Surgeon General's Report, 1990, pp. 285-287, 304)

1 year after quitting: The excess risk of coronary heart disease is half that of a smoker's.
(US Surgeon General's Report, 1990, p. vi)

5 years after quitting: Your stroke risk is reduced to that of a nonsmoker 5-15 years after quitting.
(US Surgeon General's Report, 1990, p. vi)

10 years after quitting: The lung cancer death rate is about half that of a continuing smoker's. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decrease.
(US Surgeon General's Report, 1990, pp. vi, 131, 148, 152, 155, 164,166)

15 years after quitting: The risk of coronary heart disease is that of a nonsmoker's.
(US Surgeon General's Report, 1990, p. vi)

Visible and Immediate Rewards of Quitting
Quitting helps stop the damaging effects of tobacco on your appearance including:

premature wrinkling of the skin
bad breath
stained teeth
gum disease
bad smelling clothes and hair
yellow fingernails
Kicking the tobacco habit also offers benefits that you'll notice immediately and some that will develop gradually in the first few weeks. These rewards can improve your day-to-day life substantially:

Food tastes better.
Sense of smell returns to normal
Ordinary activities no longer leave you out of breath (climbing stairs, light housework, etcetera.)
The prospect of better health is a major reason for quitting, but there are others as well.

Cost

Smoking is expensive. It isn't hard to figure out how much you spend on smoking: multiply how much money you spend on tobacco every day by 365 (days per year). The amount may surprise you. Now multiply that by the number of years you have been using tobacco and that amount will probably astound you.

Multiply the cost per year by 10 (for the upcoming 10 years) and ask yourself what you would rather do with that much money.

And this doesn’t include other possible expenses, such as higher costs for health and life insurance, as well as the health care costs due to tobacco-related conditions.

Social Acceptance

Smoking is less socially acceptable now than it was in the past.

Most workplaces have some type of smoking restrictions. Some employers even prefer to hire nonsmokers. Studies show smoking employees cost businesses more to employ because they are "out sick" more frequently. Employees who are ill more often than others can raise an employer’s need for expensive temporary replacement workers. They can increase insurance costs both for other employees and for the employer, who typically pays part of the workers’ insurance premiums. Smokers in a building also typically increase the maintenance costs of keeping odors at an acceptable level, since residue from cigarette smoke clings to carpets, drapes, and other fabrics.

Landlords, also, may choose not to rent to smokers since maintenance costs and insurance rates may rise when smokers occupy buildings.

Friends may ask you not to smoke in their houses or cars. Public buildings, concerts, and even sporting events are largely smoke-free. And more and more communities are restricting smoking in all public places, including restaurants and bars. Like it or not, finding a place to smoke can be a hassle.

Smokers may find their opportunities for dating or romantic involvement, including marriage, are largely limited to other smokers, who make up only about 1/4th of the population.

Health of Others

Smoking not only harms your health but the health of those around you. Exposure to secondhand smoke (also called environmental tobacco smoke or passive smoking) includes exhaled smoke as well as smoke from burning cigarettes.

Studies have shown that secondhand smoke causes thousands of deaths each year from lung cancer and heart disease in healthy nonsmokers.

Smoking by mothers is linked to a higher risk of their babies developing asthma in childhood, especially if the mother smokes while pregnant. It is also associated with sudden infant death syndrome (SIDS) and low-birth weight infants. Babies and children raised in a household where there is smoking have more ear infections, colds, bronchitis, and other respiratory problems than children from nonsmoking families. Secondhand smoke can also cause eye irritation, headaches, nausea, and dizziness.

Setting an Example

If you have children, you probably want to set a good example for them. When asked, nearly all smokers say they don't want their children to smoke, but children whose parents smoke are more likely to start smoking themselves. You can become a good role model for them by quitting now.

Help Is Available

With the wide array of counseling services, self-help materials, and medicines available today, smokers have more tools than ever before to help them quit successfully.

Remember, tobacco addiction has both a psychological and a physical component. For most people, the best way to quit will be some combination of medicine, a method to change personal habits, and emotional support. The following sections describe these tools and how they may be helpful for you.

