Monday, September 8, 2014

I'm only a social smoker, what's the big deal?

Melanie considered herself a social smoker. Her husband smoked and she would bum a couple of his cigarettes when she was drinking, usually at a party or out to dinner, She considered herself healthy because she ate a low-fat diet and exercised daily; yet she had a high risk for heart disease. She had a family history of heart disease, her father had died from a heart attack in his fifties. She was 65 and had high cholesterol. She complained that her throat hurt after a night of smoking, which turned out that it wasn't one or two cigarettes but often five or six over just a few hours.

Her doctor explained that there is no safe level of smoking. Anyone with any risks for heart disease should not smoke or even be around secondhand smoke because of the damage smoke does to the cardiovascular system.

There are 7,000 chemical in smoke. Many of these chemicals damage both the function of your heart and your blood vessels. Any amount of smoking even light smoking causes damage.

One of the main components is carbon monoxide, the same gas that comes out of the tailpipe of your car. Once in your blood stream, it binds to red blood cells faster than oxygen and the body is oxygen deprived for a few minutes which can lead to either a heart attack or stroke.

Smoking just one cigarette will:
·        Increase your blood pressure
·        Increase your heart rate
·        Constrict your bronchial tubes which makes your lungs work harder
·        Doubles the amount of carbon monoxide in your system and prevents oxygen from reaching your vital organs
·        Decreased the temperature of your hands and feet by constricting small blood vessels

Social smokers believe that smoking enhances their pleasure in social situations. Some social activities such as parties, golfing, playing cards become a trigger to smoke. For some individuals what starts as just a social activity can become an addiction due to the highly addictive nature of nicotine. Smokers don't start out smoking a pack a day but will start out only smoking now and then. Nicotine changes the structure of the brain reinforcing the desire for a cigarette. It can take as few as 100 cigarettes for the brain to become addicted to nicotine and now the social smoker is a full time smoker.

To quit successfully a social smoker needs to realize they can have fun without smoking. They may need to avoid social situations where they have always smoked until smoking is no longer a temptation. Abstaining from alcohol will make it easier.

There is a reason why firefighters wear masks when approaching any fire; our bodies are not made to inhale smoke and there is no safe level of smoke. So my advice to any social smoker is to stop now before any more damage is done to your body and to prevent becoming addicted.

Friday, September 5, 2014

I am a former smoker, what should I do went I am with my friends who still smoke?

