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Smoking No More... "All the resources we need are in the mind."Theodore Roosevelt If you click on Google searching for “quit smoking program” you find more than six million websites. The vast majority of these sites are pushing one modality such as nicotine replacement products or acupuncture or hypnosis. The truth is very few sites give you an honest step by step comprehensive program. When smokers check in to my clinic for anti-aging services, I tell them that there is basically no point in doing anything else until and unless they stop smoking. If you started smoking as a teenager because you wanted to look and feel older, you sure succeeded. Nothing ages your health and your appearance more than smoking. Even if you are not a smoker you should read this chapter so that you understand more about the dangers of second hand smoke and about how to help people quit. When I first started the quit smoking program in my Center, I lured friends and relatives to our new quit smoking program by offering it for free, in order to hone my skills and those of my staff. What I did not realize is that they did poorly compared to the later clients who came willing to pay for the program. The difference is that those who succeeded had reached on their own; the point where they felt sick and tired of being so hooked on smoking and were truly motivated and ready to quit. According to the Centers for Disease Control and Prevention, 80 percent of adult tobacco users started smoking as teens; 35 percent had become daily smokers by age 18. Thirty nine percent of adult smokers smoke one pack of cigarettes per day, and 20% smoke more than a pack a day. Nearly one of every five deaths is related to smoking, more than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined. The first and most effective anti-aging step is to quit smoking. When you quit smoking you start growing younger every year for ten years to come. According to the Naval research Health center in San Diego the prevalence of smoking among military personnel exceeds rates established for the general population by approximately 20%. Mark Twain said, "Quitting smoking is easy. I've done it a thousand times." Maybe you've tried to quit too. Why is quitting and continuing to live as a non-smoker so hard for so many people? And how can you quit with less grief? Sadly, eighty percent of smokers who quit do so without being in any program - unfortunately, studies show that 95% of these self-reliant quitters fail and go right back to smoking. 
Given that you have a 95% chance of failure without a program, you may wish to consider getting some professional help the next time you attempt to quit. The battle against smoking is harder when fought alone!
Seventy percent of current smokers would love to quit but are afraid of failure, of gaining weight, or dumping their best friend – their cigarette.
If you want to improve your chances of quitting six fold, read the next ten pages. The vast majority of my patients report that quitting when using my program was a lot easier than they thought. You are told that you need physicians, pharmacists, counselors, hypnotists, acupuncturists, behavior modifiers, etc., in order to stop smoking. All you need is to read this chapter a couple of times. It will give you everything you need to quit smoking, guaranteed! You will also be able to take pride in the knowledge that you did it yourself, frequently without expensive medications and nicotine replacement systems and without counseling. The key is to understand that you need to try several times to succeed. Relapse is not a failure. For those who have repeatedly failed in their past efforts to quit smoking, it's comforting to learn that most smokers in fact fail several times before stopping successfully. Your past failures are not a lesson that you are unable to quit. Instead, they are part of the normal journey toward becoming a nonsmoker. Relapse is part of your victorious quit smoking program. People who are the most successful at living life typically get a lot of help. For example, they might read up on how to prevent illness, and go to the doctor when sick. In business, a businessperson will get a lawyer to write the contracts, a marketing firm to do the marketing, - and so on. The fact is that people who are successful in life get help. Real men do ask for directions! The same applies for quitting smoking. Every time you fail to stop smoking you lose a little more faith that you really can quit. So each time you decide to quit, it gets harder and harder to motivate yourself to set a date. The resulting feelings