FAQs About Tobacco

Have a tough question about the effects of smoking and chewing? Look no further for answers to all your questions about tobacco. If you can’t find an answer to your question here, contact us or check our resource library section for help.


Cancer

How long does it take to get cancer from smoking or chewing tobacco?


Other Health Problems

What is secondhand smoke?
Does smoking really cause impotence?
How does smoking hurt your lungs?
Does smoking affect my asthma?
Does smoking affect my physical performance?
What is Buerger's Disease?


Smoking Statistics

How many people smoke?
How does smoking hurt the environment?
How big of an impact are little cigarette butts on a huge planet?
But it’s just paper and leftover tobacco, right?
What happens to butts and filters after you put your cigarette out?
What’s the connection between smoking and fire?
How does chewing smokeless tobacco hurt the environment?
How does the tobacco farming and manufacturing industry hurt people and the environment?
Does tobacco farming really hurt the rest of us?


Performance

Can smoking or chewing tobacco affect how I perform in combat?
How addicted to cigarettes are you?
How do I quit smoking when I’m living with a smoker?


Smokeless Tobacco

What are the short-term benefits to quitting smokeless tobacco and how quickly will I notice the results?
What are the long-term benefits to quitting chewing tobacco?
What’s a good line of attack when I want to quit smokeless tobacco?
Can’t switching to smokeless tobacco help me quit smoking?
Is smokeless tobacco less addictive than cigarettes?
I smoke, but I don’t use smokeless tobacco, so why should I worry about it?
I use chewing tobacco, so why worry about smoking?
What is dissolvable tobacco?

 

Electronic Cigarettes

Why would smokers consider using electronic cigarettes instead of smoking tobacco?
Are e-cigarettes safe?
Are e-cigarettes a good alternative when quitting?
What other issues surround e-cigarettes?

 

Effects of Nicotine

What are the short-term effects of smoking and chewing tobacco?
What are the long-term effects of smoking and chewing tobacco?
What are the symptoms of nicotine withdrawal?
How does nicotine addiction happen?
How does nicotine get to the brain, and how does nicotine cause addiction?
What is your lung age?
Does tobacco affect my sense of smell and taste?

 

Medicines To Help You Quit

What medicines can help with nicotine withdrawal?

 

Mental Health

Does using tobacco help people with problems like anxiety, depression, ADHD/ADD, or post-traumatic stress disorder feel better?
Will quitting smoking help me feel better if I feel overly anxious or depressed, or have post-traumatic stress disorder?
If I have an attention deficit disorder (ADD or ADHD) is it going to be harder to quit using tobacco?
Does using tobacco reduce anxiety and stress?

 

Quitting

Should I sign up for tobacco cessation classes?
What should I do if I relapse and start smoking or chewing again?
Can exercise help me quit tobacco?
How can I avoid weight gain after quitting?
When I quit tobacco, how long will the cravings last?

VA Veterans

What does "Veterans enrolled in the VA health care system" mean?
What does the VA provide to help me quit tobacco?
Does the VA provide medications to help me quit?
With the Veterans Health Administration (VA), are nicotine replacement therapies and prescription medications free?
If I am a Veteran enrolled in the VA health care system, do I have to attend classes to get the medications or NRTs?
Does the VA provide varenicline (Chantix) and bupropion (Zyban)?
What if I’m not a smoker? Will the VA still help me quit chewing tobacco?

Cancer

How long does it take to get cancer from smoking or chewing tobacco?

For most people, it takes years, but it's risky to play those odds. Your chances of getting tobacco-related cancer depend on a number of factors, such as:

  • How much you smoke/chew.
  • How long you've smoked/chewed.
  • Whether you use other substances that increase the risk for a particular disease. For example, if you often smoke and drink alcohol, you have a greater risk for some types of cancer than people who do only one or the other.
  • Whether you are also exposed to secondhand smoke.

Here are some hard facts. Most people know that both smoking and chewing tobacco can increase the chances of getting certain types of cancer. The chart below lists the average number of deaths each year from some diseases caused by smoking and chewing tobacco:

Disease
 Death
Lip, mouth and throat cancer
4,868
Cancer of the stomach, esophagus and pancreas     
 17,319
Chronic airway obstruction
 75,074
Heart disease
 107,744
Lung cancer; cancer of the trachea or bronchus
 123,836
All diseases and conditions caused by smoking
 437,902


Of course, not everyone who smokes or chews gets these diseases, and not everyone who gets these diseases has used tobacco. But people who die of smoking-related diseases generally do not live to a ripe old age. That is, they die prematurely.

Right now, time is on your side because the sooner you quit, the greater the health benefits. If you're 21 years old and have been smoking for about 5 years, quitting smoking now can reduce your chance of getting lung cancer. In fact, your risk for lung cancer won't be much greater than the risk for a person who has never smoked. But if you put off quitting, you will still be more likely to get lung cancer than someone who has never smoked. And quitting isn't going to get any easier.

Women who smoke are more likely than women who don't smoke to have menopause at an earlier age, and they also are at an increased risk for cancer of the cervix.

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Other Health Problems

What is secondhand smoke?

Smoking is not only a "drag" on you, but the effects of secondhand smoke can harm your nonsmoking friends and family members, including any children in your life. Secondhand smoke includes both:

  • Smoke exhaled by a smoker
  • Smoke that comes from a burning tobacco product.
Secondhand smoke contains the same chemicals contained in a cigarette that the smoker inhales. It's hard enough to imagine ingesting insect poison or ammonia yourself, but imagine putting them into a baby or small child! Exposure to secondhand smoke doubles a baby's risk of dying from sudden infant death syndrome (SIDS). It also can cause inner-ear and respiratory infections, like asthma, in young children. Experts believe about 38,000 people die each year from secondhand smoke.

Also, household pets that are exposed often to secondhand smoke can get cancer and die sooner than expected.

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Does smoking really cause impotence?

