Smoking and cancer

Cancer is a major cause of death and illness in Ireland and many other countries. Your chances of getting the cancers listed below are higher (in some cases much higher) if you smoke.

• Lung cancer
  
  Lung cancer is one of the most common cancers in Ireland.  In 2011, 2,175 people developed lung cancer and 90% of these cases are directly caused by smoking.
  
  It is not only smokers who are affected. Non-smokers who breathe in other people’s tobacco smoke, or ‘second-hand’ smoke, have an increased risk of lung cancer. Children and teenagers exposed to second-hand smoke may be particularly at risk of lung cancer later in life as well as have an increased risk of asthma and other respiratory problems.

  Find out more about lung cancer

• Mouth, head and neck cancer
  
  Smoking is a major cause of cancers of the oral cavity (tongue, lips, gums) and mouth, head and neck cancer. Find out more about mouth, head and neck cancer.
• Cancer of the stomach
  
  When you inhale cigarette smoke, you will always swallow some of it without meaning to. Consequently, the risk of developing stomach cancer is higher among smokers. Find out more about cancer of the stomach.
• Cancer of the pancreas
  
  Smoking is at least a contributory and may be a causal factor in the development of cancer of the pancreas. Find out more about cancer of the pancreas.
• Cancer of the kidney
  
  Smoking is also at least a contributory and may be a causal factor in the development of cancer of the kidney. Find out more about cancer of the kidney.
• Cancer of the womb (uterus)
  
  Smoking increases the risk of developing this type of cancer. Find out more about cancer of the womb.
• Cervical cancer
  
  Women who smoke have a greater risk of developing cancer of the cervix. Find out more about cancer of the cervix.
• Cancer of the bladder
  
  Smoking has been identified as a risk factor for cancer of the bladder. Find out more about cancer of the bladder.
• Cancer of the colon
  
  Recent studies show that cigarette smoking can lead to colon cancer, also known as bowel or rectal cancer. Find out more about cancer of the colon.
• Myeloid leukaemia
  
  Smokers have an increased risk of developing myeloid leukaemia. 
   

Your heart is your body’s engine, pumping blood to all vital organs. Smoking damages that engine by:

• Increasing your heart-rate and therefore, increasing your requirement for oxygen in the blood.
• Introducing carbon monoxide into the blood. This may contribute to the development of coronary heart disease and possible heart attacks.
• Increasing the risk of blood clot.
• Hardening and narrowing of the arteries, reducing blood flow to the heart.

Smokers are more likely to have a stroke (blockage of blood to the brain or bleed in the brain) than non-smokers. Strokes are a major cause of death and prolonged disability.

Smoking can cause or worsen these serious respiratory conditions. Severe emphysema causes breathlessness, which can be made worse by infections.

Smoking can reduce fertility, and smoking during pregnancy can lead to miscarriage, stillbirth and illness in early infancy.

Secondhand smoke is a combination of:

• mainstream smoke – the smoke that is inhaled and then breathed out by the smoker.
• sidestream smoke – the smoke that comes from the burning end of the cigarette and is far more dangerous than the mainstream smoke inhaled by the smoker as it contains higher concentrations of harmful chemicals.

Only a small amount (15%) of smoke from a cigarette is inhaled by the smoker; the rest of it goes directly into the air

• Environmental tobacco smoke (ETS).
• Passive smoke.

Secondhand smoke increases the risk of lung cancer and heart disease in non-smokers. It puts people suffering from breathing disorders and heart disease at particular risk and it makes illnesses such as asthma and chronic bronchitis worse.

Adults and children who live in a smoky home are at greater risk of the following:

• coughing and wheezing.
• chest infections (such as pneumonia and bronchitis).
• severe asthma.
• middle ear infections and glue ear (may cause partial deafness).
• cot death (sudden infant death syndrome).
• absence from school due to illness.

The risk of these problems is greatly reduced as soon as the individual is no longer breathing in secondhand smoke.

If you are a smoker...

Quitting smoking is the most important thing you can do for your own health. But if you are not ready to quit smoking you can still protect your family and friends from the harmful effects of secondhand smoke.

• Never smoke around your children.
• Always try to smoke outdoors and away from children.
• Make your car smoke-free; smoking is more concentrated in a small space, which makes it more harmful.
• Try and make you home smoke-free. Start by making the bedrooms smoke-free, then try to make the family rooms smoke-free.

