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Tobacco addiction

What to do when life goes up in smoke.

By Stef dela Cruz, M.D.

MAY 2013 

It’s said that cigarettes kill almost a thousand Filipinos everyday—and where there’s smoke, there’s fire.

“Approximately 500 to more than 800 Filipinos get smoking-related heart disease and lung cancer each day,” says Laurence Go, a researcher from Action for Economic Reforms. Go was one of the participants of the Cancer Stakeholders’ Consultative Meeting in May 2012.

While people are aware of the negative effects of cigarette consumption, smokers still abound and millions worldwide still die of smoking-related diseases. Why do people continue to smoke despite knowing of the many horrors a stick can bring? Is it really that hard to kick the habit?

Smoking it out

Vin Dancel, a nicotine addict for 25 years before quitting cold turkey, admits how tough it was at first to resist the urge to smoke. “Withdrawals were bad. I got sick [and had] cough, fever, anxiety and agitation. It took a while before the symptoms eased up,” he said. “I’ve been trying to quit for a decade now and this is the longest I’ve gone [without a cigarette].”

Understanding the addiction made it easier for Dancel to quit. “The withdrawals kick in usually after 72 hours,” he said. “A craving lasts only three minutes; whenever I get a craving, I check my watch and ride out those minutes.”

His advice? Take it one day at a time. “It’s too heavy on the psyche to say, ‘I quit forever.’ So, I quit every day,” he says, recalling what he did to kick the habit. “I prepare myself mentally for those situations when a ‘crave’ gets triggered. I put, ‘Never take another puff!’ on my phone to remind me.”

Why smoking is so addicting

But why is it so hard for many smokers to quit for good? A fellow of the Philippine College of Chest Physicians offers an explanation. “Nicotine acts directly on the central nervous system, attaching to receptors found in the brain. Because it is a centrally-acting substance, it is very addicting,” says Jubert Benedicto, M.D., a pulmonary critical care specialist and clinical associate professor at the University of the Philippines College of Medicine.

“Nicotine starts affecting the brain within 10 seconds of the first puff, stimulating the release of chemicals, such as dopamine, serotonin and beta-endorphins, that make a smoker feel good,” he explained. “Although no studies can sufficiently compare the addictive potential of nicotine with other drugs, its effects explain why it’s easy to get addicted.”

Vasopressin is also produced, acting on the brain to improve memory, explaining why people often smoke to perform better at work. The body also produces more adrenaline in response to smoking. “This is why smoking suppresses the appetite and increases wakefulness,” Dr. Benedicto added.

Because smoking temporarily helps a person function better, it seems acceptable to many. A cigarette carries a deceptive propensity to help, despite its potential to hurt even more.

Killing you softly

“Within 10 seconds, the brain releases many chemicals that make smoking a rewarding experience,” Dr. Benedicto reiterates. “However, this is not without consequences.” For instance, the vasopressin that improves memory also constricts blood vessels and increases water retention, leading to elevated blood pressure.

“Immediately after smoking, the airways are irritated by the chemicals found in cigarette smoke—and that’s why inexperienced smokers tend to cough,” Dr. Benedicto explains. The bad news is, the damage does not stop here. “The harmful chemicals found in cigarette smoke reach your blood, wreaking havoc on other organs,” he elaborates. In an instant, the blood vessels of the heart start to constrict, potentially limiting blood flow to your heart muscles.

But when do the lungs start showing signs of damage? “It can take years to knock out the lungs,” Dr. Benedicto answered.

“A person who consumes one pack each day for 10 years is most likely to show a 50 percent decline in lung function. Normally, a person loses about 20 to 30 mL of his lung capacity every year after the age of 30,” declares Dr. Benedicto. In a smoker, this loss is doubled.

“Through the years, the hundreds of harmful chemicals found in tobacco smoke impair a person’s capacity to heal further and further,” he warns. Someone whose capacity to repair cellular damage is subpar can develop a multitude of diseases, including cancer.

“About 80 to 90 percent of lung cancer patients are smokers. Sixty to 80 percent of people with chronic obstructive pulmonary disease (COPD) are smokers, too,” Dr. Benedicto says.

Cigarettes have also been blamed for many other cancers. For instance, about a third of all bladder and pancreatic cancer cases were related to smoking, according to an article on nicotine addiction by Gregory Lande published in December 2012 on Medscape.

The risk of lung cancer is halved 15 years after quitting smoking, especially if done before 50 years old, says Dr. Jubert Benedicto, pulmonary critical care specialist.

Get more tips on kicking the habit in the May issue of

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