The Arsenal Files 1/The Arsenal Files (Arsenal Computer).ISO/health/blackbag.031

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                          Weekly Health Bulletin
             Courtesy of Black Bag Medical Information Services
             America's Online Health Information Connection(tm)
                               302-994-3772

       This document is provided for educational purposes only. The
information provided is NOT to be considered as diagnostic or
individual advice. No specific medical quidance or treatment can be
recommended without consultation with a physician. You  should consult
your personal physician prior to utilizing any medical information
discussed in this document. Those contributing to this informational
bulletin, disclaim all responsibility for any actions taken by persons
in reliance upon information stated in this program. Should you choose to
disregard this warning, you assume the risk and responsibility for your
actions.

    This weeks issue is devoted to a friend Dean LeSher who died of
lung cancer this Thursday.  I hope all that read this and are able,
will say a prayer for him.   For those of you who smoke ..... please stop....
This weeks issue is dedicated to Dean.

CLEARING THE AIR: A GUIDE TO QUITTING SMOKING

"There is no one magic way for everybody to quit smoking. But there are a
great many effective ways. If at first you don't succeed, quit and quit
again!"

INTRODUCTION

In the following you'll find a variety of tips and helpful hints on kicking
your smoking habit. These methods can make your own personal efforts a
little easier.
  Take a few moments to look at each suggestion carefully. Pick those you
feel comfortable with. And decide today that you're going to use them to
quit.
  It may take a while to find the combination that's right for you. But you
can quit.
  Many smokers have quit "cold turkey," without first cutting down, planning
a special program, or seeking professional help. But many others have
successfully given up cigarettes by replacing them with new habits or by
using some gimmick.
  The following approaches include those most popular with ex-smokers.
Remember that successful methods are as different as the people who use
them. What may seem silly to others may be just what you need to quit--so
don't be embarrassed to try something new.
  Pick the ideas that make sense to you. And then follow through--you'll
have a much better chance of success.

WHEN THINKING ABOUT QUITTING...

1. List all the reasons why you want to quit. Every night before going to
bed, repeat one of the reasons 10 times.
2. Decide positively that you want to quit. Try to avoid negative thoughts
about how difficult it might be.
3. Develop strong personal reasons in addition to your health and
obligations to others. For example, think of all the time you waste taking
cigarette breaks, rushing out to buy a pack, hunting a light, etc.
4. Set a target date for quitting--perhaps a special day like your birthday,
your anniversary, a holiday. If you smoke heavily at work, quit during your
vacation. Make the date sacred, and don't let anything change it.
5. Begin to condition yourself physically: start a modest exercise regimen;
drink more fluids; get plenty of rest and avoid fatigue.

INVOLVE SOMEONE ELSE...

1. Bet a friend you can quit on your target date. Put your cigarette money
aside every day, and forfeit it if you smoke.
2. Ask your spouse or a friend to quit with you.

SWITCH BRANDS...

1. Switch to a brand you find distasteful.
2. Change to a brand that's low in tar and nicotine a couple of weeks before
your target date. This will help change you smoking behavior. However,
remember do not smoke more cigarettes, inhale them more deeply or place your
fingertips over the holes in the filters.

CUT DOWN THE NUMBER OF CIGARETTES YOU SMOKE...

1. Smoke only half of each cigarette.
2. Each day, postpone lighting your first cigarette one hour.
3. Decide you will smoke only during odd or even hours of the day.
4. Decide beforehand how many cigarettes you'll smoke during the day. For
each additional smoke, give a dollar to your favorite charity.
5. Don't smoke when you first experience a craving. Wait several minutes;
and during this time, change your activity or talk to someone.
6. Stop buying cigarettes by the carton. Wait until one pack is empty before
buying another.
7. Stop carrying cigarettes with you at home and at work. Make them
difficult to get to.
8. Smoke only under circumstances which are not especially pleasurable for
you. If you like to smoke with others, smoke alone.
9. Make yourself aware of each cigarette by using the opposite hand, or
putting cigarettes in an unfamiliar location or different pocket to break
the automatic reach.
10. If you light up many times during the day without even thinking about
it, try to look in a mirror each time you put a match to your cigarette--you
may decide you don't need it.
11. Don't smoke "automatically." Smoke only those you really want.
12. Reward yourself in some way other than smoking.
13. Reach for a glass of juice instead of a cigarette for a "pick-me-up."
14. Change your eating habits to aid in cutting down. For example, drink
milk, which is frequently considered incompatible with smoking. End meals or
snacks with something which won't lead to a cigarette.
15. Don't empty your ashtrays. This will not only remind you of how many
cigarettes you have smoked each day, the sight and smell of stale butts will
be very unpleasant.

JUST BEFORE QUITTING...

