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Up in Smoke

 

Imagine a single activity linked to high blood pressure, stroke, various cancers, miscarriage, premature birth, and sudden infant death syndrome. And, beyond these serious health concerns, it also causes wrinkling of the skin, discoloration of teeth, and leaves a wreaking odor in its path. Why would anyone do it? Because--as you've probably guessed--it's the nation's number one addiction: smoking. But what you might not know is that tobacco is responsible for an estimated 450,000 deaths each year in the U.S. -- more than heroin, cocaine, and alcohol combined. And smoking's jeopardizing the health of our lesbian, gay, and bisexual community.

Lesbians, gays and bisexuals--especially at risk: In a recent study, 40% of gay men said they smoked, while an even greater number of lesbians reported smoking (48%). This contrasts sharply with estimates that between 25-30% of the general population smoke. The increased rate of smoking among lesbians, gays, and bisexuals may be due to the gay community's use of bars and clubs as prime places for socializing, as smoking and drinking are strongly related. And make no mistake about it-- Madison Avenue is well aware of the love affair between the gay community and the cigarette. Flip through many gay magazines and you'll be barraged by pages and pages of cigarette ads, carefully designed to appeal to us. So, if you smoke, you have plenty of company. But you need to know that smoking is not only threatening your health it is-- quite literally--killing our community. If you've quit smoking in the past but are now smoking again, don't be discouraged. It may take several attempts before you're able to quit for good. But think about what led you to start smoking again. Was it being around other smokers or were you just not able to stop craving that cigarette? Answering this question will help you devise a new game plan to quit for good. And working with your doctor can help.

Your first steps: Once you've decided to quit, make it official and pick a quit date within the following two weeks. Note the date you're quitting on the calendar and stick to it. Tell your non-smoking friends when you plan to quit. You may find quitting on the weekend preferable to quitting during the week, as the withdrawal symptoms may be easier to deal with at home than at work or school. Between now and your quit date, work on disrupting your patterns of smoking. Change your smoking habits by placing your cigarettes in an unusual or out of the way place, removing ashtrays, and not doing anything else while smoking. Delay smoking by postponing the time you smoke your first cigarette by a couple of hours each day. Limit your access to cigarettes by only buying one pack at a time, and by gradually adding more non-smoking areas in your life, such as in the car, at work, or indoors. Begin to designate activities that you used to smoke during as non-smoking activities, such as breakfast, during breaks at work, or while driving. Increase the amount of time you spend in settings where you can't smoke, such as in non-smoking sections of restaurants, at the gym, and at public events.

More than just a bad habit

While breaking your patterns of smoking is vital to quitting, smoking is more than just a habit – it's an addiction to nicotine. Dopamine, a chemical in the brain, is associated with the craving for nicotine and the noradrenergic network of nerve cells appear to regulate symptoms of nicotine withdrawal. These include irritability, anxiety, difficulty in concentration, restlessness, and depression. New treatment options for smoking can help reduce nicotine withdrawal symptoms and make it easier for you to quit. And your doctor in an important ally in this process.

Nicotine replacement therapy

Available in several forms, nicotine replacement therapy releases a controlled amount of nicotine into the bloodstream. This replaces the nicotine that would have been obtained from smoking and the amount released is gradually reduced. As medical complications can occur from too much nicotine, you must not smoke while receiving nicotine replacement therapy. Abstain from both smoking and nicotine replacement therapy if you are pregnant. Nicotine patches are available without a prescription as is nicotine gum, which should not be chewed continuously, but chewed briefly and "parked" between your cheek and gums. Nicotine nasal spray and a nicotine oral inhaler – a plastic tube resembling a large cigarette – are available by prescription only.

Buproprion

Buproprion (Zyban (R)), a new, nicotine-free medicine has helped thousands to quit smoking for good. Buproprion is believed to act on the neurochemical pathways in the brain controlling nicotine addiction and withdrawal. This medication should not be taken if you are pregnant or breast-feeding, have a seizure disorder, a current or past eating disorder, or are taking Wellbutrin or another medicine containing buproprion or an MAO inhibitor. Treatment with buproprion has yielded higher quit rates than nicotine replacement therapy and both of these are superior to placebo. Buproprion may be combined with nicotine replacement therapy. Doing so has been shown to improve your odds of quitting over either of these interventions alone.

Whether you use nicotine replacement therapy or buproprion to help you quit or not, changing your behavior is an important component of smoking cessation. Work together with your doctor to help design a program to quit that's best for you. And--above all--congratulations! By deciding to quit smoking you're taking a most important step to improve not only your own health, but also the health of our community.

 
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