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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Cold
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
Flexibility
Gadgets & Gizmos
Get Moving!
Get Motivated
Golf Exercises
Golf Injury Prevention
Head Injuries
Hockey Injuries
Home Gyms
Immunization
Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
Low Back Pain
Osteoporosis & Exercise
Osteoarthritis
Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Prevention of Sports Injury
Proprioception
Recreational Safety Equipment
Running
Safe Snow Shovelling
Shin Splints
Ski Conditioning
Shoes & Fit
Sore Elbow
Sore Shoulder
Spinal Cord Injuries
Staying Active
Staying Fit in the Cold
Sports Nutrition & Supplements
Strength Training
Swimming Injuries
Teen Sports Injuries
Walking
Water and Exercise
Weight Training
7 Wonders of Walking
Adolescent Health
Full Listing with story descriptions
Acne
Adolescent Behaviour Problems
Adolescent Growth & Development
Body Image
Body Piercing
Bullying
Chronic Diseases in Teens
Communications Skills
Concussion in Sport
Cosmetics & Skincare
Dangers of Artificial Tanning
Depression
Depression - Causes
Drug Use
Female Physical Exam
First Period
Internet Safety
Junior High
Mentoring to Quit Smoking
Mononucleosis
Parent-Teen Communication
Parent -Teen Interaction Patterns
Personal Care
Psychological Assessment
School Problems
Self Esteem
Self Esteem & Body Image
Sexually Transmitted Diseases
Talking About Sex
Taking Chances
Tattoos
Teaching Respect
Teens & Smoking
Teenage Blues
Teen Bedwetting
Teen Drivers
Teen Girls
Teen Health
Teen Immunization
Teen Independence
Teen Rebellion
Teens & Divorce
Teenagers and Sexual Issues
Teens & Exercise
A Woman's Physical
Your First Job
Youth Violence
Childbirth
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
Exercise in Pregnancy
Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
Infections During Pregnancy
Intrauterine Growth Restriction (IUGR)
In-Vitro Fertilization
Low Birth Weight Babies
Medication & Pregnancy
Miscarriage
Managing Your Own Labour
Monitoring Your Labour
Nausea & Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Pregnancy Weight
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
Full Listing with story descriptions
Asthma in Children
Attention Deficit Disorder
Babysitter
Bed Wetting
Chickenpox
Childcare Options
Children's Headaches
Childhood Obesity
Choosing A Babysitter
Circumcision
Colds & Flu
Common Childhood Skin Infections
Croup
Developmental Milestones
Diaper Rash
Daytime Wetting
Introducing Solid Foods
Developmental Co-ordination Disorder
Diarrhea
Discipline
Earache
Eczema
Feeding Your Baby
Feeding Your Toddler
Fever
Head Lice
Hearing
How Children Grow
Hearing Loss
Hearing Issues in Newborns
Heart Murmers
Hip Clicks
Influenza
Iron
Is it an Emergency?
Children and Sports Injuries
Lazy Eye (Amblyopia)
Learning Disabilities
Leg Problems
Not Just Baby Fat
Orthodontics
Preparing for Lab Tests
Recognizing Learning Disabilities
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
School
Scoliosis
Sick Toddler
Sleep Struggles
Sniffles, Fevers, Rashes & Coughs
Sore Throats
Speech Problems
Strep Throat
Toddler Safety
Thumbsucking
Tooth Injuries
Tummyache
Urinary Tract Infections
Vaccinations
Vaccination and Autism
When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
Dental Exam
Dental Care Devices
Dental Caries
Dental Care Offshore
Dental Implants
Dental X-Rays
Dentures and Healthy Jaw
Esthetic Dentistry
Fluoride
Fluoride Findings
First Dental Visit
Headaches
A Healthy Mouth
Healthy Mouth, Healthy Body
Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Mouth Protection Equipment
Oral Cancer Screening
Oral Healthcare
Oral health and long term care
Oral Health Care Products
Orthodontics
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
Full Listing with story descriptions
10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Traveling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
Allergic Rhinitis
Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
Bladder Problems
Blood Transfusions
Breaast and Prostate Cancer Screening
Carpal Tunnel Syndrome
Check-Up
Colon Cancer Screening
Contact Lenses
Contraception
COPD
Cost of Doctor's Visit
Diabetes Management
Diarrhea
Diagnostic Tests
Do I Need a Bone Density Test?
Doctor Visit
Driving Vision
Dizziness
Dealing with Dry Eyes
Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
Electronic Medical Records
Epilepsy
Eye Exam
Family Doctor
Fibromyalgia
