Concerned About Tobacco Use and Lung Cancer?

Did you promise yourself this was the year you would give up tobacco, but the habit keeps creeping back into your life? You’re not alone.

Nearly one in five U.S. adults use tobacco products.

“Quitting is difficult. Studies show it takes several attempts, but the more you attempt to quit, the more you learn to identify your triggers and build skills,” says Taghrid Asfar, M.D., M.S.P.H., a researcher at Sylvester Comprehensive Cancer Center, and associate professor at the University of Miami Miller School of Medicine. Dr. Asfar studies tobacco use and behavioral interventions that help people give up tobacco. She also serves as a translational science leader of thoracic medicine at Sylvester.

Thoracic medicine addresses diseases of the lung, the lining of the lung and the chest wall.

A winning combination

According to Dr. Asfar’s research, the most effective way to give up tobacco products is to combine four to six weeks of behavioral counseling with 12 weeks of nicotine replacement treatment. Behavioral counseling focuses on changing habits that make people repeat the addictive cycle. Learning to identify triggers, manage stress and make lifestyle changes are techniques taught in counseling sessions.

The treatment portion involves nicotine replacement products.

“We start with high-dose nicotine replacement products based on the number of cigarettes they smoked per day; then we decrease the dose gradually during the treatment to help smokers cope with withdrawal symptoms, such as the urge to smoke. Over-the-counter patches and gums are safe and easy to use. Lozenges and sprays require a prescription and physician’s care, as does Zyban and varenicline,” Dr. Asfar says. Regardless of the product, “All are effective if used properly.”

Smoking cessation delivers immediate benefits.

When you stop using tobacco products, the body experiences immediate relief. “Within 24 hours, your blood pressure normalizes, and lung function improves. Within nine months, coughing stops and lung function continues to improve,” Dr. Asfar says. More importantly, the risk of lung cancer and stroke declines significantly after five to 10 years of quitting smoking, and you live longer, too. “Smoking takes at least 10 years off your life,” Dr. Asfar says.

The pitfalls of e-cigarettes

Although Dr. Asfar says smoking has steadily declined since 1964, the use of electronic cigarettes, such as vaping, has increased, particularly among youth. Manufacturers target young people with vape juice flavored like bubblegum or candy. Although some people believe that electronic cigarettes can wean smokers off traditional cigarettes, Dr. Asfar says that e-cigarettes are not FDA-approved for smoking cessation.

To prove that these products are no better than traditional forms of tobacco, Dr. Asfar and a group of researchers reviewed 90 studies on the risk and safety profile of e-cigarettes (a.k.a. electronic nicotine delivery systems — ENDS).

“We found that e-cigarettes expose users to toxic substances, increase the risk of cardiovascular disease, and lead to nicotine dependence. Among youth, vaping harms brain development and increases the risk of respiratory disease, anxiety, and depression. E-cigarettes also increase the likelihood of a person using traditional cigarettes. We also found that exposure to e-cigarette marketing increases the chances of initiating traditional cigarette smoking among youth,” she says.

Despite these daunting facts, Dr. Asfar is optimistic about interventional strategies such as the FDA’s public education campaign and her own research grants designed to develop e-cigarette and hookah health warnings.

Help is available — you are not alone

Overcoming tobacco addiction is hard, but finding help is easy.

“Tobacco Free Florida offers free counseling in person or by phone or text, and free nicotine replacement treatment,” Dr. Asfar says.

Your health care provider can refer you to these smoking cessation services, or you can go directly to Tobacco Free Florida’s website. The program is part of UHealth’s Miami Area Health Education Center (AHEC). Group classes and individual counseling sessions are available in English or Spanish.

Another step toward better health

If quitting is the first step to better health, lung cancer screening is the next.

“The U.S. Preventative Services Task Force recommends screening if you are 50 to 80 years old and have smoked one pack of cigarettes a day for 20 years or half a pack of cigarettes a day for 40 years. That recommendation includes individuals who are currently smoking cigarettes or for those who have quit smoking within the last 15 years,” says Nicole Gay, APRN, a nurse practitioner who performs low-dose computed tomography (LDCT) lung cancer screenings at Sylvester. If you meet the criteria, your doctor can refer you for screening, or you can self-refer. (Check with your insurance to see which option is best.)

CT scans can detect lung cancer early when it is easier to treat. “Screening is the way to detect lung cancer before you have symptoms. By the time symptoms appear, it is usually late-stage cancer,” Gay says.

When people arrive for a screening, Gay discusses their medical history and any concerns they may have about screening.

“It’s a shared decision-making visit,” Gay says. As part of the visit, “I can refer them to a smoking cessation program if they’re ready. This is a judgment-free program. I tell them, ‘You don’t have to do this on your own.’ Help and support is available.”

To make an appointment for lung cancer screening, call 305-689-LUNG (5864).

By Nancy Moreland

Tags: Dr. Taghrid Asfar, E-Cigarettes Risks, Health Benefits of Quitting, Nicotine Replacement Therapy, Sylvester Comprehensive Cancer Center