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           FREQUENTLY ASKED QUESTIONS (FAQ)

                         FOR

              ALT.SUPPORT.STOP-SMOKING (AS3)
              ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

      Part 4: TECHNIQUES, TROUBLESHOOTING, AND TIPS

     "I am definitely gaining weight. The added money in my wallet is
really weighing me down! Let the weight gain continue!" - Rick Weaver

     "I'd rather be chunky than a nicotine junkie!" - MaryJane Patterson

31. How do I avoid relapsing during stressful times?

You can avoid a lot of the things that trigger the urge to smoke until you
feel ready to handle them. But stress, bad news, and sad events come on
their own terms, and when they do, they make many of us return to the
comfort of that false friend, smoking.

There isn't any technique to guarantee that you won't smoke when the going
gets really tough, and you'd only be human if you did. But if you can try
to remember that smoking is only temporary relief and can't really solve
your problem, you might get through. Here's how Nat <[e-mail]> put
it:

     "My dad died in March of lung cancer. I had quit a couple of months
prior to that and started back during the days leading up to the funeral.
What I'm going to say may sound hard, but I feel more compassion than you
know.

     My daddy died.
     I smoked just one.
     My daddy was still dead.
     I smoked some more.
     He was still dead.
     The estate pressures were still there.
     My momma still needed me.
     My family still needed me.
     I was once again a fully involved addict with a lot of grief and
pressures.
     I have had to go through the quit all over again.

"We learn to deal with our emotions through smoking. A crisis arises after
2-3 years and we want to smoke. The quit process never ends. Every day we
must make a conscious decision to either win or lose. If you look at it
right, it's an opportunity that the never-smoker doesn't have: victory over
the most addictive substance in our culture!"

Another way to deal with a strong urge is to beat it senseless. :) Here,
Susan <[e-mail]> describes her battle with what we like to call the
Nicobeast:

"... in a drunken stupor, I did the only thing I could do. I got in a
barfight with him. I would have slammed him onto the pool table but it's a
British Pub, no table. I would have hit him with a beer bottle but I was
drinking mixed drinks. So I hit him. Hard. Then I kicked him right where it
hurts. Rest assured my friends, there will be no little nicobeasts running
around ... if you know what I mean. I was trying not to be too obvious
about beating him up as I didn't want my friends to notice. Fortunately, we
were outside. So I pretended to be stomping my feet to keep warm. Really I
was stomping the nicobeast into so much hamburger helper. I had to sing Ave
Maria to cover those awful squeals that he made. I can't carry a tune in a
bucket. It was a little embarrassing, but worth it. I walked away
unscathed."

32. I dreamt I smoked!

The 'smoking dream' is a bizarre yet very common phenomenon among
ex-smokers. It might hit at different phases of your quitting experience;
it might hit when you think you don't even think about smoking anymore.
These dreams tend to be very vivid and so realistic that you will probably
believe you actually smoked; you may even wake feeling raw in your throat.
But, no matter how real the guilt feels, dreaming about smoking is not
equivalent to actually smoking! So when the dreams come, try not to be
bothered by them, just amused at the power of the subconscious.

33. What about weight gain?

By Michael D. Myers, M.D. <[e-mail]>, as published on his
homepage. Reused with kind permission.

Smoking and Obesity.

"When people stop smoking, they commonly gain weight. Most people think
that they are substituting food for cigarettes. This is partially correct.
Smoking is usually a different form of oral gratification that obviously
does not involve the consumption of calories. However, smoking does have
another effect - it actually increases caloric requirements. A person who
smokes requires approximately 10% more calories to maintain their body
weight than when they are not smoking. Therefore, if a person maintains
constant food intake and exercise and stops smoking, their body weight is
expected to increase between 5% and 10%.

"An excellent way to help counter this is to exercise consistently. For
example, start walking 30 minutes a day three to four times a week - a very
feasible goal. Another approach is recording your food intake. If you write
down everything you eat before you eat it, you will become much more aware
of what you are eating. This helps you make better food choices, thereby
helping you maintain your weight.

