What you should know about tobacco use and cancer

Facts about tobacco use and cancer
You may already know it’s hard to quit using tobacco – whether you smoke or chew it – and there’s a good reason for why. Tobacco contains nicotine, which is a highly toxic and addictive drug. However, the importance of quitting tobacco is hard to argue because:

More than 400,000 deaths in the United States each year are from smoking-related illnesses.
Lung cancer mortality rates are about 23 times higher for current male smokers and 13 times higher for current female smokers compared to those who have never smoked.
In addition to being responsible for 87 percent of lung cancers, smoking has been linked to cancers of the mouth, throat, pancreas, cervix, kidney and bladder.
Using smokeless tobacco can cause cancer of the cheeks, gums and throat.
Tobacco use is a major cause of heart disease, and it has been associated with chronic bronchitis, emphysema and stroke.
You may have heard these or other gloomy statistics before. If so, you should also be aware that smoking is the most preventable cause of death in our society. Once you stop smoking, your health benefits begin almost immediately.

- After 20 minutes, your blood pressure drops to a level close to what
   it was before the last cigarette.
 - After eight hours, the carbon monoxide level in your blood drops to
   normal.
 - Two weeks to three months later, your circulation improves and
   your lung function increases up to 30 percent.
 - One to nine months later, your coughing, sinus congestion, fatigue
   and shortness of breath decrease.
 - After one year, your excess risk of coronary heart disease is half
   that of a smoker’s.
 - After five years, your risk of stroke is reduced to that of a non-
   smoker’s.
 - After 10 years, your lung cancer death rate is about half that of a
   continuing smoker’s, and your risk of mouth, throat, esophagus,
   bladder, kidney and pancreas cancer decreases.

This Web page is designed to provide you with information about lung cancer, one of the major diseases caused by smoking, and give you some guidance on ways to stop using tobacco. Let’s start by answering some basic questions.

What are the lungs?
The lungs are a pair of spongelike, cone-shaped organs that are part of the respiratory system. The right lung has three sections or lobes; the left lung has two lobes. When we breathe in, we take in oxygen, which our body’s cells need to live and carry out their normal functions. When we breathe out, the lungs get rid of carbon dioxide, a waste product of the body’s cells.

What are the risks for developing lung cancer?
Everyone has some possibility of developing lung cancer, but some people have higher risk factors. Risk factors are things that increase your chance of developing the disease. Some of the risk factors listed below are associated with environmental causes or your health, but most are linked with one personal habit – use of tobacco. If you fall into any of the following groups, you should be aware that your risk for developing lung cancer is increased. However, not everyone at high risk develops lung cancer.

 - personal use of cigarettes, cigars and pipes
 - exposure to environmental tobacco smoke, otherwise known as
   second-hand smoke (the smoke in the air when someone else
   smokes)
 - exposure to radon, an invisible, odorless and tasteless radioactive
   gas that occurs naturally in soil and rock.
 - exposure to asbestos, a group of minerals that occur naturally as
   fibers and are used in certain industries.
 - exposure to air pollutants, such as by-products of the combustion
   of diesel and other fossil fuels (researchers are still working to
   discover the relationship between pollution and lung cancer)
 - personal history of a lung disease such as tuberculosis.
 - personal history of lung cancer.

What can I do to prevent lung cancer?
Researchers continue to study the causes of lung cancer and to search for ways of preventing it. But the best way of preventing the disease is already known – quit smoking or never start.

The sooner you quit smoking, the better, but it’s never too late to benefit from quitting.

What are the symptoms of lung cancer?
Common signs and symptoms of lung cancer include:

 - a cough that doesn’t go away and gets worse over time
 - constant chest pain
 - coughing up blood
 - shortness of breath, wheezing or hoarseness
 - repeated problems with pneumonia or bronchitis
 - swelling of the neck and face
 - loss of appetite or weight loss
 - fatigue

These symptoms may be caused by lung cancer or by other, less serious conditions. If you have any of these symptoms, it’s important to check with your doctor and find out the cause.

What can I do to stop using tobacco?
People use tobacco for different reasons. Some feel it gives them more energy or it relaxes them when they are tense, some like touching and handling cigarettes, and some simply find smoking pleasurable. Still others crave cigarettes – they are addicted to the nicotine in tobacco.

For as many reasons people have to smoke, there are an equal number of ways to quit. Finding the best way for you is key to your success. Following are some tips for kicking the habit:

Prepare yourself for quitting

 - Decide positively that you want to quit and set a date. List off the
   reasons you want to quit. Every night before going to bed, repeat
   one of those reasons 10 times.
 - Notice when and why you smoke. Then begin changing your
   smoking routine.For instance, keep your cigarettes in a
   different place. Smoke with your other hand. Don’t do anything
   else while smoking. Smoke only in certain places.
 - When you want a cigarette, wait a few minutes. Buy one pack of
   cigarettes at a time. Switch to a brand you don’t like. Cut down
   on the number of cigarettes you smoke. Smoke only half of each
   cigarette. Each day, postpone lighting your first cigarette by
   one hour. Decide you’ll only smoke during odd or even hours of the
   day.
 - Have realistic expectations. Understand that withdrawal symptoms
   are temporary, usually lasting only 1-2 weeks. Know that many
   relapses occur in the first week after quitting. Other relapses
   may occur in the first three months after quitting, when you
   encounter stressful situations. Realize that many successful
   ex-smokers quit for good only after several attempts.

On the day you quit

 - Get rid of all your cigarettes. Put away your ashtrays and lighters.
 - Have your teeth cleaned to get rid of tobacco stains.
 - Change your morning routine.
 - Stay busy. When you get the urge to smoke, do something else
   instead.
 - Carry other things in your mouth like gum, hard candy or a
   toothpick.
 - Reward yourself at the end of the day for not smoking – buy a treat,
   see a movie or enjoy your favorite meal.

Immediately after quitting

- Develop a clean, fresh, nonsmoking environment at home and
   work.
 - For the first few days, spend as much time as possible in places
   where smoking isn’t allowed.
 - Drink large quantities of water and fruit juice, but not soda with
   caffeine.
 - Avoid beverages you associate with smoking.
 - Instead of smoking after meals, get up from the table and brush
   your teeth or go for a walk.
 - For the first one to three weeks, avoid situations you strongly
   associate with the pleasurable aspects of smoking.

Quitting for keeps – seven coping skills when you feel the urge to smoke
1. Think about why you quit.
2. Know when you are rationalizing. Common rationalizations include:

 - “I’m under a lot of stress, and smoking relaxes me.”
 - “I’ve already cut down to a safe level.”
 - “It’s too hard to quit. I don’t have the willpower.”
 - “I’m worried about gaining weight.”
 - “I blew it. I smoked a cigarette.”

3. Anticipate triggers and prepare to avoid them.
4. Reward yourself for not smoking.
5. Use relaxation techniques.
6. Get social support.
7. Sign a contract with yourself to remain a nonsmoker.

If you slip and smoke, don’t be discouraged. Instead, recognize that you have had a slip. A small setback does not make you a smoker again. Don’t be too hard on yourself. Identify the trigger.

If you think you need professional help, see your doctor. He or she can refer you to a behavior modification program and may also prescribe nicotine replacement therapy in the form of nicotine gum or a nicotine patch.

The Cancer Information Center at Saint Louis University Hospital offers a seven-week smoking cessation program developed by the American Lung Association. The hospital cancer information specialists can also provide you with material developed by the National Cancer Institute that gives step-by-step approaches to quitting smoking. For more information, contact the Career Information Center at (314)577-8833.

Cancer Services at Saint Louis University Hospital
Saint Louis University Hospital’s standing as an academic medical center puts it among those at the forefront in developing and providing some of the latest in cancer screening techniques and tests and medical treatment and procedures for cancer patients. For more information, call our Cancer Information Center at (314)577-8833.