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Let's say I have a $700 check inscribed with your pretty li'l name. In order to cash it in, all you have to do is quit smoking. Might sound like a gimmick, but the offer is legit. The average U.S. smoker spends more than $700 a year on tobacco products, and that's just a slice of the price tag.
In a 2004 study, economist Jay Zagorsky, PhD, a research scientist at Ohio State University, investigated the impact of smoking on wealth in almost 9,000 people born between 1957 and 1964 -- the first generation warned by the Surgeon General about the dangers of tobacco use. Zagorsky estimated that nonsmokers' net worth is roughly 50 percent greater than that of people who smoke less than a pack a day and nearly double the wealth of those who light up a pack or more daily. Frequent blazers can expect to lose more than $8,000 during a 13-year period, and light smokers more than $2,000. Additionally, each year of smoking causes net worth to fall by an extra $410. And figuring in inflation and the rise of state cigarette taxes, smoking will only become more costly in the future. (As of January 2007, the median cigarette tax by state was $0.80, but Congress continues to consider raising the federal cigarette tax from $0.39 to $1.)
Nonsmokers pay a different price: Approximately 50,000 Americans die annually from being exposed to secondhand smoke. A recent study found that waiters and bartenders who work in a smoky setting accumulated a marked buildup of the carcinogens found in cigarettes every hour they were exposed, compared to employees who worked in a no-puff zone. The American Legacy Foundation (ALF), a public health organization for tobacco-use prevention and education, reports that secondhand smoke causes about 3,000 lung cancer deaths in nonsmokers annually in the United States. Janis Biermann, senior vice president for education and health promotion at the March of Dimes, says pregnant smokers are especially advised to quit because "they put unborn fetuses at risk for low birth weight, preterm birth, and sudden infant death syndrome." Potential fathers may also jeopardize the health of their future children every time they take a drag. A study in mice found that tobacco smoke, which contains more than 4,000 chemicals, could mutate genes in sperm cells, putting the offspring at risk for genetic disease.
Then, of course, there are the dangers to the smoker herself. Women who light up lose an average of 15 years of life, says Susan Foster, vice president and director for policy research and analysis at the National Center on Addiction and Substance Abuse at Columbia University. A recent study discovered that among Australian smokers, women run more than twice the risk of dying from lung cancer, compared with men. Some 70,000-plus women will die of lung or bronchus cancer this year, reports the American Cancer Society. In 2003, for the third year in a row, over 50 percent of all deaths from chronic obstructive pulmonary disease (COPD) were in women. Experts aren't sure why there's a gender bias; one explanation could be that women's smaller bodies are more sensitive to cigarette toxins.
Just to clarify: The nicotine itself is not a cancer-causing agent; the real killers are some of the chemicals in cigarettes, such as formaldehyde and benzene. But nicotine is what gets you addicted. Harvard researchers found that the amount of nicotine in cigarettes jumped 11 percent between 1998 and 2005. One group in particular is hooked: 30 percent of non-college-educated adults ages 18 to 24 smoke, compared to 14 percent of college-educated adults.
Now for the good news: Forty-four million people ashed their butts for good in the year 2000 alone. Seventy percent of smokers want to quit (only about 5 to 10 percent actually do, however). Recent initiatives aimed at potential young puffers, such as "truth," a smoking-prevention campaign that exposes tobacco-marketing tactics and health risks, have proven successful in making smoking less cosmo-chic. Hollywood has also added fever to the quit crusade. This past May, the Motion Picture Association of America decided to add smoking in films as a factor in their rating system.
But you can quit -- no matter how hooked you are. Several prescription and over-the-counter drugs are available for the gutsy champs ready to defect. Experts say it may take as many as eight attempts to stave off cigs permanently, so don't get discouraged if your first few tries go up in smoke. About 80 percent of women relapse, Foster explains, especially after a stressful event. But that's no reason to put off your quit date till the New Year. November is lung-cancer awareness month. The 31st annual Great American Smoke Out -- a nationally recognized quit-smoking campaign sponsored by the American Cancer Society -- takes place on November 15. You could start saving beaucoup cash today, and stay alive longer to spend it. Now that you've decided to kick smoking, we'll help you choose a battle plan.