Floaters and Flashes
Food Poisoning
5 Ways to Stay Healthy
Gallbladder
Get Active!
Glare
Headaches
Healthcare Teams
Heart Health
Hemorrhoids
Hepatitis C
Human Papilloma Virus
High Blood Pressure
High Blood Pressure Risks
How to Talk to Your Doctor
Hypothyroidism
Insomnia
Irritable Bowel Syndrome
Joint Replacement Surgery
Kidney Disease
Lazy Eye Blindness (Amblyopia)
Medical Digital Technology
Migraine
Meningitis
Multiple Sclerosis
Multiple Myeloma
Obesity
Opioid Myths
Primary Healthcare Reform
Prostate Problems
Quitting Smoking
Red Eyes
Respiratory Tract Infections
Restore Your Core
Rosacea
Screening Tests
Shingles
Sinusitis
Special Diagnostic Tests
Stopping Stroke
Stroke
Superbugs
Thyroid
Ulcers
Urine Tests
Vaccination Controversies (ask the doctor)
Win by Losing
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
Burns
Choking
Cuts and Scrapes
Eye Injuries
Fainting and Convulsions
First Aid Travel Kit
Hypothermia and Frostbite
Nosebleeds
Poisoning - Household
Emergency Care Guidelines
Sunburn
Growing Older
Full Listing with story descriptions
Advance Care Plans
Age-Related Macular Degeneration
Alzheimer Disease
Avoiding Memory Loss
Building Strength
Dementia and Agitation
Cataracts
Can I see Well Enough to Drive?
Cholesterol
Congestive Heart Failure
Coping with Dementia
Constipation
Controlling Medications
C.O.P.D.
Delirium
Dizziness (Vertigo)
Eating Well
Elder Abuse
Exercise Benefits
Erectile Dysfunction
Eye Care
Eyesight and Driving
Feet
Frailty
Fungal Nail Infections
Get Active!
Glaucoma
Grief
Have Health, Will Travel
Health Tips for Seniors
Hearing
Incontinence
Joint Replacement
Lab Tests
Living Longer With Diabetes
Macular Degeneration
Male Menopause (Andropause)
Maintaining Quality of Life as You Age
Memory Loss
New Corneal Treatments
Nutrition for Seniors
Osteoarthritis
Osteoporosis
Parkinson Disease
Problem Gambling
Prostate Health
Retirement
Seniors and Medications
Senior Sexuality
Sexually Transmitted Infections
Screening Tests
Seniors and Driving
Sleeplessness
Skin Structure
Skin Protection
Skin Over 50
Solving Sleep Issues
Staying Healthy
Stroke Prevention
Travel Tips for Snowbirds
Wills and Personal Directives
Modern Living
Full Listing with story descriptions
Abuse
Acupuncture
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
Antidepressants
Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
Cosmetic Pesticides
Depression
Diabetes Epidemic
Discipline
Diseases from Pets
Downsizing
Dying at Home
Erectile Dysfunction New Treatments
Exotic Travel
Fertility Issues
Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
Grief
Harassment
Healing Through Music
Healthy Computing
Humidex
Hypnotherapy
Ice Safety
Indoor Air Quality
Lymphedema
Mature Student
Melamine in Food
Middle Age Health
Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Schizophrenia
Smokeless Tobacco
Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Sunburn
Time Management
Travel Health Protection
Travel Comfort Tips
Travel Immunization
Understanding Change
Unplugging
Whiplash
Wind Chill Index
Workplace Drug Testing
Workplace Health
Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
Weight Loss
Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
Insomnia
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports & Nutrition Supplements
Sunscreen
Taking Medication
Take as Directed
Using Antibiotics Wisely
Viagra
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
Alcohol
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
Disaster Planning
Diseases from Pets
Caffeine
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Meningitis
Norovirus
Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
Sun Safety
Surviving Disaster
Sushi Preparation
Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
Water Smarts
Vision Damage
Water Wisdom
West Nile Disease
Whooping Cough
Workplace Alcohol Abuse
Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception
Contraception for Mature Women
Cosmetic Procedures
Cystitis
Endometriosis
Estrogen's Effect on the Brain
Fear of Fracture
Fibroids
Heart Attack
Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menopause
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Osteoporosis
Ovarian Cancer
Ovarian Cysts
Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
xx
Sexually Transmitted Infections
Urinary Incontinence
Vaginitis
Varicose Veins
Viagra for Women
Yeast Infections
Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
All Words Any Words Phrase
Family Health Magazine - PHARMACY CARE

