Chapter List

• Introduction to Age Erasers for Women
• Stop the Clock
• Age Spots
• Allergies
• Anger
• Arrhythmias
• Arthritis
• Back Pain
• Binge Eating
• Bladder Problems
• Burnout
• Bursitis and Tendinitis
• Cellulite
• Depression
• Dieting
• Double Chin
• Drinking Problems
• Drug Dependency
• Eating Disorders
• Endometriosis
• Fatigue
• Fibroids
• Foot Problems
• Hair Loss
• Heart Attack
• Heart Disease
• Hemochromatosis
• High Blood Pressure
• Hysterectomy
• Infertility
• Midlife Crisis
• The Pill
• Respiratory Diseases
• Sex Problems and Stds
• Smoking
• Snoring and Sleep Apnea
• Stress
• Stroke
• Television
• Thyroid Disorders
• Type A Personality
• Unwanted Hair
• Varicose Veins
• Vision Changes
• Worry
• Wrinkles
• Adventure
• Aerobics
• Affirmations
• Alcoholic Beverages
• Altruism
• Antioxidants
• Aspirin
• Breakfast
• Breast Care
• Calcium
• Career Change
• Change and Adaptability
• Confidence and Self-Esteem
• Cosmetic Dentistry
• Cosmetic Surgery
• Creativity
• Fiber
• Fluids
• Forgiveness
• Friendships
• Goals
• Honesty
• Hormone Replacement Therapy
• Humor
• Immunity
• Learning
• Leisure Time
• Low-Fat Foods
• A Litany of Low-Fat Foods
• Makeup
• Marriage
• Massage
• Medical Checkups
• Optimism
• Relaxation
• Religion and Spirituality
• Resistance Training
• Sex
• Skin Care
• Sleep
• Stretching
• Vegetarianism
• Vitamins and Minerals
• Yoga
• Credits
• Gray Hair Rethinking Your True Colors
• Biological Clock
• Body Image
• Caffeine
• Cancer
• Cholesterol
• Dental Problems
• Diabetes
• Digestive Problems
• Hearing Loss
• Injuries and Accidents
• Memory
• Menopausal Changes
• Metabolism Changes
• Migraines
• Osteoporosis
• Overweight
• Premenstrual Syndrome
• Reaction Time
• Skin Cancer
• Ulcers

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Smoking

Smoking

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Clear the Air and
Put Time on Your Side

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If you're among the millions of women who started smoking as teenagers because they wanted to look and feel older, you got your wish--and maybe more than you bargained for. Nothing ages your appearance, spirit and health more than America's most practiced and most dangerous vice.

Just ask Elizabeth Sherertz, M.D., a dermatologist and researcher at Bowman Gray School of Medicine of Wake Forest University in Winston-Salem, North Carolina. "We found that on average, smokers tend to look between five and ten years older than their actual ages because of the wrinkles caused by smoking," she says. "People who smoke are more likely to develop wrinkles, because smoking damages the elastic tissue that keeps skin tight and probably also enhances the sun's damaging effects to the skin."

Or ask Richard Jenks, Ph.D., a sociologist at Indiana University Southeast in New Albany who studies the effects of smoking on our emotional state, who found that once again, puffers suffer. "Smokers know that their habit is a sure road to health problems, and they're actually even more likely than nonsmokers or ex-smokers to describe it as dirty," he says. "But what my study found was that smokers tend to feel they have less control over their lives, and feel less satisfied with their lives, than nonsmokers."

Or ask any other researcher or doctor who has ever studied the effects that smoking has on our physical and emotional well-being. Study after study--and there have been hundreds of them--backs up what experts already know: If it doesn't kill you--and one in five people worldwide dies from smoking-related diseases each year--it will most certainly take years off your life. Says Margaret A. Chesney, Ph.D., a women's health and smoking researcher and professor at the University of California, San Francisco, School of Medicine, "If you want to radically slow down the aging process and live longer, stop smoking."

