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Thursday, June 30, 2016

The Smoker’s Guide to Staying Healthy

know you know that cigarettes are bad for you. And I don’t want to harp on that subject. But knowledge is power so I’d like to share with you—as I do with my patients—some research and statistics that might give you even more of an incentive to quit.
I will also show you some excellent strategies for minimizing the damage from cigarettes until you feel you are ready to wean yourself off of them completely. And, should you decide to quit, I will give you a few tips for things you can do that might make the withdrawal process easier that you might not have thought about before.
Finally, I’ll talk about whether or not switching to organic or natural, additive-free cigarettes is a safe option.
First, though, I’ll briefly discuss some of the research that shows exactly how cigarette smoke is affecting you and your family.
How Organs Heal Once You Quit
Once you quit smoking, the good news is that your organs will start repairing themselves. Researchers used to think that once you stopped smoking it would take 15 years to reduce your risk of dying from heart disease to the level of lifelong nonsmokers. Now, new findings show that in smokers who smoke less than 32 pack years (3.2 packs a day for 10 years or two packs a day for 16 years), eight years after quitting the risk of developing heart failure or dying from heart failure, heart attacks and strokes declines to the same level as those who never smoked.55
Another study showed that your heart disease risk starts to plummet in as little as three years after quitting smoking. Female non-diabetics who quit smoking within the past three years had a 26 percent lower risk of developing heart disease compared with women who continued smoking. And women who had quit smoking for more than three years saw their risk decline by 61 percent. The news gets better for female smokers with diabetes: those who quit smoking had about a 60 percent lower risk for heart disease, no matter how recently they had quit.56
Most of the women in that study gained less than 11 pounds after quitting. The small group of women who gained more than 11 pounds didn’t see as much benefit to heart health from quitting, especially if they had diabetes.56
Quitting smoking also boosts your levels of HDL cholesterol. One study published in September 2013 showed that this increase occurs soon after you quit and then evens out thereafter.57
Your risk of lung cancer also goes down after quitting. One group of researchers estimated that for females, just under eight years is the time it takes for their lung cancer risk to become half the risk of a continuing smoker. For males, it’s closer to 11 years.58
But it’s not just your risk of lung cancer that goes down. The risk of other cancers—throat, mouth, esophagus, bladder, cervix and pancreas—decreases, too.
Your Body On Cigarettes
Let’s start with heart disease. In people under 50, smoking increases the risk of heart disease and stroke by five-fold. It doubles the risk in people who are over-60.1
Nicotine amps up the heart-harming effects of the oxidized LDL cholesterol in your body, making it even more damaging to your heart by increasing plaque accumulation in your arteries.2
And smoking isn’t good for your brain either. According to research in the American Heart Association journalStroke, brain function in adults as young as 35 may decline as their heart disease risk factors—including smoking cigarettes—increase.3
Smoking also increases your chance of developing rheumatoid arthritis and is linked to insomnia as well.4-5
Smokers’ skin ages faster, too. In a study of identical twins published in November 2013, twins who smoked had more bags under the eyes and wrinkles than their non-smoking twin sibling.6
There’s also something else you might not realize about cigarettes. Remember the Russian who was poisoned by the radioactive substance polonium? Turns out every time you smoke a cigarette—unless they’re the organic or all natural variety—you’re exposed to polonium, too. That’s because the roots of tobacco plants absorb the radioactive polonium-210 found in phosphate fertilizers.
For someone smoking two packages of cigarettes a day, the radiation dose to the lungs is estimated to be at least seven times that from background sources. And in localized areas, it may be up to 1000 rem or more in 25 years.7-10
The Dangers of Thirdhand Smoke
You’ve heard of secondhand smoke, where people who don’t smoke are exposed to cigarette smoke by being around a person smoking. Secondhand smoke is just as damaging to the heart and lungs as firsthand smoke. But, recently, scientists have pinpointed another danger known as thirdhandsmoke. This refers to residue from cigarette smoking that accumulates on the surfaces anyplace where someone smokes—in the car, in the house, on clothes.
