Lifestyle

Tobacco was introduced to Europe at the end of the fifteenth century. Smoking spread rapidly and was long regarded as having medicinal value. It was not until the 20th century, however, that smoking became a mass habit and not until after the Second World War that the dangers of smoking were firmly established.

About 13 million adults in the UK smoke cigarettes - 29% of men and 25% of women. In 1974, 51% of men and 41% of women smoked cigarettes - nearly half the adult population of the UK. Now just over one-quarter smoke, but the decline in recent years has been heavily concentrated in older age groups: i.e., almost as many young people are taking up smoking but more established smokers are quitting. Smoking is highest among those aged 20-34: 35% of men and women in this age group smoke. More than 80% of smokers take up the habit as teenagers. Polls show that people underestimate the health risks of smoking and the effects of passive smoking.

Giving up smoking is a process, and deciding to give up is the first important step in that process. Stopping smoking is not easy, but it is probably the single most rewarding thing you could ever do, taking into account the impact on your health, your wallet and your self-esteem. At the end of the day, deciding to give up is just that - a decision.

By informing you of the facts about smoking and giving up, this article aims to help you reach that decision - to move you from just thinking about stopping to actually doing it!

It has often been said that if key internal organs such as the heart and lungs were on the outside of our bodies, no one would ever touch a cigarette again. Unfortunately, tucked neatly out of sight as they are, it's all too easy for the smoker to also put them out of mind. Cigarette smoking is damaging to your health. It may seem like a simple paper tube containing chopped up tobacco leaf, but, when you light up, there are some 4,000 chemicals in cigarette smoke.

Smoking contributes to cancer, heart disease, bronchitis, strokes, stomach ulcers, leukemia, gum disease, gangrene, asthma, wrinkles, bad breath.

Smoking makes you short of breath, making sport and exercise more difficult.

Breathing in other people's smoke is called passive smoking. This can cause headaches and lack of concentration. Each year around 17,000 kids under the age of 5 go into hospital with complaints caused by smoke from their parents' cigarettes.

Children as young as 5 years old have tried cigarettes. Kids are more likely to try smoking if they have seen their brothers or sisters doing it.

Cigarettes don't make you relax. Nicotine is a stimulant. It actually speeds up your bodily functions - especially your heart rate.

Kissing someone with a mouth like an ashtray isn't sexy. Having smoke blown in your face isn't sexy. Lung cancer isn't sexy. However, buying someone special a gift with the money you didn't spend on smoking is definitely sexy.

If you think you'll put on weight if you stop smoking, then think again. Cigarettes don't keep your body weight down and they can even cause cellulite. Some people replace cigarettes with food when they give up therefore may put on a few pounds. If you've managed to give up smoking, you'll be able to tackle any weight gain, without any problems.

So you want to while away the time with your friends by killing yourself? Alternatively, there are plenty of other more body-friendly and exciting things to do: try out a new sport, go and see a movie, listen to your favourite music, read the latest bestseller.

Smoking is addictive, and being an addict makes you more dependent than independent.

Only in the sense that smoking gives you wrinkles before your time. There's nothing mature about smelling like an ashtray and inhaling vast amounts of grim chemicals.

Research shows that the top cigarette brands smoked by students are also the ones most heavily advertised.

Legislation drastically curbing the promotion of cigarette sales is being debated by MPs. The European Parliament is keen to toughen health warnings on cigarette packets. We can expect to see new legislation that will increase health warnings to 30% of the front and 60% of the back of packets. At the moment, they occupy 4% of the packaging in Europe. In the USA the proportion is 6% and in Canada it is 50%.

Ring the helpline on Freephone 0800 169 0 169 for information and advice. Pregnant women seeking help in stopping smoking can call the pregnancy Quitline on 0800 169 9169. Specialist helplines are also available in Asian languages. Your doctor, pharmacist, or health visitor should also give advice and they should tell you if there are special services for smokers in your area.

You are not alone! 70% of British smokers would like to quit and about three million try each year. More than 11 million people in Britain have quit and are now ex-smokers. However, it can be tough and you will need lots of willpower to break the hold of nicotine - a powerful and addictive drug. An important part of this is to know what you would gain and what you would lose from stopping smoking.

Soon after smoking a cigarette the body and brain start to want more nicotine and many people begin to feel increasingly uncomfortable until they have the next cigarette. Smoking feels pleasurable, but much of the pleasure of smoking is relief of withdrawal from nicotine. There are times that many people feel distracted or unable to enjoy themselves because you they were not able to smoke. This is nicotine withdrawal in action.

Most people find the first few days difficult and for some it can be a long struggle, but things will typically start to get better after the third or fourth day. Nicotine withdrawal may make you restless, irritable, frustrated, sleepless, or accident prone - but these things will pass and you will quickly start to feel the benefits.