A Tough Battle for Women

But that's easier said than done--especially for many of us. "When the surgeon general's first report on smoking and health was published in the 1960s, twice as many men as women were smoking," says Douglas E. Jorenby, Ph.D., coordinator of clinical activities for the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School in Madison. "Today, the smoking rate between men and women is almost even, and in the next few years, it will probably cross for the first time--and there will be more women smokers than men."

In real numbers, that translates to more than 24 percent of American women over age 18 who smoke, down from the 34 percent who smoked when the surgeon general's report came out in 1964. About 28 percent of American men smoke today--a drastic decrease from the 52 percent who smoked in 1964. The alarming bottom line is that because more kids are starting to smoke, the smoking rates will no longer be dropping. And lung cancer now kills more women each year than breast cancer.

Once women start smoking, statistics show we have a harder time quitting--both physically and psychologically. "There is evidence that equal numbers of men and women attempt to quit, but men succeed at about twice the rate," says Dr. Jorenby. "One reason is that women report more depression when they quit smoking, and we know from various studies that depression makes it more likely that you'll go back to smoking."

But, he adds, it seems as though women are less likely to want to quit. "Many women feel so overwhelmed by their families and jobs that a lot of them say cigarettes are their only refuge. And they're hesitant to give that up, even though they know quitting has a big benefit to their health."

Women, particularly those under age 25, have become a major target market for cigarette companies. "One of the big messages behind the advertising to women is that smoking helps you control your weight," says Dr. Jorenby. "In one cigarette advertisement I saw, there was a photo of a model who was already pretty skinny. But the photo was distorted to make her look even thinner--thinner than any human being can really be. The message, which is targeted to women in their teens and early twenties, is obvious: Smoking helps you to be thin and glamorous."

That message seems to be working. While the Centers for Disease Control and Prevention in Atlanta doesn't keep statistics on gender breakdown of young smokers, spokeswoman Suzie Gates of its Office on Smoking and Health says most of the 3,000 people who start the habit each day are females under age 25, and some are as young as 12.

No Weighty Move Here For many women who want to quit smoking, the biggest fear is gaining weight. Well, fret no more, because it's official: According to the Centers for Disease Control and Prevention in Atlanta, when you quit, the average weight gain is about five pounds. And the weight gain can be prevented through a careful diet and stress management. In fact, some people actually lose weight after they quit. For many women, quitting smoking is part of an overall get-healthy program that includes regular exercise and improvements in diet, says Douglas E. Jorenby, Ph.D., coordinator of clinical activities for the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School in Madison.

In the Meantime, Take Your Vitamins While they're no substitution for quitting, antioxidant vitamins have been shown to offer at least some protection against the harmful effects of smoking. Jeffrey Blumberg, Ph.D., associate director of the U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston, recommends these vitamins to keep your immune system strong and offset some of the damage caused by tobacco. Vitamin C. 250 to 1,000 milligrams daily. The Recommended Dietary Allowance (RDA) is 60 milligrams. Good food sources include citrus fruits, broccoli, cantaloupe, red peppers, kiwifruit and strawberries. Vitamin E. 100 to 400 IU daily. The RDA is 12 IU or 8 milligrams alpha-tocopherol equivalents. Good food sources include cooking oils, wheat germ and mangoes. Beta-carotene. 15 to 30 milligrams daily. There is no established RDA. Best sources are yellow-orange and dark green fruits and vegetables such as carrots, sweet potatoes and squash, as well as spinach and other green leafy vegetables.

Smokers Aren't Thinner

Despite what Madison Avenue would have you believe, smokers aren't thinner. True, nicotine slightly curbs the appetite, meaning that smokers consume fewer meals. But when they eat, smokers are more likely than nonsmokers to gravitate toward foods that are higher in calories and fat, says Doris Abood, Ed.D., associate professor of health education at Florida State University in Tallahassee. In her study, which examined the smoking, eating, drinking and exercise habits of 1,820 people, she also found that smokers exercise less and consume more alcohol, which is notoriously high in calories. Dr. Abood and other researchers found that the more people smoke, the more bad habits they practice, and to a greater extent.

