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Quitting Smoking

Disclaimer: I’ve never smoked.

smoke rising on a black backgroundWell, I tried in 7th grade while preparing for a science project. I had purchased with the help of a neighbor, a number of brands of cigarettes and had this small “robot” head made out of cardboard that you’d stick a cigarette into its face, the back of which had a tube that fed down to a squeeze bulb like you use for your outboard motor gas tank, which drew air from the cigarette through the tube and out through the back into a cotton ball “filter”. I “smoked” all kinds of brands to show which had the least crap in the filters and then posted them on a tagboard for my science project. Turns out, I didn’t win the Science Fair. But, I was so grossed out by the goo from a single cigarette, I never started smoking as this image was burned into my conscience. By the way, Carlton really WAS the lowest.

I’ve been asked how to quit smoking many times. To be honest, if I had that ability, I’d be hanging out with Bezos, Gates and Jack Ma. Nobody has the single answer. There are many answers. I will share what I know though.

Before that, one more anecdote:

Back in the early 90s when I was fairly new in practice, one patient, Ernie, was in his late 70s and smoked 3 packs a day. He told me he had done so since he was 10 years old. I never thought to even talk to this patient about quitting smoking. I didn’t think anything I said could matter. He was hypertensive and was in early stages of COPD (obstructive pulmonary disorder, that’s when you are going to be on oxygen soon). He came in one day and told me he quit smoking. I was quite surprised. I said, “What made you decide to quit?” He said, ” I went to the cardiologist for my heart problems, I was in the exam room waiting for the doctor for quite a while, when the nurse came in she said ‘you smell like you smoke 4 packs of cigarettes per day!’. I had no idea I smelled that bad. So, I quit. So, there you have it. Vanity. This guy was embarrassed because he stunk so bad. He didn’t care about his health. He knew smoking was going to kill him. He was already sick because of it. But, some cute nurse tells him he stinks and that was enough of a reason.

Quitting depends on your why. Why are you quitting? Except for my great aunt who in her 80s, had a stroke and forgot she smoked 3 packs a day, everyone else needs motivation. Everyone knows it’s bad for you and will hasten your demise and yet…. People still get up in the morning and reach for the Marbs. So, no amount of statistics matters. It requires a life altering event, like you can no longer breathe when you go upstairs, you can’t play the saxophone, you’ve had a heart attack already (heck, I know someone who’s had those things, is on oxygen and STILL smokes. Almost started herself on fire one day last summer!), whatever it is, that’s what you need to be clear on.

I assume if you are reading this far, you’ve got your ‘why’. But, you should actually say it or write it down so you can be mindful of it when you get the urge to smoke while trying to quit.

The physicality of it is nicotinic receptors in the body are upregulated because with constant exposure to nicotine, to function within normal range, you need more receptors and your body’s job is to adapt to the environment and it makes more receptors to accommodate this environment. So, taking away the baseline nicotine from the environment requires the opposite. So, the person with all those extra receptors unsatiated, will suffer. That’s withdrawal. Estimates vary on how long it takes to normalize. But, it’s months at least.

There’s also the habit of having something in your hands/mouth. That’s hard to readapt. And, there’s some social things about who you hang with and things you do, that will be hard to imagine without cigarettes. But, I hang with people who smoke and I don’t have any thoughts about joining them for a smoke. So, be done with that.

I can speak to the physicality of it. Take the thing apart and address one aspect at a time or just go cold turkey. I’ve seen both work.
First, the nicotinic receptors have to be managed somehow.

So, start with moving to vape. It is also really bad for you but I say this so you don’t have to break the physical habit of stuff in your hands and lips. It is only slightly less bad than inhaling incinerated ash from a cigarette for your lungs though. So, really you can break physical habits in 4 weeks, so that’s the max for that step after that, you’ve just created another addiction. You can also go “all in” and use licorice sticks (natural, not the candy) to address the habit of something in the hand and mouth.

Second, Nicorette gum and nicotine patches.

These keep the stimulus to the receptors while you break the habit of holding stuff in your hands in social situations. But, you must dial back these receptors so this is again, only 4 weeks as that’s how long it takes to create new habits. If you haven’t done by then, well, move on. And, people who use these don’t often succeed. The failure rate is high. At some point, you must reduce the receptors.

The receptors themselves need to be less stimulated. Whether you do this all at once or little by little, the body will adapt. So, that’s going to be determined by the social and habit factors. It’s either very painful for less time or moderately painful for a longer time. That’s an individual preference.
However, you CAN give the receptors a little respite with N-acetylcysteine and/or CBD.

NAC is a supplement and precursor to acetylcholine in the body that also binds to nicotinic receptors. As a bonus, it is a powerful antioxidant and smokers need lots of antioxidants. The supplement can be found all over as NAC. 3 grams per day while trying to quit. Incidentally, I use this myself. I don’t smoke, but I use a lot of different versions of antioxidants. I don’t use 3 grams but 1 gram a few times per week that I rotate with other antioxidants. Keeps vessels healthy… if you recall the Man Workshop a couple months ago. You know, vessels need to expand and contract. Which reminds me, if you didn’t have enough reasons in your “why”, smokers have a much higher incidence of erectile dysfunction.

CBD oil has been tested and found helpful while trying to quit because it activates another area of the physiology that helps relax and calm you. It doesn’t interact with the nicotinic receptor but provides another pathway to calm the cravings.

The research however, used 800mg per day. I’ve not found a source that makes that a reasonable price without help. The CBD in our office is in the vicinity of $15/day at that dose level.

However, I use CBD to help sleep. I use about 75-150mg per day.

A note about Chantix: No.

While you’re quitting, your body is going to be much tighter, your muscles will be higher tone and you will be more likely to be subluxated. If you aren’t getting adjusted regularly, you should start. And, since you’ve decided you want to live longer, yes… you should start for more reasons than just that. Also consider a massage if you’ve made it a week or a month. Set up some healthy rewards. Not the Dairy Queen or coffee. Don’t trade a nicotine addiction for a sugar or caffeine addiction.

Though, if you have to pick one, nicotine is the worst. So, you’d still be ahead with a different one provided it’s not crack or meth or something. Just sayin’

Here’s the list of what is a baseline for supplements for the current environment in additional consideration of viral threats:

  • Multivitamin (B-complex)
  • Omega 3
  • Probiotics
  • Vitamin D3
  • Vitamin C
  • Quercetin/curcumin

If you are a smoker:

Way more vitamin C (3-5grams per day) and other antioxidants like citrulline, sodium nitrite, NAC, NAD, resveratrol. Consider collagen supplementation to repair the tissue damage.

If you know someone trying to quit, pass this along. And, certainly share how chiropractic care has helped you.

Dr. Barrett

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