"It is much more important to stop smoking than to worry about weight gain.
The deleterious effects of smoking far outweigh the effects of putting on a
few extra pounds. Some people think that when they stop smoking it is also
a good time to go on a strict diet. This is not recommended because both
are very stressful and it is extremely difficult to do both effectively.
Usually, people do not succeed at either and feel like failures. Remember
that it is important to stop smoking first. Then you can deal with your
weight more effectively.

"Disclaimer Statement: The above information is for general purposes only,
and should not be construed as definitive or binding medical advice.
Because each person is medically different, individuals should see their
personal physicians for specific information and/or treatment. For
comments, please send E-mail to: [e-mail]. I do respond to
E-mail. Office Address: MICHAEL D. MYERS, M.D. Inc. 4216 Katella Av. Los
Alamitos, CA (US) 90720 phone: [phone]."


34. But I don't *want* to gain weight!

Contributed by Susan <[e-mail]>

"Another person in the ng who wanted this information thought others would
be interested, so I am passing it along.  Walking has helped me a lot, both
on the stress side and to avoid gaining weight.

Smoking fact:  A smoker who smokes 20 cigarettes per day burns
approximately 200 calories more each day than if he/she were a non-smoker.

To eliminate that 200 calorie gain, use the calculation below:

A person weighing 140 pounds who walks 3 miles [roughly 5km] per hour (a 20
minute mile) will burn about 95 calories per mile.  45 minutes at this pace
will result in about 2 miles being walked, or 215 calories burned.  This
alone will prevent weight gain after quitting. Just walk a little longer or
a little faster to lose weight.  Also remember that 3,500 calories need to
be expended or eliminated from the diet per pound of weight. I personally
much prefer working out to giving up calories!

At 120 lbs, a person walking at 3 mph will burn 80 calories.  For every 10
lbs you weigh over 120, add 5 calories burned."


35. Just how does smoking harm my health?

[This was posted to AS3 so long ago that the source has been lost. If
anyone knows where this is from, please e-mail [e-mail].]

   * Lung Cancer risk increases roughly 50 to 100 percent for each
cigarette you smoke per day;

   * Heart Disease risk increases roughly 100 percent for each pack of
cigarettes you smoke per day;

   * Switching to filter-tip cigarettes reduces the risk of Lung Cancer
roughly 20 percent, but does not affect the risk of Heart Disease;

   * Smokers spend 27 percent more time in the hospital and more than twice
as much time in intensive care units as nonsmokers;

   * Each cigarette costs the smoker 5 to 20 minutes of life;

   * A smoker is at twice the risk of dying before age 65 as a non-smoker!!


36. What are some of the less publicized health risks of smoking?

We all know that smoking greatly increases the risk of developing
emphysema, stroke, heart attack, lung cancer, etc. In addition, there are
several less publicized health conditions which are linked to smoking:

   a. Blindness

In October 1996, results of separate long-term studies linking smoking to
an incurable form of blindness called age-related macular degeneration were
published in the Journal of the American Medical Association (JAMA). In
this form of blindness, a person's field of vision becomes increasingly
limited. The research found that smoking more than doubled the risk of
macular degeneration in women over 50, with similar findings in men over
40. While researchers couldn't pinpoint the exact reason for the increased
risk, they theorized that smoking either affects the blood flow to the eye,
or causes retinal damage through oxidation.

(source: JAMA. 1996; 276:1141-1146 [study of women]; 1147-1151 [study of
men]) Thanks to Evan Herberg for calling this study to AS3's attention.


  b. COPD

From The Lung Association Home Page:

"COPD (Chronic Obstructive Pulmonary Disease) is a term that refers to a
variety of chronic lung disorders, the most common being a mixture of
chronic bronchitis and emphysema.

"COPD is the result of damage that has been done to lungs over many years.
The diagnosis is made when the symptoms become apparent to you and your
physician.

"COPD results in chronic airflow obstruction, the main symptom of which is
dyspnea, or shortness of breath, often occurring with cough and wheeze.
COPD affects both men and women. The average Canadian with COPD is 65 years
of age and has a long history of smoking. However, COPD can first be
diagnosed in patients as young as 40.

"COPD progresses slowly and worsens over time. Symptoms can range from
being barely noticeable to incapacitating. The rate of progression and
extent of disability vary from person to person.