The last two decades of research have shown that tobacco use can cause impotence, and it can worsen impotence caused by other conditions.
Impotence, often referred to as erectile dysfunction (ED), is the inability for a man to maintain an erection for sexual purposes. It is caused by the inability of blood vessels in the penis to provide enough blood to maintain an erection. Tobacco use negatively affects blood vessels throughout the body—not just in the heart and arteries, but even in sensitive areas like the eyes and genitals. Other facts include:

  • Smoking can more than double your risk of moderate to severe ED.
  • Tobacco use is the most common cause of ED for men under 40.
  • Risk of impotence increases with the amount of tobacco used AND the number of years tobacco has been used. Symptoms can start within the first year.
  • Using tobacco reduces the effects of common ED treatments like Viagra and Cialis.
By not using tobacco or by quitting now, you can eliminate this accelerating risk! In fact, improvement in ED symptoms can occur after just 24 hours of tobacco cessation or after 1 month on the nicotine patch. And regaining erectile function after quitting has been found to occur more frequently and more quickly in younger men; so quitting sooner rather than later will improve your chances of resolving ED.

Remember, the longer you use tobacco, the greater the risk of impotence and the more difficult it is to reverse the effects. So the sooner you quit, and the longer you stay quit, the less likely you will be to feel the negative effects of tobacco and impotence.

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How does smoking hurt your lungs?

Whether you smoke or inhale the smoke in the environment from others, you are at risk for lung disease, according to the American Lung Association.

Smoking cigarettes is directly responsible for 87 percent of lung cancer cases and causes most cases of emphysema and chronic bronchitis. It is also directly responsible for approximately 90 percent of lung cancer deaths and 80 to 90 percent of deaths from chronic obstructive pulmonary disease (including emphysema and chronic bronchitis), according to the Centers for Disease Control and Prevention.

Secondhand smoke causes approximately 3,400 lung cancer deaths in adult nonsmokers in the United States each year, and the Environmental Protection Agency classifies it as a known human carcinogen.

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Does smoking affect my asthma?

You probably can feel the negative effects of smoking on your asthma, but here are some lesser known facts for you to think about.

  • Smoking causes your airways to become swollen and filled with mucus, making it harder to breathe for healthy smokers and very difficult for asthmatics.
  • Cigarette smoking makes it more likely that you will have an asthma attack.
  • Asthmatic smokers have more emergency department visits and more hospitalizations than nonsmoking asthmatics.
  • Smoking can cause your corticosteroid asthma medications to be less effective.
  • When you have asthma and smoke, it increases your chances of permanently damaging your airways.
  • People who have asthma and smoke are more likely to die from an asthma attack.
  • A recent study determined that cigarette smoking increases suicidal thoughts in asthmatics.

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Does smoking affect my physical performance?

You feel strong, you have no problem keeping up with the rest of the troops, so does smoking really make a difference in your physical performance? Well, read on! You might not be feeling it, you might not be seeing it, but you are not performing as well as if you weren’t smoking, and there are studies that prove it.

  • If you smoke, your endurance is not as good as if you quit.

Joggers who were light smokers, and smoked for as little as 2 years, had less endurance than those who didn’t smoke.

Compared to men who didn’t smoke, those who smoked had worse outcomes in the length of exercise, maximum heart rate, and systolic blood pressure during exercise.

  • You are more likely to be injured during physical activity if you smoke.

Recruits who smoked at least one cigarette in the month prior to basic training had higher injury rates than those who did not smoke.

  • It will take longer to heal when you are injured and your wound is more likely to become infected.

This means when you are hurt on maneuvers you’ll be suffering longer than others in your troop. And, it also means you will heal more slowly when you have dental work done! Ouch.

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What is Buerger's Disease?

Buerger’s is a disease of the arteries and veins in the arms and legs.
  • Blood vessels swell and become blocked with blood clots.
  • Skin tissues become damaged and destroyed.
  • Skin becomes infected and gangrene sets in.
  • The affected extremity often must be amputated.
Who gets Buerger’s Disease?
  • Young male smokers, primarily between 20 and 40 years old. Heavy smokers increase their risk.
  • Some cases have occurred in moderate smokers, cigar smokers, and smokeless tobacco users.
What are the symptoms?
  • Numbness or tingling in arms and legs
  • Pain, sometimes very intense, in the hands and/or feet
  • Skin ulcerations and gangrene of fingers and/or toes.
What is the treatment?
  • The only treatment for Buerger’s Disease is to stop smoking!
  • Tobacco users who do not quit, usually get gangrene fingers and toes. Sadly, once fingers and toes become gangrenous, they must be amputated.
  • Steroid treatments or blood thinners have been tried but have not been shown to be effective.
  • Sometimes nerves in the affected areas are surgically cut to control pain.

If any of this sounds too agonizing or painful to think about, consider this: you can avoid all of the horrors of Buerger’s Disease by not smoking!

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Smoking Statistics

 

How many people smoke?

It may seem like "everyone" in the military smokes. But the truth is, most military personnel do not smoke. In 2002, 34 percent of all people in the military smoked cigarettes. Even a smaller percentage of military men aged 18–24 chewed tobacco (19 percent).1

Smoking among the general public is on the decline. In 1964, about 40 percent of American adults were smokers. In 2008, about 20.5 percent of American adults were smokers.2

In 2007, 20 percent of high school students smoked.3 Estimates are that 32 percent of teens who become regular smokers will die of a smoking-related disease. That's why it's especially important to quit smoking or chewing tobacco so that you can set an example for the younger people in your life.

1Bray, R. M., Pemberton, M. R., Hourani, L. L., Witt, M., Olmsted, K. L. R., Brown, J. M., et al. (2009). 2008 Department of Defense survey of health related behaviors among active duty military personnel: A component of the Defense Lifestyle Assessment Program (DLAP). Research Triangle Park, NC: RTI International. http://www.tricare.mil/2008HealthBehaviors.pdf
2http://www.cdc.gov/nchs/data/nhis/earlyrelease/200906_08.pdf
3http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5725a3.htm?s_cid=mm5725a3_e

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How does smoking hurt the environment?