Still, regardless of these other habits, it's smoking itself that does the most damage, causing nearly 419,000 deaths a year. It also plays a leading role in scores of diseases, from cancer to colds, from heart disease to hip fractures. "The effects of smoking are distributed so much throughout the entire body that it has an impact on virtually any disease you can think of," says Dr. Jorenby.

Why Smoking Kills

Cigarette smoke contains about 4,000 chemicals, including minute amounts of poisons such as arsenic, formaldehyde and DDT. With each puff, these poisons are inhaled through the lungs--which retain up to 90 percent of the compounds--and then passed through the bloodstream. Some of these poisons, such as carbon monoxide, are the so-called free radicals that rob blood cells of oxygen. Free radicals have been linked to a host of problems, ranging from wrinkles to cancer.

Meanwhile, the nicotine in tobacco smoke causes the adrenal glands to secrete hormones that increase blood pressure and heart rate, which makes your heart work harder--the primary reason why women who smoke are twice as likely as nonsmokers to have strokes and have nearly three times the risk of heart disease. Their risk goes up even more if they take oral contraceptives.

Smoking makes you more susceptible to infectious diseases such as colds and flu, since it damages the cilia, tiny hairlike bodies that trap and sweep out foreign substances from the lungs. Without the cilia to do their work, the tar from cigarettes clogs breathing passages, leading to emphysema and lung cancer. It also hobbles your ability to stay fit, sapping your body and mind of energizing oxygen. On the average, women smokers reach menopause at least one year earlier than nonsmokers, and menopause is associated with higher risk of early heart attack.

But even symptoms associated with smoking do their own damage. For instance, women who smoke have a higher rate of urinary incontinence because of the coughing caused by their habit. "Even if smoking is not a causal factor in a particular disease, it can certainly exacerbate it," says Dr. Jorenby. "For instance, we know that smoking doesn't cause diabetes, but people with diabetes who smoke have a much worse prognosis than those who don't."

Another case in point: A study by British researchers found that smokers with the human immunodeficiency virus develop full-blown AIDS twice as quickly as nonsmokers, although scientists aren't sure why.

How to Quit--For Good

The good news is that some of this damage can be undone. Just one year after you quit smoking, your risk for heart disease is cut in half, and after three years, your risk becomes comparable to that of someone who never touched a cigarette. Your risks for other diseases, such as emphysema, bronchitis and cancer, also diminish. Plus you'll look and feel younger, with more energy and stamina and fewer wrinkles.

Sure, quitting is tough. Fewer than 10 percent of the 20 million smokers who try to quit each year actually succeed, says Rami Bachiman, director of community education for the American Lung Association of New York in New York City. There are various strategies to help you along--keeping your hands busy, chewing on carrot sticks, taking deep breaths of fresh air, drinking lots of water or even rewarding yourself with a present. But here's how you can increase your chances of quitting successfully and not relapsing during those crucial first few weeks.

Log your progress. The first thing you should do is set a deadline up to three weeks away for when you'll have your last smoke. But in the meantime, log each cigarette you smoke--where you smoke and under what circumstances, advises Don R. Powell, Ph.D., president of the American Institute for Preventive Medicine in Farmington Hills, Michigan, and a former smoker. This will help you identify situations that cause you to smoke and then find alternative behaviors other than smoking cigarettes.

Delay the desire. If you are quitting gradually, each time you get the urge to smoke, hold off lighting up for 5 minutes, suggests Dr. Powell. After a few days, extend the delay to 10 minutes. After another few days, extend it to 15 minutes, and so on. "You'll find that the actual urge to smoke at any given moment fades relatively quickly," he says.

Seek support. Whether you're quitting cold turkey or doing it gradually by slowing decreasing the number of cigarettes you smoke, you'll probably fare better if you have a lot of encouragement. "Since they have a harder time quitting, women need as much support as they can get," says Dr. Jorenby. "Having some kind of group support can make a big difference in how you do, whether it's from friends and family or some sort of group therapy." There are probably groups in your area offering free counseling and group therapy for women trying to quit. Contact the local chapter of the American Heart Association for more information.

