We all know the answer to preventing lung cancer – or do we? Approximately 90 percent of lung cancers are attributed to smoking tobacco products. So by far the most important step in preventing this Number 1 cancer killer is to stop smoking. Many Americans already have quit. For those who are still smoking, it's easy to assume they're just making a bad decision, and it's their own fault if they get cancer.
Unfortunately, “stop smoking” is not the same kind of advice as “wear sunscreen” or “take vitamins.” According to Dr. Carlton K. Erickson, approximately one third of smokers are not going to be able to quit on their own, no matter how much they would like to. Smokers are not all created equal. For reasons that are poorly understood, some users become “dependent”, according to the following definition: “Chemical (Drug) Dependence: a maladaptive pattern of drug use, leading to impairment or distress, presenting as three or more of the following in a 12-month period:
1. tolerance to the drug's actions
2. withdrawal
3. drug is used more than intended
4. there is an inability to control drug use
5. effort is expended to obtain the drug
6. important activities are replaced by drug use
7. drug use continues despite knowledge of a persistent physical or psychological problem"
Data quoted by Erickson indicate that nicotine has the highest percentage of users who become dependent. For comparison, here are the numbers for commonly used addictive drugs:
1. Nicotine, 32 percent of users become dependent
2. Heroin, 23 percent
3. Cocaine, 17 percent
4. Alcohol, 15 percent
Treatment programs are widely available. Some approaches are:
1. Nicotine delivery devices. These include the new electronic cigarettes, as well as gum, patches, and inhalers. They allow the user to taper off nicotine while breaking the habit of actual smoking. Nicotine has its own health risks, mostly cardiovascular, but these alternatives have greatly reduced lung carcinogens.
2. Nicotine-free cigarettes. This approach assumes that the smoking habit is more significant than the nicotine. Google “nicotine-free cigarettes” to see various brands.
3. Other drugs. Buproprion (Zyban) and varenicline (Chantix) are approved for stop-smoking treatment in the United States. A third option, rimonabant (Acomplia), is also available in Europe. These drugs have side effects, but Dr. Erickson writes that the benefits of smoking cessation far outweigh the risks of these options.
4. Nicotine Anonymous offers social support similar to other 12-step programs. See www.nicotine-anonymous.org.
I hope that future research into cancer prevention will include funding for improved ways to treat nicotine addiction.
References:
Carlton K. Erickson, “The Science of Addiction”, Norton, 2007.
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.