Q: My husband and I heat our home with a wood stove. I was outside helping stack some seasoned firewood for the upcoming cold weather when I became sweaty, coughed and short-of-breath. My mother-in-law who is more than 20 years older was helping me and she had no problem continuing but I had to blow the whistle to stop because I couldn’t keep up. I know what my problem is. I smoke and I’m finding each day this awful habit affects me more and more.
I’ve finally decided to do something about it but smoking cessation patches frighten me because of the possible side effects. I need help now but am unsure what to do. Can you provide some insight?
A: The use of tobacco can lead to dependence and, as you have discovered, serious health problems. Dependence is a chronic condition that commonly requires repeated intervention, essentially because of weight gain, stress and the symptoms of withdrawal when an individual tries to quit. Nicotine dependence is the most common form of chemical dependence in our country and some researchers suggest that it may be as addictive as alcohol, cocaine and heroin.
For those who discontinue the habit, the risk for disease is reduced dramatically and while the health benefits are substantially better when people stop at an early age, cessation is beneficial at all ages, as it lowers the risk for lung cancer, coronary artery disease, chronic obstructive pulmonary disease, peripheral vascular disease and countless other disorders.
There are a number of cessation treatments an individual might consider, including speaking with a health care provider who can provide information during an office visit as to how to begin; counseling on an individual or group basis; hypnosis; gums such as Nicorette, Habitrol and Prostep, lozenges, nicotine inhalers, nasal sprays; nicotine-free prescription drugs such as Zyban and Chantix; support groups; E-cigarettes which work extremely well for some people; and the patch to which you refer.
Nicotine patches such as Nicoderm CQ and Nicotrol brands are applied to the skin once a day like an adhesive bandage for the purpose of helping people discontinue smoking as they provide a source of nicotine that lessens symptoms of withdrawal. They are available in different strengths and may be used for varying lengths of time. For those individuals who smoke more than 10 cigarettes each day and using a 10-week schedule as an example, a person might use one 21 mg patch each day for six weeks, followed by one 14 mg patch each day for two weeks, followed by one 7 mg patch each day for two weeks. To complete the entire program will increase a person’s chances of quitting successfully. The most common areas of the body for application of the patch are the upper arm, hip or a hair-free portion of the chest. The patch is worn continuously for between 16 to 24 hours a day even during showering and times of sleep depending on the brand’s directions. You are correct in that side effects can occur and may include nausea, diarrhea, redness or a reaction at the site of the patch, dizziness and headache. Less common effects might include a severe rash, difficulty breathing, an abnormal heartbeat, depression, or seizures. Individuals should not smoke while wearing the patch.
I recommend you speak with your health care professional regarding the patch to determine if it is right for you. Be guided by his or her recommendations. Further, because you complained of sweating, coughing and becoming short-of-breath, it is vital you share this information with your doctor so all the bases can be covered since you could have a blood clot to the lung, or experienced a silent heart attack.
Assistance regarding cessation can be found by calling 1-800-QUIT-NOW a free telephone support service ; by logging on to the CDC’s smoking and tobacco use web site; BeTobaccoFree.gov, a Department of Health and Human Services information; Smokefree.gov that provides free professional assistance; and still other resources.