In This Section:

What About Nicotine Replacement Therapy?
Types of Nicotine Substitutes
Which Is Right for You?
Other Methods of Quitting
Telephone-based Help to Stop Smoking
Support
A Word About Success Rates
Special Concerns
Where Can I Go for Help



Help With Psychological Addiction

Some people are able to quit on their own, without the help of others or the use of medicines. But for many smokers, it can be hard to break the social and emotional ties to smoking while getting over nicotine withdrawal symptoms at the same time. Fortunately, there are many sources of support out there – both formal and informal.

Telephone-based Help to Stop Smoking

Most states run some type of free telephone-based program that links callers with trained counselors, such as the American Cancer Society’s Quitline program. These specialists help plan a quit method that fits each person's unique smoking pattern. People who use telephone counseling stop smoking at twice the rate of those who don't get this type of help. With guidance from a counselor, quitters can avoid common mistakes that may hurt a quit attempt.

Telephone counseling is also more convenient for many people than some other support programs. It doesn't require transportation or childcare, and it's available nights and weekends. Counselors may recommend a combination of methods including medicines, local classes, self-help brochures, and/or a network of family and friends.

Smokers can get help finding a Quitline program in their area by calling ACS at 1-800-ACS-2345 (1-800-227-2345).

Support of Family, Friends, and Quit Programs

Many former smokers say a support network of family and friends was very important during their quit attempt. Other people who may offer support and encouragement are coworkers, your family doctor, and members of support groups for quitters. You can check with your employer, health insurance company, or local hospital to find support groups; or call the ACS at 1-800-ACS-2345.

What to Look for in a Stop-Smoking Program

Stop smoking programs are designed to help smokers recognize and cope with problems that come up during quitting and to provide support and encouragement in staying quit. Studies have shown that the best programs will include either individual or group counseling. There is a strong association between the intensity of counseling and the success rate. In general, the more intense the program, the greater the likelihood of success.

Intensity may be increased by having more or longer sessions or by increasing the number of weeks over which the sessions are given. So, when considering a program, look for one that has the following:

session length – at least 20 to 30 minutes per session
number of sessions – at least 4 to 7 sessions
number of weeks – at least 2 weeks
Be certain the leader of the group has training in smoking cessation.

Some communities have a Nicotine Anonymous group that holds regular meetings. This group applies the principles of Alcoholics Anonymous to the addiction of smoking. There is no fee to attend.

Often your local American Cancer Society, American Lung Association, or local health department will sponsor quit smoking classes. Call 1-800-ACS-2345 for more information.

There are some programs to watch out for as well. Not all programs are ethical. Be very careful of programs that do the following:

Promise instant, easy success with no effort on your part.
Use injections or pills, especially "secret" ingredients (nicotine replacement is covered elsewhere).
Charge a very high fee. Check with the Better Business Bureau if you have doubts.
Are not willing to provide references from people who have taken the class.

Help With Physical Addiction: Nicotine Replacement Therapy and Other Medicines

Nicotine Replacement Therapy

As mentioned earlier, the nicotine in cigarettes leads to actual physical dependence, which can cause unpleasant symptoms when a person tries to quit. Nicotine replacement therapy (NRT) provides nicotine – in the form of gums, patches, sprays, inhalers or lozenges – without the other harmful components of tobacco. It can help relieve some of these symptoms so that a person can concentrate more on the psychological aspects of quitting.

How Nicotine Replacement Works

Nicotine substitutes treat the very difficult withdrawal symptoms and cravings that 70% to 90% of smokers say is their only reason for not giving up cigarettes. By using a nicotine substitute, a smoker's withdrawal symptoms are reduced.

While a large number of smokers are able to quit smoking without nicotine replacement, most of those who attempt quitting are not successful on the first try. In fact, smokers usually need several attempts – sometimes as many as 8 to 10 – before they are able to quit for good.

Lack of success is often related to the onset of withdrawal symptoms. By reducing these symptoms with the use of nicotine replacement therapy, smokers who want to quit have a better chance of being successful.

Getting the Most From Nicotine Replacement


Nicotine replacement therapy only deals with the physical aspects of addiction. It is not intended to be the only method used to help you quit smoking. It should be combined with other smoking cessation methods that address the psychological component of smoking, such as a stop smoking program. Studies have shown that approach - pairing NRT with a program that helps to change behavior – can double your chances of successfully quitting.