Quit Smoking
It's challenging, but help is available

If you have tried to quit smoking and been unsuccessful, take heart! Most smokers attempt to quit smoking several times before finally quitting. Past failures do not mean that you are unable to quit. Instead, they are part of the normal journey towards becoming a non-smoker.

Improve your chances of quitting

  • Tell as many people as you can about your plan. If you announce it to everyone at home, work and in social grops, more people can cheer you on and support your positive efforts.
  • Reward yourself. It is so difficult to quit smoking that you deserve a treat. Choose something you would like and will be able to afford with the amount you save by not buying cigarettes. For instance, if you have a two-pack-a-day habit, the $14 a day or $420 a month can pay for a new car or vacation.
  • Make a list. Write down and post all of the reasons why you want to stop smoking. This will remind you of your motives for quitting.

You may believe that you just like to smoke. Tobacco companies have promoted the idea that smoking is a matter of personal choice. However, there really isn’t as much choice as consumers might believe. Ask yourself, and be totally honest: Am I addicted to tobacco? Am I truly making a free choice when I smoke? You may find that you need to have a cigarette. You’re not alone. Studies have shown that nicotine addiction is as hard to break as heroin or cocaine addiction.

Why nicotine is addictive

Nicotine is the most prominent addictive substance found in cigarettes. (There may also be others.) Nicotine reaches the brain about 10 seconds after you inhale cigarette smoke. The effect lasts only a minute or two. Drugs such as nicotine that are felt quickly and have a short-term effect tend to have the highest potential for abuse. Other addictive drugs that share nicotine’s quick action include narcotic street drugs such as crack cocaine and heroin.

How does nicotine affect the brain?

Nicotine causes a rapid release of dopamine, a neurotransmitter or brain chemical. Dopamine creates feelings of pleasure in the brain and helps people remember certain pleasures. These feelings and memories can also cause addiction to other activities like eating, drinking, and even sex. Since smoking is often easier and more frequently available, the pleasurable sensations produced through nicotine are constantly reinforced. Dopamine’s effect on memory is thought to be part of why people crave cigarettes even after they have quit for a year or more.

What are the benefits of quitting?

The health benefits of smoking cessation (quitting) are immediate and important. Almost instantly, blood circulation improves and the levels of carbon monoxide in your blood begin to decline. Your pulse rate and blood pressure, which may be abnormally high while smoking, begin to return to normal. Within a few days of quitting, your sense of taste and smell will improve while breathing becomes easier.

People who quit smoking live longer than those who continue to smoke. Ten to 15 years after quitting, your risk of premature death is close to that of someone who has never smoked. About 10 years after quitting, your chance of dying from lung cancer is 30 to 50 per cent less than the risk for those who continue to smoke. Women who stop smoking before becoming pregnant or quit in the first three months of pregnancy can reverse the chance of a low birth weight for the baby. Other risks associated with pregnancy and smoking will also be reduced. Quitting also decreases the threat of other diseases related to smoking, including heart disease and chronic lung disease.

Even people who are sick or have already developed cancer benefit by quitting. Stopping smoking cuts down the risk of developing infections like pneumonia, which often causes premature death in people with existing diseases.

Preparing to Quit

Before you decide to quit, you must know what you are getting yourself into and what to expect. There are many different stop smoking aids and methods that work for different types of people. They include the following.

Most successful quitters use a combination of supports. These include nicotine substitutes (patch or gum) and buproprion, along with assistance from health care professionals (nurses, pharmacists and doctors) and help from family, friends and support programs.

Before you choose a treatment, do your homework and prepare for what lies ahead once you quit. Here are some recommended steps.

Coping Strategies

Cravings for tobacco

  • Distract yourself
  • Do deep-breathing exercises
  • Realize that cravings are brief and will go away
  • Review your important reasons for quitting

Irritability

  • Take a few slow, deep breaths
  • Soak in a hot bath.

