About 34 million American adults still smoke cigarettes, and smoking remains the single largest preventable cause of death and illness in the world. Smoking causes an estimated 480,000 deaths every year, or about 1 in 5 deaths.

Quitting smoking isn’t easy.

It takes time and a plan. With 36 years in the field, developing clinical programs and evidence-based research, Judith Cooney, Ph.D., health psychologist and associate professor of psychiatry at the UConn Health Carole and Ray Neag Comprehensive Cancer Center helps cancer patients and survivors lead healthier lifestyles that include quitting smoking when diagnosed with cancer.

Tobacco smoke contains a deadly mix of more than 7,000 chemicals. Hundreds are toxic. About 70 can cause cancer. Some of the chemicals in each cigarette include:

Cancer-Causing Chemicals in Cigarettes includes

• Formaldehyde: Used to embalm dead bodies
• Benzene: Found in gasoline
• Polonium 210: Radioactive and very toxic
• Vinyl chloride: Used to make pipes

Toxic Metals

• Chromium: Used to make steel
• Arsenic: Used in pesticides
• Lead: Once used in paint
• Cadmium: Used to make batteries

Poison Gases

• Carbon monoxide: Found in car exhausts
• Hydrogen cyanide: Used in chemical weapons
• Ammonia: Used in household cleaners
• Butane: Used in lighter fluid
• Toluene: Found in paint thinners

Nicotine is an addictive substance in cigarettes. It acts fast but has a short half-life.  When an individual smokes, nicotine is rapidly absorbed and acts on the chemistry of the brain and central nervous system lead to increases in heart rate, blood pressure, endorphins, etc. This causes pleasant feelings and a sense of enhanced concentration, vigilance, and decreased anxiety and hunger.  After a few months of semi-regular smoking, our bodies develop tolerance to nicotine, and smokers need more nicotine to have the same effects. Reaching the brain within seconds after taking a puff, its effects start to wear off within two hours. The user may experience nicotine withdrawal, and feel irritated and edgy, this is what leads to the person having another cigarette. This cycle continues. If the person doesn’t smoke again soon, withdrawal symptoms get worse over time and as the body adapts to nicotine, they increase the amount of tobacco they use.

The risks of smoking are well known, smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer. It causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost.

Smoking causes about 20% of all cancers and about 30% of all cancer deaths in the United States.

About 80% of lung cancers, as well as about 80% of all lung cancer deaths, are due to smoking. Smoking, however just doesn’t cause lung cancer, it also increases the risk for other cancers including the mouth, head, and neck, esophagus, kidney, cervix, liver, bladder, pancreas, stomach, and colon.

Smoke damage in the lungs can lead to serious long-term lung diseases such as chronic obstructive pulmonary disease (COPD). It can also increase the risk of lung infections such as pneumonia and tuberculosis, and it can worsen some existing lung diseases, such as asthma.

No matter your age or how long you’ve been smoking, quitting improves health both immediately and over the long term.

Quitting smoking isn’t easy.

Nicotine is a very powerful drug and has profound rapid benefits and rewards causing a cycle of positive and negative acute effects that make it a chronic and recurring` disorder.

Cooney runs a smoking cessation program – “I CAN Quit – Nicotine and Tobacco Treatment for Individuals with CANcer”, where her nicotine and tobacco use expertise is focused specifically to help patients in the cancer center. This program provides evidence-based behavioral and pharmacological treatment to help cancer patients stop smoking and remain abstinent from tobacco for the long run.

“Cancer is a transformative illness that may lead many people to re-examine their lives moving forward,” says Cooney. “The window from diagnosis through acute treatment and survivorship is an important time to start living a healthier lifestyle that includes quitting smoking.”

Cooney meets with patients individually and creates a program tailored to each person and their circumstances while working with their providers to embed cessation as part of their cancer treatment.

Many of the patients she sees feel guilty or shameful because they feel that their smoking contributed to their cancer, don’t think they can quit, or feel that even if they quit the damage is already done.

She uses Motivational Enhancement Therapy (MET) as a counseling approach that helps individuals resolve their ambivalence about engaging in treatment and stopping smoking.

Cooney also uses Cognitive Behavior Therapy (CBT) in which she helps patients develop specific strategies to prepare to quit, set a date and deal with acute withdrawal and urges. By identifying triggers and having behavioral strategies to cope with or avoid triggers, reduce stress and negative feelings helps people deal with all of these when initiating quitting, during treatment, survivorship, and long-term.

FDA-approved cessation products can also be part of the program to stop smoking, including nicotine replacement therapies such as patches, gum, and lozenges. The FDA has approved two smoking cessation products that do not contain nicotine. They are Chantix (varenicline tartrate) and Zyban (buproprion hydrochloride). Both are available in tablet form and by prescription only.

For those who have been diagnosed with cancer, one of the profound and best benefits of quitting smoking four to six weeks before surgery, will produce better outcomes and recovery from surgery and the ability to get through treatment better. Long-term smoking cessation is associated with a lower risk of cancer recurrence and better five-year survival rates. Cooney stresses that the goal of nicotine and tobacco treatment is to help cancer patients stop smoking in the long run. She encourages that even if individuals stopped smoking at the point of their cancer diagnosis, further brief and personalized CBT-based smoking cessation treatment can be helpful to prevent relapse and achieve long-term abstinence from nicotine and tobacco.

Giving up smoking is a journey, and it can be hard, but you can increase your chances of success with a good plan and support. Getting help through counseling and medications doubles or even triples your chances of quitting successfully.

Cooney indicates that by helping cancer patients adopt healthy behaviors, they become partners in their cancer treatment and health care, improve their outcomes, and can live healthier and happier lives.