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Common Psychiatric Disorders

Information for members regarding Timothy's Law

Substance-Related Disorders

Nicotine


Important Facts

  • Eighty percent of all adult smokers tried their first cigarette by age 18.
  • The prevalence of smoking is slightly higher in males than females in the United States.
  • Between 50 – 80 percent of those who smoke have nicotine dependence.
  • In cigarette smoking, rapid onset of nicotine effects, frequency of reinforcement and physical dependency on nicotine all lead to an intensive habit that is difficult to give up.
  • Nicotine dependence and withdrawal can develop with use of all forms of tobacco (cigarettes, chewing tobacco, pipes, snuff and cigars) and with prescription medications.
  • Dependence and withdrawal occur at a faster rate when nicotine is smoked than when it is taken orally or transdermally (through the skin).
  • Nicotine dependence is more common among individuals with mental disorders.
  • Over 80 percent of those who smoke express a desire to stop smoking.
  • Thirty-five percent of the smoking population tries to stop each year. Less than five percent are successful in unaided attempts to stop smoking.
  • Most individuals who smoke have three to four smoking cessation failures before they stop for good.
  • Withdrawal symptoms are due to nicotine deprivation and are typically more intense among those who smoke cigarettes than among those who use other nicotine-containing products.
  • Health problems associated with smoking are caused by the carcinogens and carbon monoxide in tobacco smoke rather than by nicotine.
  • Those who are chronically exposed to tobacco smoke and who have never smoked appear to be at increased risk for conditions such as lung cancer and heart disease.
  • There are more than 400,000 deaths per year in the United States attributed to tobacco use.
  • There are 45 deaths per hour caused by tobacco use in the United States.
  • The average smoker loses 7 years of life.

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Withdrawal Symptoms

Withdrawal symptoms can begin within a few hours of stopping, typically peak in 1-4 days, and last for 3-4 weeks:

  • Anxiety
  • Changes in rapid eye movement (REM)
  • Cravings
  • Decreased metabolic rate
  • Decreased heart rate
  • Depressed mood
  • Decreases in levels of the neural transmitter catecholamine and the hormone cortisol.
  • Difficulty concentrating
  • Difficulty sleeping
  • Dry or productive cough
  • Increased appetite or weight gain
  • Irritability, frustration or anger
  • Restlessness
  • Slowing of brain waves as measured by an EEG test

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Treatment

  • HIP Health Plan’s Free & Clear Quit Smoking Program www.hipusa.com/myhealth/preventive_health/smoking.asp
  • Behavioral therapy
  • Group therapy
  • Individual therapy
  • Nicotine replacement therapy (e.g., gum, patch)
  • Pharmacological therapy (e.g., Zyban)
  • Self-help programs

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Tips for Quitting

  • New York State Smoker’s Quit Line: 1-888-609-6292
  • Set a quit date and tell everyone what the specific date is.
  • Ask friends to be supportive of your decision to stop smoking.
  • Have a "quit buddy."
  • Visualize yourself as a non-smoker and participate in non-smoking activities (e.g., sit in the non-smoking section of a restaurant).
  • Spend time with non-smokers. Develop new friendships and relationships.
  • Avoid people who smoke and places that increase the likelihood that you will be tempted to smoke.
  • Make a list of what you dislike about smoking and being a smoker. Keep this list with you as a reminder.
  • Set short-term, realistic goals.
  • Throw away all cigarette paraphernalia (e.g., ashtrays, lighters).
  • Replace cigarette breaks with “non-cigarette” breaks.
  • When you feel the urge to smoke, become involved in another activity.
  • Make a list of alternative activities to smoking and keep this list in a highly visible location (e.g., taped to the mirror or refrigerator).
  • As you begin to decrease your cigarette intake, alter your typical smoking routine. For example: smoke at times that you don’t normally smoke and don’t smoke when you typically smoke the most; hold the cigarette in the opposite hand; change your smoking environment.
  • Have gum, candy, toothpicks, etc. available to use instead of cigarettes.
  • Drink water and juices. Avoid substances with caffeine.
  • Eat proper meals.
  • Exercise on a regular basis.
  • Remember that cravings do not last forever. The urge to smoke usually passes within two to three minutes.
  • The first few weeks of abstinence are the hardest, but it becomes easier over time.
  • Remember that withdrawal symptoms are a sign that your body is beginning to heal.
  • Reward yourself for your successes.
  • Forgive yourself if you relapse. Most people have at least one relapse prior to complete success. If you have tried to quit before and have failed, your chances for success are better … not worse.
  • After you have stopped smoking, do not test yourself by having "just one."

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Prenatal Effects

If a woman smokes while she is pregnant:

  • There is a higher risk of miscarriage in the first trimester.
  • Nicotine readily crosses the placenta.
  • Smoking interferes with oxygen supply to the fetus.
  • Carbon monoxide from cigarette smoke inhibits the release of oxygen into fetal tissues.
  • Nicotine becomes concentrated in fetal blood, amniotic fluid and breast milk.
  • Both mother and baby may suffer medical complications.
  • There is greater chance of premature delivery.
  • The baby may have a low birth weight.
  • There is increased risk of Sudden Infant Death Syndrome (SIDS).
  • The baby may have developmental delays.

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Negative Consequences

  • Chronic obstructive pulmonary disease (COPD) and other lung diseases
  • Diminished function of the lungs
  • Lung, oral, and other cancers
  • Narrowing of blood vessels that supply the heart and brain
  • Ulcers

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Warning Signs That Nicotine is a Problem

  • Continued use despite knowledge of medical problems.
  • Difficulty refraining from smoking.
  • Giving up important social, occupational or recreational activities because they occur in smoking- restricted areas.
  • Reporting that the first cigarette of the day is the most difficult cigarette to give up.
  • Smoking more in the morning than the afternoon.
  • Smoking soon after waking.
  • Smoking when ill.

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Good Reasons to Stop Smoking

  • One year after quitting, the risk of heart disease caused by smoking is cut in half. After 15 years of not smoking, the risk is similar to that of people who have never smoked.
  • After 10 years, the risk of lung cancer for ex-smokers drops to as much as one-half that of continuing smokers.
  • In 15 to 25 years, the risk of stroke for ex-smokers returns to the level of those who have never smoked.
  • After 15 years of not smoking, the risk of death returns to nearly the level of one who has never smoked.
  • Those who have stopped smoking for many years are less likely to die of chronic lung diseases than those who continue to smoke are.
  • Ex-smokers have fewer sick days, health complaints, reduced rates of bronchitis and pneumonia, and have better self-reported health status.

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