Sunday 19 November 2017

I only smoke 5 cigarettes a day. Do I need to give up?

Ask the GP...

Quit smoking - the health benefits are immediate
Quit smoking - the health benefits are immediate

Nina Byrnes

Advice from our GP on why quitting is the best thing a smoker can do for their health and when you should visit a doctor when suffering with a cough.

Q. I am a woman in my late 60s and smoke about five cigarettes a day. I never go over that number, I often smoke less, and I am very active playing golf twice a week and walking regularly. I feel fit and healthy and have a good diet with no health problems that I know of. My daughter is always nagging at me to give up smoking, and I have tried for her, but it doesn't seem to be worth the sacrifice as I don't feel like I need to. I have regular check-ups with my GP and everything seems fine - I tell the GP I smoke one or two occasionally. How can I convince my daughter to leave me be? Or am I fooling myself?

Dr Nina replies: The percentage of those who smoke has dropped steadily in Ireland since the smoking ban from a population where approx 30pc of the population smoke to one where there is approximately 18.6pc prevalence in recent research.

Unfortunately the message about the danger of cigarettes doesn't seem to be getting through to everyone. Shockingly the highest percentage of smokers in Ireland are aged 18 to 34, a group who were raised in times where we should know better. The biggest increase is in young women and sadly our disease statistics are starting to reflect that. More and more women are dying of smoking-related illnesses. Women's lungs seem to be especially sensitive to the damage that smoking causes.

There is no safe level of smoking. Even one cigarette a day is doing you harm. There have been scientific reviews of research into smoking-related illness in light smokers. The conclusion was that women who are considered light smokers, of less than five cigarettes daily, have a reduced life expectancy of four to six years versus those who don't smoke at all.

Light smoking increases the risk of lung cancer five-fold versus non-smokers, and also increases the risk of cancer of the oesophagus, stomach and pancreas. Any smoking increases the risk of cardiovascular disease. Dementia risk is also increased in all smokers. An awareness of health and lifestyle has led many to avoid additives and chemicals in food, skincare etc. The irony is that many of those who like to be "healthy" and avoid additives in their foods are ingesting far more dangerous toxins through their cigarettes. Ammonia, methane, methanol, toluene, cadmium and stearic acid are just a few of the toxins that make it into the average cigarette.

Smoking is associated with disease in virtually every organ system. Contrary to popular myth, smoking increases stress levels.

Smokers also age faster than non-smokers. The cosmetic changes referred to as "smoker's face" can leave someone looking on average 10 years older than their non-smoking counterparts. Changes include early crow's feet around the eyes, deep wrinkles on the lip line, sunken hollow cheeks, thinner skin (due to lower levels of collagen production), superficial broken veins, ruddy cheeks and yellow teeth. Cosmetic surgery isn't always the answer as the risk of complication is higher in smokers and scars heal more slowly.

Quitting is the best thing any smoker can do for their health. The benefits are real. Within 20 minutes your heart rate and blood pressure start to fall. Within 24 hours, nicotine is eliminated from your blood. Two weeks later circulation improves and at a year, coronary heart disease risk is halved. Stroke risk is halved in five years and by 15 years the risk of cardiovascular disease and smoking-related cancer is reduced to that of a non-smoker.

The benefits are not only physical. Smoking even five cigarettes a day will cost almost €1,000 a year. Treating smoking-related illness costs the government an estimated €1bn a year. Worldwide smoking kills the equivalent of a jumbo jet crashing with no survivors every hour, everyday, 365 days a year (WHO). Who wants to be a simple statistic?

Q. How do you know when a cough will pass or whether it indicates an underlying problem for which you should visit a doctor?

Dr Nina replies: Cough is one of the most common reasons for a person to attend their doctor. However it doesn’t always mean an infection lies beneath. Coughing is a normal physiological reflex that helps to keep the lungs and airways clear. Irritation anywhere from the throat to deep in the lungs will cause someone to cough.

Acute coughs last two to three weeks and are most often associated with a viral or bacterial respiratory infection. They can also last for some weeks after the initial infection has passed. Chronic cough continues for several weeks to months and can be due to a whole range of causes, including infection, asthma or bronchitis, allergies, sinus problems, stomach acid reflux, lung tumours, heart problems, medication or psychological issues.

It’s obvious that an infection or tumour in the lung may cause a cough and these are the things that most people worry about, however chronic post-nasal drip or gastroesophageal reflux are in fact more likely to be the culprit, especially if the cough is worse on lying or after meals.

Ace inhibitors are a type of blood pressure tablet. If these cause a cough switching to an alternative can solve the problem. If all physical causes are ruled out addressing any underlying stress or anxiety can help.

It is not always necessary to visit your doctor with a cough and staying at home taking plenty fluids and resting can help in many cases. However if you have fever, coloured phlegm, blood, wheeze, shortness of breath, weight loss or night sweats, a doctor’s visit is essential.

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