Column: It’s time to quit

Most Americans know that the last Thursday in November is Thanksgiving. But how many of us know that the third Thursday in November is always the “Great American Smoke-out?”

“What is that?” you may ask. The American Cancer Society has used this day for over 40 years as an impetus to help smokers quit.

The premise is simple: Try to go just one day without cigarettes. If that day is successful, perhaps day two will be successful as well. This year the Smoke-out falls on November 18th. Of course, any day is the right day to give up cigarettes.

And every day is the right day not to start.

According to the Centers for Disease Control, the good news is that smoking rates have fallen from a high in 1954 (45%) to 19% in 2005, and to 14% in 2018. Clearly, the rates are trending in the right direction. The bad news is that cigarettes remain the leading cause of preventable death in America, killing more than 480,000 people each year.

And while many people do not die from cigarettes, they often live with diseases associated with smoking such as asthma, COPD, diabetes, cancer, heart disease, and stroke.

Most adults who smoke continue because they are addicted to nicotine. Some may say that they smoke because they like the social aspect or that it’s good for food control. But most smokers would like to quit and say they can’t. The National Institute on Drug Abuse says that every year about half try to quit, but only about 6% are permanently successful.

So how is nicotine addictive? Nicotine releases a variety of transmitters in the brain, of which the most important is dopamine. Dopamine is the chemical that allows humans to feel pleasure. Dopamine is released when we feel good about a variety of things. Nicotine (and other substances) release dopamine, making the brain feel good artificially and thus dependent on the substance.

 People have stopped in many different ways. Quitting “cold turkey” does lead to withdrawal discomfort, so tapering down is generally thought of to be the most effective. “Nicotine Anonymous,” which is modeled on other 12-step programs continues to help many people.

Members do not need to be nicotine-free to join; they just need to want to stop. Suffolk County offers free smoking cessation classes along with the American Cancer Society and other health organizations.

For people who cannot quit, but are attempting harm reduction, e-cigarettes (also known as vaping) have become popular. E-cigarettes use a battery or charger to heat a liquid (usually nicotine) that contains an aerosol. They are considered safer than cigarettes because they have fewer than the 7,000 toxic chemicals contained in traditional cigarettes.

But, but, but …. As many people know, young people have seized upon vaping and the results have been serious. What may work for adults (and the studies are still not conclusive) is devastating for kids. According to Stephen Dewey, M.D., the psychiatrist and addiction expert, e-cigarettes are unequivocally unsafe for children.

Breathing in a drug (as one does with vaping) makes it highly addictive. (Think of sniffing glue back in the 60’s.) Ironically, when marijuana was thought to be a “gateway” drug, it tended not to be. But inhalants were. Dr. Dewey says that three times as many kids now vape than use tobacco, and many are starting in elementary school.

Michele Albano, the social worker at Shelter Island School, acknowledges the seriousness of the problem. As with many other schools on Long Island, Dr. Dewey’s well-known presentation on smoking and vaping was shown to the students. Interested readers can find this hour-long program on Youtube. Additionally, Ms. Albano says that vape detectors have been installed in the school.

 The greatest tool to prevent vaping and smoking is education. Misinformation abounds, such as kids telling other kids that vaping is safe. They need to be taught the facts of smoking and vaping as early as elementary school. As with all other dangers, honest communication with children does not lead to experimentation, but to listening and learning.

 As the Great American Smoke-out comes this Thursday, let’s celebrate clean air, clean lungs, and make an attempt to quit. And the following week we can all eat turkey!

Nancy Green is a member of the Shelter Island Health and Wellness Alliance along with Lucille Buergers, Jim Colligan, Laurie Fanelli, Trish Gallagher, Jacky Kanarvogel, Bonnie Stockwell, and Ryan Sultan, MD.