If you are not a smoker...

• Ask your smoking visitors or family members not to smoke around yourself or your children and to smoke outdoors.
• If someone minds your children in their own home, ask them to keep it smoke-free or not to smoke around your children.

Smoking in the presence of young children can cause them serious illness and may make them more likely to suffer health problems in later life.

Why are children who share a home with smokers at risk?

• Children are more at risk because their immune systems, which protect them from getting sick, are not fully developed.
• It is more difficult for young children to avoid or complain about secondhand smoke.

Children depend on adults to make sure their air is smoke-free.

What can I do to protect my children from secondhand smoke?
As a parent, quitting smoking is one of the most important things you can do for the health of your child.

Children are twice as likely to smoke if their parents smoke.

Smoking in the presence of a pregnant woman may endanger the health of the fetus (unborn baby) and mother.

If you smoke when pregnant there is an increased risk of harm to the unborn baby.

• Smoking when you are pregnant increases the risk of cot death, miscarriage and other pregnancy complications.
• Smoking around an infant increases the risk of cot death

It’s good for your health

Everyone knows you feel better when you give up smoking. But did you know that the health benefits kick in almost immediately and accumulate over time? Here’s a summary of what happens to your body when you quit (Data source: US Surgeon General’s Office):

• After 20 minutes: your blood pressure and pulse rate return to normal. Circulation improves in hands and feet.
• After 8 hours: oxygen levels in the blood return to normal and your chance of heart attack starts to fall.
• After 24 hours: poisonous carbon monoxide gas is eliminated from the body. The lungs start to clear out mucous and other debris.
• After 48 hours: nicotine is no longer detectable in the body. Taste and smell improve.
• After 72 hours: breathing becomes easier as the bronchial tubes relax and energy levels increase.
• After 2 weeks: circulation improves, making walking and exercise easier.
• After 3 to 9 months: coughing, shortness of breath and wheezing are reduced dramatically.
• After 5 years: risk of heart attack falls to that of a non-smoker.
• After 10 years: risk of lung cancer falls to about half that of a smoker.

Remember, quitting smoking may well be the single most important thing you can do to improve your health.

When you quit smoking, you save money!

If you can get through the first 30 days without cigarettes, you’ll have gone a long way towards kicking the habit.

The temptation will be great, so here are some coping strategies to help you stay off the cigarettes:

• Pick a day: Pick a day to quit when you won’t be under too much pressure or stress.
• Throw it away: On the evening before, throw away all cigarettes, lighters, and ashtrays.
• Distract your hands: Find a way to occupy your hands (e.g., stress ball, rubber bands) and mouth (e.g., low-calorie nibbles, fruit, sugar-free chewing gum).
• Look after your mouth: Do things to maintain a clean mouth taste, such as brushing your teeth frequently, chewing gum or using a mouthwash.
• You are taking control: Remind yourself that this is a choice you made – you chose not to smoke and you’re in control.
• Steel yourself against temptation: Having answers ready if someone offers you a cigarette. Practise saying, “No thanks, I don’t smoke”. Or if someone is persistent: “No thanks, I’ll have one later”, or “I’ve a bit of a sore throat”.
• Start a savings jar: Put in the amount you would normally spend on cigarettes. Write or stick a picture on it of what you are saving for. Check out our savings calculator below.
• Know what to avoid: Try to avoid the places or situations that will remind you of smoking.
• Get active: Take up a sport or get active by walking or cycling. You’ll find it easier when you don’t smoke and you’ll feel better for it. Click here for the benefits of getting active.
• Treat yourself: Plan a treat such as the cinema or a meal out for yourself and your supporters.
• One day at a time!: Don’t think too far ahead. Each day without a cigarette is another success.
• Find a treatment that helps: Finally, ask your stop smoking practitioner, doctor or pharmacist about medications that can help take the edge off the nicotine cravings. There are a range of nicotine replacement therapies, such as gum, inhaler, patch, mouth spray or lozenge which can be bought over the counter.

Tips for Dealing with Cravings

Follow the 5 D’s!