Insomnia

  • Take a walk several hours before bed
  • Avoid beverages with caffeine after noon
  • Unwind by reading for a while
  • Take a warm bath
  • Eat a banana or drink warm milk

Increased appetite

  • Drink water or low-calorie liquids
  • Snack on crunchy, chewy foods to keep your mouth busy (carrots, pickles, sunflower seeds, pretzels, apples, celery, gum, rice cakes)

Inability to concentrate

  • Go to the gym or take a brisk walk
  • Simplify your schedule for a few days
  • Take a break

Fatigue

  • Get enough sleep each night
  • Take a nap
  • Try not to push yourself for two to four weeks

Constipation (sluggish bowels), gas, stomach pain

  • Drink plenty of fluids
  • Gradually change your diet
  • See a dietitian
  • Add fiber to your diet: fruit, raw vegetables, whole grain cereal

Nicotine Replacement Therapy (NRT)

Nicotine replacement by any method has been shown to double the quitting success rate. Currently, the two forms of nicotine replacement available are the patch and gum. These products can help ease your body off nicotine in a slow, controlled manner. Both have the advantage of meeting nicotine cravings while freeing smokers of the thousands of other toxic compounds found in tobacco smoke.

NRT makes it easier to avoid smoking by replacing some of the nicotine obtained from tobacco. With this type of therapy, nicotine blood levels are not at the accustomed height. Withdrawal symptoms like the cravings caused by not using tobacco are still reduced. NRT supplies nicotine more safely, without the harmful ingredients contained in tobacco smoke. NRT is available in Canada in the form of nicotine gum and nicotine patches.

Should I avoid nicotine replacement therapy (NRT)?

People with the following conditions should not use NRT products, according to the manufacturers.

Nicotine transdermal (skin) patches are often preferred to gum because they are simply easier to use. Several patches with different recommended doses and lengths of treatment are now on the market.

Skin patches provide nicotine at therapeutic levels in a way that is not obvious. Nicotine passes through a membrane and is absorbed by the skin and into the circulation system. The membrane in the patch controls the rate at which the nicotine enters the body. The patch is particularly recommended for people who have strong morning cravings for nicotine. Since nicotine is absorbed through the skin during sleep, morning cravings are reduced or eliminated.

Patches are usually tolerated well. Some people do report allergies to the adhesives or have irritation around the patch area. Smoking while using the patch can lead to serious side effects, since too much nicotine is introduced into the body. Taking the patch off to have a cigarette won’t help since the nicotine is already in your system. Another side effect is nightmares or vivid dreams.

Nicotine gum is available in two different doses - 2 and 4 milligrams. The 2-milligram gum is recommended for people who smoke up to 20 cigarettes per day. Heavier smokers should start with the stronger gum. The gum should be used on a regular schedule of about one piece per hour while awake. No more than 30 pieces of the 2-milligram gum or 20 pieces of the 4-milligram gum should be used in a 24-hour period.

To avoid problems, the gum must be chewed a certain way. Chew two or three times, then ‘park’ the gum between the cheek and the gums for one minute while the nicotine is absorbed. Repeat the same process for 30 minutes while chewing each piece of gum. To absorb the nicotine effectively, it is important not to eat or drink anything other than water for 15 minutes before and throughout chewing.

Side effects such as oral pain or irritation, hiccups, stomach acid reflux (backward flow), and jaw pain are usually mild and temporary. They usually disappear when users achieve the proper ‘chew and park’ technique. Nicotine gum may work well for those concerned about weight gain caused by quitting. When nicotine gum is used, the weight gain often associated with stopping smoking does not occur until the end of treatment.

Health Canada approved buproprion HCl for use as a stop-smoking medication in 1998, in the form of a sustained-release (SR) tablet. Sustained-release provides gradual but continual release of the medication. It is the first non-nicotine-based pill approved by government for quitting smoking. Buproprion appears to block the breakdown of dopamine in the brain. The level of dopamine in the brain increases and becomes more constant. The cravings associated with low levels of dopamine from cigarettes are reduced. Many people find that after a few weeks on buproprion, the cravings for cigarettes slowly subside or go away.

