Should You Get A Chest Cat Scan?

For years, physicians have tried to figure out a way to screen for lungcancer in people who are or have been smoking. In the past we have tried everything from xrays to testingthe sputum for cancer cells. Unfortunately, nothing seemed to be able to find the cancer early enough to get a cure.

There was a somewhat controvercial articl in the New England Journal of Medicne magazine last week. The article was about a study that included about 31,000 people who smoked and had chest cat scan, which is a type of xray. The study suggests that getting a cat scan would find many cancers in their early stages.

Finding a cancer early on can be literally life saving in this case. In fact, the study indicated that about 80-90% of the people who had a cancer detected this early would still be alive 10 years later. That's way better than the 5% rate we tell people today.

There is lots of debate going on around this, but many of us feel there is enough data to support getting chest cat scans on our patients who smoke. The test is actually called a "spiral cat scan" of the chest and it runs around $200.00. Ever since this article came out I have begun ordering these and have not had an insurance company refuse to pay for one.

DrK

Permalink | 1 Comments| Email Post

Post your comment

Does Exercise Help You Quit?

We all know we should exercise regularly, but is there proof that it will help us quit smoking? Based on a study out of Austria, the answer is yes.

This study found that if you use nicotine gum or patches you are more likely to stay tobacco free if you also did regular exercise. They took 68 volunteers and monitored them for three months. Half of them did regular exercise while the other half didn't. All of them received nicotine replacement therapy.

The results were that 80% of those who exercised were still not smoking at the end of the three months, compared to just 52% of those who didn't exercise. The researchers also discovered that the exercisers who failed to stay off tobacco smoked less than the non-exercisers who went back to smoking.

From our personal experiences, exercising is part of a healthier lifestyle that people who are quitting get into. Quitting seems to trickle down into your entire day and feeling like getting some exercise is part of that. It doesn't have to be something you don't enjoy doing. Just choosing something fun that gets you moving is all it takes.

DrQ

Permalink | 4 Comments| Email Post

Post your comment

The World's Largest Quit Smoking Program

What do you think about quitting with 100,000 people from 89 different countries? If you are not quite ready to quit, this course (https://www.stopsmoking.ucsf.edu/en/Intro/Home.aspx)
probably isn't for you. But if you are ready to give quitting a try, this web based quit program is a good one. It takes about 8 weeks to complete and it starts with some enlightening questions about why you smoke.

If the world's largest quit smoking program isn't for you, there are other options. One of my favorites is the quit smoking programs offered by Kaiser. These programs have an excellent track record of success and you don't have to be a member of Kaiser to participate. I think they run about $70.00 to attend all 8 sessions.

I am a big fan of quit smoking programs. Compared to the cold turkey approach, quit programs increase your odds of successfully quitting by 400%! That's because the cold turkey method does not address the behavioral reasons behind why we smoke. Cold turkey basically throws you into nicotine withdrawal and sets you up for failure.

Truth is, even though it may seem like everyone who has quit has done so by going cold turkey, only 3% of people using this method stay quit after a year. To really booste your odds of quitting and staying quit, a combination of meds and a recognized quit program can't be beat.

Next, I think we should discuss some of the not so legitimate quit programs that are out there. One in particular advertises a shot that will help you quit. Not only does it not work, but it can cause you harm.

DrQ

Permalink | 0 Comments| Email Post

Post your comment

Getting Off Of Gum

A reader posts, "I have been on nicotine gum forever. I am not smoking but am definitely getting nicotine. Do you think that new Chantix would help me?"

There are definitely people who are "stuck" on the gum. I came accross a study that suggested 6% of gum users continue chewing much longer than the 12 weeks recommended. One thing to remember is that this is WAY better than smoking. However, there is still the concern about nicotine intake as well as the feeling of being still hooked on something.

If there are major long term effects of chewing the gum, they have not been identified as of yet. We have come accross people who have chewed for more than a decade and their main issue is with the cost of nicotine gum. But there have been no heart or vascular problems identified in any of the literature.

For some chronic gum users, stopping is associated with some of the withdrawal symptoms we see in people who stop smoking without the aide of a medication. Those symptoms are headaches, irritability, trouble concentrating and even depression.

There was an excellent study done by a leading researcher in this area, John Hughes. He discovered that of long-term gum users, only a small number were truly addicted to the gum. He found that many could stop but were not doing so out of fear of slipping back into smoking.

I am not aware of any studies about Chantix and getting off of the gum. I will ask the lead researcher of a few of the Chantix studies what he thinks, but I suspect it would help. That's because Chantix block the effects of nicotine and helps with withdrawal.

DrQ

Permalink | 0 Comments| Email Post

Post your comment

There's A New Kid On The Block!

It's been about a decade since we have had a new prescription medication approved for cessation. To understand how this new medication called Chantix works, we have to discuss how nicotine works.

When you take a puff off of a cigarette, nicotine reaches the brain in a matter of a few seconds. Once in your brain, it binds to receptors (nicotine receptors) which activates a pleasure center. Think of a lock and key where the nicotine is the key and the nicotine receptor is the lock. Once the key is in the lock the pleasure center is activated and you feel good.

Let's put this into a real life situation by looking at how smoking can quickly calm you down. As an example, say you just had an argument with your wonderful boss. You go outside and light up. In a matter of seconds you feel calmer. What has happened on a chemical level is that the nicotine from your cigarette activated a pleasure center in your brain and you feel less upset.

The bad news is that this effect is short-lived, lasting only about 30-60 seconds. In fact, after about 30 - 60 seconds your body lets you know that you need to reactivate your pleasure center by giving you a mild craving to take another puff. This cycle of a craving leading to puffing continues until you finish your cigarette.

Chantix works by activating the nicotine receptor. In other words, Chantix becomes the key instead of nicotine. Since the key pretty much stays in the lock, you don't get the craving to smoke. Chantix also diminishes the withdrawal from nicotine, but more about that later.

Now, for the part that I think really makes Chantix stand out. If you smoke while taking Chantix your pleasure centers are not activated. This is because those receptor sites (the locks) are already occupied by Chantix (the key), so the nicotine can't attach to them. The end result is that this prevents the cycle of nicotine addiction.

If you are thinking about quitting, ask your doctor about Chantix.

DrQ.

Permalink | 0 Comments| Email Post

Post your comment