Quit Smoking

Introduction

Fewer people than ever in this country are still smoking, but even so, smoking will still kill more than 120,000 people in the UK every year. So if you're one of the 22 per cent who are still lighting up - or you're worried about someone you know who hasn't given up yet - here's what you need to know about how smoking affects your health and how to give up the habit.

There are many things you can do to improve your health, but if you're a smoker, giving up is the most beneficial by far.

Smoking is the commonest avoidable cause of premature deaths in the UK, and it doesn't just kill those who smoke.

Smoking is thought to increase your risk of developing 50 or more health problems, mostly due to the harmful substances found in tobacco smoke.

Toxic substances found in tobacco smoke include:

• Tar
• carbon monoxide
• arsenic
• formaldehyde
• lead
• mercury
• ammonia
• acetone
• benzene
• hydrogen cyanide

Tobacco smoke also contains nicotine, a substance which is as addictive as many illegal drugs, such as heroin and cocaine, and also explains why many smokers find it so difficult to give up.

Why should I give up?

If you do give up, you will feel fitter and will have a better sense of taste and smell. Your breath will be fresher, your teeth and fingernails will become less stained, and your hair and clothes will no longer have that whiff of old ashtrays. You'll also live longer.

A survey conducted by the NHS' Information Centre revealed the following Statistics:

• In 2005/06, consultants made around 571,400 primary diagnoses for adults aged 35 and over in England, which were attributable to smoking. The figure accounts for six per cent of all diagnoses made by consultants
• Of the primary diagnoses attributable to smoking, 32 per cent (184,600) were cancer related, a further 32 per cent (180,100) were due to respiratory diseases, 27 per cent (156,100) were related to circulatory diseases and five per cent (26,100) were due to digestive diseases
• In 2005, around 81,900 deaths in England (17 per cent of all deaths of adults aged 35 and over) were estimated to be caused by smoking with a larger proportion of men (23 per cent) estimated to die than women (13 per cent) from smoking-related diseases
• Among people aged 35 and over, it is estimated that in 2005, around 36,700 cancer deaths, 23,600 deaths from respiratory diseases, 20,000 deaths from circulatory diseases and 1,600 of deaths from diseases of the digestive system were attributable to smoking

The commonest smoking-related killers include cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular disease. However, it's also linked to many chronic (long-term) health conditions, such as fertility and pregnancy problems and vision problems.

Cancer

Twenty-nine per cent of people in the UK will die from cancer. Lung cancer is the second commonest cancer, with 38,000 people diagnosed in the UK every year. Lung cancer is also the second commonest cancer in men after prostate cancer, responsible for 16 per cent of all new male cancer cases. Lung cancer is the third commonest cancer in women after breast cancer and bowel cancer, accounting for 11 per cent of all new female cases.

Lung cancer isn't the only smoking-related cancer, however. Smoking is also a major cause of cancer of the mouth, oesophagus, bladder, kidney and pancreas, and is considered to be related to cancers of the stomach, liver and nose, along with myeloid leukaemia. Chewing tobacco is believed to increase your risk of mouth cancer too.

Chronic obstructive pulmonary disease (COPD)

COPD is often a mix of lung diseases, such as chronic bronchitis and emphysema, which cause breathing difficulties.

If you have COPD, your airways and possibly also your air sacs are blocked or damaged, which means oxygen and carbon dioxide have difficulty getting in and out of your lungs. Once the disease has established itself, it cannot be reversed.

While it may not be as well known as cancer or heart disease, COPD is the fourth leading cause of death throughout the world, while in the UK 30,000 people in the UK dying from COPD each year. Smoking is the main cause, accounting for between 80 and 90 per cent of cases. If you smoke, you have a 50 per cent chance of developing some degree of airflow blockage and increase your chance of developing COPD.

Cardiovascular disease

Smoking is one of the biggest causes of cardiovascular disease - which means you're a possible candidate for a heart attack.

Smoking affects your cardiovascularsystem in several ways. The nicotine in tobacco smoke increases your blood pressure and makes your heart beat faster, while the carbon monoxide in tobacco smoke also makes it more difficult for your blood to transport oxygen to your heart and the rest of your body. Meanwhile, smoking damages the lining of the arteries and may make your blood more likely to clot.

Stroke

Smoking also increases your risk of having a stroke. Heavy smokers, for example, have a relative risk of stroke two to four times greater than non-smokers.

Smokers are also 16 times more likely than non-smokers to develop peripheral vascular disease (PVD) - which causes blocked blood vessels in the legs or feet. If untreated, this condition can lead to gangrene of a leg which can mean amputation.

Buerger's Disease, which typically affects young male smokers, is a rare form of PVD that does lead to amputation. The only proven treatment to prevent the progression of Buerger's Disease and avoid arm or leg amputation is to stop smoking.

Pneumonia

If you smoke, you're more likely to suffer from pneumonia - an infection that causes inflammation of the lungs - than non-smokers. For example, 6,062 deaths from pneumonia were attributable to smoking in 2002.