By now you know you don’t live in a vacuum, and the choices you make have a way of trickling down to others. Even if you don’t mean to harm your family, your pets, your neighborhood, and even the wildlife and natural beauty of the land you love, your smoking and smokeless tobacco does just that. It doesn’t take a Sherlock Holmes to connect the dots between the cigarette butt you flick out of your car window to the cigarette filters found in the stomachs of fish and birds who mistake them for food.1 So let’s answer some basic questions about how your butts and spit make things harder for the very people you’ve pledged to protect.

1 http://www.fairfaxcounty.gov/nvswcd/newsletter/buttlitter.htm

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How big of an impact are little cigarette butts on a huge planet?

Researchers estimate that 1.7 billion pounds of cigarette butts in lakes and oceans, on beaches, and the rest of the planet every year.

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But it’s just paper and leftover tobacco, right?

Wrong answer. These butts and filters contain many dangerous chemicals including carcinogens and other poisons. All of this seeps back into the planet one way or another. The scariest scenario is when adults smoke at or near playgrounds, and then curious babies and toddlers pick up the butts. . . you can figure the rest out.

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What happens to butts and filters after you put your cigarette out?

Not much, and that’s the problem! They just do not biodegrade. Experts say cigarette butts rank at the very top of litter problems—not just because they are EVERYWHERE, but because they are toxic and non-biodegradable.1 They remain in sewers, beaches, soil, and bodies of water for years and even decades, and eventually pollute our lakes and oceans, and, of course, all the birds, fish, and mammals whose lives depend on those bodies of water.

1http://archives.chicagotribune.com/2008/jun/17/news/chi-cigarette-butts-0618-nujun18 

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What’s the connection between smoking and fire?

Lighting the match to your cigarette, cigar, or pipe puts your home at risk as well as significant commercial property damage. The losses from fires caused by smoking cost about half a billion dollars per year and $3 billion for tobacco-related cleaning and maintenance.1 It’s especially tragic that these fires killed 800 people and injured 1,660 others in 2005 alone.2

1http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf
2http://www.cdc.gov/ncipc/ERPO/UNC-success-story.pdf

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How does chewing smokeless tobacco hurt the environment?

People who chew don’t usually swallow the tobacco juice, so that residue has to go somewhere. And that somewhere can be anywhere they happen to be. If you look around a spitter’s home, you might see tobacco juice stains on their clothes, furniture, and even on their car's upholstery. It makes sense that if the smokeless user is outside, the juice will end up in the garden, in the park, on the sidewalk. . . basically anywhere the spitter walks their tobacco spit and drool is likely to be making a mess.1

1http://www.nidcr.nih.gov/OralHealth/Topics/SpitTobacco/SpitTobaccoAGuideforQuitting.htm

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How does the tobacco farming and manufacturing industry hurt people and the environment?

Because you use tobacco, someone has to work on the tobacco farm to get it to you, and laborers who have the unfortunate fate of doing this work are at serious risk for deadly disease. Farming presents some hazards to all agricultural workers, such as pesticide exposure and musculoskeletal trauma, but tobacco production presents some unique problems, most important, acute nicotine poisoning, a condition also known as green tobacco sickness (GTS).1

1 http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1497768&blobtype=pdf

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Does tobacco farming really hurt the rest of us?

Yes it does! In the United States, tobacco is grown on more than 650,000 acres in over 20 States. The U.S. Geological Survey (USGS) estimates that at least 25.6 million pounds of pesticides are used on this crop each year. The list includes acutely toxic pesticides—they may cause cancer or birth defects—and others that are potent nerve toxins. Over 450 different pesticide products are registered for use on tobacco by the U.S. Environmental Protection Agency.1

These FAQs don’t even address the many hazards associated with secondhand smoke, because most of us already know the damage this can do to our children, our families, and the environment in general. We have to face facts.

You already knew that your smoke gets in your family’s eyes and lungs, and now you know your butts and spit gets in their soil, their beaches, and their playgrounds. You have the power to reverse the damage that has been done by properly discarding cigarette butts. On second thought, you can use this knowledge as a springboard for a healthy decision to make your own quit plan. Let’s keep it clean!

1http://www.panna.org/files/tobacco.pdf

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Performance

 

Can smoking or chewing tobacco affect how I perform in combat?

Tobacco can be a weapon of mass destruction for people in the military. It causes a range of problems that can reduce your fitness for service. Some of these problems include:

  • Impairing your night vision. You might not see the enemy before he sees you.
  • Making you stink. You can't hide from enemy forces if they can smell you a block away.
  • Impairing your body's ability to heal itself. That's help you don't need on the battlefield.
  • Sapping your energy and making you short of breath. You can't carry heavy gear and equipment into battle if you're tired and wheezing.

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How addicted to cigarettes are you?

You may be surprised to know that your doctor can administer a test to help determine your level of addiction to smoking. While there are no proven tests for smokeless tobacco, addiction tests for cigarette smoking can give patients a rough idea of their addiction level. One of the most widely known, and highly regarded, tests is the “Fagerström Test for Nicotine Dependence.”

Here is an idea of some of the questions you’ll find on the Fagerström Test:

  • How soon after you wake up do you smoke your first cigarette?
  • Do you find it difficult not to smoke in places where you can’t?
  • Do you smoke 21 or more cigarettes a day?
  • Do you still smoke if you are so sick that you are in bed most of the day?

(Answering “yes” to any of these questions can mean you are highly addicted to cigarettes and you should see your doctor to take the test.)

