Recommendation to Quit Smoking

2017/06/01

To quit smoking or not?

It is a frequently discussed topic, but from a doctor's perspective, the answer is naturally yes.

Various scientific data have been accumulated, and there is no end to the health hazards of smoking that can be listed, while there is not a single piece of data suggesting it is good for health. It truly "does a hundred harms and not a single good."

Despite this, why are there so many smokers who do not quit?

I myself have experience smoking. It was for about four years during my university days, and my smoking exceeded 40 cigarettes a day just before exams. I knew that pharyngitis from a cold would worsen every time I smoked and, above all, that it was bad for my health. So, during a training camp for the Sailing Team club activity, I tried quitting smoking together with a classmate as a way of making a wish to win a match. It was something we started casually, but after the summer camp ended and we spoke at the end of autumn, we asked each other, "Are you still not smoking?" To our surprise, we both were, and with the feeling of "If he's keeping it up, I have to keep it up too!", the year passed, and the truth is I was able to quit (perhaps this wish worked, as the following year our year won the East Japan Medical Students General Athletic Meet for the first time in the history of the School of Medicine Sailing Team!). I haven't smoked a cigarette since then.

I understand the feeling of wanting to try smoking at some point in one's youth after seeing Humphrey Bogart in "Casablanca" or Jean Gabin smoldering a Gitanes in a movie. However, I want people to know that the health damage it causes is significant not only for the smokers themselves but also for those around them. A story I often tell families when I receive consultations about quitting smoking is the risk of secondhand smoke. Regarding scientific data on this, a classmate from Keio High School continued research at the National Cancer Center and produced interesting results.

The content was that as a result of tracking approximately 30,000 non-smoking wives for 14 years, those with smoking husbands were twice as likely to develop lung adenocarcinoma compared to those whose husbands were non-smokers.

When I told this story to a lady who accompanied her husband to the smoking cessation clinic, I remember wryly smiling when she turned to her husband and said, "We've been together all this time, are you trying to kill me?" It is certainly said that secondhand smoke from the lit end of a cigarette contains more harmful substances than the smoke inhaled by the smoker through a filter. In other words, not just family members, but anyone in the same room as a smoker—regardless of age or gender—suffers some kind of negative impact. Of course, the risk of developing diseases due to smoking is not limited to lung cancer; it also increases the risk of various other malignant tumors, as well as heart disease, diabetes, cerebrovascular disease, and respiratory disease. Occasionally, I see elderly people with oxygen tanks using nasal tubes; that condition is also a pathology heavily influenced by smoking.

For these reasons, I strongly recommend quitting smoking, but first, I want you to have a firm will. Then, try visiting a smoking cessation clinic, which is initially covered by insurance, to attempt quitting. Besides nicotine patches, there are oral medications that prevent irritability when quitting, and not a few people succeed in quitting smoking through these.

Of course, from my own clinical experience with hundreds of smoking cessation cases, it is said that over 60% of patients complete the smoking cessation clinic, and around 30% continue to stay smoke-free afterward; treating nicotine addiction is by no means easy. However, recently, there is a foreign tobacco company that developed a new type of heated tobacco product with the intention of reducing the harmfulness of smoking (risk reduction) if quitting is difficult. Perhaps due to my experience in smoking cessation treatment, I received various consultations and information from them, and its characteristics are interesting. Short-term data so far shows it is possible to reduce generated harmful substances by 90–95%, and by not burning the tobacco leaves and paper, secondhand smoke has been eliminated. However, whether the harmful substances reduced to 5–10% will have an adverse effect on the human body (i.e., the smoker themselves) still requires waiting for long-term results, but I believe the fact that secondhand smoke is zero is a major attraction in terms of reducing the nuisance to those around them. The Japanese Circulation Society and the Japan Society for Tobacco Control, which emphasize quitting smoking, have not yet officially recognized these new cigarettes from the perspective that they are different from quitting itself, but in actual clinical settings, some opinions suggest they are better than smoking.

As a cardiologist, my basic stance is to first recommend quitting smoking. For those who do not succeed, or who succeeded but started smoking again, I would like them to choose this risk reduction option for the time being to first eliminate the negative impact on those around them.

I hope that by the Tokyo Olympics, there will be no one smoking indoors in public places.