Category: Healthy Living

Despite his age, Mr Ithnin looks strong and able. You can still see his youth shine through as he speaks passionately about his bikes and riding experiences. Mr Ithnin, an ex-smoker, has kicked his smoking habit and remained smoke-free since 2013. This is a story of someone who quit for his daughter’s sake, only to become healthier and embrace life to the fullest.

I was 16 when I took my first puff. Smoking at that time felt grand; I felt like I was a ‘somebody’ whenever I smoked. It never crossed my mind how bad smoking could be in the long run.

I became a chain smoker after I joined the Navy. I went from about 4-5 sticks to 40-50 sticks per day!

Marriage and change

I swapped my wild days when I got married to my first wife, Ziza; she didn’t like me smoking or riding bikes as she saw them as ‘dangerous’. Riding, in fact, was my greatest passion and I loved motorbikes. But, despite how reluctant I was to give up riding, I did because I loved my wife more.

Quitting, as I recalled, was never a tough one. I was 22 then. I thank my strong willpower for that; when I decided to quit, I quit. It was also about the people I spent my time with. For instance, when I received an invitation to tea with friends who smoke, I turned down the invite with a friendly excuse, because I knew I would be tempted if I were to see them smoking!

Back to square one

I hit rock-bottom when my wife passed away due to cancer in 2012; I was in great grief. Not knowing what to do, I quickly found myself puffing away incessantly; it’s my way of dealing with her cancer and later, her absence in my life. I can’t even remember the number of smokes I had per day; I just took a puff whenever I thought about her.

Three months after my wife’s death, I picked up riding again in addition to smoking. Like her late mother, my daughter got concerned whenever I took the bike out; she worried about my safety and health. It hit home when she said, “Mom has passed away and I don’t want you to go too” and that’s when I decided that I should stop smoking.

The road to cessation

I joined the quit smoking program at UKM Medical Centre, as suggested by my daughter. Under the guidance and advice from Dr Linda and Dr Rashidi, I managed to follow the program to completion and stopped smoking after about a year.

The program itself was interesting. It is a weekly group counselling that lasts from 1 to 1 ½ hours. I attended lectures, had my breath tested for smoke and was given nicotine gums to help with quitting. It didn’t interfere with my daily schedule at all. The program was so helpful that I even imparted what I’ve learnt from the centre to help my friends who are thinking of quitting.

If there’s one thing from the program that left quite the impression in me, it has to be the slideshow on a smoker’s lung. It was frightening! I had never really given a thought about how smoking would be for my lungs until I saw the slides. The slides showed how my lungs would become darker over time, becoming black even, if I kept smoking. These images were enough to put me off smoking.

Smoke-free & care-free

Life has changed since I stopped smoking. I found the will and strength to move on, and with God’s blessing, I found a wonderful woman to become my wife. Life is great with my wife and my family, and I really feel blessed.

I still go on a ride now and then with my bike, especially with my friends. We are planning to ride up to Cambodia soon, and I am really looking forward to it!

Do you know?

Don’t worry if you cannot locate a smoking cessation clinic in your neighbourhood. You can also choose to visit a retail pharmacist for help in quitting smoking.

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The moment Mun walked into the Café, all pretty in a black floral print dress, and ordered a cup of green tea latte, you know she has confidently made her choice – to be smoke-free and to live healthily. Mun, an ex-smoker, has successfully abstained from smoking for 7 months and counting. Here’s the story about her endeavour.

Why did I start smoking? I was curious. My cousin and I would go to a petrol station to buy a pack, and we’d share the cigarettes between us. We would puff away at a nearby park before heading home. No one in my family knew, and eventually I became hooked on smoking.

Hooked

At first it was only about 10 cigarettes a day, but over a period of 8 years, the number gradually increased. Smoking became my source of comfort. It somehow felt natural, like it was the only thing to do whenever I feel frustrated or stressed.

Putting a stop to it

When I was 25, I developed a throat infection, which the doctor discovered was caused by my smoking habit. I was told that I had to quit or the infection would come back. Also, my boyfriends’ parents preferred that I quit. So yes, I had many good reasons to seriously consider quitting the habit.

It wasn’t easy quitting! I tried quitting on my own but the urge was strong; I quickly found myself puffing away despite my best efforts to stay smoke-free!

It was discouraging and things seemed hopeless after a while, but I came to know about the Quit Smoking Clinic at Hospital Universiti Kebangsaan Malaysia (HUKM) through my doctor; he referred me.

