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Guest column | Dr. M.P. Ravindra Nathan

Set a healthy priority by stopping smoking

Former U.S. Surgeon General Joycelyn Elders and Dr. M.P. Ravindra Nathan of Brooksville, the director of the Hernando Heart Clinic, attend a symposium at Silverthorn Country Club on tobacco’s risks and the role of doctors in smoking cessation.

Special to the Times

Former U.S. Surgeon General Joycelyn Elders and Dr. M.P. Ravindra Nathan of Brooksville, the director of the Hernando Heart Clinic, attend a symposium at Silverthorn Country Club on tobacco’s risks and the role of doctors in smoking cessation.

In Hernando County, 27 percent of adults and 21 percent of youths still smoke cigarettes.

''This is an alarming statistic," said Dr. Joycelyn Elders, the 15th Surgeon General of the United States.

In Pasco County, figures are equally high, 30 percent among adults and 18 percent among the youths.

Nationwide, the prevalence of cigarette smokers has dropped a little, to just under 20 percent according to recently released data. But this is just a drop in the bucket and the rate needs to be lowered even more. Our counties haven't done well at all in this regard and we have a long way to go. This is one reason the Smoke-free Campus by 2009 program was initiated by the area hospitals last year, and it seems to be on target.

"Smoking is a major preventable cause of death and morbidity in this country," emphasized Elders while speaking at a recent symposium on health risks of tobacco and the critical role of physicians in smoking cessation. It was presented by the Hernando County Health Department and the Florida Medical Association at Silverthorn Country Club.

Elders presented sobering statistics. However, much of the public hasn't gotten the message yet. Smoking is responsible for 438,600 preventable deaths annually in U.S. and accounts for 1 in 5 U.S. deaths. It kills more people than HIV, illegal drug use, alcoholism, motor vehicle accidents, suicides and murders combined. On average, a cigarette smoker dies at least 14 years earlier than a nonsmoker.

About 38,000 die from second-hand smoke alone. The risk of dying from heart disease increases by two to four times, and the risk is much higher in younger age groups. Lung cancer increases, as does asthma related to smoking.

"Even our pets also suffer from this bad habit of humans. Veterinarians tell us that dogs develop nasal cancers and cats get cancers in the mouth if their owners are smokers. Even the birds start wheezing!" Elders said.

Nationwide, we are facing a conundrum in our treatment efforts. Most smokers know they need to quit, a majority want to quit, but less than 50 percent report having even tried to quit. And many of these attempts fail to produce long-term tobacco abstinence, although effective treatments are available.

The vast majority of patients we see in our clinical practice are severely nicotine dependant and might need aggressive intervention, some needing maintenance treatment for a while. Research has shown that we could improve the outcome and increase the abstinence rates if the message is delivered by all health care personnel using available cutting-edge strategies.

"Doctors and nurses can and should definitely take a major role in keeping our environment smoke free and help patients to give up this bad habit. These are the five A's of quitting," Elders reminded the audience: Ask all patients if they smoke. Advise all smokers to quit. Assess their willingness to quit. Assist those who want to quit. Arrange follow-up for those trying to quit.

U.S. Public Health Services Clinical Practice Guidelines suggest the following to all those who are willing to quit:

• Get ready. Set a quit date and stick to it.

• Get support and encouragement — from family, friends, co-workers and, of course, your own doctors. Get counseling as needed.

• Learn new skills, hobbies and behaviors. This will reduce the stress associated with nicotine withdrawal.

• Get medication and use it correctly: Nicotine gums, patches and lozenges are available over the counter and nicotine nasal spray, bupoprion (zyban) and varenicline (chantix) are prescription drugs.

• Be prepared for relapse. Eating a healthy diet, staying active and being careful when around other smokers to avoid temptation will help.

"Quitting smoking is not easy. So be ready for challenges, especially in the first few weeks. But with help from your doctor and support group, you can do it and live a long, healthy life," advised Elders.

Currently, a free six-week tobacco dependence program is being offered at both Brooksville and Spring Hill Regional hospitals. Contact the Hernando County Health Department to get education materials for both patients and health care providers.

Cessation resources

• Click on www.ceasesmoking, an excellent Web site to assist with your smoking cessation strategies.

• The office of the Surgeon General: .

• The Hernando County Health Department, www.hernando; or call (352) 540-6848 for local tobacco cessation class information.

Dr. M.P. Ravindra Nathan is the director of the Hernando Heart Clinic.

Set a healthy priority by stopping smoking 06/16/09 [Last modified: Thursday, June 25, 2009 7:10pm]
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