of hopelessness can even cause you to smoke more than before you quit! On average ex-smokers tried four times to quit smoking before they quit once and for all. What smokers need to understand is that they cannot afford to spend several years smoking before they try again; at this rate, it would take twenty to thirty years to quit! The time to try to quit again is right after you ‘fail’. Keep in mind that just making a serious effort to quit this powerful habit is by itself a success even if it does not work with the first attempt or two. Just keep trying. You're not alone. When asked why you smoke, you might have said, "I just like to smoke!" or "It's my choice to smoke." The industry has promoted the idea that smoking is a matter of personal choice. By telling smokers that smoking is a personal choice, and insisting on “Smoker’s Rights”, the tobacco industry has helped to keep its customers in denial about the true extent of their physical and psychological addiction. If smoking is a choice, then what's the rush to quit? The tobacco companies have used this spin to help keep millions of customers buying their deadly products. Where does one person’s second hand smoke stop becoming that smoker’s ‘right” and begin violating the “rights” of their family, friends, and co-workers? As I see it, the only choice the tobacco industry cares about is what propaganda works on different demographics to keep individuals lulled in to their continued use of a lethal product. The only “rights” they are concerned with are their own, to continue marketing their product, if not in the more educated western world, then in less informed countries. Ask yourself, and be totally honest: If I could stop smoking, easily and without fail, tomorrow, would I choose to smoke? Am I truly making a free choice to smoke, or am I addicted to tobacco? The most important step to take is the first step --admitting you have an addiction. This admission will further serve to help you stay smoke-free later. In the months and years after you quit, when temptations to smoke occasionally overpower you -- and they will -- remind yourself, "I have an addiction and I'm powerless over tobacco." Saying this to yourself in overwhelmed moments of desire will help give you the strength to say no to "just one" cigarette. Nicotine is a drug found naturally in tobacco. It is addictive. Drug companies tell us that nicotine is “fiercely addictive”. They claim it is more addictive than heroin or cocaine. There is a lot of exaggeration here! They emphasize nicotine addiction to frighten smokers, so they will buy their expensive products (the patch, gum, inhalers, Zyban, Chantix, Champex, etc.) to ease the discomfort of nicotine withdrawal. You did not become a smoker after smoking one or two “fiercely addicting” cigarettes. If you are like most smokers, you started smoking in one or a very few places. You then smoked in a few more places, and then in a few more. As you smoked more and more, smoking became a learned habit wherever you smoked. However, patients with low serotonin brain levels do have low serotonin metabolites in their urine that can be tested and do benefit from Wellbutrin or other anti-depressants. 90% of the serotonin in the body is produced in the gut. No wonder that patients with yeast over-growth suffer from fatigue and depression. Patients craving serotonin tend to use comfort foods or tend to embark on excessive risk taking or gambling or extra marital affairs. Many patients avoid these pills because they carry the stigma that something is wrong with their heads. When smoke is inhaled, nicotine is carried deep into the lungs, where it is absorbed within ten seconds into the bloodstream and in this way transported throughout the body. Nicotine affects many parts of the body, including your heart and blood vessels, your hormonal system, your metabolism, and your brain. Nicotine can be found in breast milk and in cervix mucous secretions of smokers. During pregnancy, nicotine freely crosses the placenta and has been found in amniotic fluid and the umbilical cord blood of newborn infants. Only 60mg of pure nicotine (contained in two packs of cigarettes) placed on a person's tongue would kill within minutes. 
Nicotine produces pleasurable feelings that make the smoker want to smoke more. The smoker lives with a series of mini-withdrawal crisis and only feels normal or less tense and able to concentrate when he lights a cigarette. Smoking is like wearing very tight shoes all day just to experience the joy or relief of removing them! When you quit you will feel the pleasure of being relaxed and able to concentrate all the time.
