Steven M. Brown, M.D., Pulmonologist

Expert point of view: COPD and smoking

by Steven M. Brown, M.D., Pulmonologist

I tell my patients that I know it's hard. And I'm there for them when they are ready to quit. We'll do it together.

I've been practicing pulmonary medicine at the Lung Center in Milwaukee, WI, for a little over 20 years now. And I'm also on the faculty at the University of Wisconsin Medical School. So thousands of people have walked through my door with COPD. And the vast majority of them were smokers.

No one knows why one patient who smokes develops COPD and another doesn't. Only about one in five smokers develops this disease. But others may go on to develop lung cancer or heart disease or stroke. So it's never good for you to smoke.

Knowing when to quit

If you have COPD and still smoke, it's extremely important that you consider quitting. Smoking may be a serious addiction and quitting may be hard. It may take several tries before you quit for good. But before you quit, you have to be ready and you have to be in the right frame of mind. I tell my patients that I know it's hard. And I’m there for them when they are ready to quit.

The good news today, is that there are so many tools that can help you quit. Your doctor is the best person to go to when you're ready. Together you can figure out what will work best for you.

How to quit smoking

Research has shown that quitting smoking requires a comprehensive approach. To reduce or eliminate the symptoms of nicotine withdrawal, there are lots of products available. Some you can get over the counter and some by prescription. They come in different forms, such as nicotine patches, chewing gum, pills, and inhalers. There are also non-nicotine products you can get by prescription.

The patch gives you a steady level of nicotine. With the inhaler or gum, you get nicotine levels that go up and down, as they do when you smoke cigarettes. The nicotine inhaler mimics some of the oral motions that you make smoking a cigarette. Of course it's important to quit smoking before you start to use these products.

To help you break the habit, there are programs sponsored by health organizations like the American Lung Association, the American Cancer Society, and the American Heart Association. All of their chapters have smoking cessation programs. In addition, there may be smoking cessation programs that are sponsored through hospitals or HMOs in your community.

These programs tend to have fairly similar content. You begin with a group educational session, group discussion, learning your smoking triggers and how to avoid them, plus relaxation and coping techniques. These can be very helpful. However, some people have better results with individual therapy. 

You may have heard of other approaches, like hypnosis, acupressure and acupuncture. Hypnosis has been shown to work quite well, if you have a skilled practitioner. There are different types that involve cognitive and behavioral modification. It's a bit like rewiring your brain, and has been helpful with a number of habits, including overeating/weight loss and alcoholism.

Your best bet, though, is to talk to your doctor. Because many programs you see advertised may not have stood up to scientific scrutiny. And they can be costly.

Taking the next step

Maybe you're thinking about quitting. But for one reason or another, it's just not right. Maybe you just have too much on your plate. And can't deal with the additional stress of quitting smoking. I tell my patients I'm here for them when they are ready.

Maybe you don't like the idea of failing. I tell my patients it's okay to fail. And when you're ready we'll try and identify what caused the failure so we can get you back on that horse and try again. You will succeed in the end. The important thing to remember is that quitting at any time can improve your health.

Something I've observed in my patients is a general sense of well-being once they're off the cigarettes for good. Quitting smoking is a big accomplishment.

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