Over one billion people in the world smoke tobacco. That number is shocking to me. As student doctors we are trained to encourage our future patients to quit smoking. Obviously, this addicting habit is hard to stop, and it is hard for doctors to persuade their patients to quit, too!

In every system course that I have had in medical school— cardiovascular, respiratory, gastrointestinal, etc. we learned about a different disease that is caused by or made worse by tobacco.

To be fair, smoking does have some minimally beneficial health benefits, such as lower risk of needing a knee replacement surgery. However, by and large the risks of smoking far outweigh the benefits.

Because health can be improved in so many ways by tobacco cessation, encouraging quitting is a focus of osteopathic physicians and educators that seek to treat the cause of diseases, rather than the symptoms. So what are some of the more effective ways to encourage smoking cessation?

Surprisingly, showing high school students pictures of black lungs and smoking pathology (how diseases manifest) seems to have little effect on tobacco cessation. It is no secret that high school students respond to the lead of their peers rather than their teachers or other adults. Scolding someone, telling them that they will get a horrible disease, or simply that using tobacco products is unhealthy, are also rather ineffective modalities in the battle of smoking cessation.

So what are effective ways to help encourage smoking cessation?

The best way to encourage smoking cessation is to assess a person’s current stage of contemplation of change, to see if they even want to quit smoking. If someone hasn’t even thought about the need to quit, the goal is to encourage him or her to begin the contemplation.

If a person is currently contemplating the idea, the goal is to motivate them to take the next step. True understanding of the risk factors of tobacco use can help at this stage. So why is smoking so bad for our health, and what kinds of problems does it cause?

The main problem with smoking is vascular, that is, how it affects blood vessels. Everyone knows that smoking causes lung cancer, but a smoker may not know that it can cause non-traumatic foot amputations. The toxins in cigarette smoke are inhaled, and from the lungs they enter the bloodstream. In the bloodstream, they can damage the walls of arteries.

This allows proteins in our blood (from our diet, made in our liver, etc.) to be squeezed across the wall of the damaged blood vessels. As the body works to repair the damage, the result is that the diameter of the blood vessel becomes very narrow. This can cause a deficiency of oxygenated blood delivery to arms and legs.

These toxins can also damage the blood vessels that supply the heart, increasing risk of heart attack, and can also affect the blood vessels that supply the brain, increasing the risk of a stroke. Smoking is also a risk factor for bladder and kidney cancer.

In our studies, we have learned many other problems that tobacco usage creates in our bodies. To sum them up, smoking causes cancer by damaging cells, causing them to uncontrollably divide in an unregulated manner. Smoking also causes emphysema by destroying the elasticity of the lungs, so the lungs cannot squeeze air out like they are supposed to on exhalation.

Certain mechanisms of how tobacco products lead to certain diseases are still being discovered. As these mechanisms continue to be discovered, I believe that communicating these findings will be effective in further encouraging a decline in the use of this destructive habit.

The holistic approach to health at COMP-NW teaches us to encourage treatment of the cause of diseases, rather than just treating the symptoms. I hope that by helping my patients understand how and why tobacco use harms the body, that I can encourage the next stage of change for them as we work together to promote optimal health.

Jonathan Shader is a second-year student at COMP-Northwest who plans on becoming an ophthalmologist. Shader grew up in the Lebanon area.

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