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Noxious habit is linked to one out of every five deaths.
Despite all the warnings, lots of people still smoke. Why?

Date published: 4/1/2011

Do I really need to write about smoking?

You’d think there wouldn’t be any need to talk about the ill effects of lighting up. We’ve known for decades that smoking is dangerous, and it has been illegal to sell cigarettes to minors since 1992.

Yet 22 percent of Americans still light up, and smoking remains the leading cause of preventable death in our country—linked to one in five deaths each year. So why are so many people still smoking?

Nicotine, a powerful ingredient in cigarettes, is thought to be as addictive as heroin. It triggers a release of dopamine, the pleasure transmitter in our brains. Dopamine is also released with great food, sex, cocaine and amphetamines. (Sounds like a party!) This can be particularly problematic for those who start smoking early.

Studies have shown that those who start smoking prior to the age of 18—or even worse, before 16—have an incredibly difficult time quitting later in life. They are half

as likely to successfully quit.

The addiction becomes hard-wired into our brains at a young age, since our brains are still developing into our early 20s.


One of the most difficult things I have to do as a physician is explain to someone with emphysema how they will have to accept their “new normal.” Emphysema is a smoking-related lung problem that makes

it very difficult for people to breathe.

In medicine, we refer to it as “air hunger.” If you want to know what it feels like, put a clip on your nose so no air can pass through, and try to breathe only through a straw. Then imagine thick mucous in your throat and lungs that you cannot clear—all the time.

Then imagine coughing every day and feeling out of breath by simply walking across the living room. And then try wearing a portable oxygen tank that you need to carry with you everywhere you go.

I feel so sorry for my patients with emphysema, because no matter what medicines I use to try to help, this is their new reality. Lung cancer—which is also strongly linked to smoking and can lead to significant suffering—almost sounds more appealing.


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Here are some resources you can reach out to for support with quitting smoking: -- Mary Washington Hospital Support Group: 540/741-2150 -- Virginia Department of Health: 800-Quit-Now (800/784-8669) -- nicotine-anonymous.org -- smokefree.gov -- trytostop.org