Nicotine Withdrawal As nicotine leaves the bloodstream the mind experiences an empty, insecure feeling. Once you light another cigarette, nicotine is replaced and this feeling immediately disappears. It's this chemical “refueling” that smokers describe as satisfaction or pleasure. When smokers try to cut back or quit, the absence of nicotine leads to withdrawal symptoms. Withdrawal symptoms in the first three days can include any of the following; depression, restlessness and irritability, frustration and anger, troubled sleeping, constipation, nose congestion and increased coughing. You may also experience trouble concentrating, headaches and increased appetite. These uncomfortable symptoms lead the smoker to again start smoking cigarettes in order to replenish nicotine blood levels. Symptoms usually start within a few hours of the last cigarette and peak about two to three days later. Withdrawal symptoms can last from a few days to several weeks. For most smokers, the addiction is about 50% mental and 50% physical although studies show that this ratio varies with each individual. By using replacement products to deal with nicotine’s physical addiction and prescription drugs such as the FDA approved drug Zyban and, more recently, Chantix for the mental addiction, withdrawal symptoms can be very mild. Chantix or Champix in Europe was approved by the FDA in 2006 and does help the brain not crave smoking as much. One out of ten patients cannot tolerate Chantix because it produces in them nausea and vomiting. This slight nausea may be why patients on Chantix are much less likely to eat and thus rarely gain weight. Some people are against using FDA approved drugs to get help with quitting but have no problem with their dependence on thousands of chemicals in a cigarette!! It takes two weeks for these medications to work which is why you should start them two weeks before quitting and continue their use for 6-8 weeks after quitting. All products should be used in conjunction with psychological preparation, behavior modification and relaxation techniques that we shall present in this chapter which are much more important than the drugs. Common excuses used by smokers. I'm under a lot of stress and smoking relaxes me. Naturally you will feel more relaxed when you give your body a substance it has come to depend on. But nicotine really is a stimulant - it raises your heart rate, blood pressure, and adrenaline level. The majority of smokers are consistently more anxious than non-smokers. Most ex-smokers feel much less nervous just a few weeks after quitting. I cannot think or concentrate without my cigarettes. During the withdrawal period you will be tenser and smoking makes it is harder to focus, but in the long run, smoking actually deprives your brain of oxygen that is essential for concentration and lowers your IQ. I've already cut down. Cutting down is a good first step, but there's a big difference in the benefits to you between smoking a little and not smoking at all. Besides, smokers who cut back or switch to low tar cigarettes often inhale more often and more deeply - negating many of the benefits of cutting back. After you've cut back to about seven cigarettes a day, it's time to set a quit date. It's too hard to quit. I don't have the willpower. Quitting cigarettes is hard, but it's not impossible. More than 25 million people quit every year. It's important for you to remember that many people have had to try more than once, and try more than one method, before they became ex-smokers, but they have done it, and so can you. I'm worried about gaining weight. Many people who are considering quitting are very concerned about gaining weight. Major weight gain (12 Kg) occurs in ten percent of men and 13 percent of women who quit smoking. Gaining weight isn't inevitable; there are certain things you can do to help keep your weight stable. If you're concerned about gaining weight, keep these points in mind: Quitting doesn't mean you'll automatically gain weight. Studies show that ex-smokers who gain more than 3-6 kilos are, in fact, eating more once they have quit. The benefits of giving up cigarettes far outweigh the drawbacks of adding a few extra kilos. Smoking adds the equivalent of 40 kg extra burden to the heart. You would have to gain a very large amount of weight to offset the many substantial health benefits that a normal smoker gains by quitting. Watch what you eat, and if you're concerned about gaining weight, consider the following tips: Plan menus carefully, and count calories. Don't try to lose weight - just try to maintain your pre-quitting weight. Have low-calorie “finger” foods on hand for nibbling such as celery, cherry tomatoes, broccoli, and mushroom, air-popped popcorn without butter, apples and carrots. Chew a sugarless gum. Eat light in the evening so that you wake up hungry and do not skip breakfast. Drink lots of water and avoid juices, fizzy drinks and alcohol. Get back to exercise. With increased lung function, exercise that was once difficult can again be enjoyable and the pleasurable hormones produced can help to overcome feelings of craving. In his book “The Art of War”, Sun Tzu wrote hundreds of years ago that battles are won before they are ever fought. Information and intelligence are gathered, domestic and international opinion is prepared, United Nation resolutions are passed, economic blockade is conducted, psychological warfare is started, troops are positioned, and internal opposition in the targeted country is encouraged and supported, a date is fixed and so on. Quitting smoking is a battle that can be won with proper planning. Here are the steps you need to take.