Researchers recently discovered that smokers are more physically dependent on nicotine now than they were just 15 years ago. In the past, it might have been easier to quit "cold turkey" because a smoker was less addicted to nicotine. That’s just not the case today. Now, most smokers will need intensive nicotine replacement therapy in order to successfully quit. Intensive therapy is adjusted for each person. It can mean using a nicotine patch with smoking cessation medication or taking medication for a longer time.1

You can quit, even if you are highly addicted to nicotine. Knowing you may need intensive therapy to be a successful quitter can make the process easier. Ask your doctor to help you plan your strategy of attack and use all the available weapons to beat the enemy—nicotine.

1 Sachs, D. P., Hodgkin, J. E., & Bostrom, A. G. (October 28, 2008). Improving treatment outcome in the face of increasingly severe nicotine dependence in patients seeking tobacco-dependence treatment. Chest, 134: s53002.

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How do I quit smoking when I’m living with a smoker?

Now that you have made the commitment to quit you are faced with another challenge, how do you stay on target when there is a smoker, or smokers, all around you? It's like living in enemy territory! Here are some tactics that can help you succeed with your mission:

  • Remember that the people you live with may feel threatened by your quit attempt. Make sure they know you are not judging their smoking habit or pressuring them.
  • Ask the people you live with to try and help you avoid smoking triggers.
    • Maybe they'll agree to smoke outside, or in a “designated smoking area” of the house, like an unused room. And, suggest they open the window when smoking in the house, that way you won’t smell the smoke.
    • Make sure they know not to leave cigarettes or packs lying around where you can see them.
  • If your spouse is the smoker, try to go places together where smoking is not allowed. Have a date night at the movies, or try a physical activity that would make smoking more difficult, like ice skating.
  • Don't quit alone! Find a friend or coworker who has successfully quit. This will offer you the support you might not get at home. You can also get live support on this site or go to the support group page.
  • See your doctor. Using medications, like the patch or Chantix, can really help combat the urges you might have around someone who smokes.

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Smokeless Tobacco

 

What are the short-term benefits to quitting smokeless tobacco and how quickly will I notice the results?

Within the first few days of quitting tobacco, you will begin to notice benefits and improvements such as:

  • You’ll have great breath— no more trying to hide the tobacco smell with gum or mints!
  • Food will taste better.
  • You won’t be spitting brown stuff anymore—no more making sure there is a place to spit or worrying about brown drool.
  • More money! To find out how much you’ll be saving, check out our Add Up the Cash calculator.

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What are the long-term benefits to quitting chewing tobacco?

  • No more sore red gums.
  • Those nasty white patches in your mouth disappear.
  • The kids who look up to you will stop pretending to chew tobacco.
  • You’ll get fewer cavities because your teeth won’t be worn away by tobacco.
  • Your risk of cancers caused by smokeless tobacco (cheek, gums, mouth, tongue, throat, stomach) lessens each year, to the point where it is almost as if you’d never used smokeless tobacco.

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What’s a good line of attack when I want to quit smokeless tobacco?

Quitting smokeless tobacco has a lot in common with quitting smoking—you need to follow the same 4 Steps to Quitting, make a quit plan, and get support of family and friends. But there are some differences, too. Here are some good ways to get the most out of your smokeless quit attempt:

  • You may need to have something in your mouth to take the place of that wad of chew or tobacco packet. Try sugar-free hard candies or gum, cinnamon sticks, mints, beef jerky, or sunflower seeds.
  • Nicotine replacement therapies, like nicotine gum or patch, often help. Nicotine gum can be especially helpful because you hold it in your mouth, making it a substitute for chewing tobacco. You may need to combine these therapies, so ask your doctor.
  • You will notice positive physical changes pretty quickly. Maybe your gums hurt less or you have fewer, or even no, mouth sores. Pay attention to these physical changes to stay motivated.

Check out our page Getting the Most Out of Your Quit Attempt for more about quitting smokeless tobacco.

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Can’t switching to smokeless tobacco help me quit smoking?

You might have heard that switching from cigarettes to smokeless is a great way to quit, but that’s not all the experts say. When people want you to believe that smokeless is a safer alternative, they often quote a study emphasizing how many smokers switched to smokeless and then stopped smoking. What they don’t often mention is that almost half of the switchers did quit cigarettes but then they became permanent smokeless tobacco users instead! If you use smokeless tobacco to quit smoking there’s a good chance that you will be switching from one very dangerous addiction to another. And smokeless tobacco causes all kinds of cancers, like cancer of the mouth, tongue, throat, and stomach.

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Is smokeless tobacco less addictive than cigarettes?

From the start, tobacco companies have marketed smokeless tobacco as a safer alternative to smoking, but, in study after study, researchers have proved that smokeless tobacco is actually far more addictive than cigarettes because of its high nicotine levels. Researchers have found:

  • Nicotine, the addictive agent in cigarettes, is actually found in greater concentration in smokeless tobacco.
  • On average, one can of snuff contains as much nicotine as 60 cigarettes.
  • The average habitual smokeless tobacco user will receive 130–250 mg of nicotine per day, compared with 180 mg for a person with a pack-a-day cigarette habit.
  • While nicotine in smokeless tobacco is absorbed more slowly, it continues to be absorbed even after the tobacco is removed.

These high levels of nicotine can make smokeless tobacco even harder to stop using. The longer you use smokeless, the more nicotine you need to achieve the same effect. This cycle often leads to more and more dangerous behaviors such as switching to brands with more nicotine, using more frequently, swallowing tobacco juice, and leaving tobacco in your mouth overnight.

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I smoke, but I don’t use smokeless tobacco, so why should I worry about it?

If you smoke cigarettes, be worried. Cigarette smoking can actually lead to the use of smokeless tobacco. A study of 28,229 military personnel found that current smokers were three times more likely to start using smokeless tobacco. Smoking was the strongest predictor of daily smokeless tobacco use, even beating out the occasional use of spit tobacco!

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I use chewing tobacco, so why worry about smoking?

Why? Because you might be setting yourself up to become a smoker. Research shows that smokeless tobacco users are more likely to start smoking. In a study of 7,865 male Air Force recruits who reported never smoking before, those using smokeless tobacco were 233 percent more likely to start smoking than those who did not use smokeless tobacco.

