Smoking Is Trying to Kill You: How to Quit Smoking for Good

Smoking remains one of the leading preventable causes of disease and death worldwide—but it's never too late to quit.

In this comprehensive episode of Wellness Connection MD, emergency physician Dr. Jim McMinn and Coach Lindsay Mathews provide an evidence-based, practical guide to smoking prevention and smoking cessation.

Whether you're a smoker, a healthcare provider, or someone trying to help a family member quit, you'll discover:

•  Why nicotine addiction is so powerful 
•  The staggering health and financial costs of smoking 
•  How the body begins healing within minutes after quitting 
•  The proven Five Stages of Smoking Cessation
•  Why counseling plus medication dramatically improves success rates 
•  How to manage cravings, triggers, stress, and relapse 
•  The role of nicotine replacement therapy, varenicline (Chantix), and bupropion (Zyban) 
•  The latest evidence on vaping and whether it should be used for smoking cessation 
•  Practical advice for clinicians caring for patients who smoke 
•  Inspiring stories of people who successfully broke free from nicotine addiction 

Dr. McMinn also shares unforgettable experiences from decades in the emergency department caring for patients with end-stage smoking-related disease—along with the encouraging story of a new friend who transformed his health after finally quitting.

This episode is packed with motivation, practical strategies, and the latest scientific evidence to help listeners move toward a healthier, nicotine-free life.

Topics Covered:
Smoking • Smoking Cessation • Nicotine Addiction • Vaping • COPD • Lung Cancer • Cardiovascular Disease • Preventive Medicine • Lifestyle Medicine • Functional Medicine • Integrative Medicine • Wellness • Behavioral Change • Public Health • Physician Advice • Quit Smoking • Tobacco Addiction • Evidence-Based Medicine

If this episode helps you, please share it with someone who smokes. One conversation—and one decision—can change a life forever. 

Transcript

Welcome And The Real Stakes

SPEAKER_00 0:00

Welcome to the Wellness Connection MD Podcast. I'm Dr. Jim McMinn here with Coach Lindsay Matthews. Today we're tackling one of the greatest provisibuses of disease and premature death in human history, and one of the most profitable products ever sold, and that is smoking. If you smoke or you love someone who smokes, or if you're a healthcare provider trying to help your patients quit, this episode is for you. We'll explain why nicotine is so addictive, why quitting is so difficult, and most importantly, what the scientific evidence says actually works. We'll cover the proven stages of smoking cessation, medications, counseling, nicotine replacement therapy, practical strategies to overcome cravings and prevent relapse, and the latest evidence on vaping. We'll also share inspiring real life stories and practical tools that can help you break free from nicotine for good. So if you ever needed a reason or a roadmap to quit smoking, you're in the right place.

SPEAKER_02 0:54

Welcome to the Wellness Connection MD Podcast with Dr. McMinn and Coach Lindsay, where we bring you the latest up-to-date evidence-based information on a wide variety of health and wellness topics, along with practical take-home solutions. Dr. McMinn is an intercom. LindsayMex is a registered current and IIS Certified HealthCode. Together, optimize your health and wellness.com to our podcast player podcast player to be notified when future episodes come out. And now, on to the show with Dr. McMahon and Coach Lindsay.

SPEAKER_00 1:50

Hello and welcome to the Wellness Connection MD Podcast. Thank you so much for joining us today. I'm Dr. Jim McMahon. I'm here with Coach Lindsay Matthews. Together, we bring you the evidence-based podcast with honest, commercial-free, unbiased, up-to-date information about functional integrative lifestyle and wellness medicine. We're so glad you could join us today.

New Baby And Why Smoking Matters

SPEAKER_00 2:10

Well, good morning, Coach. It's good to see you again. You've been a bit busy since we got together last time, so please catch us up with what's going on in the Matthews household.

SPEAKER_01 2:18

Thanks, Dr. Mack. It is good to be back on the show and good to be with you listeners. We have had a whirlwind July, but I'm excited to say Tyler and I are no longer playing man-to-man. We are playing team parenting, where we are doing the zone, you know. We're playing the zone defense. We've got another Pluto in our in our in our household. We had a baby this past month, baby Esther. And we're we're grateful. We're a little less sleep right now, but we are happy and grateful.

SPEAKER_00 2:52

And uh little Esther's number three, right, Lindsay?

SPEAKER_01 2:54

That's right, number three. Like I said, we moved from man to man to zone this time.

SPEAKER_00 2:58

Yeah, so we started doing the podcast, you had no kids, and now you're with three kids.

SPEAKER_01 3:03

Oh my gosh.

SPEAKER_00 3:04

You guys have been busy, haven't you, coach? Well, you know, coach, over the years we talked about a lot of stuff on our podcast, and uh today we're going to talk about sort of a common denominator that affects just about every aspect of uh badness you can think of. And even worse, it's a self-inflicted wound, coach. And that common denominator is smoking.