​Just something to think about when you are with friends who still smoke----None of us want to be that nasty holy-than-thou former smoker who shames their smoking friends but do you 
1. want to be around secondhand smoke? 
2. Enable your friend in their addiction?
1. Secondhand smoke is a carcinogen. Instead of saying to a friend--"you can't smoke around me." Say- "I (have a medical problem, for me it was cancer) and my doctor has told me not avoid 2nd smoke as much as possible, it is best for my health. I'm not telling you to not smoke, only that I can't be around it. When she lights up--excuse yourself and wait until she is through and then come back. You don't need to say anything else.  You don't need to say what the medical problem is--it could be one of the many risk factors for heart disease or cancer. you might have diabetes, or be pregnant.
2. Enabling addiction--if your friend was shooting heroin would you stay around them and enable them to continue to use heroin? Heroin is less likely to kill your friend than smoking. Most smokers if they are really honest - do want to quit. In the Stages of Change--the first step is not-wanting to quit, one of the psychological interventions is-- social liberation---making their behavior a problem for THEM. People say you can lead a horse to water but you can't make them drink. I feel it is my duty to make that horse AWARE of his thirst and then remove all obstacles between him and the water. In other words, smokers won't quit until smoking is a problem for THEM. Every little thing that makes it more inconvenience for them to smoke, is another little irritation that changes their thinking from "I don't want to quit, to - maybe I should think about quitting."
Three examples: 1. A girlfriend of mine wanted her husband to quit smoking. He could only smoke outside and so they spent a lot of time on the patio so he could smoke. My recommendation to her was to stop sitting out there when he smoked. She didn't need to say anything but by staying out there while he smoke, was condoning his behavior--he had no reason to change--he could smoke AND enjoy her company. If she stopped going out there he was not getting the reinforcement (of her company) that he wanted. He started smoking less and finally did quit.
2. A girlfriend of mine, who smoked, came to visit (she lived in another state). I told her that she couldn't smoke inside my house but could go outside. First time she went out, she left the glass door open and was still talking to me as she lit up. I came over and closed the door and remained inside. I said I didn't want the smoke smell coming into my house. Years later she told me that the action of closing the door on her--caused her to smoke less cigarettes and less of each cigarette. She also thought about her behavior. I don't know if she ever quit since we lost contact over the years. 
3. I used to run a singles club (Sizzling Singles--another story but a whole lot of fun). We would meet in bars when you could still smoke in bars. Often smokers would come up to me with a lit cigarette to ask me a question. I would immediately stop them and say--"Just a minute I'll be right back." I would either go to the bathroom, to the bar to get some water or some other excuse. Once their cigarette was out, I would go back to them and say either, "I'm a former smoker and I find I am so tempted to bum a smoke that I just can't be around a lit cigarette" or "I'm a cancer survivor and my doctor has told me to avoid 2nd hand smoke as much as possible", sometimes I used both answers. No one was ever offended but sympathized with me and often said they wished they could quit too. 
In each case, no one told the smoker to not smoke, no one was "shamed" about their smoking but boundary lines were set by either blaming your doctor or yourself that you can't be around smoke, making it your problem, not shaming them that they have a problem. But in a subtle way the smoker is given a problem--"I can't smoke and be around my friend". You have just started making that horse be aware that maybe they are thirsty. 

Tuesday, August 12, 2014

Robin Williams Mental Health Care Act:

Laughter is the best medicine. If you believe that then I guess that is why it is so hard for us all to believe that such a comic genius like Robin Williams, who gave us all such joy and laughter, could feel such hopelessness and despair that he could take his own life.

I have heard that we all have thought of suicide at one time or another. I certainly have. I've had cancer twice and sometimes the cure is worse than the disease. I have always valued quality of life over quantity and if I was ever at a stage 4, I'm not sure what decisions I would make but chemo might not be one of those choices, but an extra dose of pain killers might be.

But if we can learn anything from the unfortunate event it is that no one is exempt from inner demons. We all have them, some just have stronger more powerful demons. Yet the safety net for those who struggle with depression and other mental illnesses has huge holes in it. Here is a man who had all the resources money could buy, yet it didn't save him. What about the ordinary John or Jane Doe. What are we to do? In the 1980's our mental health system was gutted and it has never recovered.

What I am suggesting is that we use this tragedy to help others. I hope that everyone who reads this, will write to your congressman/woman and suggest a "Robin Williams Mental Health Care Act". This will fund mental health services that are so badly needed in our country. Won't you join me today and write President Obama, your senators, your house representatives. 34,000 people commit suicide every year. We couldn't save one of our brightest actors but we can start to help others. If nothing else just copy this letter and email it:
President Obama:
For Congress:

Friday, July 25, 2014

What is a Tobacco Treatment Specialist and how can you help me quit smoking? Can't I just quit smoking on my own?

A Tobacco Treatment Specialist (TTS) is a person who has been specially trained in the treatment of nicotine addiction. I was trained at the Mayo Clinic. I also belong to a professional organization: The Association for the Treatment of Tobacco Use and Dependence(ATTUD). A TTS will use evidence based material (proven strategies) to help a smoker become smoke-free. One guideline that is used is the The Clinical Practice Guideline: Treating Tobacco Use and Dependence. This publication has delved into all of the research into tobacco treatment and has complied the best practices. Methods are rated A, B, C.

  • A = This method has been proven to work on a consistent basis.
  • B = These methods have conflicting information. 
  • C = No clinical controlled trials to show efficacy.

Many smokers do quit on their own, just like other addictions such as alcohol, cocaine and heroin. But many need help to kick their addiction, especially nicotine. I have had former heroin addicts tell me that heroin and/or alcohol were easier to quit than smoking.

