Monday, February 16, 2015

Monday, January 26, 2015

Why can't I stop crying since I've quit smoking?

Intense, non-stop crying can be a sign of depression, which is also a nicotine withdrawal symptom. It can also be a sign that you need to learn how to deal with your emotional connection to smoking. Most likely it is a combination of both.

Not only is quitting smoking a physical journey but it is an emotional one too. Often quitters under estimate the strength of that emotional connection. Smoking offers the illusion of being able to go through life with the least amount of pain and the greatest amount of pleasure because it enhances positive emotions like pleasure and happiness and suppresses negative emotions such as stress, anger, sadness and loneliness.

My last challenge to ending my relationship with cigarettes was learning how to deal with anger without smoking.

I had been quit for about three months when I got into a fight with my father. I had never been so angry at him before. He was an alcoholic and a prolific drunk dialer. He had been a  real estate broker for most of his life and I was now selling real estate. I'm sure in his mind he thought he was being helpful when he decided to drunk dial the manager of the office I was working at and identify himself as "Santa Claus". Lucky for me his call was intercepted by a sympathetic secretary.

I blew up and headed straight for my local convenience store and bought a pack of my favorite cigarettes - Marlboro 100's. I wasn't kidding myself about only going to smoke "just one", I knew I was going to chain smoke the whole pack and I did.  As I smoked each cigarette what I was really doing was "smoking at" my father and suppressing my anger.

This relapse only lasted a few weeks. After having cancer I knew it was stupid of me to go back to smoking. I had been trying so hard for so many years to quit, that I made the decision that no matter what I was not going to smoke ever again. That meant I had to learn how to deal with not only my anger but all of my emotions.

Almost all smokers start as teenagers, so at an early age we learn to associate smoking with emotions. They help us celebrate the good times and commiserate during the bad. No wonder it feels like we are losing our best friend when we quit.

There are four ways of dealing with emotions: express, suppress, escape and release. With anger I needed to learn how to release it in a healthy manner without smoking, instead of using nicotine to suppress it. I did have help with this from a professional therapist who I had been seeing to deal with the stress of going through cancer treatment.

The best place to start is to talk with your doctor about cessation medication to lessen the withdrawal symptoms. The use of bupropion, which is an anti-depressant, may be a suitable choice. It can also be used in combination with nicotine replacement products. Next, if professional therapy is not an option, join a support group such as nicotine anonymous, or on an online group such It helps to share your emotional journey with others who can relate how they are dealing with the same issues.

Realize that smoking has been numbing you to the full range of the emotions of life and without smoking you are just beginning to experience the richness of life. Nicotine is not a best friend but a saboteur and an enemy who doesn't want the best for you but only wants your money.

Friday, December 12, 2014

Are E-cigarettes safe? Notes from the FDA December Workshop

I love technology. I was able to attend a two day conference held by the FDA in Washington DC without leaving home. The entire event was available live-stream. The only downside was it started at 8am east coast time and I live on the west coast, so I was getting up early.

This conference was a public workshop about E-cigarettes. Presenters included researchers from around the country, including a few delivered by representatives from the tobacco companies. There was a lot of science discussed and while I'm not a scientist, I could follow most of the discussion.

I'm not going to go into all the details and information that was presented but here are the highlights that I gleamed from this workshop:

  • Everything presented at this workshop is already out dated. E-cigarette technology is expanding so fast that it is almost impossible to keep up with the advancements. 

  • The evolution of e-cigarettes may hold great promise to curb the tide of death and disease from traditional smoking. However, because of the lack of product standardization, manufacturing  and product standards, there is the potential for a great deal of harm.

  • Studies regarding impurities, contaminants and toxicants vary greatly in outcomes because there are over 450 manufacturers of e-cigarettes and many different variations in product type. Levels of most toxicants are significantly lower that those in traditional cigarettes but the range is very wide depending on the manufacturer. There is a concern that high amounts of harmful chemicals are created with higher voltage batteries.

  • Every study is limited to what product is used. For the e-liquid there are over 7000 flavors with approximately 200 new flavors being introduced each month. 

  • Manufacturing standards are needed. Products in the marketplace currently vary greatly in chemical composition and quality of product. Counterfeit and sub-par products are widely available. Some manufacturers have established some good manufacturing and product standards.
  • Some of the concerns are: leaching of metals from the atomizer/cartomizer because of poor quality materials. Some chemicals in the flavors which are considered to be safe for ingestion, are hazardous when inhaled. GRAS (generally recognized as safe) is a designation issued for food products only and any claim that flavors are FDA approved as GRAS is false and misleading. The FDA does not issue approval for food flavors but letters of "no objections". Poor quality batteries can over heat and/or explode. E-liquids made by unscrupulous manufacturers substitute preservatives which are poisonous. Some flavors are toxic. 
As far as how e-cigarettes will be regulated in the future is anyones guess but it is clear that to protect the public that manufacturing and product standards need to be established. Products need proper labeling as to exact contents. E-liquids need to be in child resistance containers, with a limited amount of nicotine available (less than a lethal dose) and a flow restrictor in the lid. Had these last regulations been in place, the death of a young child in New York a few days ago, may have been avoided.