Drink orange juice. The hardest part of quitting cold turkey, which is the most popular method, is getting through the symptoms of nicotine withdrawal, which last one to two weeks. But you'll get over the irritability, anxiety, confusion and trouble concentrating and sleeping that come with nicotine withdrawal a lot faster if you drink a lot of orange juice during that time.

That's because OJ makes your urine more acidic, which clears nicotine from your body faster, says Thomas Cooper, D.D.S., a nicotine dependency researcher and professor of oral health sciences at the University of Kentucky in Lexington. "Besides," adds Dr. Jorenby, "the citrus taste in your mouth makes the thought of having a cigarette pretty disgusting."

If you're quitting with the aid of doctor-prescribed nicotine gum or patches, however, avoid orange juice and other acidic drinks, because you want to keep nicotine in your system with these products.

Imagine it's the flu. "Before we had nicotine gum and patches, I used to tell people who were quitting smoking to imagine they were having the flu," says Dr. Jorenby. "A lot of withdrawal symptoms are similar to the flu: You fly off the handle easily, you have trouble concentrating, your stamina is down. And as with the flu, there's little you can do other than let it run its course. But you will get over it. As long as you don't relapse and have a cigarette, the withdrawal will be over and done within a week or two."

Stay out of bars. The greatest chance of relapsing occurs in bars, says Dr. Jorenby. "For many people, having a drink in one hand means having a cigarette in the other. I advise that anyone trying to quit stay out of bars for at least the first two weeks after they stop smoking." Instead, he advises, go to libraries, museums and other public places where smoking is prohibited. "People who quit smoking don't have to swear off going to bars, but we know from many studies that they are at much higher risk of going back to smoking unless they stay away for the first few weeks."

Write a letter to a loved one. When a nicotine fit hits, pick up a pen instead of a butt and write a letter to a loved one explaining why smoking is more important than your life, suggests Robert Van de Castle, Ph.D., professor emeritus of behavioral medicine at the University of Virginia Medical Center in Charlottesville. In the letter, try to explain why you continue a habit that you know will kill you rather than quit and live to see a child graduate from college or get married or to witness other important events. When Dr. Van de Castle's patients try this letter, he says, they feel so selfish that it often gives them the courage to put up with withdrawal symptoms and stay smoke-free.

Do Shortcuts Work? Nicotine patches and gum and hypnosis may take some of the sting out of the withdrawal symptoms that come with quitting, but don't expect these aids to replace grit and determination. Smokers who quit with the assistance of these tools are two to three times more likely to succeed than those doing it cold turkey. Although quitting cold turkey is the most popular method, it is also the least successful, having a success rate of only 5 percent. The smoker using nicotine gum or patches plus enrolling in a comprehensive behavioral smoking cessation program increases her chances of stopping and can anticipate a one-year success rate of 23 to 40 percent. Meanwhile, there's a 15 percent success rate using hypnosis. There are some side effects to nicotine patches and gum, which are prescribed by a doctor usually to heavy smokers who simply can't quit or who have had severe withdrawal symptoms when they've tried. The patch, an adhesive square that secretes nicotine through the skin and into the bloodstream to help ease the pain of withdrawal, can cause itchiness and minor burning. And smoking even one cigarette while wearing the patch can cause a heart attack. The effectiveness of the gum, meanwhile, is washed away if you eat or drink anything--especially diuretics such as coffee and cola--within 15 minutes of chewing it. And although the gum isn't supposed to be used after four months from your last cigarette, 1 in 12 smokers continues using it for over a year after quitting. The bottom line: If you've tried to quit and failed in the past, ask your doctor about these products. But, says psychologist Mitchell Nides, Ph.D., of the University of California, Los Angeles, you have to "learn" how to be a nonsmoker, and that's something that no pharmaceutical can do by itself.