1. Distract – distract yourself by focusing on something else
2. Delay – delay doing anything about the craving until the urge passes
3. Deep breaths – Take 20 deep breaths
4. Drink water – drink a cold glass of water or fruit juice
5. Don’t dwell on it – You can confuse cravings for food with cravings for nicotine and vice versa. It’s important to eat 3 regular meals a day.

Giving up smoking is a process. Knowing where you are in that process can help you decide what to do next to stop smoking.

The quitting smoking cycle has many stages. Some smokers move through the cycle faster than others. Ask yourself where you fit in the cycle outlined below and then see what you can do to move forward.

Cycle of Change – where do you fit in?

1. Not ready to stop
   
   You may not have considered stopping and may be unaware in a specific sense of the health risks and consequences of smoking.
2. Thinking about stopping
   
   You are no longer happy to be smoking. You know you should stop but still feel drawn to cigarettes. If you’re at this stage, write down your reasons for smoking and your reasons for quitting. For example, you might think that smoking might help you relax or give you something to do with your hands. Weigh these up against the reasons for quitting, like better health, whiter teeth, fewer wrinkles and major cost savings.
3. Preparing to quit
   
   You are getting ready to stop and are motivated enough to make some changes to your lifestyle. Smoking is often linked to certain situations, such as drinking coffee, walking the dog or watching a sporting event. We can call these ‘trigger’ events. Keep a diary of the cigarettes you are smoking and what your triggers for smoking are. Then work out and plan how you are going to cope in these situations. Plan new activities to replace smoking.
   
   Finally, pick your date to stop, a day that you are not under too much stress. Get rid of all your cigarettes from the house. Clean ashtrays and clean your home in preparation for its new smoke free life.
4. Quitting
   
   Put your plans into action. Changing routine is one of the key elements to successful quitting, for example:
   
   -Change your usual drink from coffee or tea to fruit juice or water.
   -Get up from the table once you’ve finished your meal.
   -Instead of smoking at night while watching television, keep busy by going to the cinema or for a walk.
   -Avoid the triggers for the first couple of weeks until you’re comfortable with your new no-smoking routine.
   
   Finally, ask your stop smoking practitioner, doctor or pharmacist about medications that can help take the edge off the nicotine cravings. There are a range of nicotine replacement therapies, such as gum, inhaler, patch, mouth spray or lozenge which can be bought over the counter.
   
   It is important to stay motivated and believe that you can succeed. Remember, hundreds of people every year successfully give up smoking – people just like you.
5. Being a non-smoker
   
   You become more comfortable with the changes you have made in your lifestyle. For successful quitters these changes become a new way of life. You are no longer thinking about smoking.
6. Relapsing
   
   Having a drink socially, being with friends who smoke or coping with stress can make you slip. But all is not lost if this occurs. Remember many smokers relapse before they quit for good. Return to the reasons you wanted to stop smoking in the first place and prepare to quit again.

here are treatments available to help you quit. These are designed to make quitting more comfortable and to reduce the symptoms of withdrawal.

Using the products below as directed can double your chances of quitting. Many of the treatments listed below are available free to medical card holders.

• Nicotine replacement therapies.
• Non-nicotine replacement therapies.

Nicotine replacement therapies

Nicotine-replacement therapy replaces a small amount of the nicotine that your body misses when you quit. It's designed to replace just enough nicotine to ease your cravings and withdrawal symptoms.

Nicotine replacement therapy can take various forms. Ask your pharmacist for advice on the therapy that suits you best.

Nicotine gum

Nicotine gum replaces some of the nicotine previously obtained from smoking but at lower levels. These levels are just enough to help relieve withdrawal symptoms and to help concentrate breaking the habit. There are two strengths of gum: 4mg for the heavier smoker and 2mg for those who smoke less. It is important to use the correct strength of gum and the correct technique.

Patch

There are various brands of patch available, some of which are of varying strengths to help you gradually reduce your dependency on nicotine. Talk to your pharmacist for information on the patch and on which one you should use.

Inhaler

This consists of a plastic holder and a cartridge, which contains nicotine. You can draw on it like a cigarette and nicotine is absorbed through the lining of your mouth. The inhaler is the most suitable for people smoking 20 cigarettes or fewer per day.