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What is dissolvable tobacco?

Dissolvable tobacco is finely milled tobacco bound together in flavored, breath mint-sized tablets, toothpick-sized sticks, or breath strip-sized dissolvable tongue strips. Depending on the product, one piece takes between 5 and 30 minutes to dissolve. Because these dissolvable tobacco products contain tobacco, they also contain the same carcinogens found in tobacco and can increase the risk of tobacco-related oral cancers (e.g., tongue, lip, and mouth cancer).

Dissolvable products generally contain between 1.5 mg and 4 mg of nicotine compared to the 1 mg found in a light cigarette. The Food and Drug Administration (FDA) is investigating the potential of these products to produce accidental nicotine poisoning or overdose.

Is it a good alternative when quitting?

While these products may appeal as an alternative way to use tobacco without dealing with smoke or spit, dissolvable tobacco contains high levels of nicotine and serves only to continue nicotine addiction. As such, these products will not help with quitting tobacco and may only serve to increase nicotine dependence. Tobacco users looking for smoke- and spit-free alternatives to step down nicotine intake while quitting should consider proven nicotine replacement therapies, including the patch or nicotine gum.

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Electronic Cigarettes

 

Why would smokers consider using electronic cigarettes instead of smoking tobacco?

Electronic cigarettes, also known as e-cigarettes, are designed to imitate the experience of smoking real cigarettes. Made to look like the real thing, e-cigarettes contain liquid nicotine that is heated by a battery-powered element and turned into vapor that users inhale. E-cigarettes are marketed as a safe and healthy cigarette substitute, free of the harmful tar and chemicals that come with tobacco smoke. Some manufacturers and e-cigarette supporters have promoted these products as aids to help smokers quit.

1http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm

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Are e-cigarettes safe?

The health effects of e-cigarettes are not known. Clinical studies of e-cigarettes have not been submitted to the Food and Drug Administration (FDA) for review and approval. As a result, consumers cannot know whether e-cigarettes are safe for their intended use, what types or amounts of harmful chemicals they contain, and how much nicotine they deliver when inhaled.1 Meanwhile, FDA has issued warnings to several e-cigarette makers for legal violations including unsupported claims and poor manufacturing practices.2

1http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm
2http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2010/ucm225224.htm   

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Are e-cigarettes a good alternative when quitting?

E-cigarettes may appeal as a way to quit. Yet until the claims about them are backed up, smokers should look to proven alternatives for nicotine replacement therapy. These include the patch and gum, each of which is FDA approved and safe when used according to directions. Nicotine inhalers, also approved by FDA, work differently from e-cigarettes and provide consistent doses of nicotine without questions about safety.1

1http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm

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What other issues surround e-cigarettes?

Nicotine is addictive.1 Without clear steps to reducing the intake of nicotine or certainty about the doses being provided by e-cigarettes, using them may maintain a smoker's addiction. E-cigarettes may attract young people and lead them to try real cigarettes and other tobacco products. The appeal of e-cigarettes to young people may include novelty, appearance, sweet flavors, and a belief that these products are safe. Because nicotine is addictive, the risk that young people who try e-cigarettes will move on to other tobacco products is raised.

1http://drugabuse.gov/researchreports/nicotine/addictive.html

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Effects of Nicotine


What are the short-term effects of smoking and chewing tobacco?

  • The smell. Nobody wants to smell like an ashtray. But there's no escaping it—smoking makes your breath, your clothes, your hair, your car or truck, and your home stink.
  • The stains. Smoking and chewing tobacco stain your teeth and fingers and make your breath rank. They also can lead to serious dental problems, like rotting teeth.
  • The smoker's cough. Clean lungs and bronchial tubes rid the body of unwanted gunk to keep your airways clean. But when smoke enters your body, some of it remains trapped and prevents your body from getting rid of all the junk in the lungs. The result: that nasty-sounding smoker's cough. But here's the good news: Once you quit smoking, your lungs may clear out again.
  • The health problems. Why does smoking cause a rise in blood pressure? Because nicotine increases heart rate and blood pressure. Over time, this can damage your heart, arteries, and lungs, increasing your risk for heart attack, stroke, and chronic lung disease.

Tobacco use also can interfere with your sex life and plans for having a family:

  • Men who smoke are twice as likely as men who don't smoke to have impotence problems (difficulty having an erection). Thanks, tobacco.
  • If a woman smokes while pregnant, she is more likely to give birth too early.

If you smoke or chew, expect to have at least a few issues that might have been avoided by not using tobacco. Shortness of breath and lack of energy are common results of smoking. Smoking also can irritate your digestive system and contribute to acid reflux.

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What are the long-term effects of smoking and chewing tobacco?

Each time you use tobacco, you are putting chemicals in your body that can cause cancer (and other diseases such as emphysema and lung disease, which are related mainly to the carbon monoxide—a poisonous gas—in cigarette smoke).

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What are the symptoms of nicotine withdrawal?

If you're on day 3 of your quit plan and you feel like the grouchiest person on earth, you're not alone. Many people go through tough withdrawal symptoms while quitting smoking or tobacco use. Common symptoms of nicotine withdrawal are:

  • Strong cravings for nicotine
  • Headaches
  • Grumpy, short-tempered, or jumpy feelings
  • Difficulty concentrating
  • Itchy feelings
  • Muscle twitches
  • Constipation

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How does nicotine addiction happen?

You once may have claimed to be addicted to bacon cheeseburgers or to a new reality show. But a nicotine addiction is a different beast altogether. What exactly is a real medical addiction?

An addiction is a process that changes the chemistry of the brain and body and causes withdrawal symptoms when the addictive substance (in this case, nicotine) is not kept high enough.

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How does nicotine get to the brain, and how does nicotine cause addiction?