Have you ever talked to a former smoker and asked what helped them to quit? They can tell you the long trial and error process they used and what ultimately worked for them. It doesn't mean that it will work for you. Working with a professional will shorten your learning curve in what will help you quit and stay quit.

Here is what you can expect when working with a professional Tobacco Treatment Specialist:

  • A detailed personal history. Every smoker is different. There is no one-size-fits-all when it comes to tobacco treatment, not even a one-size-fits-most. You will be asked about how much you smoke, for how long, your previous quit attempts, your medical and mental health history, previous or current substance use, your common triggers, assessment of your nicotine dependence and your perceived obstacles to quitting. 
  • From your detailed history, an individualized treatment plan is developed. It will include information of what medications may help and what practical counseling skills are needed for your particular situation including: emotional cues, dealing with stress, weight gain, handling withdrawals with or without medications, being around other smokers, and relapse prevention.
  • Motivation when times are tough. Some days you will feel that nothing can ever drag you back to smoking and other days you will feel that nothing will help except a cigarette. 
  • Explanations for any questions or myths related to smoking. I have had many clients whose doctors have told them that if they quit they would: breathe better, have lower cholesterol, their neuropathy will improve etc. yet they didn't believe their doctors. Why? Because their doctors didn't take the time to fully explain what smoking is doing to their body and how the body heals itself when you quit. 
  • Someone who understands how difficult it is to become smoke-free. While I am a former smoker having quit 9 separate times for at least 3 months and I personally know how hard it is, many TTS's have never smoked but with their specialized training and after working with countless smokers, they don't need to know what it is like. Just as an OB/GYN doctor doesn't need to know how it feels to be pregnant to deliver a baby. 
Signs that it is time to use a TTS instead of trying to quit on your own:
  • You have quit multiple times, only to relapse back to smoking. 
  • Have a history of other substance abuse and/or addiction, or a history of mental illness.
  • A sense of shame or guilt that you are still smoking. Shame is when you feel there is something wrong with you that you can't quit. Guilt is when you feel you should quit and want to quit, but are still smoking. These are normal emotions that a TTS can help you work through instead of letting these emotions stop you from moving forward. 
  • You've tried everything and nothing works. A TTS will help you cut through the "noise" of quitting, helping you focus on what will work. Too often a smoker relies on the latest fad or gimmick to quit instead of what will work, or will rely on just one tool instead of developing several coping strategies. A TTS will focus on the process of quitting, not just the method, since every method will work for some smokers, NO method will work for every smoker.  
Call me today at 760-333-1270 for a FREE 15 minute counseling session to see how I can help you. 

I just turned 50, had a physical and my doctor says I'm in great health. Why should I quit?

It is common to believe that you are one of the "lucky" ones who can smoke without it doing any physical damage, especially when hearing something like this from your doctor. Or believing that when your doctor listens to your chest and says, "Your lungs sound fine", thinking this means smoking has done no damage. This is called having an "optimistic bias".

The average life expectancy for men is 76 and for women 80. Smokers die about 10 years earlier than non-smokers. But since we all have to die of something, it might as well be something you enjoy -right?

Age 45 to 50 seems to be the tipping point. What your doctor should say is, "How do you want to live the last 20 years of your life? If you stop now, you will probably stay healthy and be able to continue doing the activities you enjoy most. However, if you keep smoking, you will probably end up disabled from heart disease, cancer, stroke, or emphysema."

Here is a graph that shows the progression of lung function decline of smokers, non-smokers and quitters leading to disability and ultimately death.

The truth is that no one who smokes is healthy. Fifty percent of all smokers will die from their addiction but almost all will develop some type of disability from smoking. The problem isn't that you will die too young from smoking but you will live too long suffering from a horrible debilitating disease. So quit now while there is still time to stay healthy. Turn your optimistic bias into believing that if you do quit, you will continue to be healthy but if you continue to smoke, you will suffer the disabling effects.