It means different things to different people, but if you know what you want from stopping, it could help you through the most difficult moments. Reasons could include some or all of:

• Better all-round health - stopping smoking reduces risk of 50 different illnesses and conditions.
• Heart attack risk drops to the same as a non-smoker three years after quitting
• Cancer risk drops with every year of not smoking
• Live longer and stay well - one in two long-term smokers die early and lose about 16 years of life
• Set a good example to the kids (or other people's kids) - don't want to be a smoking role model
• Have lots of money to spend on other things - smoking 20 a day can cost £1,850 per year
• Improved fitness and easier breathing - better at sports and getting up stairs
• Better chance of having a healthy baby
• Food and drink tastes better
• Better skin and complexion, and no early wrinkles
• Fresher smelling breath, hair and clothes, and no more cigarette smells around the house
• Back in full control and no longer craving or distracted when not smoking or not able to smoke
• Travel on trains, aircraft, buses will be easier
• Work will be easier and you won't have to spend so much time outside or in the smoking room

Main brand cigarettes now cost roughly £5.00 after the April 2005 budget. The table shows how much smoking costs at current prices.

Cigarettes Per day	Years of Smoking
	1	5	10	20	50
5	£475	£2,373	£4,745	£9,490	£23,725
10	£949	£4,745	£9,490	£18,980	£47,450
20	£1,898	£9,490	£18,980	£37,960	£94,900
40	£3,796	£18,980	£37,960	£75,920	£189,800

Some people make a New Year's Day resolution, others pick their birthday, and you can join in with others on No Smoking Day - the second Wednesday of every March - when up to a million smokers have a go. Any day will do, but choosing a date will help mental preparation.

If you live with someone else that smokes, it will be much easier to quit if you do it together. When expecting a baby, both parents should do it together. One common mistake is not to take the effort to quit smoking seriously enough. Really putting your whole commitment behind it will help you have the right frame of mind to face the challenge.

Nicotine is a powerful addictive drug and you can roughly double the chances of successfully quitting smoking by using nicotine replacement therapies such as patches, lozenges, inhalers, and/or gum. The idea is to come off nicotine gradually by using a low nicotine dose to take the edge off the cravings and have a 'soft landing'. Nicotine products include Nicorette, NiQuitin CQ and Nicotinell. An alternative to nicotine products is the drug Zyban which is only available on prescription. Although it is proven to be effective, as with all drugs there is a risk of side effects and you will need to discuss with your doctor whether this form of therapy would be suitable for you.

Hypnosis, acupuncture or other treatments may help some people, but there isn't much formal evidence supporting their effectiveness. Our advice is to use with caution, but even if they help mental preparation, then they have some value. Herbal cigarettes are pointless - you get all the tar, but nothing to help you deal with nicotine withdrawal.

Smoking also involves having something to do with the hands or mouth. Non-smokers manage without this, so it will not be necessary in the long term. It might be an idea to use chewing gum, drink more water, fruit juice or tea, or to chew or eat something.

Yes it is true: many people do gain weight when they quit smoking. Nicotine changes the appetite and body's energy use (metabolism). Even if you do gain weight it will be worth it if you quit, but if you want to avoid weight-gain then you can prepare. For example, you can change your diet or avoid alcohol, or take more exercise.

In the difficult first few days you can change your routine to avoid situations where you would usually smoke. For example, it might be worth avoiding the pub on the first Friday night after you quit.

In the difficult first few days you can change your routine to avoid situations where you would usually smoke. For example, it might be worth avoiding the pub on the first Friday night after you quit.

Although it might seem like a good idea to cut down and then stop, this is actually very difficult to do in practice. If you cut down, the likely response is that you will smoke each cigarette more intensively and end up doing yourself just as much harm. The best approach is to go for a complete break and use nicotine replacement products to help take the edge off the withdrawal symptoms.

You will need to be on your guard especially in the first few days and weeks. "I'll have just one, it can't harm" is the top of a long and slippery slope. If you are upset or under pressure, it is really important to fight off the temptation to smoke - don't let this be an excuse for slipping back. You could lose everything you've achieved just in a momentary lapse.

Treatment	Information	You can get these from
Prescription only products	There are some effective treatments that only your doctor can provide you with. Some treatments can help with cravings and withdrawal symptoms, if this is a problem for you.	Only available from your GP
Nicotine patches	Different strengths are available. Can be worn round the clock if necessary.	Your GP, pharmacist or smoking clinic
Nicotine gum	Again, different strengths available. Can be used when needed.	Your GP, pharmacist or smoking clinic
Nicotine spray	Intended for heavier smokers	Only available from your GP
Nicotine inhalator	Mimics the action of smoking. Keeps your hands busy	Your GP, pharmacist or smoking clinic
Nicotine sublingual tablets	You can vary the dose easily and they are discreet	Your GP, pharmacist or smoking clinic
Nicotine lozenges	Discreet and easy to use	Your pharmacist or smoking clinic
Alternative therapies	Some people find acupuncture, hypnotherapy, meditation, etc are helpful	Find details of these in your local paper or phone directory, or your smoking clinic may keep information