For this treatment to be effective, you must begin taking buproprion before you quit smoking. Buproprion therapy is usually started in a dose of 150 milligrams per day for three days. The dose is then increased to 150 milligrams twice a day. The quit date should be set for one to two weeks after buproprion therapy is started. Medication should be continued for a total of 10 to 12 weeks.

Although it is quite effective, buproprion is not for everyone. People on anti-depressant medications or with a history of seizures should talk to their doctor before taking this drug. It should not be combined with alcohol because of the increased risk of seizures. The most common side effects include nausea, insomnia, disturbed sleep, headache, and skin rash.

Combination Therapy: Buproprion and the Patch

While you may choose to use either NRT or buproprion alone, combining the two may be more effective. In theory, using buproprion and the patch together makes sense. Buproprion works on chemicals in the brain while NRT tapers the body’s physical need for nicotine. Recent studies suggest that using the patch with buproprion at the start of therapy is more effective than using one method alone. Smokers who wore a low dose patch for the first few weeks of quitting had a higher success rate than those using just the patch or just buproprion.

One concern with using them together is the risk of increased blood pressure.

Be sure to discuss combination therapy with your doctor before you start. Do not smoke at any time when using the patch. Since cost is a factor combination therapy is not an option for everyone, and may not suit the needs of those who smoke less than seven cigarettes a day.

Other Drugs

Newer, more effective treatments such as Zyban™ and NRT have phased out other prescription drugs. Some past treatments and reasons why they are no longer used are listed below.

Silver Acetate, which causes cigarettes to have a bad taste, was used as a stop smoking aid for many years. However, research does not support its use.

Alprazolam (Xanax™) and other benzodiazepines have been used to reduce anxiety associated with nicotine withdrawal. However, treatment with these medications has not been shown to improve rates of quitting smoking.

Clonidine (Catapres™) seemed at first to be useful in the treatment of nicotine withdrawal, but long-term quit rates did not improve when this drug was used alone.

Buspirone is a non-benzodiazepine tranquilizer that may help patients with tobacco withdrawal anxiety. It is generally used early to support therapy.

Internet Resources

American Cancer Society - www.cancer.org
American Lung Association - www.lungusa.org
Canadian Cancer Society - www.cancer.ca
Heart and Stroke Foundation - www.heartandstroke.ca
Canadian Lung Association - www.lung.ca
CDC’s Tobacco Information and Prevention Source (TIPS) -
www.cdc.gov/tobacco
Health Canada -
www.hc-sc.gc.ca/hecs-sesc/tobacco/index.html
Kickbutt - www.kickbutt.org
The QuitNet - www.quitnet.com
Tobacco BBS - tobacco.org/
Try to Stop - www.trytostop.org
Zyban SR (Buproprion) - www.zybanplus.ca
Habitrol - www.habitrol.com
Nicoderm - www.nicoderm.ca
Nicorette - www.nicorette.ca

Coping with psychological cravings

NRT and buproprion help you control your body’s physical nicotine addiction. However, you must also cope with the mental habit. You likely associate certain activities or times with smoking. A cigarette with your morning coffee, or with a drink at the bar, may have become part of your routine. Unless you change your lifestyle to avoid these associations, it is easy to fall prey to old habits. So to quit successfully, you must also mentally break the habit.

For instance, if you usually smoke after dinner, try going for a walk instead. If idle hands crave a cigarette while watching TV, keep them busy with knitting. You are the only one who can change triggers related to your smoking habits.

Even after you have quit successfully, expect the temptation to arise even more than a year after your last cigarette. If this happens, remind yourself that you are a non-smoker. If you are experiencing a moment of weakness, leave the situation and find something else to do. Thinking it’s possible to have ‘just one’ is the main reason why people start smoking again.

If you have the will, there are many different ways to help you successfully quit smoking. While over-the-counter and prescription products can help make things easier, you must want to be a non-smoker.

Just as there are many effective methods for quitting smoking, there are many different people who quit smoking. You have your own special requirements and needs. Decide which option is best for you. Regardless of what method you use, you must first be ready to quit.

Becoming smoke-free is challenging, but with determination and assistance you can be successful. Quitting smoking offers a new sense of freedom and personal achievement, and the health benefits will last a lifetime.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specifid medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physican promptly. Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6  [PC_FHa04]
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