When a person smokes a cigarette or uses smokeless tobacco:

  • Nicotine travels through the body in the bloodstream, headed straight for the brain.
  • The brain gets a hit of nicotine about 10–15 seconds later.
  • The nicotine boosts the "reward center" of the brain, causing a pleasant, happy feeling.
  • Adrenaline is released, which makes the heart rate and blood pressure increase and makes breathing rapid and shallow. Over time, these effects can damage your heart, arteries, and lungs, increasing the risk for heart attack, stroke, and chronic lung disease.

As an addictive substance, nicotine has a job to do: to be sure that the level of nicotine in the body stays high enough to avoid withdrawal symptoms. And the more nicotine your body gets, the more it wants. This is mainly because it takes more and more nicotine to keep the body from having withdrawal symptoms.

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What is your lung age?

If you smoke, there just may not be enough candles for your birthday cake. On the outside, you may seem young and full of life, but one look at your lungs will tell the truth about your age. That’s because smokers have a lung age that is older than their chronological age. Ask your physician to perform a spirometric assessment (spirometry test) of your lung function. This test determines your forced expiratory volume at one second (FEV1) score, which then translates into your lung age. You might be surprised by the results, and, in turn, it may be just the motivation you need to pick a quit date and develop a quit plan.

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Does tobacco affect my sense of smell and taste?

How important is your sense of smell? Don’t disregard the pleasure you get from smelling flowers, fresh air, hotdogs and burgers cooking on the backyard grill, or your mom’s favorite pies and cookies baking in the kitchen. Since smell is connected to the ability to taste, try to imagine your future without the flavors of pizza, chili, chocolate ice cream sundaes, or ice-cold lemonade on an August afternoon. On a more serious note, you need your sense of smell to detect certain dangers, including chemicals, gas leaks, and smoke. Lucky for you, 48 hours after you quit smoking your sense of smell begins to return to normal. Then, if you feel the urge for a smoke or dip, do something refreshing. Make your surroundings clean and fresh at work, in your car, and at home. Clean your drapes and clothes. Shampoo your car. Buy yourself flowers. You will enjoy their scent as your sense of smell returns.

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Medicines to Help You Quit

 

What medicines can help with nicotine withdrawal?

A number of medicines can help with nicotine withdrawal. Some of them work by giving you low doses of nicotine so that your withdrawal symptoms will not be as strong. Using some form of nicotine-containing medicine doubles your chances of quitting smoking for good.

Below are some nicotine-containing options for you to consider:

  • Zyban
  • Chantix
  • Nicotrol
  • Nicobate CQ
  • Nicocure
  • Nicoderm CQ
  • Nicorette Inhalator
  • Nicorette Microtab
  • Nicorette Nasal Spray
  • Nicotinell
  • Nicotrol/Nicotrol NS
  • NiQuitin CQ

Ask your doctor for more advice on these medicines. And remember: Medicine alone can't do all the work. It can help with cravings and withdrawal, but quitting smoking or chewing will still be hard at times. More information about medicines to help you quit tobacco.

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Mental Health

 

Does using tobacco help people with problems like anxiety, depression, ADHD/ADD, or post-traumatic stress disorder feel better?

It can seem like nicotine is helping, but people who use tobacco to feel better are self-medicating and it’s not a good solution. Nicotine temporarily changes the chemistry in the brain and can lessen some of these symptoms, but it doesn’t last long and it’s no cure.1 There are ways to help you if you are feeling overly stressed, anxious, depressed, or have ADD or ADHD. Talk to your doctor about ways to relieve stress or depression and medications that can help.

1 Carter, B. L., Lam, C. Y., Robinson, J. D., Paris, M. M., Waters, A. J., Wetter, D. W., Cinciripini, P. M. (July 2008). Real-time craving and mood assessments before and after smoking. Nicotine and Tobacco Research, 10(7):1165–1169. 2. Goodwin, R. D., Zvolensky, M. J., Keyes, K. M. (March 26, 2008) Nicotine dependence and mental disorders among adults in the USA: Evaluating the role of the mode of administration. Psychological Medicine, 1–10.

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Will quitting smoking help me feel better if I feel overly anxious or depressed, or have post-traumatic stress disorder?

Yes! Smoking can actually make you feel more anxious or depressed when you can’t smoke and it can make you more stressed than you would feel if you weren’t addicted to nicotine. 1,2,3 Quitting means that you have more control over your emotions, that they aren’t controlled by the nicotine. Read Unlocking the Mysteries of Post-Traumatic Stress Disorder and Tobacco Use for more information about PSTD and smoking.

1 Carter, B. L., Lam, C. Y., Robinson, J. D., Paris, M. M., Waters, A. J., Wetter, D. W., Cinciripini, P. M. (July 2008). Real-time craving and mood assessments before and after smoking. Nicotine and Tobacco Research, 10(7): 1165–1169.
2 Parrott, A. C. (October 1999). Does cigarette smoking cause stress? American Psychologist, 54(10): 817–20.
3 Parrott, A. C. (February 1995). Stress modulation over the day in cigarette smokers. Addiction, 90(2): 233–44.

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If I have an attention deficit disorder (ADD or ADHD) is it going to be harder to quit using tobacco?

If you have ADHD, you already know that your behavior is really not something you can control by willing yourself to focus, concentrat, or even sit through a movie without fidgeting! You may have learned behavior modification or a doctor may have prescribed medication to help control your symptoms. Smokers with ADHD can be more physically dependent upon nicotine, and while that can make it more difficult to quit, it doesn’t mean you can’t! You should talk to your doctor who can advise you about cessation medications that can help you. Just like you know you can’t will yourself to be rid of ADD or ADHD, you might not be able to defeat tobacco without assistance. 1,2

1 Wilens, T. E., Vitulano, M., Upadhyaya, H., Adamson, J., Sawtelle, R., Utzinger, L., & Biederman, J. (June 4, 2008). Cigarette smoking associated with attention deficit hyperactivity disorder.
Journal of Pediatrics, (published ahead of print version, retrieved July 24, 2008).
2 Gehricke, J. G., Whalen, C. K., Jamner, L. D., Wigal, T. L., & Steinhoff, K. (February 2006). The reinforcing effects of nicotine and stimulant medication in the everyday lives of adult smokers with ADHD: A preliminary examination. Nicotine and Tobacco Research, 8(1): 37–47.