1. Information and intelligence gathering. You need to know that to win this war you need help from your physician, your family, and your friends. Most importantly you need to take charge of your own health by reading more about how to maximize your chances of success. Find a good book on how to stop smoking or investigate a smoke cessation program. 2. Psychological warfare. Everyone knows that smoking is bad for you, but very few appreciate how bad smoking is. Part of quitting smoking is to get angry at the cigarette instead of thinking of it as your best friend. You should be able to recite by heart the bad effects of smoking on your health and on your family. In 2004, cancer replaced cardiac disease as the number one killer of elderly people in the USA. 40% of cancers are caused by smoking. Smoking is behind 21 different cancers. Cigarettes contain 4,000 different chemicals, 60 of which are known to cause cancer. Lung cancer accounts for one third of all cancer-related death. By the time a chest X ray shows lung cancer, it has been present for at least five years and contains a billion cancer cells. Breast cancer is three times more likely in women who smoke, as is prostate cancer in men. Bladder cancer also occurs three times more often in smokers than in non-smokers. Cigarettes cause cardiac disease, high blood pressure and strokes, all of which can kill you if you are lucky or worse, can confine you to a wheelchair for the last part of your life. What most people do not appreciate is that smokers may or may not get cancer or heart disease but every heavy smoker destroys his or her lungs (emphysema) which destroys the person's ability to exercise or climb stairs. The "usual" morning cough of the smoker is a sign of chronic bronchitis - infection of the bronchi. I ask my patients to do a simple breathing test that measures their lung function before they enroll in my quit smoking program. Two months after quitting their score improves by an average of 30%. Smoking is a major factor behind asthma and allergies. In addition, smoking aggravates stomach ulcers and heartburn as it increases gastric acidity. Smoking increases the risk of blindness from macular degeneration and the risk of Alzheimer’s. The risk of fractures and osteoporosis is significantly increased with smoking. Blood clots in the legs and poor wound healing after surgery also plague smokers. Another unappreciated fact is that smoking robs you of your natural beauty not only by staining your teeth and nails and the bad smell that it produces but through decreased blood circulation to your skin. This decrease permanently damages subcutaneous elastin fibers the result of which is sagging not only of your neck and face but also of your abdomen, breast, thighs and rear. Smokers have a higher incidence of impotence and have a decrease in their sexual performance. The Michigan Addiction Research Center revealed in 2005 that 87% of alcoholics smoke cigarettes, compared to less than 30% of the general population. They are both starving to increase their dopamine (energy) and serotonin (pleasure) neurotransmitters. Smoking predicted poorer performance on verbal and visual-spatial reasoning and lowered the IQ more than chronic alcohol abuse. Parents, health professionals and teachers who smoke have a bad influence on their kids. Smoking can be the first step to alcohol and drug abuse as a child learns from his role models that it is acceptable to harm one’s body instead of respecting this amazing and complex machine. Passive smoking can be very dangerous to your family as the smoke coming out from the unfiltered cigarette end is 80% more harmful than the filtered one that the smoker inhales. For every cigarette that the smoker smokes, you are inhaling a third of it yourself. This can increase asthma, respiratory and ear infections and can affect the unborn child of pregnant women. Designating a smoking section in a restaurant is like designating a “peeing”area in a public pool! Smokers waste a lot of time consumed in the act of smoking and taking unproductive breaks. Smoking is less socially acceptable now than it was in the past. The majority of employers prefer to hire nonsmokers. Landlords, also, may choose not to rent to smokers since maintenance costs and insurance rates may rise when smokers occupy buildings. Like it or not, finding a place to smoke can be a hassle. Smokers may find their opportunities for dating or romantic involvement, including marriage, are largely limited to other smokers, who currently make up only about 1/4 of the population. My son, Danny, reported that when he was seventeen, fifteen out of twenty one students in his Dubai high school smoked cigarettes. Most parents are not even aware their kids are smoking. Why wouldn't they smoke when their teachers are smoking, their parents are smoking, doctors are smoking, movie actors on their Arabic TV are smoking and a pack of cigarettes is six times cheaper than it is in the States or the UK? Smoking is very expensive. The