• Smoking Cessation

    by Matthew Goldenberg, D.O.
    on Oct 13th, 2016
                                                         

Today is the 37th annual Great American Smokeout, which is held on the third Thursday of November by the American Cancer Society. The basis of the event is to challenge people to stop smoking cigarettes for 24 hours with the goal that the decision not to smoke will last forever.

Read more about the history of The Great American Smokeout.

Being that smoking cessation is getting national attention, I thought today would be an appropriate day to share my thoughts on smoking. Smoking is highly prevalent in the patients that I treat and so I spent the last year researching cigarette smoking and the impacts of nicotine addiction.  It is a highly topical area of medicine as a whole, as nicotine replacement therapy was provided by more psychiatric hospitals than any other treatment in both 2008 and 2011.1

There are three additionally important reasons that smoking cessation is such a critical topic and they are why I chose this area of research:

1) Despite knowing the risks and ongoing anti-smoking efforts, around 43.5 million American adults, or 21% of the population, continue to smoke cigarettes, according to data from the American Lung Association. In addition, individuals with psychiatric illness are about twice as likely to smoke cigarettes as the general population and consumed 45% of the total cigarettes smoked in the United States.2

2) Tobacco-related illness is now the leading cause of preventable and premature death in the U.S. and around the world. In 2008, the CDC reported that one in five deaths in the U.S. is attributable to tobacco and the average smoker will die at least 10 years earlier than non-smokers. As a benchmark, in the year 2000, the mortality rate of smoking-related illness surpassed the combined death total of HIV, illicit alcohol and drugs, suicide, murder and car accidents.3

3) Remarkably, health significantly improves after one quits smoking. In 2010, the U.S. Surgeon General reported that 10 years after quitting smoking the risk of developing lung cancer is cut in half. We also know that 15 years after quitting smoking the risk of coronary heart disease drops usually to that of a non-smoker.4

This data has motivated me, and I hope it encourages anyone who smokes or lives with a smoker to focus on smoking cessation. The key is to understand what motivates the smoker to quit. If they have ever tried to quit before, what aids have or have not worked in the past? And what is the severity of nicotine addiction? The answer to these questions will help one make an educated choice between the various treatment options available.

My research has also yielded that our efforts can be highly effective. For example, in addition to pharmacotherapy, group behavioral therapy and intensive physician advice can each independently at least double quit and abstinence rates. Individual and telephone counseling can increase quit rates by 1.5 times and nursing and self-help interventions are better than none.5

I believe we are up for this challenge. Patients with schizophrenia and/or mood and anxiety disorders do require more intensive interventions and longer durations of treatment to achieve abstinence. However, we may take heed that recorded quit rates of patients with psychiatric illness are similar to those of the general population, even though they smoke more cigarettes and smoke them more deeply.6

I have concluded that doing nothing is more harmful than screening, educating and formulating a specialized smoking cessation treatment plan. I encourage you to take action as tobacco abuse continues to devastate the health and quality of life of our friends, family and neighbors.

 If you are interested in getting help with quitting smoking, contact your primary care doctor and work together to come up with a personalized plan. You may also contact me at docgoldenberg@gmail.com and I would be happy to provide additional resources in the community or set up an appointment for a formal consultation in our clinic at Banner Good Samaritan.

You can also use these free resources:

• Arizona Smokers Help (ASH) Line: http://www.ashline.org/ or call: 1-800-55-66-222 The Arizona Smokers' Helpline (ASHLine) provides free services in both English and Spanish. Quit coaches are real people located right here in Arizona. Most of them are former tobacco users so they've "been there" and understand how hard it is to quit and stay quit.

• SmokefreeTXT: Get 24/7 encouragement, advice, and tips to help you quit and stay quit. To sign up, text the word QUIT to 47848 from your mobile phone or click below.

• CDC: smokefree.gov For free help, call 1-800-QUIT-NOW (1-800-784-8669) or, for assistance in Spanish, call 1-855-DÉJELO-YA (1-855-335-3569).

Lastly, here are some of the best tips I have found to make this quit attempt a successful one:
          1) To get motivated, you need a powerful, personal reason to quit.
          2) Set a quit date within 2 to 4 weeks.
          3) Tell your friends, family, and co-workers that you're trying to quit and they will encourage you.
          4) If possible, avoid stressful situations during the first few weeks after you stop smoking. • Learn new ways to manage stress: massages,        relaxing music, yoga.
          5) Forget about smoking. You don't want to see or smell anything that reminds you of smoking. • Throwaway ashtrays and lighters. • Wash clothes that smell like smoke and clean carpets, draperies, and upholstery. • Use air fresheners.
          6) Avoid Triggers. Alcohol, coffee (switch to tea for a few weeks) and meals (brush your teeth or chew gum). • Practice saying, “No thank you, I don’t smoke.”
          7) Make it through the urge:10 deep breaths. Drink water. Eat a snack or chew gum.
          8) Reward yourself with all the money you save on cigarettes.

Everyone’s path to quitting is unique and each success story should serve as motivation that we can all overcome this epidemic together. Please share your quitting story in the comments section below.

Have a smoke-free, healthy and happy Thanksgiving.


Best,

Dr. Goldenberg
docgoldenberg@gmail.com

Author Matthew Goldenberg, D.O. Matthew Goldenberg D.O. is double Board Certified in Psychiatry and Addiction Psychiatry and is a certified Medical Review Officer (MRO). He is an expert in the evaluation and treatment of mental health disorders and is an addiction specialist for adults in his private practice in Santa Monica, California. Dr. Goldenberg also provides addiction psychiatry consultations to some of the nation’s top residential and outpatient treatment programs in the Los Angeles area and is experienced in the evaluation and treatment of professionals working in safety-sensitive positions. In addition to his clinical work, Dr. Goldenberg is an active author, researcher and invited speaker at local and national conferences. He also volunteers his time as a Clinical Instructor in the Department of Psychiatry at UCLA and is an Assistant Professor of Psychiatry at Cedars Sinai Medical Center.

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