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SMOKING ADDICTION

ADMIT IT: YOU REALLY DO WANT to quit because you know smoking
is bad for your health. Just in case you need a little extra encouragement, here are the facts: smoking is the major preventable cause of death. It causes cancer and heart disease. It gives smokers raspy voices and nagging coughs. And it makes smokers' mouths smell and taste like ashtrays. So why are you still smoking?

It's because nicotine is highly addictive - as addictive as heroin, according to some researchers. Nicotine binds to specific receptor sites in the brain, causing changes in mood. That's why heavy smokers who attempt to quit experience withdrawal symptoms such as nervousness, irritability, insomnia and even mild depression. No wonder it can be hard! But it can be done.
Several drugs are available for smokers trying to quit. Most are aimed at helping smokers gradually wean themselves from nicotine instead of going 'cold turkey'.

Those who are quitting smoking with the help of a doctor may be prescribed other medicines, among them anti-anxiety drugs, adrenergic blockers and antidepressants. See the chapters on anxiety and depression for details on these medications.
Cigarette smoke irritates cells in the airways, paralysing the tiny hairs, or cilia, which move impurities out of the lungs. When you quit smoking, you may notice increased coughing and mucus production.

This phase may last a few weeks to a few months, depending on how long and how much you have smoked. While it may be irritating, this reaction is a good sign - it means your lungs are beginning to recover. Lung tonics and expectorants can help you expel the yucky junk and heal the lung tissues.
In addition, calming herbs and herbs that provide support in times of stress can reduce anxiety and insomnia. Herbs that alleviate depression can be especially helpful for people who smoke as a way of coping with this mood disorder. And several types of herbal medicine can help alleviate the symptoms of nicotine withdrawal.

DRUG TREATMENT

Nicotine Supplements
Transdermal nicotine (skin patches) and nicotine chewing gum (Boots Nicotine Gum, Nicorette, Nicotinell). Function: alleviate symptoms of nicotine withdrawal. Patch side effects: insomnia, headache, nausea, vertigo, muscle aches, stomach upset, skin irritation. Gum side effects: mouth irritation, hiccups, excess salivation.

MAKING YOUR QUIT DAY STICK
Kicking the cigarette habit starts with small steps. Although there is no perfect time to quit, it is probably best not to try during especially stressful times - when you're moving into a new home, for example, or starting a new job. When the time is right for you, here are some tips that can help you snuff the cigarette habit.
* Make the commitment. Before having that last drag, set a quit date and make it public, possibly even signing a contract with family and friends. Mark your quit date on your calendar.
* Reduce your intake. Once you've determined your quit date, gradually reduce the number of cigarettes you smoke each day. On the day you set as your quit date, you must stop smoking completely.
* Avoid smoking cues. Get rid of all your cigarettes, lighters and ashtrays, and avoid situations where you would normally smoke. Spend time in places that do not allow smoking.
* Occupy your mouth and hands. Chew on straws or carrot sticks, eat sugarless sweets or chew gum. * Fiddle with elastic bands or paper clips; carry around a small rubber ball and squeeze it vigorously whenever a craving occurs. When a craving is strong, do something incompatible with smoking, such as taking a shower, going for a brisk walk or doing a short aerobic exercise routine.
* Reward yourself. Make a list of all the benefits you enjoy when you don't smoke and review it frequently. On your quit day, give yourself a special treat - a new pair of shoes, a dinner at your favourite restaurant, a bouquet of roses. Save the money you would have spent on cigarettes, and at the end of the first month buy something frivolous.
* Exercise. Taking a brisk walk or working out at a health club channels some of the nervous energy many ex-smokers feel when they quit. Exercise also helps prevent weight gain, which is common while quitting.
* Seek out help. Hypnotherapy, acupuncture and support groups seem to help some people quit successfully, although no controlled clinical studies have evaluated the effectiveness of such interventions.


A CHINESE HERBAL INHALER
Herbal inhalers have been used in China for decades. Smoker's Aroma is a commercial product in the United States that uses a combination of aromatic herbs in an inhaler designed specifically to help people who are trying to give up smoking. To use it, people sniff the product for two minutes three times per day, plus whenever the craving for a cigarette hits them. The herbs contain molecules that attach to nicotine receptors in the brain. After users have successfully quit smoking, they keep the bottle of herbs with them for occasional cravings that occur when their resolve is low. To find Smoker's Aroma, see Resources at the end of this book.

HERBAL REMEDIES

Mullein (Verbascum thapsus)
This herb tones the mucous membranes of the respiratory tract, soothes irritated lungs and speeds healing of damaged tissues. It also helps thin mucus secretions so they can be coughed up more easily. Typical dosage: 2 to 3 cups of tea per day (steep 1 to 2 teaspoons of dried leaves in 1/4 litre of hot water for 10 minutes); or 1/2 to 1 teaspoon of tincture three times per day.