The US Agency for Healthcare Research and Quality (AHRQ) Clinical Practice Guideline on Smoking Cessation recommends NRT for all smokers except pregnant women and people with heart or circulatory diseases. If a health care provider suggests nicotine replacement for people in these groups, the benefits of smoking cessation must outweigh the potential health risk. Smokers who are pregnant or have heart disease should consult with their doctor before using over-the-counter nicotine replacement.

The most effective time to start NRT is at the beginning of an attempt to quit. But often smokers first try to quit on their own, then decide to try NRT.

Nicotine replacement therapy should not be used if you plan to continue to smoke or use another tobacco product. The combined dose of nicotine could be dangerous to your health.


Types of Nicotine Substitutes


Five types of nicotine replacement therapy have been approved for use by the US Food and Drug Administration (FDA).

Nicotine patches (transdermal nicotine systems): Patches provide a measured dose of nicotine through the skin. As the nicotine doses are lowered by switching patches over a course of weeks, the tobacco user is weaned off nicotine. Patches can be purchased without a prescription. Several types and different strengths are available. Package inserts describe how to use the product as well as special considerations and possible side effects.

The 16-hour patch works well for light-to-average tobacco users. It is less likely to cause side effects like skin irritation, racing heartbeat, sleep problems, and headache. But it does not deliver nicotine during the night, so it is not helpful for early morning withdrawal symptoms.

The 24-hour patch provides a steady dose of nicotine, avoiding peaks and troughs. It helps with early morning withdrawal. However, there may be more side effects such as disrupted sleep patterns and skin irritation.
Depending on body size, most tobacco users should start using a full-strength patch (15-22 mg of nicotine) daily for 4 weeks, and then use a weaker patch (5-14 mg of nicotine) for another 4 weeks. The patch should be applied in the morning to a clean, dry area of the skin without much hair. It should be placed below the neck and above the waist - for example, on the arm. The FDA recommends using the patch for a total of 3 to 5 months. However, some studies have shown that using it for 8 weeks or less is just as effective as using it for longer.

Side effects are related to:

the dose of nicotine
the brand of patch
your individual skin characteristics (such as the person’s tendency to have a skin reaction to the patch)
how long you use the patch
how it is applied
Some possible side effects of the nicotine patch include:

skin irritation – redness and itching
dizziness
racing heartbeat
sleep problems or unusual dreams
headache
nausea
vomiting
muscle aches and stiffness
What to do about side effects:

Try a different brand of patch if skin irritation occurs.
Reduce the amount of nicotine by using a lower dose patch.
Sleep problems may be temporary and pass within 3 or 4 days. If not (and you're using a 24-hour patch), try switching to a 16-hour patch.
Stop using the patch and try a different form of nicotine replacement.
Nicotine gum (nicotine polacrilex): Nicotine gum is a fast-acting form of replacement that acts through the mucous membrane of the mouth. It can be bought over-the-counter without a prescription. It comes in 2 mg and 4 mg strengths.

For best results, follow the instructions of the package insert. Chew the gum slowly until you note a peppery taste. Then, "park" it against the cheek, chewing it and parking it off and on for about 20 to 30 minutes. Food and drink can affect how well the nicotine is absorbed. You should avoid acidic foods and drinks such as coffee, juices, and soft drinks for at least 15 minutes before and during gum use.

If you smoke a pack or more per day, smoke within 30 minutes of rising, or have trouble not smoking in restricted areas, you may need to start with the higher dose (4 mg). No more than 20 pieces should be used in one day. Nicotine gum is usually recommended for 1 to 3 months, with the maximum being 6 months. Tapering the amount of gum chewed may help you stop using it.

If you have sensitive skin, you may prefer the gum to the patch. Another advantage of nicotine gum is that it allows you to control the nicotine doses. The gum can be chewed as needed or on a fixed schedule during the day. The most recent data have shown that scheduled dosing is more effective. A schedule of 1 to 2 pieces per hour is common. On the other hand, with an as-needed schedule, you can chew more gum during a craving.

Some possible side effects of the gum:

bad taste
throat irritation
mouth sores
hiccups
nausea
jaw discomfort
racing heartbeat
Symptoms related to the stomach and jaw are usually caused by improper use of the gum, such as swallowing nicotine or chewing too rapidly. The gum can also cause damage to dentures and dental prostheses.

Long-term dependence is one possible disadvantage of nicotine gum. In fact, research has shown that 15% to 20% of gum users who successfully quit smoking continue using the gum for a year or longer. Although the maximum recommended length of use is 6 months, continuing to use the gum is likely to be safer than going back to smoking. But since there is little research on the health effects of long-term nicotine gum use, most health care providers still recommend limiting its use to 6 months.

Nicotine nasal spray: The nasal spray delivers nicotine quickly to the bloodstream as it is absorbed through the nose. It is available only by prescription.

The nasal spray immediately relieves withdrawal symptoms and offers you a sense of control over nicotine cravings. Because it is easy to use, smokers report great satisfaction. However, the FDA cautions that since this product contains nicotine, it can be addictive. It recommends the spray be prescribed for 3-month periods and should not be used for longer than 6 months.

The most common side effects last about 1 to 2 weeks and can include the following:

nasal irritation
runny nose
watery eyes
sneezing
throat irritation
coughing
There is also the danger of using more than is needed. If you have asthma, allergies, nasal polyps, or sinus problems, your doctor may suggest another form of nicotine replacement.

Nicotine inhalers: Introduced in 1998, inhalers are available only by prescription. The nicotine inhaler is a plastic tube with a nicotine cartridge inside. When you puff on the inhaler, the cartridge provides a nicotine vapor. Unlike other inhalers, which deliver most of the medication to the lungs, the nicotine inhaler delivers most of the nicotine vapor to the mouth. In terms of similar behavior, nicotine inhalers are the closest thing to smoking a cigarette, which some smokers find helpful.

The recommended dose is between 6 and 16 cartridges a day, for up to 6 months.

The most common side effects, especially when first using the inhaler, include:

coughing
throat irritation
upset stomach
At this time, inhalers are the most expensive of the forms of NRT available.

Nicotine lozenges: These are the newest form of NRT on the market. The FDA recently approved the first nicotine-containing lozenge as an over-the-counter aid in smoking cessation. As with nicotine gum, the Commit lozenge is available in 2 strengths: 2 mg and 4 mg. Smokers determine which dose is appropriate based on how long after waking up they normally have their first cigarette.

The lozenge manufacturer recommends using it as part of a 12-week program. The recommended dose is one lozenge every 1-2 hours for 6 weeks, then one lozenge every 2-4 hours for weeks 7 to 9, and finally, one lozenge every 4-8 hours for weeks 10 to 12. In addition, the manufacturer recommends the following:

Stop all tobacco use when beginning therapy with the lozenge.

Do not eat or drink for 15 minutes before using the lozenge. (Some beverages can reduce the effectiveness of the lozenge).

Suck on the lozenge until it dissolves. Do not bite or chew it like a hard candy, and do not swallow it.

Do not use more than 5 lozenges in 6 hours, or more than 20 lozenges total per day.

Stop using the lozenge after 12 weeks. If you still feel you need to use the lozenge, talk to your doctor.

Do not use the lozenge if you continue to smoke, chew tobacco, use snuff or any other product containing nicotine (e.g., nicotine patch or gum).
Possible side effects of the nicotine lozenge include:

trouble sleeping
nausea
hiccups
coughing
heartburn
headache
flatulence (gas)
Which Type of Nicotine Replacement May Be Right for You?

There’s no evidence that any type of nicotine replacement therapy is significantly better than any other. When choosing which type of nicotine replacement you will use, think about which method will best fit your lifestyle and pattern of smoking. Do you want/need something to chew or occupy your hands? Or are you looking for once-a-day convenience?

Some important points to consider:

Nicotine gums, lozenges, and inhalers are oral substitutes that allow you to control your dosage to help keep cravings under better control.

Nicotine nasal spray works very quickly when you need it.

Nicotine inhalers allow you to mimic the use of cigarettes by puffing and holding the inhaler.

Nicotine patches are convenient and only have to be applied once a day.

Both inhalers and nasal sprays require a doctor’s prescription.

Some people may not be able to use patches, inhalers, or nasal sprays due to allergies or other conditions.
Combination of the patch and other nicotine replacement products: Using the nicotine patch along with shorter-acting products such as the gum, lozenge, nasal spray, or inhaler is another method of nicotine replacement therapy. The idea is to provide a steady dose of nicotine with the patch and to use one of the shorter-acting products when strong cravings arise.

