Cancer Prevention: What You Need To Know
Smoking
Peer Review Status: Internally Reviewed by Cancer
Center Staff
Creation Date: 1996
Last Revision Date: February 2007
What Is Known About This Topic?
Smoking is the single most important cause of cancer. Tobacco use is responsible for nearly one if five deaths in the United States. It is estimated that smoking is related to 438,000 deaths per year in the US. World wide it is estimated that 4.8 million deaths are due to tobacco. Smoking has been linked to cancers of the lung, larynx, pharynx, esophagus, kidney, oral cavity, pancreas, bladder, cervix and one of the leukemias. Cigarette smoking is also associated with an increased tendency to form adenomas which can turn into colon cancer.
There are two new types of tobacco products becoming popular with teenagers and young adults. They are cigars and bidis. Bidis are small flavored cigarettes. This increase in use is due, in part to cigars being promoted as "one of the finer things in life. They also are touted as a "privilege of success". Bidis are provided in flavors preferred by young people, such as cherry, licorice and vanilla. Both of these tobacco products are just as harmful as traditional cigarette tobacco.
What Can I Do to Prevent the Problem Associated With Smoking?
Your risk of developing cancer is reduced by quitting smoking. This is regardless of the type of tobacco product used. After five years off cigarettes, your risk of developing cancer is greatly decreased. Even in those who have smoked for many years, life expectancy is increased after quitting smoking. After ten years the ex-smoker has nearly the same risk as a non-smoker.
Many smokers want to quit. Finding the method that is best to meet your individual needs and styles can be difficult. The following information describes several options for quitting smoking.
- "Cold Turkey"
With this method, smokers just stop cold. Many quitters have used this method. It may require several attempts before the person is successful. It is simple, self-managed and low cost. The person must be highly committed to his/her goal of quitting. Withdrawal symptoms may be severe for some people. This is especially true if they have been smoking a high nicotine cigarette.
Nicotine-fading
When using this method, smokers reduce the nicotine level of cigarettes smoked by 30/60/90 percent over a three week period. They stop altogether during the fourth week. This method may help reduce the effects of nicotine withdrawal symptoms. The American Lung Association can provide a list of the nicotine levels of the cigarette brands. This method is simple, self-managed and inexpensive. It requires a high level of motivation. Nicotine Gum
Nicotine gum provides another source of nicotine. It helps reduce withdrawal symptoms. It requires smokers to stop the use of cigarettes when using the gum. Persons who are highly addicted to cigarettes have a greater chance of becoming dependent on the gum. This method is self managed. It requires a high level of motivation. Smokers often need to chew 10 to 12 pieces of gum daily. This is usually over 3-6 months. It can cost up to several hundred dollars, but is less expensive that smoking. Few insurance policies cover this expense. Nicotine gum is not recommended for use in pregnancy, for those having a recent heart attack, person with heart rhythm problems, chest pain, or with joint problems in the jaw. Minor side effects from the gum include: light headedness, nausea, mouth/throat irritation, hiccups, and an excess of saliva. Nicotine Lozenge
The nicotine lozenge is a type of nicotine replacement that comes in the form of a hard candy. It releases nicotine as it dissolves in the mouth. The lozenges can help control cravings. It continues to work for a time after the lozenge is dissolved. Lozenges come in different dosages. The dose used depends on the timing of the first cigarette smoked in the day. Lozenges should be sucked on and moved side to side in the mouth. It should not be chewed since that allows a large dose of nicotine to be swallowed. Indigestion or nausea can develop when this happens. Nicotine Transdermal Patches
Transdermal (skin) patches are thin medicated patches which are attached to the skin with adhesive. They provide an alternate source of nicotine, and so helps reduce withdrawal symptoms. It requires smoker to stop smoking cigarettes when using the patch. This method is a good choice for highly addicted smokers if they have been smoking cigarettes with high nicotine levels. Each patch lasts 24 hours. In order to be successful, the person must be highly motivated. Therapy with this method is usually recommended for 10-12 weeks. This can cost up to several hundred dollars but is much cheaper than smoking. The patches are not advised for use during pregnancy, for those with high blood pressure or other heart disease. Side effects include skin redness where the patch is applied and restless sleep. Nicotine Nasal Spray
This method helps to reduce cravings and withdrawal symptoms. It allows smokers to gradually reduce their dependence on nicotine. The dose delivered in one squirt is about the same as that of a low tar filtered cigarette. The spray is absorbed through the soft membranes in the nose and acts quickly to stop cravings. There is a risk individuals will become addicted to the nasal spray, so it should not be used longer than three months. Nicotine Inhaler
A nicotine inhaler provides about 1/2 the amount of nicotine in a cigarette. This method is about as effective as the nicotine patch. The inhaler should not be used any longer than six months because of the risk of addiction. Cigarette Filters
The filters attach to cigarettes and gradually reduce the amount of nicotine consumed. The filters usually reduce the nicotine by 25% the first week, 50% the second week, 70% the third week, and 90% the fourth week. Filtered cigarettes, those that come with the filter attached when purchased, are not the same as a cigarette filter. A cigarette filter to filter out nicotine is purchased separately from cigarettes and has to be attached to each new cigarette. Zyban
Zyban is a prescription drug to help people stop smoking. It does not contain any nicotine. It is very different from the nicotine replacement therapies such as the patch or gum. It is not known exactly how Zyban works. It has been shown, however to help people stop smoking. It also can reduce nicotine withdrawal symptoms and cravings. The most common side effects include dry mouth, agitation and trouble sleeping. Those who take Zyban should never increase the dosage of Zyban without their doctor's knowledge. It can cause seizures at higher than recommended dosages.
Zyban is not a new drug. It has been used as an anti-depressant called Wellbutrin. Zyban was approved by the US Food and Drug Administration (FDA) in 1997 as an aid to smoking cessation. Chantix
Chantix is a prescription medicine to help adults stop smoking. Chantix acts at sites in the brain affected by nicotine. It may help those who wish to stop smoking in two ways.
- By providing some nicotine effects to ease withdrawal symptoms and
- By blocking the effects of nicotine from cigarettes if the patient resumes smoking
Smokers start taking Chantix 7 days before their quit date. This lets Chartix build up in the body. Patients can keep smoking during this time. It is important to stop smoking on the quit date. Most people will keep taking Chantix for up to 12 weeks. If you have completely quit smoking by 12 weeks, as the doctor if another 12 weeks of Chantix can help you stay cigarette free.
The most common side effects of Chantix include nausea, changes in dreaming, constipation, gas and vomiting. Combined Therapies
Studies show that smokers who use a combination of cessation aids greatly increase their chances of staying smoke free. Smokers who used a combination of a nicotine patch and nasal spray doubled their chances of remaining smoke free for six years. Another study showed that smokers who used Zyban and the patch were more successful than those using the patch alone or Zyban alone.
Your family doctor can help advise you on which method of quitting might be best for you. All of these methods are most successful when combined with a support group or smoking cessation program that discusses stress management, weight control, resistance to social pressure, and suggestions for resisting the temptation to light up.
Where Can I Get More Information?
University of Iowa Resources
Other Resources
For more information about smoking and cancer or telephone numbers to the above organizations, please contact the Cancer Information Service
(1-800-237-1225) or e-mail: cancer-information@uiowa.edu.
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