By Dr. Sanjay Gupta

Smoking is a practice in which a substance is burned and the resulting smoke is breathed in to be tasted and absorbed into the bloodstream. Smoking is one of the most common social addictions among teens and adolescence. Smoking is a hard habit to break because tobacco contains nicotine, which is highly addictive. Like heroin or other addictive drugs, the body and mind quickly become so used to the nicotine in cigarettes that a person needs to have it just to feel normal.

Not only smoking cigarettes has a bad effect on the health, but even other forms of smoking such as hookahs & E-cigarette are equally bad for health. Hookahs are no safer than cigarettes — and since they don’t have filters and people often use them for long periods, the health risks might be even greater. Hookahs are usually shared, so there’s the additional risk from germs being passed around along with the pipe. Similarly, E-Cigarettes are also harmful, which contains cancer-causing chemicals and other toxins, including a compound used in antifreeze. These battery-operated devices use cartridges filled with nicotine, flavorings, and other chemicals and convert them into a vapor that’s inhaled by the user.

Effects of smoking on health

Anything taken from outside, which isn’t needed, has a bad effect and the body develops a defense against it. So, first-time smokers often feel pain or burning in the throat and lungs, and some people feel sick or even throw up the first few times they try tobacco. Over the long term, smoking leads people to develop health problems like heart disease, stroke, emphysema (breakdown of lung tissue), and many types of cancer — including lung, throat, stomach, and bladder cancer.

Other effects are:

  • Bad breath
  • Bad smelling clothes and hair
  • Reduced athletic performance
  • Great risk of injury and slow healing process
  • Increased risk of illness




It is never too late to quit smoking. Quitting smoking is the most important step to protect your lungs. As soon as you quit smoking, positive changes start in your body.

The benefits of cessation of smoking are:

  • Prolong your life
  • Improve your health (Smoking increases your risk of lung cancerthroat canceremphysema, heart disease, high blood pressureulcersgum disease and other conditions.)
  • Feel healthier (Smoking can cause coughing, poor athletic ability and sore throats.)
  • Look better (Smoking can cause face wrinkles, stained teeth and dull skin.)
  • Improve your sense of taste and smell
  • Save money

Benefits to the body start as soon as someone starts quitting smoking.

After 20 minutes

  • Blood pressure and pulse decrease
  • The temperature of hands and feet increases

After 8 hours

  • The carbon monoxide level in blood returns to normal
  • Oxygen levels in blood increase

After 24 hours

  • Chance of heart attack decreases

After 48 hours

  • Nerve endings adjust to the absence of nicotine
  • Ability to taste and smell begin to return

After 72 hours

  • Bronchial tubes relax

After 2 weeks to 3 months

  • Circulation improves
  • Exercise tolerance improves

After 1 to 9 months

  • Coughing, sinus congestion, fatigue and shortness of breath decrease
  • Cilia re-grow, increasing the ability of the lungs to handle mucus, clean the lungs and reduce infection
  • Overall energy level increases

After 1 year

  • Risk of heart disease decreases to half that of a current smoker
  • After 5 years
  • Risk of stroke is reduced to that of people who have never smoked

After 10 years

  • Risk of dying from lung cancer drops to almost the same rate as a lifelong NON-smoker
  • The incidence of other cancers – of the mouth, larynx, esophagus, bladder, kidney and pancreas – decreases

Process for smoking cessation

All patients should be asked about tobacco use and assessed for motivation to quit at every clinical encounter. Physicians should strongly advise patients to quit smoking, and use motivational interviewing techniques for patients who are not yet willing to stop smoking. Patient should be explained about benefit of smoking cessation at every encounter unless they are motivated for quitting. Once they are motivated, they should be given option for treatment.

Steps for Smoking Cessation Process


Every patient who visits the clinic should be asked about their smoking habit, so that smoking cessation advice can be given.


To the smoking patient, counseling should be done regarding harms of smoking and benefits after they quit smoking. It should be done at every visit.


Patients’ motivation to quit smoking should be assessed at every visit. Patients not yet willing to quit should receive a motivational intervention. This process should be continued unless they are motivated to quit.


Once the patient is motivated, they need assistance in the form of counseling, and medication if necessary. Nicotine withdrawal symptoms, depression, and weight gain are specific areas in which patients may benefit from clinical guidance.

Arrange for follow up:

Once the patient quits smoking, they  should be congratulated on their abstinence and should be in regular contact which increases abstinence rate. Patients who are unable to quit or who relapse should be reassessed. Pharmacologic therapies and additional behavioral counseling should be considered, and patients should be encouraged to set a new quit date.

Available medication:

  • Nicotine replacement therapy
  • Bupropion
  • Varenicline
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