Smoking Cessation

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.

How can I control my chronic bronchitis?

DEAR DOCTOR K: After years of smoking I've developed chronic bronchitis. Every morning I cough up lots of mucus. What can I do to control this cough?

DEAR READER: Chronic bronchitis is a common form of chronic obstructive pulmonary disease, or COPD. COPD refers to a group of disorders that damage the lungs and make breathing increasingly difficult over time. Most cases of COPD are related to cigarette smoking.

Battle to quit smoking is fought on many fronts

DEAR DOCTOR K: At a recent medical visit for my heart condition, my doctor urged me again to quit smoking. At 70, I've quit repeatedly without lasting success. I've tried the patch. I've tried medicine. Neither has worked. Support groups aren't for me. Being told over and over that I need to quit smoking just leaves me feeling depressed and weak. Can you offer me any hope?

DEAR READER: Yes, absolutely! The fact that you've tried so hard to quit smoking is a good sign: Wanting to quit is the necessary first step. I know you feel discouraged right now. I've had many patients in exactly your situation who have successfully become ex-smokers. That's why I'm going to encourage you to try again.