cost is not just the thousands of dollars wasted buying cigarettes. More important is the cost paid to treat major health problems that invariably affect the smoker. Finally, there is the cost of lost earnings due to frequent sicknesses reported by smokers or worse, their early retirement due to disability. Finally, new studies revealed that tobacco leaves used in making cigarettes contain radioactive material. The radionuclide content of tobacco leaves depends heavily on soil conditions and fertilizer use. For example, phosphate fertilizers, favored by the tobacco industry, contain radium and its decay products (including lead-210 and polonium-210). When phosphate fertilizer is spread on tobacco fields year after year, the concentration of lead-210 and polonium-210 in the soil rises. Having the above list present in your head helps you resolve to seek help, take action and view each cigarette as the enemy camouflaging as a friend and source of pleasure. 3. Setting the date. There is no convenient date to quit smoking. Do not put off quitting until you have less stress, this will always serve as one more excuse to postpone the decision. The best time is usually 2-3 weeks from the time you finish reading this chapter, at which time you should be mentally ready to quit. If you smoke less at home than at work then choose the date you are quitting so that it falls on a weekend or while on vacation. If you smoke less at work then choose the beginning of the work week. Announce to everyone you know or meet the significance of this date and ask them for their support. If your spouse is a smoker, it is essential that you quit together. 4. Two weeks before the date you have set up for quitting you should change cigarette brands. Switch to a brand you do not like. Switching increases your success rate. A common strategy is to switch from Menthol flavored to a non-menthol brand or vice versa. Remember, you will be quitting soon. You want to sever this love-hate relationship gradually. This is also the time to start Chantix. 5. Exercise. Smokers know that exercise is good for them. Why then do most of them not exercise? Most smokers suffer from a state of low energy making them feel older than their age. Exercise is an essential tool to deal with the temporary increase in stress or depression of the first 2-4 weeks after quitting. Quitters who exercise four hours a week are 30% more likely to succeed than those who do not exercise. Exercise releases dopamine, a substance that gives us a “high”, in much the same way nicotine does. Smoking speeds up metabolism by 100 calories per day. This translates to four kg weight gain per year. You can get the equivalent calorie burning benefits by lifting weights to build muscle. Every kilo of muscle burns 100 calories per day (the equivalent of twenty olives) while a kilo of fat burns only five (one olive). By gaining only one extra kilo of muscle you would make up for the return to your normal metabolism. Keep in mind that exercise also helps us sleep better and fights constipation. 6. Stress reduction strategies. Beside exercise you need to get plenty of sleep, and cut down on coffee and other caffeine drinks. Do not stop coffee cold turkey as you will experience headaches and feel very lethargic. Instead ask for a smaller size, mix half decaf and half regular, and /or add skim milk. Coffee increases your blood pressure and increases stress making it harder to quit smoking. A few days before quitting you need to get Nicotine replacement patches (10 mg patch for each pack you smoke per day). You should start the patches the day you quit. Learn how to use deep breathing exercises to control stress, anger or frustration. Take a yoga class if you can. Book a visit to your dentist on day one or two after your quit date in order to clean your stained teeth and gums. Stock up the night before on sugarless gum and healthy snacks. The Big Day - The quitting phase.
Deep breathing is perhaps the single most powerful and important technique in fighting the urge to smoke. Every time you want a cigarette, do the following and repeat three times. Inhale the deepest lung-full of air you can, and then, very slowly, exhale. Purse your lips so that the air must come out slowly. As you exhale, close your eyes, and let your chin gradually sink over onto your chest. Visualize all the tension leaving your body, slowly draining out of your fingers and toes, flowing completely out. Learn to relax quickly and deeply. Make yourself limp, visualize a soothing, pleasing situation, and get away from it all for a moment. Concentrate on that peaceful image and nothing else. This is a variation of an ancient yoga technique from India, and is very centering and relaxing. If you practice this, you'll be able to use it for any future stressful situation you find yourself in. It will be your greatest weapon during the strong cravings sure to assault you in the first few days. This deep breathing technique will be a vital help to you. Reread this point.