The few studies that have been done on combination NRT have found that it may be slightly better than a single product, but more research is needed to prove this and to find safe and effective doses. The combined use of nicotine replacement products has not yet been approved by the FDA. If you are considering using more than one nicotine replacement product, be sure to discuss this with your doctor first.

Bupropion (Zyban)

Bupropion (Zyban) is a prescription antidepressant in an extended-release form that reduces symptoms of nicotine withdrawal. It does not contain nicotine. This drug affects chemicals in the brain that are related to nicotine craving. It can be used alone or together with nicotine replacement. The usual dosage is one or two 150 mg tablets per day.

This medication should not be taken if you have a history of seizures, anorexia, heavy alcohol use, or head trauma.

Some doctors may recommend combination drug therapy for heavily addicted smokers, such as using bupropion along with a nicotine replacement patch and/or a short acting from of nicotine replacement (such as gum or lozenges).

Varenicline (Chantix)

Varenicline (Chantix) is a newer medicine developed specifically to help people stop smoking. It works by interfering with nicotine receptors in the brain, which has two effects. It lessens the pleasurable physical effects a person gets from smoking, as well as reducing the symptoms of nicotine withdrawal.

Several studies have shown varenicline can more than double the chances of quitting smoking. Some studies have also found it may be more effective than bupropion, at least in the short term.

Reported side effects of varenicline have included headaches, nausea, vomiting, trouble sleeping, unusual dreams, flatulence (gas), and changes in taste.

Stop Smoking Solution

Quitting smoking is not easy, but it can be done. To have the best chance of quitting successfully, you need to know what you’re up against, what your options are, and where to go for help. This document is intended to provide you with this information.

Why Is It So Hard to Quit Smoking?

Mark Twain said, "Quitting smoking is easy. I've done it a thousand times." Maybe you've tried to quit too. Why is quitting and staying quit hard for so many people? The answer is nicotine.

Nicotine

Nicotine is a drug found naturally in tobacco. It is highly addictive – as addictive as heroin or cocaine. Over time, the body becomes physically and psychologically dependent on nicotine. Studies have shown that smokers must overcome both of these to be successful at quitting and staying quit.

When smoke is inhaled, nicotine is carried deep into the lungs, where it is absorbed quickly into the bloodstream and carried throughout the body. Nicotine affects many parts of the body, including your heart and blood vessels, your hormonal system, your metabolism, and your brain. Nicotine can be found in breast milk and in cervix mucous secretions of smokers. During pregnancy, nicotine freely crosses the placenta and has been found in amniotic fluid and the umbilical cord blood of newborn infants.

Several different factors can affect the rate of metabolism and excretion of nicotine. In general, a regular smoker will have nicotine or its by-products present in the body for about 3 to 4 days after stopping.

Nicotine produces pleasurable feelings that make the smoker want to smoke more. It also acts as a kind of depressant by interfering with the flow of information between nerve cells. As the nervous system adapts to nicotine, smokers tend to increase the number of cigarettes they smoke, and hence the amount of nicotine in their blood. After a while, the smoker develops a tolerance to the drug, which leads to an increase in smoking over time. Eventually, the smoker reaches a certain nicotine level and then smokes to maintain this level of nicotine.

Nicotine Withdrawal

When smokers try to cut back or quit, the absence of nicotine leads to withdrawal symptoms. Withdrawal is both physical and mental. Physically, the body is reacting to the absence of nicotine. Psychologically, the smoker is faced with giving up a habit, which is a major change in behavior. Both must be dealt with if quitting is to be successful.

Withdrawal symptoms can include any of the following:

dizziness (may only last 1-2 days in the beginning)
depression
feelings of frustration and anger
irritability
trouble sleeping
trouble concentrating
restlessness
headache
tiredness
increased appetite
These symptoms can lead the smoker to again start smoking cigarettes to boost blood levels of nicotine back to a level where there are no symptoms.

If a person has smoked regularly for a few weeks or longer and abruptly stops using tobacco or greatly reduces the amount smoked, withdrawal symptoms will occur. Symptoms usually start within a few hours of the last cigarette and peak about 2 to 3 days later. Withdrawal symptoms can last for a few days to several weeks. For information on coping with withdrawal, see the section, "How to Quit."