Fun times (really!) at the clinic

I started sessions at the clinic in November 2014. At first, I had to attend a weekly meeting, each one lasting about 3 hours, but as the programme progressed and I became better at managing my craving, once a week become every 2 weeks. All in all, the programme lasted half a year, but it did not affect much of my normal routine. To my surprise, the programme itself was fun. There was never a dull moment!

Thanks to the clinic, I reduced the number of smokes per day gradually over the course of the programme. From smoking one packet per day, it went down to 16 sticks, 14, 12 and finally none with the help of doctors from the programme and the prescribed medication.

The doctors were good; they were really patient and understanding. There was once when I was so close to giving in to temptation of taking a puff again; I was stressed at that time. The programme’s one-on-one counselling session turned out to be useful; I took on the doctor’s advice and decided to jog instead whenever I’m stressed. It works!

Would I be able to resist temptation when I see others smoke? Let’s be honest, I will still be tempted but I‘m better than that; I can now control myself.

Feeling good again

I have successfully quit smoking since December 2014. And, I do feel better now. I found that my sense of taste has improved; I can now taste food a lot better. I no longer need to search for smoking areas when I go shopping; which means more shopping time for me! And my friends are happy for me; we can all finally sit in the non-smoking areas when we meet up!

Do you know?

Many smokers find it easier to cope with withdrawal symptoms using aids such as nicotine patches and gums. These are available at retail pharmacies. Ask your doctor or pharmacist for more information.

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Nicotine in cigarettes (and other forms of tobacco) is addictive, and most regular smokers are addicted to that substance. Over time, the body and brain become so used to the constant presence of nicotine in the body, they have to adjust when the smoker decides to quit and nicotine is no longer present in its usual amount in the body.

These “adjustments” can result in what we call withdrawal symptoms. Some smokers may not experience them, but others do, and there is a possibility that you will experience them too when you attempt to quit.

In this section, we will share with you how you can manage these withdrawal symptoms.

EVEN EX-SMOKERS GET THE BLUES

Withdrawal is different for every smoker‚ but here is a list of the more common symptoms.

Withdrawal symptoms are usually the strongest during the first week after you quit smoking. Be prepared for them, but don’t worry – with the advice of your smoking cessation team, and some determination and willpower, you will be able to “survive” them!

But are withdrawal symptoms dangerous?

We will not lie, there may be times when you are so uncomfortable that you may think that you will expire if you do not light up a cigarette! However, there is no evidence that these symptoms will endanger your health. In fact, quitting the habit is one of the best things you can do for your health!

The 1st week is crucial!

It is worth repeating here that research has shown that if you succeed in abstaining completely – this means not even one cigarette! – within the first week, you are 9 times more likely to remain smoke-free a year later. It is very important, therefore, that you start your quitting efforts on the right track.

Unfortunately, the 1st week is also when the craving and withdrawal symptoms tend to be at their highest, which is why you should seek help from qualified professionals when necessary.

Now, let’s take a look at some ways your healthcare team can help you deal with withdrawal symptoms and other common problems associated with smoking. Let us start with nicotine replacement therapy (NRT), the go-to method used by most smokers with success.

DEVICES TO HELP YOU QUIT

“Nicotine replacement therapy (NRT) is the most common treatment for smoking cessation,” explains family medical physician Dr Rashidi Mohamed. “It employs a range of delivery devices such as gums and patches.”

Let’s take a closer look at some of these devices.

Patch Up Your Life

Nicotine patches: what are they?

These are transdermal patches – they can be placed on your skin to help reduce the symptoms of nicotine withdrawal.

How do they work?

According to psychiatrist and smoking cessation specialist Dr Amer Siddiq, these patches provide a form of nicotine that replaces the stuff you previously supplied your body through smoking.

However, these patches are different from cigarettes. “The nicotine is delivered more slowly and in a more stable manner,” explains Dr Amer. “Compare this to smoking, in which nicotine is delivered in a single dose (bolus) all at once.”

The patch releases a steady stream of nicotine, just enough nicotine to keep away withdrawal symptoms. Over time, your withdrawal symptoms will decrease and your doctor or pharmacist may lower the dosage of the nicotine in your patches. As a result, your body’s craving for nicotine will lessen as well.

How do you use them?

“You can apply them to the bigger muscles of the body, such as the pectoral muscles of the chest, the muscles of your back, or on the biceps (the muscle on your upper arm),” says Dr Amer.

He adds, “Do not put them at areas where the skin is thinner such as between the thighs or on your arms.”

