Posted in Health, news, smoking, vaping

Can’t Stop Vaping or Smoking….Tips to Quitting

Some of you are trying to get a head start before the family makes you come up with a New Year’s resolution to quit vaping and smoking.  So you’ve cut back on tobacco and nicotine and have decided to quit.  Awesome!    Within the first half hour of quitting, studies have found your blood pressure and heart rate improve, so your health starts to improve immediately!

So, way to go!!!!  But now what?  It’s not that easy.  You’ve got cravings.

Not being able to manage these cravings can put you at risk of relapsing back into nicotine dependence.

Withdrawal from nicotine can manifest in any of the following:

  • anxiety
  • depression
  • cough
  • sore throat
  • headaches
  • hand tingling
  • increase appetite
  • sleep disturbances
  • constipation
  • mood changes
  • poor concentration
  • memory loss

and more.

Firstly don’t be afraid to get help if you need to.  Nicotine is a powerful, addictive drug and retraining your body to not ask for it is a challenging process.  Smokefree.gov offers multiple resources to help one quit smoking/vaping.

Your medical provider can offer you nicotine replacement therapy to help you wean slowly, or medications such as (brand names) Chantix and Wellbutrin that can help you with your cravings as you cut back or quit.

Therapy and counselling can also be very beneficial while you are weaning off nicotine.

But some of you will want to quit cold turkey.  How do you manage the cravings then?

So we break this down into biological and psychological factors.

Biologically, we can hit this a few ways.  One, is the food choices you make can help with your cravings.

Vegetables like celery and carrots are great quick-to-grab veggies when you’re in a bind. Citrus fruits like oranges work well. Bananas with their vitamin B and potassium melt in your mouth and don’t leave room for a cigarette.  Potatoes have potassium and when not loaded up with butter and cheese are….well… not as yummy.

Peppermint is good at curbing cravings, so when you’re walking out of a restaurant don’t forget to grab some of those free candies sitting there.  Ginsing and ginger help with cravings as well, and don’t forget fiber.  Stuffing your mouth with oats, bran and fibrous foods keep you so busy trying to pick them out of your teeth that you are too exhausted to smoke.  Top all of this with lots and lots of water, and you’ll find yourself off the nicotine in no time.

Let’s celebrate.  Some one grab me a beer….no wait! No alcohol!  Alcohol fuels your cravings as does meat and caffeine.  Sorry, I never said it would be easy.

Exercise also helps because it will help you keep busy, increase your endorphins and works on the weight gain that might accompany smoking cessation.  Take a nice stroll every time you feel the need to grab a cigarette.

Which transitions nicely into psychological ways to quit.

Distraction is huge.  As the cravings come on, distract yourself by exercise, reading, dancing, or writing about your journey towards a smoke-free life to help others.

Have index cards written out with reasons to quit.

Have a disgusting picture of tobacco-destroyed lung in the kitchen or wherever you get the urge to smoke.

And get your friends and coworkers on board to help. If they vape/smoke in front of you, it will make it that much harder.  Have a friend, family member designated as your support guide who texts you encouraging messages throughout the day as you try to quit. Remind them that the content cannot include chores or reminders to pick things up on the way home.  There……if these tricks don’t help you quit vaping/smoking, at least you can use them to get out of chores…..

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, Millennials, students, suicide, teens, vaping

Teen Suicide Rates Soaring…Is Vaping and Nicotine Dependency a Cause?

The CDC reported this week that teen suicide rose 58% over the years 2007-2017 in the age group 10-24.  Although many experts blame social media and teen drug use, one theory may need to be considered:  nicotine withdrawal from vaping.

Millions of middle school and high school students admit to vaping…and many more are assumed who don’t admit to it when surveyed.  So we have an underestimation of how many adolescents take regular hits of their electronic cigarette, exposing them to the powerful, addictive nicotine. One pod, placed in an electronic cigarette to be vaped, contains as much nicotine as a pack of cigarettes.  Hence if a pod is smoked at school, and when the child is home goes hours without, they may “come down” off the nicotine high that they had hours earlier.

In 2002 Picciotto et al discussed how nicotine can affect mood swings, anxiety and depression, where in some cases it can act as an antidepressant but when one withdrawals from it can have increased and anxiety and depression.

The teenage mind and psyche is still developing during this time and a chemical dependency could muddy the mental health waters.

There’s no doubt social media and the misconception teens have that their lives are not as glorious as those who they view online is contributing to lack of confidence, poor self-esteem and depression.  But the decision to commit suicide may also be chemically induced, or a withdrawal of one and should be investigated.

Vaping Linked to Heart Disease and Cancer

 

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.   That dose would be commonly consumed by many humans who vape.

nicotine.jpg

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucous production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

Toxic metals found in vaping liquid

Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.

Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure.  Moreover they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, news, vaping

More Reports of Vaping Linked to Seizures in Teens

The FDA is investigating 127 reports of seizures in e-cigarette users (up from 35 this Spring).

Many were teenagers and young adults.

Since 2010 the agency has received multiple reports but is unclear if e-cigarettes actually caused the seizures or if there were underlying medical conditions predisposing the neurological disorder.

The 92 additional cases since this April is concerning and the FDA is working to determine if vaping contributes contributes directly to serious neurological conditions.

In April FDA Commissioner Dr. Scott Gottlieb tweeted:

While we’re still learning about the long-term potential benefits and health risks of e-cigs, existing scientific research offers some clear evidence that several of the dangerous chemicals in tobacco smoke are also present in the aerosol of some e-cig products.

Dr. Ned Sharpless, current acting FDA Commissioner, is encouraging people to report adverse events as, “Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” (Reported by CNBC).

