Successful Smoking Cessation by Dr. Marwan Elya, McLeod Pulmonary and Critical Care Associates


Lung cancer is the major cause of cancer deaths in the United States, primarily because of exposure to cigarette smoke.

Smoking tobacco products, mainly cigarettes, is the most important risk factor for the development of lung cancer. The cumulative lung cancer risk among heavy smokers may be as high as 30 percent, and increases with both the number of cigarettes smoked per day as well as the lifetime duration of smoking. Other factors that increase the likelihood of developing lung cancer in smokers include the age of onset of smoking, the degree of inhalation, the tar and nicotine content of the cigarettes, and the use of unfiltered cigarettes.

Second-hand smoke is also a significant cause of the disease. While the intensity of exposure to second-hand smoke is less than what occurs in the smoker, exposure to second-hand smoke often begins at an earlier age than active smoking, increasing the exposure to carcinogens over time.

November is National Lung Cancer Awareness Month, and a good time to address smoking cessation.

Smoking cessation decreases the risk of lung cancer. The reduction in risk becomes evident within five years, with a steady decline over time of abstinence. Studies show that former smokers who have quit smoking for more than 15 years had an 80-90 percent reduction in their risk of lung cancer. Adults who quit smoking can gain six-to-ten years of life expectancy, depending on the age at which they quit.

Quitting smoking will improve your health no matter how old you are or how long you have smoked.

If you want to quit smoking, START can help you remember the steps to take:

S – Set a quite date.

T – Tell family, friends, and the people around you that you plan to quit.

A – Anticipate or plan ahead for the tough times you will face while quitting.

R – Remove cigarettes and other tobacco products from your home, car and work.

T – Talk to your doctor about helping you to quit.

Your doctor can give you advice on the best way to quit and can help you with resources you need. Studies show that quit rates are higher in those who utilize both medications and counseling. Many smokers who have failed to quit state they have “tried everything”, when they have not engaged in any formal smoking cessation counseling program or have not used medications adequately.

The addictiveness to nicotine is the primary barrier to quitting. Nicotine is a potent psychoactive drug that causes physical dependence and tolerance. In the absence of nicotine, a smoker develops cravings for cigarettes and symptoms of withdrawal, including trouble sleeping, irritability, anxiety, frustration and difficulty concentrating.

Medication can help reduce cravings for cigarettes and withdrawal symptoms. Nicotine replacement therapy eases withdrawal symptoms and reduces your body’s cravings for nicotine. Non-prescription forms include patches, lozenges, and gum. Prescriptions can include nasal sprays or inhalers. Bupropion is a prescription medication that reduces your desire to smoke. Varenicline is a prescription medicine that reduces withdrawal symptoms and cigarette cravings. Your physician can help identify which medications will work best for you.

Counseling can also offer support, through identifying triggers, helping you overcoming cravings, and analyzing past failed attempts to quit. Behavioral counseling can be provided in a variety of formats, including meetings in person, over the phone, computer programs, text-messaging or group based therapy. Free telephone counseling in the United States can be accessed through 1-800-QUIT-NOW.

Some people who stop smoking become temporarily depressed and require additional treatment. If you become depressed, be sure to talk to your doctor.

To maximize your efforts:

  • Start exercising.
  • Stay away from smokers and places you associate with smoking.
  • Keep gum and hard candy on you for when cravings strike.
  • Don’t give up, even if you start smoking again. It takes most people a few tries before they succeed.


McLeod Physician Associates welcomes Marwan K. Elya, MD, to McLeod Pulmonary and Critical Care Associates. Dr. Elya is pleased to return to the Florence area, where he previously cared for patients from 2008 from 2011. Dr. Elya is board certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine and Sleep Medicine. For more information, call McLeod Pulmonary and Critical Care Associates at 843-777-7863.