Don't be afraid to ask. This is more important than you may realize. Until you're confident of your ability to stay off cigarettes, limit your socializing to healthful, outdoor activities or situations where smoking isn't allowed. If you must be in a situation where you'll be tempted to smoke (such as a cocktail or dinner party), try to associate with the nonsmokers there. The Maintenance Phase and Avoiding Relapses. Know that most relapses occur in the first three months after quitting, with situational triggers - such as a particularly stressful event – that occur unexpectedly. These are the times when people reach for cigarettes automatically, because they associate smoking with relaxing. This is the kind of situation that's hard to prepare yourself for until it happens, so it's especially important to recognize it if it does happen. Here is perhaps the most valuable information among these points. In the period which begins a few weeks after quitting, the urges to smoke will subside considerably. However, it's vital to understand that from time to time, you will still be suddenly overwhelmed with a desire for "just one cigarette." This will happen unexpectedly, during moments of stress, whether negative stress or positive (at a party, or on vacation). Try to remove yourself from the physical situation you are in. Most people don’t realize subtle stimulus in their surroundings that can overwhelm their resolve, i.e. standing around the bar at a party may be difficult whereas sitting at a table or going out on the dance floor may not; being at the pool while on vacation may trigger memories of always having smoked there, where getting up and walking on the beach stops the association. If you are unprepared to resist, succumbing to that "one cigarette" will lead you directly back to smoking. Remember the following secret: in these surprise attacks -- and they will definitely come -- do your deep breathing, hold off the craving for five minutes, and the urge will pass. Remember that smoking is a habit, but a habit you can break. Remind yourself that you are addicted to something very powerful and that only you can chose not to allow that substance to control you. Just three times a year you may ask your loved one - briefly - very briefly - and in very loving and warm tones, to please quit smoking. Try surrounding your request with honest complements, keep it brief, and they might be more open to listening. More than this and you risk being seen as an obnoxious nag. We are a nation of good people and very stressed out people, many of whom are also addicts. The whole world is importing our lifestyle. We are addicted, often, not just to one thing but to several - cigarettes, food, television, music, drugs, sex, and exercise, even work. Each of these things is a kind of drug -- because each temporarily gets your mind off of stress, depression and pain. We are talking about both current pain, such as anger, loneliness, or sadness --- and pain we've carried with us since childhood, such as unmet emotional needs perhaps due to an absent or abusive parent. Sometimes life is painful. It issupposed to be that way. All of us are faced with grief, loss and struggle. Controlling anger and frustration It is helpful -- and healing -- to let your feelings of frustration out verbally as you quit smoking. Better those words should come out of your mouth, in loud complaining tones, than a cigarette or unneeded calories going in! Do not worry; if you ask for support and tolerance, you will get it. Each of us is surrounded by people willing to help if asked, if only for a friendly hug. Do not isolate, and do lean on others. Especially for men, asking for help should be seen as a sign of strength. Not going to a support meeting could be construed as a response prompted by fear, and therefore cowardice. So especially you stoic males, be brave, and seek encouragement from others. Let us not lie about it, quitting will be like losing a very dear friend - and you will find yourself grieving a bit. That is not only natural, it is okay! In coming decades, we shall look back on smoking as a thing of the past century. We know that statistically only children and teens are beginning the smoking habit. As our government passes laws making it increasingly difficult for youth to obtain cigarettes, and as the rest of the world follows suit, teens will no longer start smoking in such huge numbers. Western governments are limiting tobacco advertising as well as insisting that all advertising carry the consequences of smoking. As a deterrent and in order to use the increase to offset a huge health toll, government is increasing cigarette prices through taxation. Hollywood, which once glamorized smoking, has curtailed on-screen smoking by today’s heroes and heroines. One day smoking will be no more. No more deaths, no more disease and no more grieving families. Supplements to take to help you during the quitting stages.
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