"While there is no cure for COPD, the progression of the disease can be
controlled first and foremost by quitting smoking. Appropriate medication,
exercise rehabilitation and prevention of infection are also important
factors in the rate of deterioration and symptom control."


   c. Depression

This is a biggie, and comes up for discussion frequently. The excellent
discussion below was posted to AS3 on 30 Sept. 1996:

Darcy Binder <[e-mail]> wrote:

"Does anyone know the connection between smoking (or quitting smoking) and
depression? I have quit three times in my life, and each time I have been
getting seriously depressed. Is there a chemical connection? Is it the lack
of stimulant? I don't want to start again -- its been SIX weeks -- but I
also would like to stop crying!"

Bob Christofferson <[e-mail]> followed-up:

"Hi! There definitely *is* a chemical connection between nicotine and
depression, but as with most matters of brain chemistry, it's less than
perfectly understood. What is quite certain is that people who are
depressive find nicotine an especially effective drug, and consequently
find it especially hard to quit.

"That doesn't mean that *you* are depressive, however. It's a normal
response to nicotine withdrawal to have some feelings of depression. If you
read the posts to this group, you'll notice that many people go through
periods of depression while completing the process of smoking cessation.
Different people have the experience at different times after they quit,
and some people don't seem to have it at all. But, for most people, it's a
withdrawal symptom which isn't too severe and doesn't last too long, and
they recover from it and feel 'like themselves' again.

"In some people, though, smoking cessation does trigger serious episodes of
clinical depression which require medical treatment, and which, in the
extreme, can be life threatening. In recent years, new medication and
therapies have been developed which can help most people with depression,
and which often produce dramatic improvement quickly. Many people who could
benefit from these treatments, though, are reluctant to get help because
they feel embarrassed or ashamed, because they think they should be able to
'snap out of it' or somehow make their illness go away by themselves. Of
course, there's no reason for anyone to think that, but symptoms of
depression typically include feelings of guilt and hopelessness, which make
it hard for the person to see the situation objectively.

"So, how does anyone decide if their symptoms are more than the normal
consequence of smoking cessation? My advice is that anyone who has any
doubt should be evaluated *really soon* by a medical professional qualified
to determine whether medical attention is needed. I say that in part
because I'm convinced people hardly ever exaggerate the seriousness of
their own situation but often will *understate* it, even to themselves --
for perfectly sensible reasons, really. No one I know has ever been eager
to get mental health treatment (but quite a few people I know have
benefited by getting it).

"So, my point of view is that if someone feels they may be more depressed
than 'normal' nicotine withdrawal would explain, then there's a good chance
that they are -- at least, a good enough chance that they should talk it
over with someone who can tell."

   d. Gastro-Esophageal Reflux Disorder (GERD)

Again, I'll let the information come from our impressively well informed
members. This was posted 22 Oct. 1996:

Luci wrote:

"Hi! I need an info buddy... After years of smoking and sinus problems,
etc., I've been diagnosed with a new disorder - gastro esophageal reflux
disorder. Does anybody out there share my problems??? Any advice???"

Ed replied:

"I've had GERD for years ...

"GERD, according to my doctor, is often caused by cigarette smoke
irritating the valve that separates the esophagus from the stomach. It
seems that the smoke also goes down the esophagus when we inhale. For some
not completely understood reason, the smoke irritation causes a loose
closure of this valve and at times stomach acid can rise into the
esophagus. The tissue of the esophagus, unlike the stomach, reacts with
pain when in contact with stomach acid. A prescription drug - PRILOSEC, has
really helped me. It is time-released and I take one each day. On rare
occasions, usually at night, I also use liquid GAVISCON and within 20
minutes the discomfort is gone. PRILOSEC is prescription. GAVISCON is
over-the-counter. Both are not cheap but they work for me.

