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The long-term adverse effects of smoking are well documented. Nurses, however, realize that in the absence of symptoms, patients find it difficult to visualize themselves living with a chronic illness not yet present. Therefore, it may be useful to discuss the short-term symptoms of tobacco use affecting smokers. When a person smokes, the following physiological processes occur:
- an increased heart rate of 15-25 bpm (can present with tachycardia and chest palpitations)
- an increased blood pressure of 10-20 mm Hg
- corrosion of the lip and palate mucous membranes
- sensation of choking in the airways and shortness of breath
- carbon monoxide enters the system, depriving tissues of oxygen. (This may result in decreased energy level and exercise intolerance)
- a morning cough
- increased gastric acid flow which may lead to gastric ulcers
- periodontal disease
- increase in nervousness or anxiety levels
- impotence and infertility
- exacerbations of asthma
- premature skin aging
Discussing the above symptoms may help the patient appreciate the daily impact of smoking that will eventually result in the debilitating and deadly diseases identified in the introduction.
Advantages of Smoking Cessation
Focusing on the short-term benefits of smoking cessation may be more motivating to a patient than emphasizing the long term prevention of chronic illnesses, especially if the patient is of a younger age. Listed below are some positive short term changes that occur. The long-term risks of smoking are also listed for the nurse to reinforce.
- Within two hours after smoking cessation, the blood pressure and pulse start to normalize and the body temperature of extremities increases.
- Within four hours after the last cigarette the CO (carbon monoxide) level returns to normal. (Carbon monoxide, the same poison that is present in exhaust fumes from cars and faulty furnaces, is present in the smoke from cigarettes and is readily inhaled.
- Within eight hours, indigestion and dyspepsia improve and the oxygen level in the blood increases.
- Within 24 hours, the chance of a myocardial infarction decreases and returns to baseline as a nonsmoker at one year.
- Within 48 hours, the nerve endings in the oropharyngeal area are stimulated and the sense of taste and smell improve. (This means home, car, and breath will smell better!)
- Within 72 hours, the bronchial tubes relax and a person feels less dyspneic; lung function and capacity increase. (The patient will feel better physically and have greater endurance in sports.)
- Within one to nine months, the cilia in the bronchus regain function, thereby decreasing the chance of developing bronchitis and emphysema. (Morning cough will gradually subside.)
- By 10 years, the chance of lung and other cancer decreases (but never reaches the level of a nonsmoker) and the chances of myocardial infarction, stroke, cancers of the larynx, oral cavity, pharynx, esophagus, bladder, or cervix, are reduced. The risk of smoking-related cancers decreases more slowly after smoking cessation than the risk for coronary artery disease.
Additional benefits of smoking cessation, especially important for youth, include the absence of bad breath, improved endurance in sports, more pocket money, and freedom from dependence on nicotine.
The "Take Home Message" includes the notion that positive changes occur in the body and mind when a person quits smoking and that the changes start immediately and continue on for years if the patient remains smoke-free. This subsequently leads to an improved daily functional status, a higher quality of life and a reduced death rate!
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