manchester

healthy options

general health

Smoking

IF we were told we had to consume a deadly product containing 4,000 chemicals including the poison used in gas chambers, and at least 60 cancer-causing agents, there would be national uproar.

Civil liberty groups would be up in arms, the media would campaign against the outrage, and demand government action to stamp it out.

Yet millions of smokers voluntarily inflict this potentially fatal risk on themselves every day with every single cigarette. Even worse they force it on others. Non-smokers inhaling ''second-hand'' tobacco smoke also breathe in the same lethal cocktail against their will.

You won't find this 'list of ingredients' on a cigarette packet.

Among the poisons are hydrogen cyanide (used in the gas chambers), acetone (paint stripper), methanol (rocket fuel) cadmium (used in car batteries) DDT (insecticide) carbon monoxide (poisonous gas in car exhausts) butane (lighter fuel) arsenic, ammonia (floor cleaner) and vinyl chloride (used to make PVC). And of course nicotine.

According to latest research from the Royal College of Physicians, it is as addictive as ''hard drugs'' such as heroin or cocaine. Which may explain why when everyone knows smoking is bad for your health, with the risk of chronic illness, early death or these days social ostracism, many still find it hard to quit.

Most smokers don't continue smoking out of choice, but because they are addicted to nicotine, so that only 3% of smokers who attempt to give up with willpower alone, succeed, according to latest research. Experts believe that nicotine exerts its powerful addictive effects by altering two chemicals in the brain - dopamine and noradrenaline - known as neurotransmitters. Over time, a smoker comes to rely on nicotine because of its effect on these chemicals. And so a cycle of addiction is set up. Within ten seconds of inhaling from a cigarete, a concentrated dose of nicotine is delivered directly to the brain, producing a nicotine ''rush'' - it is faster than an intravenous injection. This rush stimulates the release of a number of naturally occurring chemicals in the brain and over time the effects on these - especially dopamine and noradrenaline, cause a smoker to become physically addicted to the nicotine. When a smoker quits, levels of these two chemicals are affected, which is believed to cause both the psychological cravings for cigarettes and the classic withdrawal symptoms such an anxiety, depression and irritability.

The strong urge to smoke, combined with the withdrawal symptoms, drives many people to keep on smoking.

The brain of a smoker adapts so that increased levels of nicotine are needed to maintain normal function.

More than 120,000 people die in Britain each year from smoking-related illnesses. Conditions linked to smoking include a range of cancers (lung, of course, but did you know skin cancer too?), heart disease, stroke, impotence and low-weight babies.

Smoking is also said to cost the NHS £1.7billion a year, and then there is the ''hidden'' damage to the British economy - fires, smoking breaks at work and sick days.

Fires started by cigarettes are said to cost £151m a year in England and Wales, with 34million working days lost a year to smoking-related illnesses. If just one in every 100 smokers kicked the habit, the NHS would save more than £1.1billion in 10 years, according to recent research from the London School of Hygiene and Tropical Medicine - enough for a dozen new hospitals.

No wonder so many are desperate to quit - the figure is as high as 80% according to latest NHS figures - for giving up smoking is the single most important thing smokers can do to improve their health. The chance of a heart attack, for example, begins to fall within two days after quitting. And kicking the habit has never been easier because there is more help at hand than ever before, says regional public health director Professor John Ashton. ''Until now smokers wanting to quit have often been very much on their own. The NHS is now committed to providing support to help in ways that are shown to work,'' says Prof Ashton who urges smokers to ''give your lungs a taste of fresh air and commit yourself to living long enough to see your grand-children grow up.''

What happens when you stop smoking?

20 mins: blood pressure and heart rate improve as does circulation.
8 hours: nicotine and carbon monoxide levels in blood halve.
24 hours: no nicotine left in the body. Taste and smell senses improve.
48 hours: lungs start to clear out mucus and other smoking debris. Chances of a heart attack start to fall.
72 hours: breathing becomes easier.
2-12 weeks: circulation improves, making walking and running easier
3-9 months: coughs, wheezing and breathing improves.
1 year: risk of heart disease is reduced to about half that of a continuing smoker.
10 years: risk of lung cancer falls to half that of a continuing smoker. Risk of heart disease similar to that of someone who has never smoked.
15 years: risk of stroke similar to that of someone who has never smoked.

Treatment

The drug Zyban is now available on NHS prescription. It is taken for eight weeks, and acts on the addiction processes in the brain and eliminates the craving for nicotine - for ever.
Counselling - available to help you tailor giving up to your own lifestyle, through GPs and smoking cessation clinics.
Nicotine patches - (smokers who are exempt from prescription charges can start off with at least one week's worth of free nicotine patches).
Acupuncture Don't try and battle on alone.
Manchester Evening News Dr Chris Steele, a smoking cessation expert, believes that GPs are crucial in encouraging smokers to stop. ''Smoking cessation treatment together with advice and support will give motivated patients the best chance of quitting. In my experience those who succeeed at giving up smoking take their addiction seriously, visit their GP for professional advice and understand that motivation is vital, alongside preparation,'' he says.
Tips on getting through the first few days

The Department of Health advises:

If you have to put something in your mouth, keep it healthy and non-fattening - try sugar-free chewing gum.
If you need to do something with your hands, find something to fiddle with such as a pencil, coin or ring. Anything but a cigarette.
Try drinking juice or eating fruit when you feel like having a cigarette.
Be sensible with alcohol. A few drinks can make you ''forget'' you've given up!

Links
Department of Health pages on giving up smoking
NHS Direct healthcare guide on smoking and lung cancer
Action on smoking and health