Here are some tips from Dr Amer.

• Stop first. You should stop smoking before you start using a patch.
• Apply once a day. Morning is the best time. However, if the patch falls off during the day, you can re-apply a new one.
• No hair zone. Stick to hairless areas that will not rub constantly against your clothes. If you are particularly hairy and there is no available area to stick the patch, try shaving a spot just for the patch. 
• Rotate your patches. Each time you switch to a new patch, use it on a different part of your body. This helps reduce the chances of skin irritations such as itchiness and redness.

There are different brands of patches available, and they may have more specific instructions for use. Check with your doctor or pharmacist if you have any doubts about proper usage.

Are they safe?

In most cases, yes, although there are minimal reported cases of skin irritations such as itchiness and redness at the site of the patch placement. This is often seen after applying the first few patches and usually goes away after a week. For itchiness, there are over-the-counter treatments which you can apply to the affected area.

According to Dr Amer, some people may experience vivid dreams that can be distressing when the patch is used at night, but these dreams will go away within a week.

Dr Amer adds that the adhesives used in the patches may cause allergy in certain people. For these people, there are other alternative methods (such as nicotine gums) which may suit them better.

I still feel the urge to smoke after applying the patch!

Nicotine patches will not eliminate all craving or withdrawal symptoms – they serve to lessen the intensity over time to make it easier for you to remain smoke-free.

However, there are several reasons why a patch may not be working like it should:

• The dosage of nicotine is too low. Consult your doctor or pharmacist for the appropriate dosage.
• You may be using the patch incorrectly. Check the instructions on the package. If you still have doubts, consult your doctor or pharmacist.

But do they really work?

Well, a few years ago, there was a large study in Europe called the Collaborative European Anti-Smoking Evaluation (CEASE). CEASE involved 3,575 smokers and its purpose was to find out whether NRT success rate is affected by the dosage and duration of use of nicotine patches. This is what they found:

• Smokers are 9 times more likely to remain smoke-free one year later if they succeed in abstaining within the first week.
• Smokers using the 25mg patch have a generally higher success rate in staying smoke-free compared to smokers using the 15mg patch. They conclude that “a higher than standard dose of nicotine patch was associated with an increase in the long-term success in smoking cessation.”

Therefore, it may be worth discussing with your doctor or pharmacist about whether the 25mg nicotine patch is suitable for you.

Gum is the Word!

Nicotine gums: what are they?

These are somewhat similar to chewing gums, only they contain nicotine. Just like chewing gums, they come in several different flavours.

How do they work?
“They are somewhat similar to nicotine patches in that they release nicotine into the body to reduce withdrawal symptoms. The difference is that nicotine gums are shorter acting and, hence, probably safer for high-risk groups such as pregnant women or heart attack patients,” explains Dr Amer.

Nicotine gums can also be used as a way to keep your mouth busy and reduce your craving for cigarettes.

How do you use them?

Why, simple – just pop one into the mouth and chew! Dr Amer explains that chewing nicotine gum would release a spicy flavour – that is the medication present in the gum.

Getting the most out of your gum in 3 steps

1. Chew the gum slowly until you feel a slight tingling or taste the spicy medication.
2. Then, you should stop chewing and park the gum between your cheek and gum.
3. After a while, the tingling or spicy taste would reduce in intensity. When it is almost gone, chew again.
4. Repeat the above 3 steps until the gum is completely “flavourless”.

Your doctor or pharmacist would prescribe the number of gums you would need each day. The amount depends on how many cigarettes you smoke daily.

Here are some additional tips from Dr Amer:

• Usually, you would be advised to use one on the hour for every hour, but check with your doctor or the package for specific instructions as they may vary from brand to brand.
• Do not eat and drink for 15 minutes before and during chewing of nicotine gum.
• You may find it enjoyable to chew on the gum – especially when it comes in your favourite flavour! – but do not to take more than the prescribed number of gums a day.
• Don’t let them fall into the hands of children, who may mistake them for candies!

Are they safe?

Generally, yes. However, Dr Amer points out that people with recent dental work or chewing problems may have difficulties using nicotine gums.

And the Rest

While patches and gums are two commonly used smoking cessation aid in NRT, there are other options available in case neither patch nor gum is suitable for you, such as:

Nicotine lozenges

Works similarly to lozenges, these “hard candies” dissolve slowly in your mouth to release nicotine.

Some options (such as microtab and mouthspray) are not yet available in Malaysia but according to Dr Amer, they are being researched by the University Malaya Centre of Addiction Sciences (UMCAS). In the future, a few of these may make their way to our shores.

