AskDocQ: Why You Should Give Up Smoking, And How You Can Do It


Stock photo of cigarette smoke

Nearly everyone who has smoked for more than 5 years wants to quit. Being a smoker makes you a train wreck waiting to happen – the slow poisoning of your lungs, your heart and your arteries will likely one day lead to heart attack, stroke, blood clots, lung cancer and chronic lung disease.

Have you ever seen one of those old guys who can only walk a few paces before he has to stop to catch his breath? You can bet your bottom dollar he was once a pack-a-day man. Not quite the sexy cattle-wrangling Marlboro man poster boy any more.

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And did I mention the ageing effect? Smokers’ skin becomes wrinkled prematurely, and skin wounds take longer to heal.

Of course you want to give up, but why can’t you? The answer is nicotine. It’s not the poisonous part of the cigarette, but it’s the addictive part. Going cold turkey works for some people, but the relapse rate is high thanks to the lure of nicotine.

If you’re a smoker, your body and brain are hooked on one of the most addictive substances in existence.

Apart from its addictive properties, nicotine is actually quite harmless. It’s all the other chemicals in cigarettes that make them so dangerous. That’s why nicotine replacement therapy is recommended as a tool for giving up – it’s safe and provides exactly the substance you’re addicted to.

So why have you been unable to give up using nicotine patches or gum? It’s because your body is used to the sudden hit that smoking provides. You’re probably using nicotine replacement all wrong. The trick is to understand how each product works, and how long it takes to get to those needy nicotine receptors in your body.

Nicotine patches provide a continuous baseline level of nicotine that helps prevent cravings. However they will not be enough when you get a craving.

Cravings occur quite predictably, and you can work out when they will be by looking at when you currently smoke. It’s likely you will get a craving after a meal, when you have a tea or coffee, and when you are drinking alcohol and socialising.

When you get a craving, you need nicotine fast, and that’s where other products come in. Lozenges and gum can get nicotine into your system more quickly, but they don’t work instantly like smoking does. You need to give them time to be absorbed.

Nicotine gum needs to be chewed a few times until a peppery tingling taste is noted, then you “park” it between your gum and cheek. Chew again when the taste disappears.

It takes 15 to 30 minutes to get good levels of nicotine this way, so you need to try an predict when you are going to get a craving and start chewing well before!

Another newer instant nicotine product is vapourised nicotine. Currently this is not able to be bought in Australia, however this is likely to change in the future. You can buy vapers here and import nicotine vaping liquid if you have a doctor’s prescription.

Vaping looks like being the safest and most effective nicotine replacement therapy so far, as it can deliver instant nicotine without chemicals or smoke, and seems more likely to lead to complete smoking cessation.

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If you have HIV, Hep C or are taking opioid substitution therapy then you are eligible for a new University of Queensland vaping trial that is currently enrolling people. Ask your doctor to help you enrol.

Giving up smoking is one of the hardest things you will ever do, but your body (and bank balance) will thank you for the rest of your (much longer) life!

Dr Fiona Bisshop specialises in LGBTIQ health and is available by appointment at Holdsworth House Medical Brisbane. Call (07) 3894 0794 or visit the website. For more by Dr Bisshop visit drfionabisshop.com, follow @DrFionaBisshop on Twitter. Send your health questions to doctorqnews@gmail.com to get them anonymously answered in QNews Magazine.