"Hope this helps you. GERD is not uncommon. Just another reason for me to
stop the cigs."

   e. "Smoker's Face" and Other Dermatological Ailments

This phrase seems to have been coined in 1985 by Dr. Douglas Model of
Eastbourne, England, who found, in empirical evidence, that nearly half of
the smokers he studied looked far older than they were. Similar research
was conducted by Dr. Jeffrey Smith, a senior resident in dermatology at the
University of South Florida in Tampa. He found these conditions to be
directly related to smoking:

(From The St. Paul (Minnesota) Pioneer Press, 23 June 96. Originally posted
to AS3 by <[e-mail]>)

"Wrinkles: 'For some patients the threat of wrinkles may be a more powerful
motivator to help them stop smoking than the more deadly consequences of
smoking,' Smith wrote. He explained that, as with skin that is overexposed
to sunlight, smoking causes thickening and fragmentation of elastin, the
elastic fibers that are long and smooth in healthy skin. Smoking also
depletes the skin's oxygen supply by reducing circulation. It decreases the
formation of collagen, the skin's main structural component, and may reduce
the water content of the skin, all of which increase wrinkling.

"Smoking also interferes with the skin's ability to protect itself against
damage by free radicals, highly reactive substances that are omnipresent in
tobacco smoke. In women, smoking diminishes the level of circulating
estrogen, which in turn fosters dryness and disintegration of skin tissues.

"Skin Cancers: Two kinds of skin cancers, the more curable squamous cell
carcinomas and the often lethal melanomas, are influenced by smoking. Smith
said that although smoking did not cause melanoma, smokers with melanoma
were more likely to die of their disease. They are twice as likely to have
advanced disease at the time of diagnosis and are more likely to have their
cancers spread within two years of diagnosis, probably because smoking
impairs the immune system. As for squamous cell carcinoma, even when
exposure to sunlight was taken into account, smokers were found to be at
greater risk of developing this cancer. In a study of more than 107,000
nurses, for example, the risk of developing squamous cell carcinoma was 50
per cent greater in smokers than in those who had never smoked. Smokers
also tend to get particularly 'large, bad' skin cancers, Smith said.

"Other Cancers: Cancers of the lip, mouth, penis, anus and vulva are also
more common in smokers than nonsmokers. For example, in one study of 903
female cancer patients, 60 percent of those with vulvar and anal cancers
and 42 percent of those with cervical and vaginal cancers were smokers as
against only 27 percent of comparable women without cancer. Smoking more
than 10 cigarettes a day more than doubles a man's risk of developing
penile cancer.

"Delayed Wound Healing: The problem of slow or incomplete healing of wounds
associated with exposure to cigarette smoke was clearly demonstrated in
laboratory animals in the 1970s. Then surgeons began reporting on similar
problems in patients who smoked: larger scars in women undergoing
exploratory abdominal surgery, more complications and skin sloughing after
facelifts and a much higher failure rate of skin grafts, for example. The
more and the longer patients had smoked, the greater the likelihood of
impaired wound healing. Even resuming smoking during an uneventful recovery
could lead to adverse effects. Smith linked the slow healing of wounds to
known effects of cigarette smoking, which constricts surface blood vessels,
reduces the oxygen level in the blood, thickens the blood and impedes the
laying down of collagen needed for healing.

"Psoriasis and related disease: Studies of both men and women with this
unsightly and discomforting skin condition have shown that smokers are
about two to three times as likely to develop it as nonsmokers. And the
more cigarettes smoked, the greater the risk. Palmoplantar pustulosis, a
difficult-to-treat skin condition that resembles psoriasis, occurs only on
the palms of the hands and soles of the feet. The skin blisters, then forms
a scaly rash. It occurs almost exclusively in smokers and it does not
necessarily go away when the patient quits smoking.

"Oral lesions: In addition to smoker's face, there is also smoker's palate
and smoker's tongue. The tars and heat of tobacco smoke can cause tiny red
pimples in the mouth that result from an inflammation of the openings of
salivary glands. Smokers also often develop depressions on the surface of
the tongue. Potentially more serious, however, are lesions called
leucoplakia, which are about six times more common in smokers than in
nonsmokers. Although benign, these white patches in the mouth can become
cancerous.

"Buerger's disease: This blood vessel disease results in poor circulation
in the lower legs, causing skin problems like burning, tingling and
ulcerations. 'It usually occurs in young men who smoke, men in their 30s,'
Smith said. 'But now that women are smoking a lot more, we're seeing it in
women too.'