1. Smoke more heavily than usual so the experience becomes distasteful.
2. Collect all your cigarette butts in one large glass container as a visual
reminder of the filth smoking represents.
3. Practice going without cigarettes. Don't think of never smoking again.
This of quitting in terms of one day at a time. Tell yourself you won't
smoke today and then don't.

ON THE DAY YOU QUIT...

1. Throw away all the cigarettes and matches. Hide lighters and ashtrays.
2. Visit the dentist, and have your teeth cleaned to get rid of tobacco
stains. Notice how nice they look, and resolve to keep them that way.
3. Make a list of things you'd like to buy yourself or someone else.
Estimate the cost in terms of packs of cigarettes, and put the money aside
to buy these presents.
4. Keep very busy on the big day. Go to the movies, exercise, take long
walks, go bike riding.
5. Buy yourself a treat, or do something special to celebrate.

IMMEDIATELY AFTER QUITTING...

1. The first few days after you quit, spend as much free time as possible in
places where smoking is prohibited, e.g. libraries, museums, theaters,
department stores, churches, etc.
2. Drink large quantities of water and fruit juice.
3. Try to avoid alcohol, coffee, and other beverages with which you
associate cigarette smoking.
4. Strike up a conversation with someone instead of a match for a cigarette.
5. If you miss the sensation of having a cigarette in you hand, play with
something else--a pencil, a paper clip, a marble.
6. If you miss having something in your mouth, try toothpicks or a fake
cigarette.

AVOID TEMPTATION...

1. Instead of smoking after meals, get up from the table and brush your
teeth or go for a walk.
2. If you always smoke while driving, take public transportation for a
while.
3. Temporarily avoid situation you strongly associate with the pleasurable
aspects of smoking, e.g., watching your favorite TV program, sitting in your
favorite chair, having a cocktail before dinner, etc.
4. Develop a clean, fresh non-smoking environment around yourself--at work
and at home.
5. Until you are confident of your ability to stay off cigarettes, limit
your socializing to healthful, outdoor activities or situations where
smoking is prohibited.
6. If you must be in a situation where you'll be tempted to smoke (such as a
cocktail or dinner party), try to associate with the non-smokers there.
7. Look at cigarette ads more critically to better understand the attempts
to make individual brands appealing.

FIND NEW HABITS...

1. Change your habits to make smoking difficult, impossible, or unnecessary.
Try activities such as swimming, jogging, tennis or handball. Wash your
hands or the dishes when the desire for a cigarette is intense.
2. Do things to maintain a clean mouth taste, such as brushing your teeth
frequently, and using a mouthwash.
3. Do things that require you to use your hands. Try crossword puzzles,
needlework, gardening, or household chores. Go bike riding; take the dog for
a walk; give yourself a manicure; write letters; try new recipes.
4. Stretch a lot.
5. Get plenty of rest.
6. Pay attention to your appearance. Look and feel sharp.
7. Absorb yourself with activities which are the most meaningful, satisfying
and important to you.
8. Add more spontaneity and excitement to your daily routine.

WHEN YOU GET THE "CRAZIES"...

1. Keep oral substitutes handy--things like carrots, pickles, sun-flower
seeds, apples, celery, raisins, sugarless gum, and so on.
2. Take 10 deep breathes, and hold the last one while lighting a match.
Exhale slowly, and blow out the match. Pretend it is a cigarette, and crush
it out in an ashtray.
3. Take a shower or bath if possible.
4. Learn to relax quickly and deeply. Make yourself limp, visualize a
soothing, pleasing situation, and get away from it all for a moment.
Concentrate on the peaceful image and nothing else.
5. Light incense or a candle, instead of a cigarette.
6. Never allow yourself to think that "one won't hurt"--it will.

MARKING PROGRESS...

1. Each month, on the anniversary of your quit date, plan a special
celebration.
2. Periodically, write down new reasons why you are glad you quit, and post
these reasons where you'll be sure to see them.
3. Make up a calendar for the first 90 days. Cross off each day and indicate
the money saved by not smoking.
4. Set other intermediate target dates, and do something special with the
money you've saved.

ABOUT GAINING WEIGHT...

Many people who are considering quitting are very concerned about gaining
weight. If you're one of those, keep these points in mind:
1. Just because you quit doesn't mean you'll automatically gain weight. Most
of the time that people gain it's because they've begun to eat more once
they quit.
2. Giving up cigarettes is far healthier for you than adding on a few extra
pounds. It would take the addition of more than 75 pounds to offset the
health benefits which a normal smokers gains by quitting. Watch what you
eat, and if you're concerned about gaining weight, you may want to consider
the following:
  A. Start a diet program while you are preparing to quit.
  B. Don't set a target date for a holiday when the temptation of high
calorie food and drinks may be too hard to resist.
  C. Weigh yourself daily.
  D. Plan menus carefully and count calories.
  E. Have low calorie food on hand for nibbling.
  F. Take time for daily exercise, or join an organized exercise group.

