Smoking Cessation

Are hookahs safe for teens?

DEAR DOCTOR K: You recently wrote about e-cigarettes not being safe for teens. What about hookahs? I don't completely understand what they are. Are they OK for my teen? I think he might be smoking them.

DEAR READER: A hookah is a water pipe that people use to smoke a specially made tobacco. Often the tobacco used in hookahs is flavored, which makes smoking it more attractive to some people. A hookah uses coal to burn the tobacco. This creates either smoke or a vapor that is inhaled through a tube.

What exactly are e-cigarettes? Are they safe?

DEAR DOCTOR K: I caught my son and his friends smoking e-cigarettes. My son tells me I have no reason to worry, and that they're safer than regular cigarettes. What exactly are e-cigarettes? Are they safe?

DEAR READER: E-cigarettes are battery-operated devices that look like cigarettes. They are built around a heating element, a cartridge that contains nicotine and other chemicals, and an atomizer that converts the chemicals into a vapor. Instead of inhaling smoke from e-cigarettes, the user inhales this vapor. (This is sometimes called "vaping.")

What nicotine replacement options can help me quit smoking?

DEAR DOCTOR K: I've been trying to quit smoking with nicotine replacement patches, but it hasn't worked. Any suggestions?

DEAR READER: Smoking may be the toughest unhealthy habit to break, but it is possible. There are more ex-smokers in the United States today than there are smokers. There are two main obstacles that make cigarettes particularly hard to quit: First is the physical withdrawal from nicotine. Second is the psychological withdrawal from a habit that has become part of your daily routine.

As a longtime smoker should I be screened for lung cancer?

DEAR DOCTOR K: I'm a longtime smoker. Do I need to be screened for lung cancer even if I don't have any symptoms?

DEAR READER: Until recently, my answer would have been "no." In the not-too-distant past, screening of people without symptoms -- even smokers who were at high risk -- was judged useless for lung cancer. That's because screening for lung cancer involved using standard chest X-rays, and they produced too many "false positive" results: They identified "spots" in the lungs that were harmless.

Are electronic cigarettes safe?

DEAR DOCTOR K: After smoking for more than 15 years, I finally quit eight months ago. But I still miss my cigarettes. I recently heard about electronic cigarettes. Are they safe?

DEAR READER: I've been getting a lot of questions lately about electronic cigarettes, or e-cigarettes, from my patients. Like you, my patients want to know if they're a safe alternative to cigarettes. The truth is that nobody knows if e-cigarettes are safe. That's because e-cigarette makers have not submitted their products for FDA approval, which would require proof of safety and effectiveness. Ads claim e-cigarettes help people stop smoking, but I'm not aware of any strong evidence to back this up.

How can I help my teenage son quit smoking?

DEAR DOCTOR K: I recently discovered that my teenage son is smoking. How can I help him quit?

DEAR READER: Parents can do many things to help their teens quit smoking. First and foremost, if you smoke, stop. It will be hard for your teen to take you seriously if you're telling him to do something you won't do.

Can medications help me quit smoking?

DEAR DOCTOR K: I've tried to quit smoking on my own, but it never lasts. Could medications help? How do they work?

DEAR READER: Medicines can help, and they have improved "quit rates." Although smoking is a particularly hard habit to break, you can do it. The proof: There are more ex-smokers in the United States today than there are smokers.

What are the health effects of secondhand smoke?

DEAR DOCTOR K: My husband smokes. Is secondhand smoke really as dangerous for me as I've heard?

DEAR READER: When I first became a doctor, very few people thought that secondhand smoke affected your health. I was one of the skeptics. It just seemed like the amount of smoke you take into your lungs when you smoke is so much more than when you are with a smoker.

Is smokeless tobacco safe?

DEAR DOCTOR K: Is smokeless tobacco safer than cigarettes? What about other non-cigarette tobacco products?

DEAR READER: It's tempting to think so, but there is no safe way to use tobacco. Any level of tobacco, in any form, increases your risk of heart attack, stroke, emphysema, chronic bronchitis, pneumonia, lung cancer and other cancers. Don't fool yourself into thinking that any tobacco products are safe to use.

How can I quit smoking?

DEAR DOCTOR K: I have tried to quit smoking several times but just can't. The patch and Chantix didn't work. Support groups aren't for me. Are there any other approaches that might help?

DEAR READER: Keep trying. It often takes smokers several tries before they are successful. I spoke to my colleague, Dr. Thomas Lee, editor-in-chief of the Harvard Heart Letter, who has heard this question from many of his patients. Here are our thoughts.