"Other Skin conditions: Many skin diseases are associated with diabetes,
which impairs circulation to the outer reaches of the body. A study of more
than 112,000 female nurses followed for 12 years showed that current
smokers faced an increased risk of developing noninsulin-dependent
diabetes, and that the risk rose with the number of cigarettes smoked each
day. Another study of nearly 43,000 male health professionals showed that
smoking 25 or more cigarettes a day doubled a man's risk of developing
diabetes.

"People who smoke are much more likely to develop the bowel disorder
Crohn's disease, which can cause 'big, ugly-looking ulcerations, most often
on the legs, and painful red nodules, usually on the lower legs,' Smith
said. Another condition more common in smokers is systemic lupus
erythematosus, an autoimmune disease that can cause rashes on the face,
scalp, hands and elsewhere, ulcerations in the mouth and hair loss."

37. How do the numbers from smoking-related deaths compare to other causes
of death?

The statistics which follow were obtained from an American Cancer Society
pamphlet and are for 1993.

Cause of Death : Number per Year
(excluding smoking) (U.S.A. only)

Alcohol-related: 105,000
Car accidents: 49,000
Suicide: 31,000
AIDS: 31,000
Murder: 22,000
Fire: 4,000
Cocaine: 3,300
Heroin/Morphine: 2,400

~~~~~~~~~~~~~~~~~~~~

Total (of above): 247,700

Cause of Death: Number per Year
(Tobacco only) (U.S.A. only)

Total tobacco related: 434,000

38. What is metastasis?

By Barry Pekilis:

"'Metastasis' is defined as the transfer of a disease-producing agency from
the site of the disease to another part of the body. One of the mortal
threats of cancer is metastasis. Early detection of cancer can be the
difference between life and death. Most cancers can be detected at an early
stage mainly because of physical symptoms such as lumps, bleeding, or some
other clue.

"Unfortunately there are two types of cancer in which early detection is
highly unlikely: lung cancer and pancreatic cancer. By a dint of bad luck,
if an individual has one of these two cancers, they will probably not know
it until the disease has invaded other vital organs and parts of their
body. By this time is may be too late for any meaningful treatment or cure.

"The five-year survival rate for pancreatic cancer is 5% and for lung
cancer, 10 percent. This compares to a survival rate of 50 80% for most
other cancers.

"This information is being supplied in this FAQ to help provide motivation
for those of you who have either quit or are trying to quit. Cigarette
smoking appears to be a major cause of both of these two malignant cancers."

[For more on lung cancer in particular, including a GIF of a diseased lung,
try http://ourworld.compuserve.com/homepages/LungCancer/

39. What if I quit ... will I ever get better?

Smoking cessation has major and immediate health benefits for men and women
of all ages. These benefits apply to people with and without
smoking-related diseases. The following information is from a booklet
produced by the American Cancer Society:

Within 20 minutes of your last cigarette:

   * blood pressure drops to normal
   * pulse drops to its normal rate
   * body temperature of your hands and feet increases to normal

Within 8 hours:

   * carbon monoxide level in your blood drops to normal
   * oxygen level in your blood increases to normal

Within 24 hours:

   * chance of heart attack decreases

Within 48 hours:

   * nerve endings start regrowing
   * your abilities to smell and taste things are enhanced

Within seventy-two hours:

   * bronchial tubes relax, making breathing easier
   * lung capacity increases

Within two weeks to three months:

   * circulation improves and walking becomes easier
   * lung function increases by up to 30 percent

Within one to nine months:
   * coughing, sinus congestion, fatigue, shortness of breath decreases
  * cilia regrow in lungs, increasing ability to handle mucus, clean the
lungs, and reduce infection
  * the body's overall energy level increases

Five years:

   * lung cancer death rate for average ex-smoker decreases from 137 per
100,000 people to 72 per 100,000 (... almost half!)

Ten years:

   * lung cancer death rate for average ex-smoker drops to 12 deaths per
100,000 (... almost the rate for a non-smokers and a full order of
magnitude less than a smoker)
   * precancerous cells are replaced
   * other cancer rates (e.g., mouth, larynx, oesophagus, bladder, kidney
and pancreas) decrease as well

In addition:

   * ex-smokers tend to live longer than continuing smokers
   * smoking cessation decreases the risk of lung cancer, other cancers,