PRESCRIPTION MEDICATIONS

Depending on the case, a doctor may sometimes prescribe medications to help the smoker cope with withdrawal symptoms. These medications include:

BUT WHAT ABOUT…?

There are other new or recent methods that are purported to be useful in helping you quit the habit, but are they really effective or are just hype?

E-cigarettes. Debate – and controversy – arises over the possible use of e-cigarettes as an aid in smoking cessation therapy. Dr Amer explains, “So far, there were only 2 trials looking at its use for smoking cessation and both were small studies. We just don’t have the data to make any conclusion at this time.”

He points out that the World Health Organization (WHO) and the US Food and Drug Administration (FDA) at this point in time do not approve of the use of e-cigarettes for smoking cessation. Our Ministry of Health Malaysia holds the same stance.

Therefore, it looks like we should wait until we have more evidence to prove, or disprove, the effectiveness of e-cigarettes. In the meantime, there are already tried-and-tested reliable ways to quit the habit that you can fall back on.

Acupuncture and hypnosis. “The use of acupuncture and hypnosis has not been shown to be effective as a method of treatment in large clinical trials,” Dr Amer says. “However, they may be good options for a very limited group of patients.”

References:

Cochrane.  Can electronic cigarettes help people stop smoking or reduce the amount they smoke, and are they safe to use for this purpose? Retrieved on July 9, 2015 from http://www.cochrane.org/CD010216/TOBACCO_can-electronic-cigarettes-help-people-stop-smoking-or-reduce-the-amount-they-smoke-and-are-they-safe-to-use-for-this-purpose

Tønnesen, P, et al. (1999). Higher dosage nicotine patches increase one-year smoking cessation rates; results from the European CEASE trial. Eur Resp J; 13:238-246.

Smokefree.gov. Available at http://smokefree.gov/

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So, what’s your goal?

Whether you are quitting on your own or with the help of healthcare professionals, it is important that you have a set of clear goals to keep your eye on.

To demonstrate what we mean, imagine that we hand you a ball and ask you to kick it. You will probably kick it without caring where it goes.

Now, suppose we tell you to kick that ball into that goal over there. Your eyes will zoom in on the goal, and your brain will be working out how hard you should kick and from which angle you should come in from. You want to score that goal!

See? Having a goal can really make the difference in getting you motivated!

Having goals is also important because you can revisit these goals when you feel like giving up, and regain your determination to keep going.

Therefore, take time to write down your goals before you begin to quit. There is no “right” or “wrong” goal – as long as the goal can motivate you, you should write it down. If you are stumped, you can ask your family, friends, doctor or pharmacist for advice.

Controlling your craving

There are medications and devices such as patches and gums to help you manage your withdrawal symptoms, but there is another threat to your plan to quit: the craving for cigarettes.

Here are some tips to help you get that craving under control.

Identify your triggers.
Certain situations, people, or emotions can give rise to your cravings, so learn to recognize them. You can ask your smoking cessation expert for advice on how to do this if you are stumped. Once you have identified them, come up with ways to avoid them or, if avoidance is not possible, mentally prepare yourself to deal with them in the future.

Reward yourself for meeting your goals.
Pamper yourself when you successfully reach milestones in your smoking cessation plan. You would have some spare Ringgit around after quitting your cigarettes, so give yourself a treat. This helps you stay motivated to keep being smoke-free.

Work up a sweat!
Regular physical activity such as exercise can help keep your mind off cigarettes as well as keep you healthy and in good shape. Just think: the new you would be healthy and smoke-free, with a smoking hot body too!

Eat right to keep the extra kilos away
Unwanted weight gain is a possible withdrawal symptom that can be particularly demoralizing, but you can keep the extra flab away by practising a healthy diet. Eat a variety of food from all food groups, but in the appropriate portion size while keeping fats, oils, sugars and salt to a minimum. Coupled to regular physical activity (see above), a healthy diet will also improve your health and help reduce certain withdrawal symptoms such as problems with sleeping.

Stay positive, be positive.
Surround yourself with positive and supportive people. Not only will they keep you motivated, their presence can also help improve any mood swings caused by nicotine withdrawal. If you need more supportive people in your life, you can join a support group either in real life or in social media such as Facebook.

Don’t Give Up!

Standfirst: “It is important to know why you need to quit and how to quit. If you lapse, you should understand that such a thing can happen – the trick is to keep trying until you succeed. And you will succeed if you keep trying.” – Dr Amer Siddiq

Quitting the habit is not going to be smooth sailing for many people, so there may be moments when you slip up and light up despite your best efforts to resist the craving.