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Does using tobacco reduce anxiety and stress?

One of the most common reasons given for using tobacco is stress, and it is a common belief that using tobacco relieves stress and has a relaxing effect. But does it really reduce anxiety and stress? Surprisingly the answer is no, not at all. Tobacco use actually increases stress and the effects of stress on your body.

The chemicals in tobacco, especially nicotine, have a wide variety of effects on the body, including the release of chemicals in the brain that temporarily increase feelings of pleasure and relaxation. Beware though, this is only masking the stress and anxiety, and the feeling is short lived. Using tobacco actually intensifies many of the physical problems associated with stress such as increasing blood pressure, causing gastrointestinal problems, and making sleeping difficult. In addition to creating these problems, it creates a new one: nicotine addiction.

Nicotine addiction alone has proven to be a major source of stress (just ask anyone who’s tried to quit). Studies show that tobacco users experience periods of heightened stress between each cigarette or chew, and using tobacco only briefly restores their stress levels to normal. However, soon they need to use tobacco again to stop cravings. These swings in nicotine levels cause negative moods between cigarettes and slightly above-average levels of daily stress. Some studies indicate that those who quit using tobacco actually notice a gradual decrease in stress over time.

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Quitting

 

Should I sign up for tobacco cessation classes?

Research shows that by participating in a tobacco cessation class you can double your chances of quitting smoking or chewing tobacco successfully. Cessation classes will teach you what to expect when quitting, and, more important, how to cope with the effects of withdrawal and the cravings to smoke or chew. The class will help you create your own unique plan for quitting and set you up for success. Classes are also a great way to find ongoing support from others at your installation who are quitting smoking or chewing. Quit Buddies, like Battle Buddies, can be there for you to lean on if quitting gets tough, and you can do the same for them.

Chances are your installation’s cessation classes are also the gateway to receiving free medications or nicotine replacement therapies. Adding either of these to your quit plan will further increase your chances of success, making quitting easier by reducing the cravings and effects of nicotine withdrawal.

You wouldn’t want to go into combat without your unit there to support you, and you don’t have to fight against tobacco alone either. You can start finding support now by contacting your installation’s cessation program through our online locator. And don’t forget about our cessation coaches standing by to chat online, provide anonymous support, and answer any questions you have.

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What should I do if I relapse and start smoking or chewing again?

If you are quitting and have a slip, or even a full-blown relapse, you are probably asking yourself, “What should I do now? “ First of all, don't panic! This happens at least once to most people who are quitting, and even though most relapse happens in the first week, it can even happen after months of being tobacco free. If you have had a slip and just used tobacco again once or twice, don’t let it stop you from quitting. Get back on track with your quit plan and keep it going. If you have relapsed and resumed your normal tobacco use, take this opportunity to start planning your next quit attempt. Either way, this is a chance to flip the situation into a positive one and learn from your past quit experience.

Start by analyzing the situation(s) where you started using tobacco again. Are there certain activities or certain times of the day when you always smoke or chew? Maybe first thing in the morning, after a meal, before bed, or with a drink? These are known as triggers, things you might connect to using tobacco.

Ask yourself the following:

  • Where was I?
  • Who was I around?
  • What were my senses experiencing (sight, smell, sound, touch, taste)?
  • What was I thinking about?
  • What was I feeling emotionally?
  • What was in my hands?
  • Was I hungry, angry, lonely, tired?

All of these answers are clues you can use to identify your triggers and plan for similar situations in the future. The more you know about yourself and your triggers, the more prepared you will be for all high-risk situations and the less likely you will be to relapse again.

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Can exercise help me quit tobacco?

Exercise is a great way to help you become tobacco-free. Research has proven that, if you exercise while quitting tobacco, you are much more likely to succeed in staying quit. For example, just 10 minutes of moderate-intensity exercise, like a jog around the block, can reduce nicotine cravings and improve your mood. Exercise helps relieve the anxiety, irritability, and depression that nicotine and nicotine withdrawal can create.

But that’s not all. In addition to these short-term effects, exercise has some helpful long-term benefits for the person trying to quit. If you think about it, exercise works to combat the negative effects of tobacco like an antidote:

  • Exercise reduces cardiovascular disease risk. Tobacco increases it.
  • Exercise improves blood pressure. Tobacco worsens it.
  • Exercise improves glucose (blood sugar) metabolism. Tobacco puts users at increased risk for diabetes.
  • Exercise lengthens life overall. Tobacco shortens it.

So, use exercise as a way to get your quit plan up and running! For maximum benefit, we recommended that you start your new exercise program a couple of weeks before your quit date.

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How can I avoid weight gain after quitting?

The way people talk about it, you would think that everyone who quits tobacco gains weight. In reality, three out of four people who successfully quit DO NOT gain weight at all. How do many of them do it? By having a solid plan for eating and exercising when they quit, that’s how! So, when you get ready to quit, set yourself up for success by planning in advance. Consider trying the following:

  • Set up a new exercise plan. Exercise will help you keep off unwanted pounds, and it also reduces stress and keeps you busy.
  • Eat smart! Quitting tobacco means making a lot of changes to your lifestyle, and eating healthier will have a positive effect on your waistline.
  • Be prepared. Whether you are quitting chewing or smoking, you may reach for food when cravings strike. Stock up on healthy snacks to get you through.
  • Make your eating habits healthier to also help curb cravings. If you regularly use tobacco after meals, you might associate tobacco with the foods you usually eat. By changing up your eating habits and eating smaller, healthier meals more frequently, you can help combat the cravings you might normally have with foods, as well as cravings that the feeling of being full can create.