heart attack, stroke, and chronic lung disease
  * women who stop smoking before pregnancy or during the first three to
four months reduce their risk of having sickly babies, as compared to women
who continue to smoke

40. OK, I quit. Why do I feel worse?

[From CancerNet from the National Cancer Institute. CancerNet News.
Clearing the Air: How to Quit Smoking...and Quit for Keeps. U.S. Department
of Health and Human Services, Public Health Service, National Institutes of
Health.]

National Cancer Institute, NIH Publication No. 94-1647, September 1993:

"Immediate Effects

"As your body begins to repair itself, instead of feeling better right
away, you may feel worse for a while. It's important to understand that
healing is a process - it begins immediately, but it continues over time.
These 'withdrawal pangs' are really symptoms of the recovery process.

"Immediately after quitting, many ex-smokers experience 'symptoms of
recovery' such as temporary weight gain caused by fluid retention,
irregularity and dry, sore gums or tongue. You may feel edgy, hungry, more
tired, or more short-tempered than usual; you may have trouble sleeping or
notice that you are coughing a lot. These symptoms are the result of your
body clearing itself of nicotine, a powerful addictive chemical. Most
nicotine is gone from the body in 2-3 days."

[To treat these 'symptoms of recovery,' give your body what it really needs
- NOT the poison which it is working so hard to expel! If you're tired,
nap; edgy, try camomile tea, warm milk, a soothing bath; when constipated,
get some exercise and eat some dried fruit. Keep in mind that these
symptoms are temporary and are steps leading to better health than you've
known in a long time! -ed.]

41. On the other hand ... why do I feel so potent?

Smoking robs the bloodstream of oxygen, causing constricted blood vessels
and reduced bloodflow to the fingers and toes, the brain, and er, other
extremities. Men who quit smoking have erections which are comparatively
larger, firmer, and of longer duration than when they smoked. Enjoy.

42. I've smoked for so many years, what's the point of quitting now?

By Barry Pekilis:

"LOTS! A new study (coordinated by the University of Manitoba and involving
10 sites in the United States and Canada) proves for the first time that
smokers who quit wind up with healthier lungs, no matter how long they had
smoked. The study involved more than 5,800 smokers who were victims of
chronic obstructive lung disease: a combination of emphysema and bronchitis
(the fourth leading cause of death in the U.S.A.).

"The study was the first proof that if you stop smoking at any age, you
will have healthier lungs.

"It was the largest study ever conducted on the prevention of lung disease
and showed without a doubt that quitting smoking is the most effective way
of preventing lung function decline.

"So there you have it, conclusive proof the it worth quitting no matter how
old you are or how long you have smoked for."

43. How can I urge someone to quit smoking, or encourage someone who is
trying to quit?
   * Do not pester someone who is trying to quit smoking or who is in the
initial stages of thinking about quitting as it is probably the worst thing
someone trying to offer support can do -- also do NOT nag, insult, or
attempt to shame a smoker into quitting;
   * Remember that even well-intentioned praise might irritate the quitter
at any given moment. Do what you can to gauge the quitter's mood, leave a
wide berth where necessary, and forgive what seem to be irrational
reactions;
   * Let your spouse/friend/roommate know that no matter what happens that
you value them as a person (even though you may disapprove of their
smoking) and that you respect them for trying to break free
addiction;
   * Learn to listen non-judgmentally and attempt to understand and see the
problems of quitting a powerful and seductive addiction through the
smoker's eyes;
   * Remember to praise a smoker for even the smallest effort in trying to
quit or cut down -- quitting is a process and it takes time!


A final thought:

"The hard part is staying quit and to do that, you need an armamentarium of
alternatives to smoking as long as they aren't other addictions that just
serve as a substitute 'friend'. It important not to use anything that will
obscure or divert us from finding out that the best friend that we have, in
some ways, the only consistent one, is the one inside." - Donna Payne,
posted March 1996

  -=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=

End of Alt.Support.Stop-Smoking FAQ.

  Good journey, everyone!