Smoking Cessation

Most smokers need to “practice” quitting several times before they make it for good. Dr. David Affleck, M.D., Cardiothoracic Surgeon at St. Mark’s Hospital, discusses smoking and ways to quit.

Hello, my name is David Affleck I’m a cardiothoracic surgeon at St.  Mark’s Hospital in Salt Lake City. I’ve been asked to talk to you today about smoking cessation.

Smoking affect many other organs system sother than the lungs. While it causes lung cancer, and emphysema,and pulmonary fibrosis, it also affects blood pressure and heart disease. That’s probably the single biggest thing outside of lung cancer that I worry about as a cardiothoracic surgeon.

Smoking cessation is probably the only thing that we could do to seriously decrease the number of cardiovascular deaths that we see each year in the United States. In the United States, exposure to second-hand smoke is thought to cause about 46 thousand deaths from heart disease. So three thousand deaths from lung cancerbut 46 thousand from heart disease. Again, as a cardiothoracic surgeon I deal with the heart and the lungs and cardiovascular disease is a major, major problem in this country.

Almost 46,000 deaths as a direct result of second-hand smoke. So a common question that patients ask me goes something like this,Doc, I’ve been smoking for 40 years since I was a teenager. I’m 65 years old, what does it matter now? I tell them that on smoking cessation,their lungs begin to repair themselves almost immediately. In fact, within about seven to 10 days, the cilia, or the little finger projections that are paralyzed by the cigarette smoke begin to work and clear particles and mucus out of the lungs.

And over time, the actual lung function studies dramatically improve. In fact, over the course of just a couple months we’ll see dramatic improvements in the lung function that can be measured by smoking cessation. So, patients that are coming to me for heart surgery, for example, I will insist they quit smoking before I’ll do surgery on them.

Even to the point, if they’ll quit for seven to 10 days, because I know their lung function will be so much better even in that short period of time. So the immediate health benefits of smoking cessation are significant. They include improvement in the circulation,improvement in the lung function, a decrease in the level of carbon monoxide in the blood.

What’s interesting is people have carbon monoxide detectors in their home, yet cigarette smoking increases carbon monoxide levels in the blood. All of these improvements can be expected to begin to occur almost immediately on smoking cessation and continue to improve your health over time. The amount of phlegm produced will decrease and your health benefits will be seen for years to come.

I council my patients who want to quit smoking to use the most tried a true methods. Those are nicotine replacement therapy, so such as gum or patches, in combination with behavioral therapy. And that could include the use of a councilor or a quit coach, those sort of things. The other, I often get asked questions about electronic cigarettes and there’s no data at this point to suggest that using electronic cigarette allows a patient to quit smoking.

So right now, the recommendations are nicotine replacement therapy and behavioral therapy. And those are, again, things we can provide the resources for the patient that wants to quit. In addition to nicotine replacement therapy,there are two web-based resources available to patient’s inclinations. One is smokefree.gov and the other is way toquit.org. It’s important to not feel bad if you fail your first time or your second or third or fourth or fifth, but that you keep trying because you probably,you may not be successful on the first try.

But being successful will improve your life dramatically. There’s some sense of guilt when a patient tries to quit smoking and they’re unable or they relapse and they don’t want to talk to their doctor. I assure you that there’s so judgment. The doctor wants what’s best for you and you should discuss this with him or her and continue to try to quit. Keep trying, no matter how many times to eventually quit.