6 Pillars of Good Health: Stop Smoking, Stay Healthy, Live Longer

                Smoking and alcohol consumption are among the leading causes of non-communicable diseases (NCDs) and death. Therefore, ‘Avoidance of Risky Substances’ is recognized as the fourth pillar of Lifestyle Medicine, which emphasizes health promotion through lifestyle modification.

                Cigarettes are a major factor contributing to premature death, with approximately 5 to 7 million deaths worldwide each year. Smoking also affects the functions of many body systems, including:

• Respiratory diseases - Female smokers are 7.6 times and male smokers are 6.3 times more at risk to develop respiratory diseases compared to non-smokers. This leads to smokers’ life expectancy being reduced by 20 years in female and 18 years in male.

• Cardiovascular diseases - Female smokers are 3.1 times and male smokers are 2.9 times more likely to develop cardiovascular diseases compared to non-smokers. It has also been found that female smokers may lose up to 10 years of their life expectancy due to this risk, while their male counterparts may lose up to 14 years.

●       Cancer - Smoking increases the risk of cancer by 2.8 times in women and 3.1 times in men. Both sexes may lose an average of 12 years of life expectancy due to the increased risk.

                Thus, the sooner one quits smoking, the greater the health benefits. Early cessation also offers a better chance of recovering from damage. A study have shown that individuals who quit smoking before the age of 40 may reduce their risk of smoking-related death by up to 90%, compared to those who continue to smoke. Those who quit before the age of 40 also have a longer life expectancy, by an average of 12 years. However, the life expectancy benefit declines with age: those who quit between ages 40 and 49 may gain about 6 years, while those who quit between 50 and 59 may gain only 2.5 years.

The benefits of quitting smoking diminish as the habit continues. Individuals who have remained smoke-free for over 10 years may regain 8 to 15 years of life expectancy, depending on their sex and the age at which they quit. In fact, the mortality risk of long-term former smokers may become comparable to that of individuals who have never smoked.

Approaches to Quitting Smoking

Smoking cessation can be achieved through three main approaches:

1.  Pharmacotherapy

Medication-assisted therapy plays an important role in easing nicotine withdrawal symptoms. This approach aims to reduce cigarette cravings, thereby increasing the likelihood of successfully quitting smoking.

• Nicotine Replacement Therapy (NRT) - helps regulate nicotine intake with a gradual dosage reduction over time. Five forms of NRT are approved by the U.S. Food and Drug Administration (FDA), including nicotine patches, lozenges, chewing gum, inhalers, and nasal sprays.
• Nicotine Inhibitors, such as Bupropion and Varenicline: Both medications are highly effective in suppressing nicotine cravings.

However, medication-assisted approaches must be used under medical supervision and with a physician’s approval to avoid unwanted side effects and potential interactions with other medications.

2. Behavioral Therapy

This approach focuses on modifying smokers’ thoughts and behaviors without the use of medication. Examples include Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and other therapeutic methods that designed to encourage behavioral change.

Oftentimes, a combination of methods is used to achieve the ultimate goals of self-control, quitting smoking, and changing smokers’ opinions and attitudes that make quitting difficult. This approach may also help establish a constructive path for behavioral changes, such as setting a clear goal and timeline for quitting, tracking smoking habits, and learning self-care skills to prevent relapse.

3. Combination Therapy

Combination therapy involves using both behavioral and pharmacological approaches together. This includes brief consultations with physicians or nurses alongside the use of medication. This integrated approach is popular among those who are actively seeking to quit smoking.

There is no one-size-fits-all method for quitting smoking. Each individual responds differently depending on various factors such as gender, culture, and age. Therefore, the key to successful smoking cessation lies in tailoring strategies to fit each person’s unique needs.

Today, individuals who wish to quit smoking, many existing organizations are pleased to support and assist. These include the “Quitline 1600” and the “Fahsai Addiction Clinic,” which is available in over 500 hospitals across Thailand. In addition, the Thailand’s National Health Security Office (NHSO) supports a network of participating pharmacies that offer smoking cessation service, as well as online clinics providing telemedicine-based therapy.

Smoking cessation is ‘the greatest gift you can give yourself and your loved ones’. Providing everyone with a smoke-free environment leads to a healthier body and a longer life. Start today for the best results. The decision to quit smoking is the first step toward better health and improved quality of life in the long run.