Whenever a non-smoker is exposed to thirdhand smoke, they are also being exposed to the carcinogens found in it. Researchers have found a tobacco-specific lung carcinogen known as 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone—or NNK for short—on surfaces in smokers’ homes.11
In addition, some thirdhand smoke components react with other environmental compounds and produce secondary cancer-causing pollutants.12
Although more studies are needed to specify exactly how thirdhand smoke affects the health of non-smokers exposed to it, researchers have found that thirdhand smoke causes DNA damage in human cells.13
They’ve also found that thirdhand smoke can damage lungs extracted from rats in the uterus.14
Young kids who crawl around the floor, touch surfaces (including car upholstery and the clothes of smokers) and then place their fingers in their mouth are especially at risk of coming into contact with thirdhand smoke. Researchers have found that when infants’ bedrooms are contaminated with higher levels of thirdhand smoke, the infants have higher levels of urine cotinine, a nicotine metabolite.15
Are Natural and Organic Cigarettes Better?
The answer to that question is both yes and no. Natural (American Spirit) and organic cigarettes don’t have polonium, since phosphate fertilizer wasn’t used to grow the tobacco. Natural and organic cigarettes also contain slightly less nicotine and lack the additives that cigarette manufacturers usually include—additives that are thought to make cigarettes even more addictive. For this reason, many people swear anecdotally that natural and organic cigarettes are easier to withdraw from than regular cigarettes.16
Organic cigarettes also are better for the planet, at least in regards to the lack of pesticides sprayed on the tobacco crops.
Having said all that, natural and organic cigarettes still contain 40 known or probable carcinogens.17
Additionally, your lungs are still being exposed to smoke filled with toxins rather than clean air. In fact, the FTC requires manufacturers of the natural and organic cigarettes to include the standard Surgeon General warning about cigarettes on the packages and on marketing materials and ads.
So while natural and organic cigarettes do have some advantages over regular cigarettes, they can’t be considered safe or healthy.
If You Are Trying to Quit, Here Are Some Options
First, I recommend joining a social media support group. A recent study in the Journal of Communication found that it was easier to quit smoking if the person participates in health-specific social networking sites that focus on quitting smoking. Because of the increased social connectedness associated with participating on the sites, the members were more likely—and found it easier—to quit smoking. The members also stayed away from cigarettes for longer because of their increased ability to abstain from smoking during tempting situations such as when out drinking, stressed, sad, etc.18
Second, try acupuncture. Studies have shown that it is often effective in helping smokers quit, especially when combined with nicotine replacement therapy (chewing gums and dermal patches).19-21
eCigarettes—battery-powered metal tubes that turn nicotine-containing. Viwater into a vapor—are another option. You’ve probably heard of them, if you haven’t already tried them. In fact, a study published in The Lancet in September 2013 found that eCigarettes are as effective as the nicotine patch in helping smokers quit. The study also found that subjects who had not managed to quit smoked significantly less cigarettes when they were also smoking eCigarettes, compared to the subjects on the nicotine patch or who were given a placebo eCigarette that contained no nicotine.22
Just keep in mind that while eCigarettes result in substantially less toxin exposure than regular cigarettes—levels of toxic compounds found in the smoke from a conventional cigarette are 9-450-fold higher than levels in the vapor of an eCigarette—they aren’t completely free of toxins. For example, exposure to the carcinogen formaldehyde was comparable with that received from cigarette smoking, although formaldehyde exposure varied greatly among eCigarette brands from just 3.2 micrograms per 150 puffs to 56.1 micrograms per 150 puffs.23
Researchers have also found evidence that, among both non-smokers and smokers, using an eCigarette for only 10 minutes may result in damage to the lung.24

The bottom line? eCigarettes are an improvement over conventional cigarettes, but they’re not the perfect solution.
Other Effective Strategies
Another way to increase your odds of kicking the habit is to boost your dopamine levels. Cigarettes, like most addictive substances, influence dopamine levels.25
Most smokers who are withdrawing from cigarettes subconsciously try to increase their dopamine levels by eating too much of sugary foods and refined carbs, which increase dopamine levels.