Eye disease

Conditions including age-related macular degeneration (AMD) and cataract are linked to smoking. AMD is the leading cause of blindness in people aged 55 and over in the western world, and smoking is the biggest preventable risk factor that causes it.

Smokers with a 20-plus-a-day habit are around twice as likely to develop cataracts as non-smokers. There's also evidence that smoking is linked to diabetic retinopathy, a disease that leads to blindness in people with diabetes.

Pregnancy problems

Smoking during pregnancy can be harmful to both mother and baby, and is linked to miscarriage, premature birth, still birth and low birth weight.

According to the latest figures, however, 17 per cent of mothers still smoke throughout their pregnancy.

Even if you're still smoking when you first become pregnant, it is still worth quitting. While smoking during any stage of pregnancy is unadvisable, the most damaging effects of smoking will occur between the fourth and ninth month of pregnancy, when the baby is growing rapidly.

For example, if you give up smoking during the early stages of pregnancy, your risk of having a baby with a low birth weight is similar to that of a woman who doesn't smoke.

Both men and women who smoke may be less fertile than non-smokers - though the effect of smoking on fertility is thought to be more significant in women than in men. Even passive smoking can affect a woman's chances of becoming pregnant.

Other potential risks from smoking while pregnant:

• Ectopic pregnancy:a potentially life-threatening condition for the mother which can lead to difficulties in becoming pregnant again. The egg implants in one of the fallopian tubes and begins to grow there instead of the uterus (womb). This type of pregnancy will almost always not result in the live birth of a child, as there is not enough room for the baby to grow fully, so the embryo must be removed either an injection of drugs or by surgery
• Foetal death:when the baby is still a foetus (less than 28 weeks) and dies in the uterus. Maternal smoking has been linked to the death of five to 10 per cent of all foetal and neonatal deaths
• Stillbirth and death of the babyin the first week is increased by a third if the mother smokes due to SIDS (Sudden Infant Death Syndrome) or cot death
• Miscarriage: the risk of suffering a miscarriage is increased by 25 per cent for a smoker
• Placenta previa:where the placenta lies extremely low in the uterus and block or covers the opening of the cervix and can result in a difficult delivery and puts the mother's and baby's life at risk
• Early detachment of the placentafrom the wall of the uterus before delivery, which could result in heavy bleeding
• Increase of heart rate and blood pressurein the mother due to the effects of the nicotine
• Blood clots
• Vaginal bleeding
• Thrush:a fungus that grows in and on the body
• Urinary tract infections, such as cystitis
• Lack of necessary vitamins and folic acidnecessary for normal development of the baby
• Premature birth: going into labour prematurely is twice as common in smokers than it is in non-smokers. The risks are even higher if the mother is still smoking throughout the latter half of her pregnancy

Other health problems associated with Smoking

There is evidence linking several other illnesses with smoking, including osteoporosis (brittle bones), diabetes, asthma and peptic ulcer.

Smoking is also thought to prematurely age your skin, while a certain type of acne called non-inflammatory acne has, in one study, been found in 40 per cent of women who smoke, compared with just 10 per cent of non-smokers.

Passive smoking

You don't have to smoke to experience the harmful effects of smoking. According to a government report, breathing someone else's smoke can cause lung cancer and heart disease, while in children it can cause respiratory disease, cot death, middle ear infections and asthma attacks.

With each new study scientists are discovering more about the harmful effects of passive smoking (second-hand smoke). Currently it's estimated that 2,700 deaths in people aged 20-64 and 8,000 deaths in people aged 65 and over are caused each year in this country by passive smoking at home.

Giving up

Around 70 per cent of smokers say they want to quit, but most think it will be too difficult.

The effort, however, is well worth it. If you give up smoking before the age of 35, for instance, your life expectancy becomes just slightly less than that of a lifetime non-smoker. If you quit before the age of 50, your risk of dying from a smoking-related illness falls by 50 per cent.

If you find it difficult to cope with nicotine cravings there are several types of nicotine replacement therapy (NRT) products available that can help, including patches, gum, lozenges, nasal sprays and inhalators. These work by gradually releasing nicotine into your bloodstream, but at much lower levels than you get from smoking.

Many NRT products are available over the counter at pharmacies. You can, however, get them on prescription from your GP too. You can also get drugs to help you give up, such as bupropion (Zyban ®) and varenicline (Champix ®), which work on the brain to reduce cravings, though these are only available on prescription.

A smoker who tries to quit with the NHS Stop Smoking Service using NRT products or bupropion is up to four times as likely to succeed than by willpower alone.

Each method has possible side effects and may not be suitable for certain people, so it's important to talk to your GP about which one is right for you.

Clickthrough information and support links:

Find your nearest smoking cessation clinic at the NHS Stop Smoking Service, where you can get counselling and support in group or one-to-one sessions, plus access to NRT, bupropion and varenicline. For further help on giving up, call the NHS Smoking Helpline on 0800 169 0169

Action on Smoking and Health
British Heart Foundation
Cancer Research UK
Go Smoke Free
Quitline