ONE POPULAR FOUR-STEP PROGRAM...

These self-help suggestions can be combined into a variety of programs to
meet your needs. One popular four-week quitting program is outlined below.
  FIRST STEP: List the positive reasons you want to quit smoking, and read
the list daily. Wrap your cigarette pack with paper and rubber bands. Each
time you smoke, write down the time of day, what you are doing, how you are
feeling and how important that cigarette is to you on a scale from 1 to 5.
Then rewrap the pack.
  SECOND STEP: Keep reading your list of reasons, and add to it if possible.
Don't carry matches, and keep your cigarettes some distance away. Each day,
try to smoke fewer cigarettes, eliminating those least or most important
(whichever works best).
  THIRD STEP: Continue with the second week's instructions. Don't buy a new
pack until you finish the one you're smoking and never buy a carton. Change
brands twice during the week, each time choosing a brand lower in tar and
nicotine. Try to stop smoking for 48 hours sometime during the week.
  FOURTH STEP: Continue the above, increase your physical activity. Avoid
situations you most closely associate with smoking. Find a substitute for
cigarettes. Do deep breathing exercises whenever you get the urge to smoke.

WHAT HAPPENS AFTER YOU QUIT SMOKING...

A. Immediate Rewards

Within 12 hours after you have your last cigarette, your body will begin to
heal itself. The levels of carbon monoxide and nicotine in your system will
decline rapidly, and your heart and lungs will begin to repair the damage
caused by cigarette smoke.
  Within a few days, you will begin to notice some remarkable changes in
your body. Your sense of smell and taste will return. Your smoker's hack
will disappear. Your digestive system will return to normal.
  Most important of all, you feel really alive--clear-headed, full of energy
and strength. You're breathing easier. You can climb a hill or a flight of
stairs without becoming winded or dizzy. And you will be free from the mess,
smell, inconvenience, expense and dependence of cigarette smoking.

B. Long-Range Benefits

Now that you've quit, you've added a number of healthy productive days to
each year of your life. Most important, you've greatly improved you chances
for a longer life. You've significantly reduced your risk of death from
heart disease, stroke, chronic bronchitis, emphysema, and cancer.

C. Recovery Symptoms

As your body begins to repair itself, instead of feeling better, you may
feel worse. These "withdrawal pangs" are really symptoms of recovery.
Immediately after quitting, many exsmokers experience "symptoms of recovery"
such as temporary weight gain caused by fluid retention, irregularity and
sore gums or tongue. You may also feel edgy and more short-tempered than
usual.
  It is important to understand that the unpleasant aftereffects of quitting
are only temporary and signal the beginning of a healthier life.

WHEN YOU CALL IT QUITS...

When you call it quits, you will feel a great deal of personal satisfaction.
You will have accomplished a very difficult task. And you will be rewarded
in more ways than you had imagined. But, because it is a difficult
challenge, you must anticipate the problems, and avoid self-pity or
compromises.
  The above information can only give you a good start. Now it's up to you.
with a strong commitment, and with the support of your friends, YOU CAN QUIT
SMOKING!

OTHER SOURCES OF INFORMATION ON QUITTING SMOKING...

American Cancer Society
777 3rd Avenue
New York, New York 10017
[phone]
(Consult your local telephone directory for listing of local chapters)

American Heart Association
7320 Greenville Avenue
Dallas, Texas 75231
[phone]
(Consult your local telephone directory for listing of local chapters)

Office on Smoking and Health
U.S. Department of Health and Human Services
5600 Fisher Lane
Park Building, Room 110
Rockville, MD 20857
[phone]

Office of Cancer Communications
National Cancer Institute
National Institutes of Health
Bethesda, MD 20205
[phone]

FREEDOM FROM SMOKING CLINICS
Georgetown University Hospital
3800 Reservoir Road, NW
Washington, DC 20007
[phone]

AMERICAN LUNG ASSOCIATION OF NORTHERN VIRGINIA
9735 Main Street
Fairfax, Virginia  22031--3798
[phone]


UPDATE-

A report in Addictive Behaviors sugges that nicotine gum (Nicorette) may
help people quit smoking without gaining weight.  Of 104 ex-smokers, 20
chewed nicotine gum for a month.  Most of those who had smoked heavily (but
didn't use the gum) gained 5.8 ponds on average.  Those who chewed the gum
gained little if any weight.  The reason: the gum's nicotine stimulates
metabloism, so calories get burned quicker; it may also stop oral pangs.


WHY DO WOMEN SMOKE?

