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Published: Monday, 10/17/2005

Can't quit smoking? Reduce the harm

Most of the 46 million people in the United States who smoke cigarettes realize they're committing slow-motion suicide.

Smokers know, for instance, that cigarettes cause about 90 percent of all cases of lung cancer, which will strike 170,000 people this year.

Some patients, diagnosed and treated early, are cured of the disease. Improved treatments do give other lung cancer patients better quality of life. However, barely 15 percent of them live five years after the diagnosis. About 160,000 lung cancer deaths will occur this year.

Those dismal figures are why stopping cigarette smoking is the best solution.

It never is too late to stop.

The typical smoker faces 1 chance in 6 of developing lung cancer. The smoker who stops at age 60 reduces that risk to 1 in 10. Stopping at age 50 cuts it to 1 in 17, and stopping at age 40 means a drop to 1 chance in 33. People who stop by age 30 have almost the same risk as individuals who never smoked.

However, for people who have tried to stop but can't, "harm reduction" may make sense until the next attempt to stop succeeds.

A new study of more than 19,000 European men provides strong scientific evidence that smokers can reduce the harm by smoking fewer cigarettes. Reported in the Journal of the American Medical Association (JAMA), the study found that reducing the number of cigarettes from 20 a day to 10 cuts the risk of lung cancer by about 27 percent.

The drop in risk probably would have been even bigger if the men hadn't resorted to "compensatory smoking."

Most people who cut back on cigarettes - for health or budget reasons - do the same. It's the tendency to get as many puffs as possible out of each cigarette. People smoke each butt right down to the filter.

In doing so, they unknowingly smoke extra cigarettes. They also inhale smoke that contains more of the hundreds of carcinogens and other toxic chemicals in tobacco. The tobacco at the butt end of a cigarette has a filtering effect. It collects chemicals from tobacco at the burning end. Smoke the butt-end tobacco, and you inhale more toxic chemicals.

Starting a harm reduction program also can reduce smoking's damage to the household budget. Suppose that each pack of cigarettes costs about $4. Smoking a pack a day means an annual tobacco bill of about $1,500. Cutting back to half a pack a day will mean about $750 that doesn't go up in smoke, and is less harmful.

New research also hints that increasing consumption of natural substances called "phytoestrogens" also can reduce the risk of lung cancer - by more than 20 percent. "Phyto" means "plant" and these healthful chemicals are found in many fruits and vegetables.

Rich sources include tea, coffee, red wine, tofu and other soy products, black-eyed peas and kidney beans, spinach, broccoli, and fruit.



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