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The Effects of Tobacco: Q&A with Thoracic Surgeon Dr. Rose Ganim

October 28, 2015

November is Lung Cancer Awareness Month, and Thursday, November 19 is the date for the American Lung Association’s “Great American Smoke Out.” While the dangers of smoking are well publicized, there are still over 42 million Americans who smoke cigarettes, and additional millions who smoke cigars or pipes, or use other forms of tobacco.

I am a thoracic surgeon at Baystate Medical Center who works in tandem with doctors from the Baystate Regional Cancer Program to treat lung cancer and other diseases. The following are some of the common questions I receive from patients and their families regarding tobacco use.

Q: My 18-year-old has started smoking with her friends. I won’t let her do it at home, but is she still likely to get addicted to cigarettes?

RG: Smoking is our #1 killer and is responsible for 20% of all deaths in the United States each year. These are deaths due to heart attacks, strokes, emphysema, lung cancer and more. Lung cancer kills more men and women each year than colon, breast, and prostate cancers combined; 90% of lung cancers occur in smokers.

More than 90% of adults who smoke started before they were 21. Around 30% of 9th graders are already smoking, and they keep on doing it. Few manage to quit. Among adults, almost 20% are smokers. Most kids smoke because they think it's cool and makes them look older. And it works! Smoking breaks down firm parts of your skin, the elastin, and gives you wrinkles making you look older than you are.

Q: What about marijuana, pipes, and cigars? Or products like chewing tobacco or snuff? Are they better than cigarettes?

RG: They are all bad. For example, it was long believed that smoking a joint a day is no big deal because it is only one, and may even prevent cancer. The opposite is true! One joint a day seems to carry the same health risks as a whole pack of cigarettes. Pipes and cigars have risks that are nearly equivalent to cigarettes.

Smokeless tobacco products, like chewing tobacco or snuff, result in a higher risk of developing mouth cancer, which can also spread to the neck and lymph glands. Treatment for these cancers is very difficult and often disfiguring.

Q: Is vaping – using e-cigarettes – a healthier option than smoking?

RG: While the risks of e-cigarettes are currently being studied, they are increasingly popular among teens. There is a lot of concern that these products might lead to eventual use of conventional cigarettes with these kids. A study published last year in the journal Nicotine and Tobacco Research noted an alarming increase in those middle and high school student who used e-cigarettes, but never smoked a cigarette.

The study also found that these youth were almost two times more likely to intend to begin smoking regular cigarettes as youth who had never used e-cigarettes. It’s important to remember that e-cigarettes still contain nicotine, which is addictive. Some in the “vaping” industry like to say that it isn’t addicting and won’t lead to smoking; I think they should leave the nicotine out then. 

Q: My husband's doctor said that his bladder cancer is due in part to smoking. I thought smoking only caused lung cancer?

RG: Tobacco and cigarettes contain many chemicals that are absorbed into the blood and are toxic to the body. Several cancers are associated with tobacco use including: lung, mouth, laryngeal (voice box), esophagus, stomach, pancreas, kidney, bladder, cervix, and leukemia. Besides cancer, tobacco use is associated with heart attacks, strokes, poor circulation leading to amputations, asthma, emphysema, poor healing, wrinkles, yellow teeth, and more.

Q: I'm afraid that if I quit smoking then I will get fat. Will I?

RG: Many people, but not all, who quit smoking gain weight. This is caused by many things including the need to put something in your mouth (oral fixation) and improved taste buds so food tastes better. Nicotine from smoking acts as a mild appetite suppressant and increases metabolism slightly. A healthy diet and exercise can counteract these effects, and can be as easy as a daily 20 minute brisk walk.

Q: I have tried to quit smoking, but it is too hard. Why is that?

RG: Nicotine is a chemical addiction and causes changes in your brain chemistry. Quitting smoking is the hardest thing that many people ever have to do. It can take four or more tries before you are successful. Don't be discouraged, and get help!

Studies have shown that people who get counseling and/or medications are more likely to succeed. Talk to your doctor to get help. The effort is worth it! There are immediate benefits to your blood pressure, heart and lungs. These translate into long-term improvements too. Added bonus: You will also smell better!

Q: I’ve heard lung cancer is easier to treat if it’s caught early. I quit smoking after 45 years. Is there anything else I can do?

RG: The National Lung Screening Trial has shown that low-dose CT screening can save the lives of people at high risk for lung cancer by finding cancer early, when it is easier to treat. Low-dose CT screening is one of the easiest screening exams you can have. To find out if you qualify, call Baystate’s Lung Cancer Screening Program at 1-855-794-LUNG (5864).