You
Know You Want to Quit
Let us help persuade
you about how much happier and healthier you’ll
be without those little white cancersticks in your life
By Susan Fan
Ask
almost any smoker, and they will agree they ought to quit.
Even a kindergartner knows smoking is bad for you, though
they may not know why. As a physician, I am frequently
puzzled by how little attention is given to the many consequences
of tobacco abuse. It seems like you cannot pick up a magazine
or turn on the television or radio without hearing some
reference to the killer epidemic of breast cancer, or
the latest celebrity victim of prostate cancer. The truth
is, heart disease and stroke kill more people every year
than cancer, and these diseases are directly linked to
cigarette smoking. Which is not to say that nonsmokers
do not develop heart trouble or suffer from strokes, because
they certainly do. However, smokers have a significantly
increased risk for these sometimes-catastrophic events.
Although no official statistics exist, there may be a
higher incidence of smoking among gays and lesbians. If
this is true, it is paradoxical to me that a community
which is already at risk for certain life-threatening
problems (HIV/AIDS for men, increased risk of breast cancer
for some women) would further jeopardize its collective
health. In this article, I am going to challenge the rich
and powerful Oz—I mean tobacco industry—and
enlighten you as to the evils of smoking.
There are hundreds of different chemicals in cigarette
smoke, and the biological effects of many of these are
not fully understood. What we do know is that, first and
foremost, tar and nicotine are cancer promoters. This
means that any abnormal cancerous cells which may be present
in the lungs can be encouraged to divide and increase
in number in the presence of these agents. Such abnormal
cells develop randomly in all tissues of the body, and,
usually, our defense mechanisms can eliminate them before
they become large enough to form tumors. Cancer promoters
interfere with this process, and full-blown lung cancer
results. There is also evidence that cigarette smoke is
a cancer initiator, that it actually causes abnormal cells
to develop in the lungs. There are many other factors
in play in the development of cancer, of course. While
we do not understand all of them, we do know that women
are more susceptible to the effects of cigarette smoke,
and therefore a female smoker is more likely to develop
cancer than a male who smokes the same amount for the
same number of years. We also know that the effect is
cumulative; for cancer to occur in men, it seems to require
a “20-pack” history; that is, smoking a pack
a day for 20 years, or two packs a day for ten years,
etc. For women, this number is reduced. Also, not all
smokers develop lung cancer, and some nonsmokers do. In
fact, only 18 to 25 percent of long-time smokers ever
develop cancer of the lung. However, because 25-30 percent
of the adult population smokes, and the survival rate
from lung cancer is dismal, it is the number-one cancer
killer of men and recently moved ahead of breast cancer
as the number-one cancer killer of women.
So, if lung cancer probably won’t kill you, why quit?
Cigarettes can do much more harm than just lung cancer.
A severe stroke can leave one unable to talk, walk, or
use an arm. Cancer of the mouth, tongue, and voicebox
are common, and the treatment is not only incredibly disfiguring,
but many patients lose the ability to speak. There are
worse things than dying, I believe.
Cigarette smoke greatly accelerates aging. Smokers have
more wrinkles, and develop heart disease and hardening
of the arteries much earlier than nonsmokers. This can
lead to loss of limbs from gangrene, and kidney failure
because of decreased blood flow. Male impotence is another
common consequence of hardening of the arteries. Because
they have a lower oxygen concentration in their blood,
smokers are more prone to cataracts and lumbar disc degeneration.
They have a propensity for poor wound healing, especially
after surgery. Many smokers develop a chronic hacking
cough, which can lead to emphysema and bronchitis. The
worst cases become oxygen dependent, hooking them up to
an oxygen tank for the rest of their impaired lives. Even
young smokers have a decreased exercise tolerance, and
perform worse than their nonsmoking counterparts on lung-function
testing. And if quitting for your health is not reason
enough, consider the odor that permeates clothing, hair,
skin, indeed everything surrounding a smoker—not
to mention yellow teeth, yellow skin, and bad breath.
I know the cigarette habit is highly addictive and that
quitting is difficult, especially when everywhere you
go, you see people smoking. But don’t be discouraged
if you’ve tried and started up again. For most smokers,
it takes seven separate trials before they are finally
able to quit. The good news is that many of the adverse
effects are reversible, depending on the length of tobacco
use. No matter how old or how long a smoker, there are
always benefits to stopping.
As a community, we are too smart to continue to play Russian
roulette with our collective health. I would challenge
our family to be trendsetters in good health as we are
in politics, and become the first community to address
and eliminate tobacco abuse.
Dr. Susan W. Fan, M.D., is a radiologist in private
practice.
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