Roughly one out of three American women smokes.  Women outnumber men in
programs designed to help them overcome nicotine addiction.  Addiction may
seem like a strong word for a habit that is linked to such a sociable event
as an after dinner conversation.  However, the body's reaction to withdrawal
from cigarettes demonstrates that nicotine is a highly addictive drug.
Physical reactions to nicotine in the bloodstream have shown that small
doses of nicotine act like a stimulant, while larger amounts act like a
tranquilizer.

For women, nicotine has a more dramatic effect on the body's metabolism.
Smoking causes a woman's heart, breathing and pulse rates to increase by
nearly 10 percent.  Men experience less metabolic change.  This increase in
metabolism enables smokers to consume more calories on a daily basis.  One
study showed that, one average, smokers consume as much as 350 calories more
per day than non-smokers.  The metabolic changes that nicotine creates
within the body enable smokers to eat more without gaining weight.

Smoking doe "burn" more calories in an unhealthy way.  This contributes to
women's realistic fear that if they quit smoking they might gain weight.  It
has been shown that the average weight gain for someone who quits smoking is
five to 10 pounds.

This metabolic change can be anticipated when a woman chooses to quit
smoking.  Diet management and increasing the body's metabolism naturally
through exercise are two ways to avoid weight gain.

The psychological addiction to cigarettes can last weeks or years after the
smother has stubbed out her last cigarette.  It has been found that women
use smoking as a sedative to relieve negative feelings.  Men, other the
other hand, are more likely to smoke to add to positive experiences.  In one
study, men and women viewed a brutal horror film and a comedy.  Nearly 75
percent of the women smoked during the horror film as compared to 30 percent
of the men.  Conversely, none of the women and most of the men smoked during
the funny movie.

Because smoking acts like a sedative for many women, the physical symptoms
associated with withdrawal cause many women to resume smoking.  The woman
who says "I've tried to give up smoking, but after a few days my family begs
me to go back to cigarettes because I am impossible to live with..."
reflects the dilemma of a number of women.  If a woman smokes to sedate
angry or negative feelings, withdrawing from nicotine can carry a double
effect.  The woman feels irritable because she hurts physically and is
experiencing feeling that used to be tranquilized with a cigarette.  For
many women this internal conflict is resolved by resuming behavior that is
more comfortable for the family even if it is more dangerous for her.  In
one program 43 percent of the women who began smoking again gave
"nervousness" as the reason.  Less than half of the men in the same survey
cited this as the reason that they were unable to stop smoking.


Boredom on the job is another element that prevents women from giving up
cigarettes.  Not surprisingly, women who smoke are more likely to be in
home or work situations where they are under pressure but have little
authority in their jobs.   The highest rates of smoking are found among
women who work as waitresses, cashiers, nurse's aides, practical nurses and
in assembly line crews.

Women who are unsuccessful in ending their smoking addiction describe
cigarettes as "companions."  This is particularly true if the woman feels
restricted in her ability to develop outside activities or adult companions.
Women who work at home with young children are particularly vulnerable to
this dependency on cigarettes.

Cigarette smoking represents an outlet for many women that significantly
complicates their ability to kick this dangerous habit.

                     -----------------------------
                     TIPS FOR STAYING A NON-SMOKER
                     -----------------------------

1.    Review your lists of reasons to quit smoking each time you want a
      cigarette.

2.    Remind yourself how good you feel about yourself and that you're
      worth this much difficulty.

3.    Keep drinking a lot of water and fruit juices.  It helps flush the
      nicotine out of your system.

4.    Destroy all of your "left-over" cigarettes.

5.    Take one day at a time.  Plan your non-smoking pattern for a day
      at a time.

6.    Get your list of substitute activities for smoking and begin to
      substitute an activity for smoking.

7.    Brush your teeth frequently.

8.    Avoid the "triggers" for smoking you identified earlier.  Plan to
      do a different activity at that time.

9.    Get involved in a fitness class or talk with the Healthsteps Fitness
      Coordinator so you can begin substituting exercise for smoking.

10.   Put all your ash trays away and out of sight.  Clean them up first.

11.   Avoid smoking friends and situations where you will want a cigarette.

12.   Reward yourself!  You deserve it.

13.   Keep reviewing your list of reasons for quitting.

14.   Use your deep breathing exercises to help overcome the urge to smoke,
      to relax you and to help you fall asleep at night.

15.   Keep your hands busy. (e.g. doodle, fold clothes, pull weeds, clean
      the room, hold a pencil or straw.)

16.   Make a plan to cope with special social situations.  Write it down
      and carry it with you.

17.   Use you buddy for support.

18.   Plan something special for yourself with the money you are saving.

          This news file is compiled weekly from the archives of the
                      BLACK BAG MEDICAL INFORMATION SERVICES
                                  302-994-3772
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