Quitting tobacco is tough. Start your new routine at least 2 or 3 weeks before you quit, if possible, so you will not be making too many changes at once.

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When I quit tobacco, how long will the cravings last?

When quitting tobacco, everybody wants to know what to expect, especially how long it will take before the craving to use tobacco again subsides. For many, time seems to stand still when quitting tobacco and the answer to when cravings will subside varies from person to person. The reason that the length of cravings varies is because cravings can be caused by physical withdrawal (nicotine addiction) and/or from psychological withdrawal (missing the habit). Each of these types of withdrawal also varies depending upon the length and amount of tobacco you have used; your other lifestyle habits such as diet, exercise, water intake, and stress management skills; and the number of temptations to which you are exposed after quitting.

Even with so many variables, we can tell you what the average experience looks like. Normally, withdrawal symptoms and severe cravings last about 2 to 4 weeks, and the first week to 10 days can be the toughest. Research shows that the average quitter experiences cravings and withdrawals:

  • Beginning within the first 1 to 2 days
  • Peaking sometime in the first 7 days, then slowly subsiding
  • Lasting an average of 2 to 4 weeks.

Just remember that after 2 to 4 weeks you may feel over the hump, but that is not the same as being out of the woods. Make sure to keep your guard up for unexpected cravings and over-confidence that try to trick you back into using tobacco one more time. Planning to avoid risky situations may be something that continues throughout your life, particularly in times of stress, such as during deployments. When it comes to cravings, the only way to make them go away forever and have days where you never even think of using tobacco, is to continue to fight and win the craving battle every single day.

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VA Veterans

 

What does "Veterans enrolled in the VA health care system" mean?

"Enrolled for care" means that a VA Veteran has applied for and been found to qualify for health benefits through the VA.

For answers to specific questions about enrollment or benefits, the VA provides these websites to assist Veterans in finding information about:

  • Enrollment — http://www4.va.gov/healtheligibility/eligibility/enrollment.asp
  • Health benefits — http://www4.va.gov/healtheligibility/coveredservices/ StandardBenefits.asp
  • VA health care facilities or primary care providers — VA Facility Locator

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What does the VA provide to help me quit tobacco?

The VA provides a number of services to help VA Veterans enrolled for care in the VA health care system, including individual counseling; prescriptions for nicotine replacement therapies, such as the nicotine patch or gum or other smoking cessation medications; brief counseling in primary care or outpatient mental health clinical settings; participation in evidence-based smoking cessation programs; and online resources such as this website and Live Chat service. To find tobacco cessation services near you:

  • If you are already receiving care at a VA Medical Center or community-based outpatient clinic, please contact your primary care provider for more information about services available at your facility.
  • If you are enrolled for care but not currently receiving care at a VA Medical Center or clinic and would like to locate the nearest facility, please use the VA Facility Locator or call the toll-free number, 1–877–222–8387.

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Does the VA provide medications to help me quit?

Yes, nicotine replacement therapies (NRTs)—in the form of the nicotine patch, gum and lozenge, as well as varenicline, also known by its brand name Chantix, and bupropion, also known as Zyban—are formulary options available through the VA for tobacco cessation. You can get a prescription from your primary care provider or another health care professional, and prescriptions may be filled through the VA pharmacy. Normal copayments apply when filling the prescription based on your category.

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With the Veterans Health Administration (VA), are nicotine replacement therapies and prescription medications free?

As a Veteran enrolled for care in the VA health care system, you can get tobacco cessation medications such as over-the-counter nicotine replacement therapies and prescription medications through the VA pharmacy with a prescription from your primary care provider or another health care professional. Standard co-payments apply per your individual plan for VA formulary tobacco cessation medications, such as over-the-counter nicotine replacement therapy and prescription medications. So, if you are a Veteran who already has a co-payment for the medications that you receive through VA, you will pay a co-payment for smoking cessation medications as well. But this co-payment for even medications, such as over-the-counter nicotine gum or patches will be much lower than that charged by retail pharmacies. If you do not usually pay a co-payment for your medications through the VA, you will not have a co-payment for smoking cessation medications either.

If you are enrolled for care and have not yet begun receiving care in the VA, please contact the VA Medical Center or community-based outpatient clinic nearest you to set up an appointment and learn more. To find a primary care provider or other health care professional near you:

  • Use the VA Facility Locator
  • Call toll-free 1–877–222–8387

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If I am a Veteran enrolled in the VA health care system, do I have to attend classes to get the medications or NRTs?

There is no national policy requiring that Veteran patients attend a smoking cessation clinic before they can receive a prescription for nicotine replacement therapies (NRTs) or bupropion, however, enrollment in counseling and classes are encouraged to help you learn about quitting, develop a plan, and be well prepared to handle the challenges of quitting.

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Does the VA provide varenicline (Chantix) and bupropion (Zyban)?

Yes, varenicline, also known by its brand name Chantix, and bupropion, also known as Zyban, are formulary options available through the VA for tobacco cessation. You can get a prescription from your primary care provider or another health care professional, and prescriptions may be filled through the VA pharmacy. Normal copayments apply when filling the prescription based on your individual plan.

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What if I’m not a smoker? Will the VA still help me quit chewing tobacco?

Yes. The VA recognizes the dangers of smokeless tobacco and provides a number of services to help Veterans enrolled for care in the VA health care system, including individual counseling; prescriptions for nicotine replacement therapies, such as the nicotine patch or gum, or other medications; participation in evidence-based smoking cessation programs; and online resources such as this website and Live Chat service. If you are already receiving care in the VA, please contact your primary care provider to get more information about services available at your facility. If you are enrolled for care and have not yet begun receiving care in the VA, please contact the VA Medical Center or community-based outpatient clinic nearest you to set up an appointment to learn more about the tobacco cessation services available to you:

  • Use the VA Facility Locator
  • Call toll-free 1–877–222–8387

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