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Smoking and Tobacco

Want to Quit Smoking

11/30/2010

Question:

I HAD A SEVERE STROKE IN 1997 SINCE MY STROKE I HAVE BEEN DEALING WITH SEVERE SPASISITY AND AM CURRENTLY UNDERGOING INTRATHECAL BACOLFEN THERAPY, MY PROBLEM IS IN ORDER TO DEAL WITH THE SIDE EFFECTS OF THE DRUG MY SMOKING HAS GOTTEN INCREASING WORSE, WHAT I WOULD LIKE TO FIND OUT IS THE BEST WAY OF GOING ABOUT TRYING TO QUIT? I WOULD BE EXTREMELY GRATEFUL FOR YOU ADVISE IN THIS MATTER! BEST REGARDS

Answer:

This is a very interesting and challenging question. First, my condolences for the ordeals you have been undergoing. It sounds just miserable. But, my suspicion is that your misery is being compounded by your smoking.

As you are doubtless aware, smoking harms your lungs, heart and blood vessels, and may have contributed to your stroke. It certainly increases your risk of another stroke even if the first one was unrelated. More importantly smoking and the rapid changes in nicotine and dopamine that it induces increase long-term, chronic pain even though it may seem to relieve pain in the short run. Many expert references seem to indicate that nicotine and caffeine increase spasticity.

So, how do to quit. First set a quit date at some time in the future and make sure all of your friends and family are on board with your resolve to quit. Once you've done that, it’s time to sit down with your doctor to talk about this exclusively and make a plan. He or she may recommend nicotine replacement therapy or varenicline (Chantix). Bupropion (Wellbutrin or Zyban) may not be a good choice as it might increase your risk of seizures with Baclofen. You should also call 800-QUIT-NOW to get free expert help and advice in planning your attack on this very tough addiction.

Most importantly, be honest with yourself. Try not to make excuses about your use or minimize your addiction. Remind yourself that even one puff once you are off, may lead to full addiction again. That first week you quit is the most critical week. Perhaps put a picture up on your refrigerator that reminds you of the main reason you want to quit (and live).

Good luck. You can do this!

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Response by:

Rob  Crane, MD Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University