SPEAKER_01 3:24

You know, Dr. Mack, it's hard to think of any illness that smoking doesn't affect. I mean, think about it. Every single organ is affected by smoking. And if you look at the top 10 causes of disease in America, smoking has a significant negative effect on just about every single one.

SPEAKER_00 3:43

You know, coach, one might say we should have done this podcast a long time ago. And and they're right, uh, we should have done it back in the 80s, but we didn't really exist in the 80s. So anyway, here we are, a little bit late, but uh, you know, it's it's interesting. There has been a big drop in smoking since then. However, even today, nearly one in nine Americans still uh light up. And that translates into about 30 million Americans who continue to expose themselves to thousands of toxic chemicals with every packet. And so to me, that's still 30 million too many people who smoke. And the tobacco epidemic doesn't just affect health, it affects families, workplaces, and the economy. Smoking-related illness costs United States well over six hundred billion dollars each year when you combine health care expenses with lost productivity. So even though less people are smoking, it's still a big deal.

SPEAKER_01 4:31

That one in nine really surprised me, Dr. Mean. One in nine people.

SPEAKER_00 4:36

Yeah, I know. I know.

SPEAKER_01 4:37

It's that's that's that's a big statistic. And even though we have less people smoking now than in the 80s, there's still a there's a dark cloud on the horizon, Dr. Mack. And the latest news is that due to social media influencers and other factors, smoking is actually making a comeback among the Gen Z folks. And on top of that, vaping has also become very popular. And by the way, for those folks who can't keep up with their generations, we've got Gen Z, which would be the people in their late teens to mid-20s.

SPEAKER_00 5:10

You know, coach, when I I remember those days when I was young, and I thought I would never grow old and never get sick. And I know what you're thinking, coach. Looking at me now, it's hard to believe that I too was young once. But I I have pictures to prove it, coach. And unfortunately, the time catches up to all of us. And so these people who think they're never gonna grow old and never gonna get sick, yeah, it's gonna catch up to them too, coach.

SPEAKER_01 5:28

You know, I'm feeling the time factor. We bought a minivan, Dr. Max. So I'm still in the age. But you know, circling back though, the folks also that we have this temptation of vaping, and that's becoming so popular now, um, as if there wasn't enough

ER Reality And A Quit Success

SPEAKER_01 5:50

temptation with smoking already. Now we have vaping to whole add to this whole picture, and I think that's kind of worth talking about too.

SPEAKER_00 5:57

You know, coach, as you know, I was an ER doc for 20 years, and when I think back to my years in the ER, one of the saddest things I ever saw on a regular basis was the folks coming in with uh end-stage lung disease from smoking. There were things like, especially like chronic emphysema, asthma, CLPD, which is chronic obstructive pulmonary disease, which is basically from smoking. And I'll never forget the look on their faces, Coach. It was so sad. These folks were literally starving for air, and they were dying a slow, miserable, frightening death. And sometimes there really wasn't much we could do about it. And I guarantee you that every single one of them in that moment wished that they had never picked up their first cigarette.

SPEAKER_01 6:35

That's a hard picture to think about. So this podcast is for those 30 million folks out there who still smoke, for those who are thinking about picking up the habit, and for those in the medical community and the loved ones who want to help these people quit.

SPEAKER_00 6:56

I met him at the gym one day and I was swimming some laps and he happened to be in the lane next to me. So we struck up a conversation at the end of our workout, and he mentioned something about being a smoker. And I try not to put on my doctor hat in those situations, but I did venture to say, without lecturing him, that that quitting smoking would be one of the most important things he could ever do for his health. It was just a brief conversation, but somehow it got through to him. The next time I saw him, I was floored when he told me that he had quit. Whoa, really, I just couldn't believe it. If only my wife, uh Dr. Cheryl, would listen to my words like Ro did. But anyway, it's been a few months now since he has uh been smoke-free, and I ran into him at the gym again just this morning, and he said that he's breathing easier, swimming more laps, has better energy, and went to the doctor who said that his lungs sounded much better. The chronic wheezing was gone, and that's all just in a few months. He seems to be a super nice guy, and I'm so happy he's made this profound change in his life, which will benefit him immensely in the years to come. And hopefully it'll keep him from being one of those people dying from a slow, miserable death in the ER, like we just talked about.

SPEAKER_01 7:57

I love that story, Dr. Mack. I love hearing how just a simple conversation what really made an impact for Ro. And that's just encouraging and empowering, really. So, like with Roe's case, it's never too late to quit smoking. But after a while, smoking does cause permanent damage to the tissues of the lungs and to other parts of the body. So when it comes to smoking sensation, the sooner the better.

