Nama : Adam Ramadhan

NPM : 20112113
Kelas : 4 KB 01
STOP SMOKING

It's Never Too Late to Quit Smoking

By Michael Smith, MedPage Today | Reviewed by Zalman S. Agus, MD
No matter your age, the benefits of quitting smoking far outweigh the risks to your
health.
Giving up cigarettes has benefits even if it happens later in life.
That's one of the findings of a meta-analysis of 17 studies that looked at the risk of allcause mortality in smokers 60 or older, according to Hermann Brenner, MD, and
colleagues at the German Cancer Research Center in Heidelberg, Germany.
Regardless of age, the risk of dying in a given time frame from any cause is sharply
increased in smokers compared with people who have never smoked, they reported in the
June 11 issue of Archives of Internal Medicine.
But the increased risk decreases in people who quit, and that benefit is still present even
after age 80, the researchers found.
A host of studies have found that the risk of all-cause mortality is higher in smokers but
most have focused on people in middle age, and it has not been clear if there is any
attenuation of risk as a person grows older, Brenner and colleagues noted.
Indeed, commented Tai Hing Lam, MD, of the University of Hong Kong in Pokfulam,
Hong Kong, the studies have shown that the absolute risk is that smoking will kill one of
every two smokers.
The key finding of the study by Brenner and colleagues, Lam argued in an accompanying
comment article, is that the risks of smoking remain high even into old age, and
the benefits of quitting are also high.
In 17 cohort studies that included men and women 60 and older, Brenner and colleagues
found that point estimates of relative mortality for smokers compared with never smokers
ranged from 1.3 to 3.4 for men and 1.2 to 2.5 for women.
A meta-analysis of the studies found the relative mortality compared with never smokers
was 1.83 over all ages and both sexes, they reported.

The relative mortality fell slightly with age but remained substantial.
The decline with age is likely due to a "depletion of susceptibles" effect, in which smokers
most likely to die of the habit have already done so, the researchers suggested.
Brenner and colleagues found a similar pattern in former smokers. Over all, the relative
mortality compared with never smokers was 1.34, but it was 1.54 among people ages 60
through 69, 1.36 among those ages 70 through 79, and 1.27 in those 80 or older.
The difference between the relative mortality rates for former and current smokers
amounted to a risk reduction of 28 percent for those who quit.
And a similar calculation for the different age groups suggested that even at 80 or older,
those who quit have a 24 percent reduction in the risk of death compared with current
smokers of that age.
The analysis had some limitations including the fact that the involved studies had varying
follow-up periods and age ranges. Also, the age ranges did not always match the age
ranges chosen for the age-specific meta-analyses. But the findings emphasize the need for
effective public health messages, Lam said. For public health information and education,
the great death risk of 1 in 2 to 2 in 3 should be highlighted consistently and widely," he
wrote. But for many older smokers, that message is not getting through, Lam argued.
"Many older smokers misbelieve that they are too old to quit or too old to benefit from
quitting," Lam said. "A simple, direct, strong, and evidence-based warning is needed."
For physicians, the message is also clear, Lam concluded: "If you have helped two
smokers quit, you have saved (at least) one life."
How to Quit Smoking
By Anne L Fritz Medically Reviewed by Robert Jasmer, MD
Here's a simple step-by-step plan to help you stop smoking.
You decided to stop smoking? Great it's one of the best things you can do for your
health.
But quitting isn't easy. Nicotine the addictive ingredient in tobacco is as addictive as
heroin or cocaine, according to the American Cancer Society. In fact, the average person
attempts to quit six times before succeeding. Fortunately, there are steps you can take to
set yourself up for success and kick the habit for good.

Set a date: Pick a day and time in the near future that you expect to be relatively stressfree so you can prepare to quit smoking.
Quitting when you have a big project due at work, or even when you have something
happy on your calendar like a birthday party (if you tend to light up when you are drinking
or socializing), can be more challenging.
Write down your reasons: Consider why you want to stop smoking and jot the reasons
down. You can refer to them once you quit when you get a craving. A few universal
benefits:

My risk of cancer, heart attacks, chronic lung disease, stroke, cataracts, and other

diseases will drop.

My blood pressure will go down.
I'll look better. My skin will be more hydrated and less wrinkled, my teeth will

look less yellow and my fingers won't be stained with nicotine.

I'll save money.
My hair, clothes, car, and home won't reek of smoke.
I'll have more energy.
I'll set a better example for my kids, friends, and family.
I'll live longer.
Get your friends and family on board: The more support you have, the more likely you
are to quit smoking.
Ask your loved ones to help keep you distracted by taking walks or playing games, and
bear with you if you become cranky or irritable as you experience nicotine withdrawal.
Tell any smokers not to smoke around you, or better yet, ask your smoking buddies to quit
with you.
Identify your triggers: You'll be most tempted to smoke during the same times you do
now. Knowing your habits and what situations may set off a craving will help you plan
ahead for distractions.
For example, you may typically smoke while driving, drinking, or after dinner, or it may
be that you reach for a cigarette when you're feeling stressed, lonely, or depressed.
Create healthy distractions to head off potential smoking triggers. If you smoke while you
drive, keep a pack of gum on hand, or if you smoke after dinner, plan to take a walk or
chat on the phone with a friend.

Anticipate cravings: It's expected that you'll experience nicotine cravings as your body
begins to go through withdrawal. The good news is that cravings aren't endless. They
generally last for five minutes and no longer than 10. When cravings strike, focus on
something else: Drink a glass of water, review your list of reasons for quitting, take deep
breaths, play with your cat or dog do whatever it takes until the craving subsides.
Distract yourself: Keep celery stalks, carrot sticks, nuts, or gum handy to give your
mouth something to do when cravings occur.
And finding some way to occupy your hands knitting, woodworking, cooking, yoga, or
yard work will help keep your mind off smoking.
Expect to feel a little off: Nicotine withdrawal can make you feel anxious, cranky, sad,
and even make it hard for you to fall asleep.
It helps to know that all these feelings are a normal and temporary part of the process.
Throw out all your cigarettes: Yes, even that emergency one you stashed away.
If you don't have cigarettes on hand, it will make it that much easier to stay the course
when a craving hits.
Reward yourself: With all the money you'll save by not buying tobacco, you can buy new
clothes, splurge on dinner, or start a new hobby.
Some people keep their cigarette money in a jar, then reward themselves with a treat each
week.
Talk to your doctor about cessation medications: If you're not sure you can go cold
turkey, don't.
Speak with your doctor about over-the-counter (OTC) and stop-smoking medications that
can make quitting easier.

Bibliography/Sources:

http://www.everydayhealth.com/quit-smoking/

http://www.everydayhealth.com/smoking-cessation/0613/its-never-too-late-to-quitsmoking.aspx