Time after quitting	Beneficial health changes that take place
20 minutes	Blood pressure and pulse rate return to normal.
8 hours	Nicotine and carbon monoxide levels in blood reduce by half, oxygen levels return to normal.
24 hours	Carbon monoxide will be eliminated from the body. Lungs start to clear out mucus and other smoking debris.
48 hours	There is no nicotine left in the body. Ability to taste and smell is greatly improved.
72 hours	Breathing becomes easier. Bronchial tubes begin to relax and energy levels increase.
2 - 12 weeks	Circulation improves.
3 - 9 months	Coughs, wheezing and breathing problems improve as lung function is increased by up to 10%.
1 year	Risk of a heart attack falls to about half that of a smoker.
10 years	Risk of lung cancer falls to half that of a smoker.
15 years	Risk of heart attack falls to the same as someone who has never smoked.

Withdrawal symptoms are the physical and mental changes that occur following interruption or termination of drug use. They are normally temporary and are a product of the physical or psychological adaptation to long-term drug use, requiring a period of re-adjustment when the drug is no longer ingested. In the case of smoking, some of these are:

Withdrawal symptom	Duration	Proportion of those trying to quit who are affected
Irritability / aggression	Less than 4 weeks	50%
Depression	Less than 4 weeks	60%
Restlessness	Less than 4 weeks	60%
Poor concentration	Less than 2 weeks	60%
Increased appetite	Greater than 10 weeks	70%
Light-headedness	Less than 48 hours	10%
Night-time awakenings	Less than 1 week	25%
Craving	Greater than 2 weeks	70%

The main groups at risk of developing lung cancer are those who smoke or who have smoked regularly in the past. It is never too late to give up smoking, and stopping now will greatly reduce your risk of getting lung cancer or heart disease in the future.

If you have any of the following symptoms - especially if you smoke or have smoked in the past, you should consult your doctor. There are often simple explanations for such systems, so you shouldn't worry unnecessarily:

• A chest infection that doesn't get better
• Coughing up blood
• A cough that is changing or has been troubling you
• Feeling more breathless than usual
• Chest pain
• Voice changes that last for more than three weeks, eg. Hoarseness
• Problems with swallowing
• Feeling generally unwell and tired

To find out what is causing your symptoms your doctor will:

• Examine you
• Arrange for you to have a chest x-ray, if necessary within one week
• Talk through the results of the x-ray with you, within two weeks
• If further tests are needed make an appointment for you

• 40,000 new cases are detected every year
• Smoking causes 90% of lung cancer cases
• The number of cases of lung cancer is rising especially among women

Smoking causes serious damage to your health. It causes heart disease and many cancers, including lung cancer. 111,000 people in the UK die every year from smoking related diseases, 46,000 of these from cancers due to smoking. Smoking causes 30,000 deaths from coronary heart disease and many more people suffer years of pain and discomfort from angina.

Cigarette smoke contains several thousand chemicals, at least two of which - carbon monoxide and nicotine - are main factors in causing coronary heart disease.

Carbon monoxide is a poisonous gas (also present in cat exhaust fumes) and is picked up by the blood much more readily than oxygen. So, when carbon monoxide is present, there is less 'room' for oxygen in the blood. The oxygen carrying capacity of a smoker's blood can be cut by up to 15%. This means that the heart has to work much harder to get enough oxygen all around the body.

Nicotine stimulates the nervous system and this leads to an increase in the rate the heart beats at and causes the blood vessels to narrow. This again, puts a strain on the heart. Nicotine also makes the blood 'sticky' and more likely to clot and block the blood vessels.

A cigarette smoker has about double the risk of having a heart attack as a non-smoker. For the smoker who has high blood pressure and high cholesterol, the risk is eight times greater. Women who smoke are at especially high risk of heart disease if they also take the contraceptive pill.

Many people see smoking simply as "a bad habit". As a smoker, you don't tend to see yourself as an addict; you smoke because you enjoy it. Sadly this perception is just that: a perception. Research shows that cigarettes are as addictive as drugs such as heroin or cocaine. In fact, smoking is complex because it is both addictive and habit forming. It is the combination of the two that makes giving up so hard.

In order to stop smoking, the smoker has to break both the habit and the nicotine addiction. Smoking is deeply ingrained in almost all smokers and it takes time and effort to stop for good. However, 10 million people have given up and of the 13 million currently smoking in the UK, over 9 million actively want to stop.

There are many websites offering good advice and help to those wishing to stop smoking. A list of recommended ones can be found below:

• Ways to stop smoking
• Giving Up Smoking
• Ash
• No Smoking Day
• Department Of Health

Your GP, health centre, pharmacist and practice nurse can also be of help.