SPEAKER_00 8:26

Before we get into cessation, let's just talk a little bit about prevention. The best

Prevention And Non-Smoker Identity

SPEAKER_00 8:30

strategy is to never start at all. Someone who's only thinking about smoking or is tempted by smoking can do a lot to avoid ever forming that habit by planning ahead for social pressure, managing curiosity, and choosing who you hang out with, and deliberately building a firm identity as a non-smoker.

SPEAKER_01 8:47

It helps to understand why people start smoking in the first place. Common reasons are peer pressure, just wanting to fit in, or simply being curious, stress relief for a lot of folks, weight concerns, of course, looking cool or feeling more grown up, and having friends and family members who are already smoking.

SPEAKER_00 9:10

So, one of the most important things is to build a strong non-smoker identity, and then education, either self-education or brief counseling that explains how harmful smoking is and how quickly nicotine addiction can develop, and how hard quitting can be. All of these can reduce initiation of smoking. One thing I found that impactful is to show patients images of pink, healthy lung tissue versus ravaged smoke damage lung tissue. It's pretty remarkable, Coach. I don't know if you've ever seen it or not, but uh um it's a stark difference. And it's really kind of truly startling when you look at it. And when you make that connection that you've got to breathe to live, then those images can really get somebody's attention.

SPEAKER_01 9:47

And we also want to encourage people to be careful with alcohol in this setting, it lowers your guard. And this just this just one cigarette starts to sound very harmless if you aren't really strong and clear-headed. But here's the thing the moment you take that first drag, you're not a non-smoker anymore. And I don't smoke was never just a label. It really is your best defense against starting to smoke. And once that identity as a non-smoker slips, the door swings open and one harmless cigarette can quietly turn into another and another, and then it's a lifetime of addiction for people.

SPEAKER_00 10:29

So in high pressure social situations, having a kind of a rehearsed script can dramatically improve your odds of saying no to smoking. So for instance, uh simply saying, no thanks, I don't smoke, or I get sick around smoke, so I skip it, or what do you have to say to avoid that pressure?

SPEAKER_01 10:44

If social media influencers are tipping your scale towards smoking, well then turn to other smoke-free role models online or in real life. Remember, those influencers are often getting paid to get you hooked. And they show, you know, these young, healthy, sexy, beautiful looking people lighting up and having so much fun. And it makes you want to be like them. And they're painting this enticing picture that's really not reality at all.

SPEAKER_00 11:14

Mm-hmm. And so, like me, I I refuse to be a victim of the tobacco marketing that intentionally targets curiosity and that sort of rebellion. A lot of guys like to be that tough guy, bad boy, rebellious, sort of Marlboro man kind of guy. But the reality is that wrinkled skin, yellow teeth, chronic cough, stinking like smoke, and erectile dysfunction are not very attractive or sexy. Nobody wants to be your caretaker when you have lung cancer or severe COPD, or or when you can't get it out of that lazy boy because you're starving for oxygen.

SPEAKER_01 11:43

It also helps to know what your potential smoking triggers are. So common triggers include lighting up with a cup of coffee, while driving, when drinking alcohol, after meals, or with stress, while making a phone call, when fishing, or playing golf, watching football, and of course after sex. So being aware of when those trigger moments happen can really help you be forewarned and think ahead so that you're not gonna light up in that moment.

SPEAKER_00 12:13

So the bottom line when it comes to prevention is that it is greatly to your benefit for so many reasons to not start smoking in the first place.

SPEAKER_01 12:21

However, for those who have already succumbed to the habit, there's hope. And that's what we always come back to on this podcast, right, Dr. McMahon?

SPEAKER_00 12:29

That's right.

SPEAKER_01 12:30

You don't have to be a slave to this delivery system for disease and death, but you can quit. It's never too late. And we're here today to show you how.

SPEAKER_00 12:41

Yeah, I have some great news for you, Coach. One of the most remarkable facts about smoking cessation is that the lungs start repairing themselves almost immediately. Within minutes, carbon dioxide levels begin to fall and the oxygen delivery to the tissue starts improving. In the next few weeks, circulation improves, and many people notice that they're less short of breath during walking or climbing stairs. Within one to nine months, the lungs start to clear and the sinus infections of bronchitis become less frequent. And after about a year, chronic airway inflammation has decreased substantially. Many former smokers have much better exercise tolerance and and less chronic cough. And over time, after quitting, your risk of lung cancer decreases steadily. So there are so many reasons to quit. And like my friend Ro, you'll start to see benefits almost immediately.

SPEAKER_01 13:25

As we've said so many times on the show, the body really wants to be healthy. And if you just stop messing with it and give it what it needs, as far as things like nutrition and sleep, then many of our diseases just magically go away. It's really amazing when you stop and think about it.

SPEAKER_00 13:42

Mm-hmm. Yeah, it really is getting a coach up. Sometimes I think of the timeline of life as a path, and we're cruising down the path, and we sometimes come to a fork in the road. In some situations, it's really hard to tell whether to go down the left fork or the right fork. But which path you choose can make all the difference as far as what happens to you the rest of your life. When it comes to smoking, your decision should be crystal clear. Smoking is a complete disaster for the body. Choosing the wrong path will end up in a lifetime of addiction, misery, and premature death. So choose the right path. The path of being a non-smoker and doing whatever it takes to get there, whether it be prevention or cessation.

SPEAKER_01 14:20

For decades, the tobacco companies tried to hide the badness of smoking from us. They chose profits over the lives of loyal customers. So it's fair to say that as consumers, for a long time, say back in the 50s, we really didn't know that smoking was that harmful. Doctors even did commercials for some of the cigarette companies. But these days, there's no longer any question as to the terrible effects of smoking on the body. It says so clearly right on the package, even when you're purchasing it. So now, nowadays nobody can plead ignorance on this issue.

SPEAKER_00 15:05

Take up the whole show. So, but some of the biggies are cough, shortness of breath, less energy, frequent respiratory infections, heart attacks, strokes, many types of cancer, and many types of lung disease, premature aging, dry wrinkly skin, yellow teeth, stinking of cigarette smoke, and erectile dysfunction, and early death.

SPEAKER_01 15:23

Yikes. However, and you know, just as a as a mother baby nurse, I also gotta name SIDS among that with secondhand smoke. Um infant death syndrome. That one's just close to my heart to think about how effects of this on babies who really have no control.

SPEAKER_00 15:42

Well, come to think of it, you know, mothers who smoke, there there are lots of effects on babies. So that's just one of one of many. Again, the the the the downsides are just too numerous to list. But but yeah, from your point of view as a nurse in uh where you work, yeah, it has huge effects on mothers and babies.

SPEAKER_01 16:00

Yes. And before we get to the details of how to quit smoking, let's

Death Rates Money And Lost Freedom

SPEAKER_01 16:05

talk a bit more about the epidemiology of smoking. Because from the provider point of view, one of the most important things we need to do is to educate and motivate. Hopefully, if you're a smoker, then you will use these hard facts as motivation to help you quit.

SPEAKER_00 16:21

There's no other way to put it, coach. Smoking has been one of the greatest public health disasters in modern history. Smoking kills more than 8 million people worldwide every single year. And that includes about 1.3 million folks who never touch a cigarette, who die from secondhand smoke. And for every person that it kills, there are countless others who are made sick and miserable from smoking.

SPEAKER_01 16:43

In the United States alone, cigarette smoking causes more than 480,000 deaths annually. That's about one out of every five deaths. In fact, it kills more Americans each year than alcohol, illegal drugs, AIDS, motor vehicle accidents, and fire firearm-related deaths combined. If another product caused this level of harm, it would probably be banned worldwide. It's it's just staggering. It's sobering, it's profound. And if you do the math, smoking essentially wipes out a small American city every single year.

SPEAKER_00 17:20

Smokers lose about 10 years of life expectancy on average compared with people who never smoke. And smoking is responsible for hundreds of billions of dollars in annual health care cost and lost productivity.

SPEAKER_01 17:32

Let's also look at the personal economic impact. A packaday smoker often spends a quarter of a million dollars or more buying cigarettes over their lifetime. Had that money been invested instead, it could have grown into a million dollars for retirement.

SPEAKER_00 17:48

Imagine, kosher, opening your retirement account and seeing an extra $1.5 million sitting there. That'd be kind of nice, wouldn't it? That would be. Money that could be used where however you want, if cigarettes and tobacco corporations hadn't taken it from you. Think about what you could do with that extra $1.5 million. Travel, peace of mind, legacy for your kids, whatever. Instead, you are a smoker and you have squandered it away. So smoking doesn't just rob your health, it can also rob your financial future as well.

SPEAKER_01 18:16

Smoking also steals your freedom to live the way you want to live and do what you love. Most smokers don't simply lose years at the end of life. They often lose years of independence before they die. Years where walking across the room is exhausting. Years where climbing a flight of stairs is impossible. Years spent carrying oxygen tanks, recovering from heart attacks, strokes, or enduring cancer treatment.

SPEAKER_00 18:45

Every day becomes organized around the next cigarette, every trip, every flight, every restaurant, every family gathering, and every time you go to work, you have to think about when and where you can smoke your next cigarette. Imagine never having to think about that again. Wouldn't that be nice? People often think that quitting smoking is just about adding years to your life, but it's also about adding quality life to the years that you have.

SPEAKER_01 19:09

Yes. And there is premature aging. Smoking doesn't just damage your lungs, it ages nearly every organ in your body. It causes dry, wrinkly skin, yellows your teeth, causes bad breath, stains your fingers, contributes to hearing and vision loss, and makes you look way older than your years. And quite frankly, it can make you stink and smell bad. And for the guys, and this is a big one, it's a major cause of erectile dysfunction. That right there should make a lot of guys want to quit.

SPEAKER_00 19:39

That's right. And you know, coach, if if you're like me and a lot of other folks, you don't want to be a stooge for the tobacco industry. Remember, nicotine addiction wasn't an accident. Cigarettes were purposely engineered to keep you hooked. Tobacco companies spent decades manipulating nicotine delivery while downplaying the dangers. Every pack that you buy, every cigarette that you smoke is another victory for the industry that is making millions from your addiction, your disease, your misery, and your death. So at the end of the day, quitting is one of the most rebellious acts that you can take. It's like saying to Big Tobacco, I'm not gonna be your stooge any longer. You don't get to profit off my body anymore. And again, it's never too late. Even people who quit in their 60s and 70s can gain years of life and improve their quality of life. As we already talked about, you'll start to see the benefits almost immediately. Within days, food tastes better, breathing starts to improve, coughing often decreases, walking becomes easier, energy improves, and your body wants to heal. It simply needs the chance.

SPEAKER_01 20:38

If you do quit, your family benefits too. Quitting reduces your loved ones' exposure to secondhand smoke, and that improves their health. And your quitting models healthy behavior for your children and your grandchildren. Because the facts are that parents who smoke produce children who are more likely to start smoking. Your children are watching you. So when you quit, you're not just breaking your addiction, you're breaking a generational pattern. You're rewriting the health story for your family.

SPEAKER_00 21:12

So if you've been waiting for a sign that it's time to quit, this is it. Like my friend Ro, let this be your pivotal moment that creates a brighter future for you. There is never a perfect time. We can always make excuses why we can't quit right now. But like Ro, seize this day and make it happen. Your future self for the rest of your life is counting on the decisions you make right now, today.

SPEAKER_01 21:36

The best time to quit was 20 years ago. And the second best time is today. And most former smokers say the same thing. I wish I had quit sooner. And if you tried to quit before and slipped, that doesn't mean you failed. It means you're human. But every attempt rewires your brain towards a greater chance of success the next time.

SPEAKER_00 21:58

You know, it's interesting because About two-thirds of smokers want to quit. So why isn't it happening more often?

SPEAKER_01 22:05

The problem is that most people try to quit by themselves and with will their willpower alone. And some folks, like Ro do actually succeed. But for many people, going at it alone is a recipe for failure because nicotine is one of the most addictive substances on the planet.

SPEAKER_00 22:23

I have found kind of a formula for meaningful changes in our lives called the arch of wellness. And you can and you can actually see a visual representation of that at McMinnMD.com under the documents section. The first step to change, really of any kind, is awareness. You have to acknowledge that there's a problem. And then the next step is intention. You have to decide that you're going to actually do something about it. For instance, some people have the awareness that something is bad for them, but they have no intention of changing. So both awareness and intention are super important if you're going to enact meaningful change.

SPEAKER_01 22:55

So once you've decided that you're going to do something about it, then it's time to make a plan. And unless you've decided to go at it alone, that plan would include seeing a counselor and or a provider.

SPEAKER_00 23:08

Now I know I'm a bit biased, but I do think it would be helpful to have someone on your team to be a knowledgeable and caring medical provider, since there are some medications that may be helpful in your attempt to stop smoking.

SPEAKER_01 23:19

So now

The Five Stages Of Quitting

SPEAKER_01 23:20

let's move on and take a big picture look at how the process could work. Smoking cessation researchers identified five stages of quitting back in the 1980s. So stage one, that's what they call pre-contemplation. And the name is a bit of a giveaway. This is the stage before you're even thinking about change. You might know in some abstract way that smoking isn't great for you, but it hasn't really landed yet. Maybe you tell yourself it's not that bad or that you'll deal with it someday, or just don't think about it that much at all. And what often moves someone out of this stage isn't willpower, it's a crack in that denial structure. Cough that lingers, a number on a lab report, a spot on the lungs during an x-ray, or maybe a grandchild asking why you smell like smoke. Something small enough to notice, but big enough to plant a seed.

SPEAKER_00 24:18

And once that seed is planted, you've crossed into what we call stage two, which is contemplation. This is where you start doing the research, running the math on your health and your wallet, and actually start weighing whether change is worth it.

SPEAKER_01 24:31

Then stage three is preparation. This is where the real work begins. You commit, and ideally, you get help. Again, we recommend that you do not go at this alone. Don't set yourself up for failure. The nicotine addiction is just too strong for most folks. So see your provider, sign a smoking cessation contract with your official quit date, and consider picking a meaningful date, like a birthday, an anniversary, or a significant holiday. For instance, New Year's Day can be a great day when you start a new lease on life. That is the day when you will celebrate freedom from addiction and declare yourself a non-smoker.

SPEAKER_00 25:11

You know, coach, we're always evidence-based on this show. So here's what the data shows. About 95% of people who go it alone will be smoking again in one year. Ouch, coach, that kind of hurts. Whereas with proper counseling and medication, about 75% will still fail. Again, that's 95% versus 75%, and both are bad. 75% failure rate is still pretty bad, but it's a lot better than 95%. That goes to show the addictive power of nicotine.

SPEAKER_01 25:37

Another way to put it is only about 5% of people who try to do this by themselves will succeed at one year. But about 25% of people who have proper help will succeed in that year. So listen up. Getting some help in this super important endeavor improves your chances of success by 400%. That's super important. So be smart and get some help, and you'll be really glad you did.

SPEAKER_00 26:04

That's why both the U.S. Prohibitive Services Task Force and the American College of Physicians keep landing on the same conclusion. Behavioral counseling combined with medication is the gold standard of smoking cessation.

SPEAKER_01 26:15

Stage three is also where you start practicing positive imagery and visualization of your new healthier self. Also, consider starting a smoking diary and list your triggers that make you want to light up. Understanding those triggers will help you avoid a relapse. Also, learn some stress management tools that you can use when you have that urge to smoke, like go taking a hot bath, exercising, getting a walk around the block in, a stroll in the park, or call a friend or talk to a loved one.

SPEAKER_00 26:48

About two weeks before your quit date, start smoking cessation medications that you'll be taking. There are a couple of medications that may be particularly helpful to improve your odds of success, such as zyban and virinclin. Zyban has been around for decades and has a lot of good evidence. It roughly doubles the quit rate versus placebo and can be combined with nicotine replacement therapy. Whereas viriniclin remains one of the most effective single agents we have today for tobacco dependence. However, these drugs should be considered on a case-by-case basis. Not everybody needs them. And for some people, the risk may outweigh the benefits.

SPEAKER_01 27:21

Before your quit date, start slowly weaning off cigarettes, one or two per day, and see if you can get down to half of your initial intake.

SPEAKER_00 27:32

And then the night before your quit date, enjoy your last cigarette and then go around the house and through your car and your office and make sure that everything having to do with smoking is gone. All the cigarettes should be in the trash. All the ashtrays, lighters, gone, out of the house. And now when you wake up the next morning, you live in a smoke-free house.

SPEAKER_01 27:51

And finally, we're at stage four. This is where you actually slay that nicotine monster. This is your quit date. Ideally, you see your provider on your quit date to officially kick off the program and celebrate your freedom from those shackles of smoking.

SPEAKER_00 28:07

Then we recommend a brief office visit at least once a week for the first month. At this point, your provider needs to keep a close eye on things. Be sure to report any side effects of medications and also avoid alcohol during the stage since it lowers your inhibitions and may make it a bit easier to say yes to temptation.

SPEAKER_01 28:23

And during this phase, your doctor may recommend nicotine replacement. There are many forms of nicotine available, including gum, patches, lozenges, nasal spray, oral inhalers. You may want to consider a nicotine patch for steady state coverage, and then having some active, fast active forms like the lozenges, gum, or spray for those urgent cravings.

SPEAKER_00 28:47

There's another aspect of smoking called oral manual gratification. And what that means is the oral habit is having something in the mouth, and the manual habit is something in the hands. So with smoking, we're constantly going hand to mouth, hand to mouth with the cigarette. So adapt healthy substitution behaviors. Use, for instance, toothpicks, straws, or stir sticks, or anything else that puts something in your hands and in your mouth instead of a cigarette.

SPEAKER_01 29:12

And finally, there is stage five, which is maintenance, also known as long-term abstinence. Congratulations! Now you're through the worst of it. You have the right to be very proud of yourself at that point and reward yourself for this victory. Set aside money, the money that you would have spent on cigarettes, and buy yourself a real treat.

SPEAKER_00 29:33

But don't let your guard down. For some people, the temptation to pick up a cigarette never really leaves. But that one cigarette usually leads to more and more. And once again, you become a smoker. Another stat in the failed column. So instead of being proud of yourself, you actually start to despise the fact that you allowed smoking to get the best of you. So at this stage, continue to recognize and avoid your triggers. And as Nancy

Cravings Relapse Weight And Rewards

SPEAKER_00 29:55

Reagan once said, just say no.

SPEAKER_01 29:58

Going into this whole process, it helps to believe in yourself and to believe in your ability to succeed. Studies show that people who believe they can quit actually quit at a much higher rate.

SPEAKER_00 30:11

Another important tool is what we call behavioral support. This includes weekly visits, accountability, the smoking diary review, motivational interviewing, and stress coaching. Group counseling sessions may also be available. They offer peer support and they may be more affordable. Telephone quit lines may also be helpful. For instance, in the United States, there's one called 1-800 Quit Now, and that can provide counseling, free information about nicotine replacement therapy, and other resources. It's a really great resource to help you quit.

SPEAKER_01 30:41

Hypnosis can help with some folks too, even when other modalities have failed. And also acupuncture has been shown to help, including ear acupuncture with crest needles, which are quite easy to apply. And the patient response to this in the clinic that we saw, Dr. Mack, was really quite good.

SPEAKER_00 31:01

There are also some digital interventions, such as text message programs, for instance, a smoke-free TXT, lots of smartphone apps, and web-based interventions. And some workplaces offer financial incentive programs for smoking cessation.

SPEAKER_01 31:15

When you stack these tools together: medication, behavioral support, nicotine replacement, acupuncture, weekly accountability, your odds of long-term success multiply greatly.

SPEAKER_00 31:27

And to my doctor and provider friends out there, screening for smoking should happen with every single patient. And those identified as smokers should be offered a robust smoking cessation program. Especially of concern are those high-risk patients, such as the pregnant mothers we talked about, and folks with specific problems like diabetes, heart disease, and underlying lung disease. As it turns out, one of the most successful tools in getting people to stop smoking is their doctor telling them to stop smoking. So as a provider, do not miss this opportunity.

SPEAKER_01 31:56

However, we're not going to sugar quote this. Quitting is tough, and there will be some challenges along the way. Remember, the first few days are always the hardest. But you will be surprised how quickly the cravings fade when you have the right tools, the right support, and the right mindset. With the crave when the cravings hit you, keep repeating this mantra. This too shall pass. This too shall pass.

SPEAKER_00 32:24

That's a good mantra to use with a lot of things in life, isn't it, Lindsay?

SPEAKER_01 32:27

You're right.

SPEAKER_00 32:29

Yeah, I use it quite frequently, but a little bit more about cravings. Initially, they can happen fairly often, but the good news is that they usually only last about three to five minutes. And they come like waves, they peak and then they fade away. So try to distract yourself, like a glass of water, maybe do some deep breathing, go for a walk, listen to some music you love, and just try to survive those few minutes.

SPEAKER_01 32:50

Most relapses happen in the first three months, and they almost always start with just one puff. But that one puff lights the whole system back up. Your brain doesn't forget nicotine. It remembers it like an old friend and it'll welcome it right back in. So do your best to avoid that temptation. Sometimes, like a drug addict, you have to change who you hang out with just for a while to stay away from other smokers and certainly stay out of the smoking area at work. Don't risk it.

SPEAKER_00 33:24

But remember, if you do smoke that one cigarette, it doesn't mean total failure, game over. It's just a brief laugh. So just get right back on track.

SPEAKER_01 33:34

Also, you're probably going to gain a few pounds. And here's our actual clinical advice on that issue. We do not rec recommend going on a major diet while you are quitting smoking. The added stress works against you. Just practice healthy eating and moderate exercise and focus on the smoking cessation and deal with the weight issues later. It's just too hard to deal with weight and smoking at the same time.

SPEAKER_00 33:59

You know, we recommend that when you get to a year, reward yourself. This is a big deal. Take that money you would have spent on cigarettes, and for most of our patients, that's about $3,000 to $4,000, and put it towards something that will bring you some joy. That's real vacation money. So take a trip that you've always wanted to take, or buy that piece of furniture you've always wanted, buy some nice clothes that you would like, or create the emergency fund you've been needing. Make the reward visible and meaningful.

SPEAKER_01 34:24

And now, before we wrap this up, let's address the issue of vaping, which in some

Vaping Risks And Where It Fits

SPEAKER_01 34:30

situations is actually becoming quite popular, especially with young people. For someone who has never smoked, we certainly do not recommend starting vaping. Nicotine is nicotine, whether you get it from a cigarette or from vaping. And nicotine is addictive. So folks who vape are more likely to become nicotine dependent.

SPEAKER_00 34:50

And vaping has been shown in cardiovascular studies to cause stiffness of the arteries and damage the lining of the arteries. Also, in 2026, a meta-analysis reported that e-cigarette use was associated with disease outcomes such as cardiovascular, respiratory, and metabolic outcomes approaching or indistinguishable from cigarette use. And dual use, vaping and smoking, was associated with even higher odds of disease than cigarette use alone. So our bottom line is that we do not recommend that anybody start vaping.

SPEAKER_01 35:20

What about people who already smoke? Should they switch to vaping? Unfortunately, the answer isn't exactly clear. The evidence supports that nicotine e-cigarettes are more effective than nicotine replacement therapy for smoking cessation, but most U.S. professional organizations still recommend FDA-approved cessation therapies, perenoclein, buproprion, nicotine replacement therapy, for examples, as the first-line treatment, rather than switching to e-cigarettes. However, other bodies like the guidelines for the United Kingdom disagree.

SPEAKER_00 35:55

Certainly for somebody who already smokes cigarettes, switching completely to vaping may reduce exposure to many of the toxic chemicals produced by burning tobacco. So ideally, if vaping is used as a temporary step for quitting, then it should be used exactly as that, a temporary step towards cessation and not as a permanent substitute. The healthiest goal is to become free of both cigarettes and vaping.

SPEAKER_01 36:17

And our ultimate goal is freedom. Freedom from cigarettes, freedom from nicotine, freedom from addiction, and freedom from the tobacco companies who are profiting off the misery and death of their loyal customers as they take everything on to the bank, laughing as they go.

SPEAKER_00 36:35

In five years from now, you'll either be glad you quit today or you wish that you had. That choice belongs to you, and we hope that this podcast helps you make that right choice. And if you love somebody who smokes, and share this episode with them. This is not intended to be a lecture, it's just a helping hand. So let me close with this true story. When I was a kid, one of my favorite characters on TV in the marketing space was the Marlborough man. He was this rough-looking, weather beaten, handsome cowboy, the kind of macho dude that men and boys all wanted to grow up to be. The character was actually played by several men throughout the years, and many of whom were heavy smokers in real life. Almost all of these Marlboro men that were smokers went on to develop things like emphysema, COPD, and lung cancer. And for many it was the cause of their death. One of my favorite was a guy named Wayne McLaren. He's probably the most famous Marlboro man. He died at the tender age of 51 years old with lung cancer, as well as other respiratory diseases. In his latter years, he much regretted smoking and he regretted his association with the tobacco industry, and he became a passionate crusader for the anti-smoking movement. So what looks like macho and sexy in your younger years can lead to misery and death in your older years. And again, I've seen so many of these folks on the Gurney in the ER. It's not a pretty sight, folks. I can guarantee you that every single one of them wishes they had stopped.

SPEAKER_01 37:57

And it's our greatest hope that if you are a smoker, this podcast will plant a seed of thought that will ultimately move you toward a path of nicotine freedom. We wish you all the best in your journey to better health and wellness.

SPEAKER_00 38:11

Well, coach, that'll about do it for this edition of the Wellness Connection MD podcast. And thank you so much for listening. I hope that we were able to share something with you that informed you and inspired you.

SPEAKER_01 38:21

And before we part, I'd like to remind our folks listening that our podcast is one of the rare podcasts these days that remains completely unbiased and commercial free. So if you would like to make a contribution to the show to help us keep

Marlboro Myth And How To Help

SPEAKER_01 38:35

it coming, then there are a couple ways that you can contribute.

SPEAKER_00 38:41

First, if you buy nutritional supplements and we're not asking you to buy anything you don't already take, then consider purchasing physician grade supplements from our Full Script Dispensary at a 10% discount. You can see the link to Full Script in the show notes, or you can go to McMinnMD.com and the link will also appear there at the bottom of the homepage under Helpful Links.

SPEAKER_01 39:00

It's quite simple. Just click on the link and they'll guide you through the process. It's a win-win. You get the high-quality supplements at a discount, and we get your support for the show, for which we're forever grateful.

SPEAKER_00 39:12

Or you can also make a contribution directly to the show via credit card or PayPal at the Support the Show link, which is also in the show notes. And thank you so much for your support. It really means a lot to us.

SPEAKER_01 39:23

Please don't forget to subscribe to the show so that you won't miss any episodes and tell your friends and family about us. Help us spread the word about evidence-based, holistic, functional, lifestyle, and integrative medicine.

SPEAKER_00 39:36

And if you like the show, please then help us by taking a moment to rate us on iTunes.

SPEAKER_01 39:40

And if you want to reach out to comment to us on the show or make a recommendation for future topics, then you may do so at drmcmin at yahoo.com. And if you'd like to view a complete transcript of the show, then go over to McMinnmd.brsprout.com and you will find it there.

SPEAKER_00 40:00

And now, coach, can you please leave us with one of your wonderful coach Lindsay pros of wisdom?

SPEAKER_01 40:06

You know, remember this. Cigarettes don't just take years from your life. They often take life from your years, like we talked about. And if you're a smoker, know that it's never too late to choose freedom. And if you love someone who smokes, never underestimate the power of a kind word or a hopeful conversation like Dr. Mack had with Roe. Sometimes one small seed of encouragement can grow into a lifetime of healthier living.

SPEAKER_00 40:34

Well, thank you so much, Coach. And uh that should do it. Until next time, stay curious, stay informed, keep it real, and remember small actions like quitting smoking can lead to big changes. Take that first step towards better health.

SPEAKER_01 40:46

This is Coach Lindsey signing out.

SPEAKER_00 40:49

And this is Dr. McMahon. Take care. Be well.