By Sherry McKee
Tuesday, June 10, 2014
Women are more likely to use smoking as a way to handle stress, says Sherry McKee, and quitting itself is stressful. While she researches gender differences in the physiology of quitting, she also urges women to just keep trying.
Credit: verdienter Künstler on Flickr, under Creative Commons
(WOMENSENEWS)-- We know that women, more so than men, are likely to smoke to manage their stress and other negative mood states. Stress is also a primary reason why women start to smoke, maintain their smoking and relapse back to smoking.
I direct an interdisciplinary research center funded by the National Institutes of Health, focused on developing treatments to help women and men quit smoking. Our main goal is to tailor treatments for women and men that take into account gender differences in tobacco dependence.
We are currently targeting an area of the brain called the noradrenergic system. From animal studies, we know that this system is involved in stress responses. It's also involved in the experience of pleasure or reinforcement that smokers obtain from nicotine. Nicotine is the main addictive ingredient in cigarettes.
We think that medications targeting this system may be effective for both women and men, but might operate through different mechanisms. We believe that this medication will be more likely to reduce the negative effect that stress has on smoking in women. Since women are more likely to relapse back to cigarettes in the face of stress, we also think this medication will reduce the experience of stress and help women continue to maintain abstinence from cigarettes.
In men, we believe this medication will reduce the reward or pleasure that they obtain from nicotine. We know that smoking behavior in men is more closely tied to the nicotine in cigarettes. We are excited by the potential of this research to improve quit rates for both women and men.
I may be a health professional focused on developing better treatments for tobacco dependence, but as a former smoker myself, I know this from personal experience.
At the height of my addiction, I was smoking two packs a day. I enjoyed the timeout that cigarettes provided, how they made me feel calm and relaxed. I enjoyed the taste and sensations of smoking. I enjoyed pairing cigarettes with coffee.
But when I balanced out the positives and negatives, it was impossible to rationalize why I would want to continue smoking.
Tobacco use hurts every system in our bodies. Smoking continues to be the leading preventable cause of death and disability in the United States, contributing to 440,000 deaths in the past year alone. And worldwide, the smoking habit may result in 6 million deaths each year, as World No Tobacco Day publicized on May 31.
Women are more susceptible to serious tobacco-related diseases such as lung cancer and heart disease, even when you equate tobacco exposure across women and men. Women also experience a number of sex-specific health risks, primarily related to their reproductive health.
So I decided to quit. I'd like to be able to say that I quit smoking on my first try, but to quote Mark Twain, "To cease smoking is the easiest thing I ever did. I ought to know. I've done it a thousand times."
The first two times I tried quitting cold turkey and stayed cigarette-free for three days the first time and one week the second. Both times I struggled with withdrawal symptoms such as cravings, restlessness and irritability that made me want to crawl out of my skin.
The third time worked. I used a nicotine replacement product, which helped alleviate those symptoms. While most smokers are successful quitting on their own, medications may increase the chances of success.
It's been over 20 years since I quit, and I no longer crave cigarettes, nor think of them fondly. I am just thankful that I am not dependent on tobacco anymore. To conquer a tobacco addiction, you may need to keep trying. Don't give up.
Regardless of age, your risk of heart disease and stroke decreases up to 50 percent in the first year after quitting. In 10 to 15 years after quitting, your risk of lung cancer is reduced by 50 percent and your risk of heart disease is the same as a non-smoker. For individuals with a cancer diagnosis, quitting smoking can improve the effectiveness of cancer treatments, lower the risk of further tumors and increase rates of survival.
I also smoked to help manage my weight. When I was hungry, I would smoke a cigarette.
If you are worried about gaining weight, the truth is that smokers gain an average of 5 to 10 pounds after they quit. Surprisingly, researchers have found that smokers who were willing to accept a small weight gain in exchange for the health benefits accrued from quitting actually gained less weight and were more successful at quitting smoking.
Cravings can be very hard to handle when you try to quit. Even smokers who have developed serious health consequences as a result of their tobacco use, such as emphysema or cancer, will continue to smoke and feel helpless in the face of their addiction. By some metrics, such as "capture rate," cigarette smoking is more addictive than alcohol, cocaine or heroin. (Capture rate is the proportion of users who after first using a drug--legal or illegal--go on to become dependent.)
But while it's important to understand the difficulties of quitting don't let them defeat you. Yes this is a serious challenge. But know that other people have done it and so can you. There's no shame in trying and failing. When you succeed you will be enhancing the health of people around you.
Smoking increases the risk of disease for entire families. The Environmental Protection Agency has classified second-hand smoke as cancer-causing, leading to 50,000 deaths a year in adults. Children exposed to second-hand smoke are at increased risk for sudden infant death syndrome, lower respiratory tract infections, ear infections and asthma.
Resources are available to help smokers quit, including free treatment and support available through your state quitline (1-800-QUIT-NOW), and effective medications are available both without a prescription (nicotine replacement) and with one (bupropion, varenicline).
This year has seen the 50th anniversary of the first Surgeon General's Report on tobacco, which identified the health consequences of smoking and forever changed public perception of tobacco use. Quitting smoking is the most important change you can make to improve your health and the health of your family.
Sherry McKee, Ph.D., is an associate professor of psychiatry at Yale University School of Medicine. She is a Public Voices Fellow with The OpEd Project.
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