What is a seizure?

A seizure occurs when there is abnormal electrical activity in the brain.  If the electricity doesn’t conduct properly, brain function gets disrupted. This could lead to convulsions  (involuntary jerking movements), loss of muscle tone, changes in senses such as vision, hearing and smell, loss of bladder control, loss of consciousness and sometimes stroke, brain damage and death.

HGT0066_neurons-seizure-brain_FS.jpg

 

Nicotine toxicity has been linked to seizures.  E-cigs sometimes contain more nicotine than cigarettes alone.

 

_________________________________________________________________________________________

A study published by the American Heart Association found nine different E-cig flavors  to impair blood vessel function, which can impair heart health.

Endothelial cells, which delicately line blood and lymph vessels, were found to become inflamed at low concentrations of some vapor flavors.  And at high concentrations of others, exibited cell death.  Nitric oxide production, necessary for vessel dilation to improve blood flow, was impaired as well. These are often the same changes seen in early heart disease.

sample_01001118_110141.jpg

The 9 flavors (and the chemicals within) cited in the report to cause the endothelial inflammation and/or damage were:

  • Mint (menthol)
  • Vanilla (vanillin)
  • Clove (eugenol)
  • Cinnamon (cinnamaldehyde)
  • Strawberry (dimethylpyrazine)
  • Banana (isoamyl acetate)
  • Butter (diacetyl)
  • Eucalyptus/spicy cooling (eucalyptol)
  • Burnt flavor (acetylpyridine)

Strawberry flavoring appeared to have the most adverse effect on the cells.

Now many other flavors were not included in this study, so its unknown how safe they may be.

For more on the study, read here.

An alternate study published last November looked at vaping flavors and their effects on heart muscle cells.

For more on this study, read here.

The moral?  Just because we love the taste of something, doesn’t mean its safe to inhale.

___________________________________________________________________

Vaping Linked to Heart Disease and Cancer

 

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.   That dose would be commonly consumed by many humans who vape.

nicotine.jpg

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucous production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

Toxic metals found in vaping liquid

Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.

Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure.  Moreover they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

ultimate book cover final

Great Gift!!!

The Ultimate Medical Student HandBook

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in Health, news

E-Cigarettes May Leak Toxic Metals During Vaping

A new study reveals that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure.  Moreover they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

Vaping Linked to Heart Disease and Cancer

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.   That dose would be commonly consumed by many humans who vape.

nicotine.jpg

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucous production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

 

Twitter @DrDaliah

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news

E-cigs Should Not be Used to Help Curb the Obesity Epidemic

While we’re winning the war on tobacco, we’re fueling the obesity epidemic.  Americans kept themselves slim for decades puffing on a cigarette, some mistaking the hunger pains as a need for more nicotine.  Some purposely curbing their appetite reaching for a smoke.

In the 1920’s Lucky Strike targeting female consumers by promoting the appetite suppressant effects of their cigarettes.

 

2-Lucky-Strike–To-Keep-A-Slender-Figure-No-One-Can-Deny.jpg

 

Over the years, adults have wised up to the risks of heart disease, lung cancer, COPD, and chronic respiratory infections, and tobacco users have fallen to record numbers, 16.8% to be exact.  Last year, however, the CDC reported 36.5 % of Americans are obese, more than doubling since the 1980’s.

 

imrs (1).jpg     obesity chart

 

Now smoking cessation doesn’t get all the blame for our obesity crisis.  Junk food being cheaper than healthy food, fast food franchises opening up on every street corner, and the average consumer being inundated with plastic products, manipulating one’s metabolism have led to higher weights.  But when someone who used cigarettes to curb their appetite can’t reach for one anymore, weight happens.

So many Americans trying to quit smoking have turned to electronic cigarettes, or e-cigs.  They “vape” a vapor composed of nicotine, propylene glycol, glycerin, water and flavorings.

In 2011, Yale researchers looked into how nicotine can decrease the appetite by studying receptors in the hypothalamus, the part of the brain involved in appetite.  Activation of pro-opiomelanocortin (POMC) cells within the arcuate nucleus region decreased appetite and food intake and additionally increased energy expenditure, according to Mineur et al.

Nicotine patches and gum have been used anecdotally as well for weight loss.  Further research has found nicotine to decrease blood glucose levels, increase insulin resistance and break up stored fat.

Yet nicotine is not without its risks as its one of the most addictive agents out there, equal to that of heroin according to some experts.  Moreover, nicotine has been found to affect the kidneys, heart, and induce cancer in studies involving  the lungs, GI, breast, and pancreas.

The safety of vaping liquid in e-cigs has been debated as well as the chemicals involved may seem benign at room temperature but what happens when the internal e-cig coil turns the liquid into vapor?

So how can we combat the obesity epidemic if we want consumers to avoid tobacco and stay clear of nicotine and vaping liquid?

Going back to 2011, the Yale researchers also looked at cytisine, a plant compound similar to nicotine, and it worked on the POMC cells as well.   According to WebMD, cytisine is found in the seeds of the golden rain tree, and has been used in Eastern Europe for decades to help smokers quit.  In late 2014, a study published in the New England Journal of Medicine found cytisine to trick the brain into thinking it was getting nicotine and was more effective than nicotine replacement therapy in helping smokers stay off cigarettes in the first week, and after two and six months.

Cytisine, a partial agonist of nicotinic acetylcholine receptors, can produce side effects as well such as nausea, vomiting, fast heart rate, but appears to be less toxic than nicotine.

So we have a compound that acts like nicotine and can help stave off the obesity ensuing after smoking cessation.  In the meantime, I would use caution turning to e-cigs.

For more on the harmful effects of nicotine

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician