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Do you mind if I don't smoke?

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C. A. V. Nogueira, M.D. ▼ | October 28, 2009
SmokingEvery doctor will tell you that you should quit smoking. While it's true that smoking is the cause of many health problems, let's see what smoking actually is and why out there exists old smokers with no problems at all.


When we are talking about smoking we must define two terms: smoking and nicotine dependence. When you light the cigarette you are obviously smoking but that doesn't mean that you have nicotine dependence, an addiction to tobacco products caused by the drug nicotine. How to tell the difference? It's easy: a person dependent on nicotine smokes in every situation: right after awakening, while working, driving the car, in house, in the bathroom, on the street, while cooking a meal, under stress or on holidays... In a word: smoke everywhere and anytime.

In the other hand, there are people who smoke while under stress at work or just enjoy in cigarette after a good meal or with a glass of whiskey. So, the key words here are: from time to time. Of course, "mild smoker" has a chance to become a nicotine addict but there's no rule for that. For example, people in Latin America smoke cigars and live a long life with no major health problems. But they don't smoke every time, anywhere. One must realize that those are two different conditions with different consequences.

So, what is nicotine dependence? Smoke from cigarettes, cigars and pipes contains thousands of chemicals, including nicotine. Nicotine dependence means you can't stop using the substance, even though it's causing you harm - your body simply need nicotine. Nicotine produces physical and mood-altering effects in your brain that are pleasing and these effects lead you to dependence.

While it's the nicotine in tobacco that keeps you hooked, the toxic effects come mainly from other substances in tobacco. Smokers have significantly higher rates of heart disease, stroke and cancer. There is a simple test: if you keep smoking despite health problems, like problems with your lungs or heart, then you are "on it".

Some people experiment with smoking and don't experience pleasure, so they never become smokers. Other people develop dependence very quickly. Some "social smokers" can smoke just once in a while, and yet another group of smokers can stop smoking with no withdrawal symptoms. These differences can be explained by genetic factors.

When you inhale tobacco smoke, you ingest numerous chemicals that reach most of your body's vital organs. Tobacco smoke contains more than 60 known cancer-causing chemicals and more than 4,800 other harmful substances. Smoking harms almost every organ of your body. The negative health effects include lung cancer and other lung diseases, heart and circulatory system problems, other cancers, pregnancy and newborn complications, diabetes (smoking increases insulin resistance, which can set the stage for the development of type 2 diabetes.)

Several medications, including nicotine replacement therapy and non-nicotine medications are effective in treating nicotine dependence. Using more than one medication — such as a nicotine patch along with a nicotine gum, lozenge, nasal spray or inhaler — may help you achieve better results than if you use a single medication. If you're pregnant or breast-feeding, you smoke fewer than 10 cigarettes a day or you're under age 18, talk to your doctor before taking any over-the-counter nicotine replacement products. Talking to your doctor and other people who quit smoking is very helpful and it make the process of quitting easier.

What if you smoke while drinking coffee or if it's your daily ritual? Keep in mind that moderate smoking will not kill you but keep it under control. There is no firm rule, but as the rule of thumb remember that 25 cigarettes a day is maximum, try not to go over that.

If you are lucky and you can stand three hours without smoking there's a great chance that you are not dependent. If you have cold and don't smoke, if you smoke much less on holidays, if you don't wake at night to light a cigarettes - those are all good signs. However, if you are sick and still smoke or can't stand a half an hour without smoking - see the doctor immediately.

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