Lobelia (Lobelia inflata)
This cough-easer gently relaxes bronchial muscles and the entire nervous system. Lobelia may have some binding action on nicotine receptor sites, which could decrease cravings. Typical dosage: 2 to 3 cups of tea per day (steep 1/4 to 1/2 teaspoon of dried leaves in 1/4 litre of hot water for 10 minutes); or 6 to 10 drops of tincture three times per day. Caution: lobelia can cause nausea and vomiting. If this occurs, discontinue use.

Skullcap (Scutellaria lateriflora)
This sedative herb can help alleviate the anxiety that sometimes accompanies giving up cigarettes. Typical dosage: 2 to 6 cups of tea per day (steep 1 to 2 teaspoons of dried leaves in 1/4 litre of hot water for 10 minutes); or 4 to 2 teaspoons of tincture two to six times per day.

Colts foot (Tussilago farfara)
Here's another herb that helps soothe inflamed lung tissue, loosen secretions and tone the lungs. Typical dosage: 2 to 3 cups of tea per day (steep 1 to 2 teaspoons of dried leaves in 1/4 litre of hot water for 10 minutes); or 1/4 to 1 teaspoon of tincture three times per day. Caution: limit use of coltsfoot to no more than four weeks per year.

Valerian (Valerian officinalis)
Can't sleep without a last puff? Valerian relaxes tense muscles; it can be used as a sleep aid if insomnia is one of your quitter's symptoms. Typical dosage: 2 to 6 cups of tea per day (steep 1 to 2 teaspoons of dried root in 1/4 litre of hot water for 10 minutes); or 1/3 to 2 teaspoons of tincture up to six times per day. Caution: avoid if you are pregnant.

Kava-Kava (Piper methysticum)
This South Pacific ceremonial herb relieves anxiety without causing drowsiness or decreasing mental function. Typical dosage: up to 6 cups of tea per day (simmer 1 to 2 teaspoons of dried root in 1/4 litre of hot water for 10 minutes); or 1/4 to 2 teaspoons of tincture up to six times per day; or 3 or 4 capsules of extract standardised to 30 per cent kavalactones per day (a daily total of 250 to 300 milligrams). Caution: do not use kava if you're pregnant. Do not combine with alcohol; do not operate heavy machinery or drive when taking kava. If you suffer from depression, check with your doctor before taking kava.

Passion Flower (Passiflora incarnata)
This gently sedating herb can be used as a sleep aid. If your daytime anxiety is severe, it can also be taken during the day. Typical dosage: 1/4 to 1 teaspoon of tincture or glycerin extract three or four times per day; or up to 2 teaspoonfuls at bedtime to relieve insomnia.

St John's Wort (H),pericum perforatum)
St John's wort has been proven to help in cases of moderate depression. If a blue mood plays a role in your smoking habit, you should begin taking St John's wort two to four weeks before your quit date. Typical dosage: 900 milligrams of standardised extract capsules per day; or 1/2 to 1 teaspoon of tincture per day. Caution: may cause increased skin reactions to sun exposure. Avoid if taking antidepressants or L-dopa.

Liquorice (Glycyrrhiza glabra)
Stress is one reason that many people smoke. The act of quitting is itself stressful for both the emotions and the body. Liquorice nourishes the adrenal glands, the ones most worn out by stressful conditions. It also eases lung symptoms by fighting inflammation, soothing irritated tissues and helping to expel mucus. Typical dosage: 1 to 3 cups of tea per day (simmer 1 to 2 teaspoons of dried, chopped root in 1/4 litre of water for 10 minutes); or 1/8 to 1/2 teaspoon of tincture two or three times per day. You can also buy long pieces of whole liquorice root and chew on them throughout the day - this gives you something to do with your hands and mouth. If you notice darkening of the teeth, discontinue using the herb in this way. Caution: do not use liquorice for more than six weeks. Avoid the herb if you have high blood pressure, if you're on heart medications, if you're pregnant or breastfeeding, or if you have heart, liver or kidney disease.

Schisandra (Schisandra chinensis)
This herb supports the whole body in times of stress and has the added advantage of toning the lungs and easing coughs. Typical dosage: 1 to 3 cups of tea per day (simmer 1 to 2 teaspoons of dried fruit in 1/4 litre of water for 10 minutes); or 1/8 to 1/2 teaspoon of tincture three times per day.

Turmeric (Curcuma longa)
This bright yellow spice has been shown to help remove the car­cinogens that smoking puts in your body. If you're overwhelmed by the number of herbs recommended here, just put turmeric on your spice shelf where it's handy and add it to food several times a week. Typical dosage: 250 to 500 milligrams in capsules two or three times per day, with meals; or 1/8 to 1/2 teaspoon of tincture two or three times per day.