Face it: You're out of reasons not to. When it comes to quitting smoking, whatever you're worried about, we've got a real solution that'll help you ditch the excuses and start changing your health.If You're: Worried about the scale
Try: The weight-loss pill Rimonabant, regular exercise, nicotine-replacement therapy (NRT) and/or cognitive behavioral therapy (CBT)
What They Do: Rimonabant is a drug that's prescribed to reduce food cravings, but some doctors also use it off-label to help patients quit smoking. Still in the testing phase, the drug has not been approved by the FDA as a bona fide smoking-cessation treatment. Vigorous exercise for up to 40 minutes can reduce smoking urges and calm withdrawal symptoms, compared with staying inactive. Working out can nearly triple the time it takes for smokers to reach for their next fix, studies show. Researchers say that even 5 to 10 minutes of movement may be beneficial. Theoretically, because endorphins produced during exercise offer a natural high, a little cardio may serve as an antidote for quitting pangs. The welcome side effect: You might actually lose weight.
On average, female quitters can expect to gain between six and eight pounds after quitting. Over a 10-year period, the average weight gain is 11 pounds. Researchers believe that using a nicotine-replacement therapy (such as the nicotine patch, nicotine gum, lozenge, nasal spray, and inhaler) may help prevent weight gain. "Not only does nicotine suppress hunger, but it also speeds up the metabolism," says Cheryl Healton, DrPH, president and CEO of ALF. She suggests piggybacking NRT with a morning workout to rev up the fat burn and dampen your smoking itch. Clinical trials using CBT -- a treatment that reframes the way patients think about smoking and teaches them techniques to better cope with stressors -- have shown promising results, Foster says. In one study, participants who completed a seven-week CBT program had gained less weight by the time of their one-year follow-up than women who received a standard weight-control treatment.If You've: Failed with other quit fixes
What It Does: "Chantix targets the nicotine receptor in your brain to help control cravings," says Steven A. Schroeder, MD, distinguished professor of health and health care and director of the Smoking Cessation Leadership Center at the University of California at San Francisco. The drug affects the brain's pleasure chemicals while reducing cravings for nicotine. However, studies using Chantix in conjunction with other remedies are still in the testing phase. For now, it's best to take the drug by itself.If You: Spark up nonstop
Try: An NRT medley
What They Do: The drugs work collaboratively, like a tag team. For example, you may use the patch, which delivers a specific, steady dosage of nicotine over time, as an adjunct to short-acting formulas, such as the gum or lozenge, which can squash cravings expeditiously. Schroeder says such dual therapies are becoming more popular in patients with severe addiction.If You're: Emotionally strung out
Try: The antidepressant Wellbutrin (also prescribed as Zyban) and NRT. This combination has proven to be the most effective course, Healton says.
What They Do: The NRT slowly weans you off the chemical dependency. Wellbutrin treats both cravings and withdrawal by affecting certain neurotransmitters, such as dopamine, that may augment the desire to smoke. This line of defense is best for smokers who are also depressed, Healton says, because the drug addresses the mental problem and the smoking addiction simultaneously. Your hips could nab a profit too. Wellbutrin may also help prevent weight gain.If You: Smoke in social settings
Try: A fast-acting NRT and CBT
What They Do: When environmental factors are the main cause of your cravings, one of the best remedies is to avoid trigger places, or find substitutes for them. In some instances, a quick "nic" hit via the gum or lozenge may be helpful, Schroeder says. On top of that, behavioral training will teach you how to ameliorate the situation without reaching for cigarettes.If You: Need moral support
Try: Group or phone counseling
What They Do: Having the fellowship and support of quit buddies can give you the ammo to stay clean, Schroeder notes. Studies show group therapy may be a successful intervention, compared with self-help. Looking for a more anonymous route? Call 1-800-QUIT-NOW to be connected to a trained phone counselor in your region who will customize a kick scheme just for you. Review studies have shown that abstinence rates for people using quit lines are comparable with those using NRT.If You're: Holistically inclined
Try: Acupuncture, hypnosis, or going cold turkey
What They Do: There are arguments supporting all three, but the scientific evidence is scant and inconclusive. "Lots of people quit before there were any drug therapies," Healton notes. "But the success rate increases by about 30 percent when you use a state-of-the-art treatment," such as the ones mentioned.
Source: American Cancer Society
Originally published in FITNESS magazine, November 2007.