A healthier way to boost dopamine levels while trying to quit smoking is by supplementing with tyrosine or eating foods rich in tyrosine. The body uses tyrosine to make dopamine. Foods high in tyrosine include chicken, duck, ricotta cheese, oatmeal, mustard greens, edamame, wheat germ, dark chocolate, fava beans and seaweed.
The form of niacin known as nicotinamide also boosts dopamine levels in the brain by protecting brain cells against factors that cause dopamine depletion.26-27
Niacin also is a precursor to phenylalanine, which, in turn, is a precursor to tyrosine. Plus, it lowers cholesterol levels, raises levels of HDL "the good" cholesterol (found to be lower in smokers) and protects your heart—an organ that’s particularly vulnerable to damage from cigarette smoke.28-29
Also, if depression is an issue for you, be sure to get it treated either before or while withdrawing from cigarettes. About half of smokers seeking treatment for smoking cessation have a history of depression. Scientists have found that smokers who suffer from a major depressive disorder (MDD) have a harder time quitting compared with smokers who are not depressed.30-31
Finally, try supplementing with cinnamon and green tea. Believe it or not, cinnamon has been shown to help you quit smoking,32 while green tea also helps reduce nicotine cravings.33
Do Non-Smoking Hotel Rooms Really Protect You From Smoke?
If you think staying in a non-smoking hotel room will protect you from thirdhand smoke, you may want to pay attention to the results of a study published in the June 2013 Tobacco Control.
In this study, researchers examined whether non-smoking guests staying in hotels with and without complete smoking bans were exposed to tobacco smoke pollutants. The researchers took random samples from 10 hotels with smoking bans and 30 without complete smoking bans. They analyzed surfaces and air for the tobacco smoke pollutants nicotine and 3-ethynylpyridine, or 3EP. Non-smoking subjects who stayed overnight in guestrooms provided urine and finger wipe samples to determine exposure to nicotine and a tobacco-specific carcinogen.
Compared with hotels with complete smoking bans, surface nicotine and air 3EP were elevated in both non-smoking and smoking rooms of hotels that allowed smoking. Non-smoking subjects staying in hotels without complete smoking bans had higher levels of finger nicotine and urine cotinine (a marker of nicotine exposure) than those staying in hotels with complete smoking bans. After staying in the 10 most polluted rooms, subjects had significant elevations in urinary levels of a tobacco-specific carcinogen.59
The study authors concluded, “Partial smoking bans in hotels do not protect non-smoking guests from exposure to tobacco smoke and tobacco-specific carcinogens. Non-smokers are advised to stay in hotels with complete smoking bans.”
Keeping Yourself Healthy While You Smoke
I don’t have to tell you that quitting smoking is extremely difficult. So if you are finding it impossible to quit or have only been successful at cutting back the number of cigarettes per day, at least you can try to keep your cardiovascular system as healthy as possible until you succeed at going cold turkey. There are a number of healthy habits you can engage in that will partially protect your body against the toxins you inhale each time you take a puff. And these habits will put you in a stronger place emotionally and physically where you might be more likely to quit.
One of these habits is exercise. Moderate exercise strengthens the heart and reduces the risk of cancer.34-35Additionally, in smokers with post-traumatic stress syndrome (PTSD), the highest levels of PTSD symptoms occurred in regular smokers reporting low weekly exercise levels.36
In some, but not all, studies, exercise has reduced cigarette cravings and withdrawal symptoms.37 In a study of pregnant women, exercise significantly reduced cigarette cravings. It also produced some non-significant—but yet still large—effects on reducing restlessness, stress, irritability, tension and depression.38
It’s important not to overtax yourself, though. Too much exercise can cause free radical damage in the healthiest of people, but this damage is even worse in smokers.39
One exercise you might want to try is yoga. Many studies have shown it’s a great way to keep your cardiovascular system in shape and that it can lower hypertension.40-41
Plus, clinical trials have concluded yoga may help smokers quit the habit. Although researchers are still calling for larger studies, the studies that have been conducted are very promising and show that yoga can reduce cigarette cravings.42-43

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