Lozenge

The lozenge should be sucked until the taste becomes strong and is then lodged between the cheek and gum of the mouth. When the taste fades it should be sucked again and the process repeated until the lozenge dissolves, in 20 to 30 minutes. Always read the label for clear instructions.

Mouth spray

This gives an instant release of nicotine that gets to work on cravings in 60 seconds. The fresh tasting minty spray provides small doses of therapeutic nicotine to help manage the nicotine withdrawal cravings when quitting. Always read the label for clear instructions.

It's important that you don't smoke when using nicotine replacement therapies.

Non-nicotine medication

Champix

Champix is a pill (non-nicotine) designed to help you stop smoking; it's available on prescription from your GP.

Zyban

Zyban is another non-nicotine smoking-cessation drug that is only available on prescription from your GP.

Not everyone manages to give up smoking at the first attempt. Having a cigarette or two doesn’t mean you have failed. It certainly doesn’t mean you can’t quit smoking.

To get back on track to becoming a non-smoker, here are some tips:

• Be on guard and make plans to get back on track.
• Look back over your reasons for quitting in the first place.
• If you have not already written these down, now would be a good time to do so.

Learn from the experience – what was the trigger that made you light up? Were you having a drink or feeling angry with someone perhaps?

Make a list of things you will do the next time you are in that situation and other tempting situations.

Supporting and encouraging a family member or friend to quit smoking is the greatest gift you can give someone. Recent research has indicated that 85% of smokers feel that the best help that they can receive when quitting smoking is from family and friends. If your friend or family turns to you for support, follow these helpful tips:

• Be encouraging: Wait for them to say it’s time to quit. Then offer your support and ask them how you can help. Let them know how proud you are and have patience. Try to avoid badgering and nagging. Encourage them to talk about their feelings and what they are going through as they quit smoking.
• Give practical help: Help them get what they need. Help them make a ‘Quit Kit’, including stress balls, sugar free gum, straws, toothpicks, mints, toothpaste or anything they might use instead of tobacco. Add pictures of loved ones as motivation to stay quit. Link them to our audio guide podcasts below, top 10 tips for quitting and other information. Provide them with the HSE Quit Team number (Freefone 1800 201 203) or take them along to their GP or pharmacy to consider the various medical stop smoking aids.
• Help them get through cravings: Reminding them of the 4 Ds: Delay at least 3-5 minutes and the urge will pass, Drink a glass of water or fruit juice, Distract move away from the situation, Deep breathe slowly and deeply.
•  Help them stay busy and distracted: This will help take their mind off tobacco use. Make a list of things that you can do together when the cravings are tough like going for a walk, going to the cinema, helping with house work or gardening, cooking a meal together or doing puzzles; sudoku, crosswords and jigsaws.
• Be understanding: You may feel frustrated if your loved one becomes grumpy, irritable or cranky around cravings. Don’t take this personally. Tell them you understand quitting is difficult. Remind them this won’t last forever and this is just one of the positive signs that their body is recovering from the harmful effects of smoking. Remind them of the many benefits of quitting smoking for good.
•  Be a good listener: Reassure them that you are there to listen when they talk about quitting. Remember how far they have come and keep offering help and support.
• Help in dealing with relapses: Stay positive, praise them for trying to quit, and for whatever length of time (days, weeks, or months) of not smoking. “Now you know you can do that much. You can get even further next time.” Remember this is a normal part of the quitting process. Remind them that they didn’t fail – they are learning how to quit. Encourage and support them to quit again. Think of the relapse as practice for the next time and not to lose hope. Remind them again of all the reasons why they wanted to quit in the first place and help them to forget about the relapse as soon as possible.
• Celebrate: Quitting smoking is a big deal! Plan something special together to celebrate the quit date or encourage them to treat themselves now and again with the money they are saving. Celebrate key milestones – one week, one month, one year smoke free!

Additional tips if you too are a smoker:

• Keep all cigarettes, lighters, matches and all reminders of smoking out of sight.
•  Don’t ever offer the quitter a cigarette (even as a joke!).
•  Always smoke outside and away from the person you're helping to quit.
•  Be aware of situations where you would usually smoke together - after a meal, with a drink, at a party, etc.
•  Work together to develop a plan to deal with these situations when they arise.
•  Why not use this opportunity to change your lifestyle and quit yourself? It might be easier to quit with someone who is trying to quit too!