Don’t be so hard on yourself if you succumb to your craving. This is a small setback; it does not mean you are never going to succeed in quitting.

There’s always the next time

• You should have prepared a list of reasons as to why you want to stay smoke-free. Review these reasons, add to them if necessary, so that you will regain your motivation to try again.
• Think back about all those times you managed to go without smoking, or when you were able to resist temptation, and draw from them the strength to get back on track.
• Think about the possible triggers that caused you to slip up. Plan for how you will cope should they come up again in the future.
• If you slip up often, perhaps your medications are not working properly, or there are other possible reasons that you may not be able to identify yet. Share your concerns with your doctor, pharmacist or support group – together, you will be able to come up with a plan to get you back on track.
• You can also download apps that can deliver motivational messages, tips and other helpful materials to keep you going.

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Meningococcal disease strikes an estimated 1.2 million people each year – and out of these cases, a staggering number of 135,000 deaths are reported. In the United States alone, as many as 2,500 Americans are struck with the disease with roughly 10-15% of cases taking a fatal end. For some of us, these figures might just be nothing more than statistics – mere numbers on a piece of paper. But for others, these figures represent real lives and real loss. They represent teenagers with bright futures awaiting them, small children probably too young to grasp the concept of life and death – all taken away far too soon from their families.

Mother on a mission

Lynn Bozoff’s son, Evan would have been 36 years old this year if he had not lost his battle with meningitis 16 years ago. An honour student and a pitcher on his college baseball team, Evan was the definition of healthy. But everything came crashing down when he was struck by meningococcal disease.

“In just 26 days, in 3 different hospitals, Evan’s body was ravaged by the illness. Both his arms and legs were amputated but that wasn’t enough to salvage his life. He had to endure 10 hours of seizures, lost liver and kidney function and was finally declared brain dead,” Lynn recounts. As devastated as she was by her loss, she eventually picked herself up and channelled her grief into the National Meningitis Association, a non-profit organization aimed at educating families about meningococcal disease and its prevention because “no parent ought to watch their child be taken off life support and be carried away.”

One crucial preventative measure, stresses Lynn is vaccination. “I’ve always been a mother who vaccinates her kids. But at that time, I wasn’t aware there was a vaccine for meningococcal disease. The bottom line is that my son didn’t have to die. There were vaccines which could have saved him but we were not informed about them.”

Awareness is key

Like Lynn previously, many are unaware of the dangers of meningococcal disease and the importance of getting vaccinated against it. A survey by public health initiative, Voices of Meningitis found that out of 2,000 mothers in the US, 45% didn’t realize that the disease could result in death within 24 hours of symptom onset while 28% thought receiving the vaccine’s primary dose was vital but a second dose wasn’t essential. The Centers for Disease Control and Prevention (CDC) recommends that children receive one dose of the vaccine at age 11 or 12, accompanied by a second one at 16 years old. As vaccine protection tends to diminish within 5 years, the importance of a second shot cannot be overlooked.

Hence, Lynn hopes with more awareness initiatives, parents will be well-informed on how to protect their kids in every way possible. “I’m not afraid of vaccines. I’m afraid about what occurs when parents choose not to vaccinate.”

The 411

• Meningococcal disease is caused by the bacteria Neisseria meningitides. This disease can include septicaemia (blood infection) or meningitis (inflammation of the membranes surrounding the spinal cord and brain).
• Most survivors fully recover without permanent after effects but some are left with long-term disabilities like limb loss, mental retardation and hearing loss.
• It can transmit via infected respiratory secretion and close, prolonged contact with infected people increases the risk.
• It may strike anyone of any age. However, young adults and small children are mainly affected.

References:

Meningitis Research Foundation. Available at www.meningitis.org

Voices of Meningitis. Available at www.voicesofmeningitis.org

WebMD. Available at www.webmd.com

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Our head and throat are comparable to a close-knit neighbourhood. The throat and the ears share the same kind of lining layers, composed of similar cells, and therefore, they can be infected by the same type of germs. It is possible, hence, for us to have a sore throat, followed shortly by an ear infection. If we are really unlucky, we may suffer from both at the same time!

Ear, hear!

While a sore throat may seem like a simple problem – just take some lozenges – ear infections are a different story. If left untreated, they can open up a series of possible complications, some of which are as follows:

• Rupture of the eardrum and/or infection of the mastoid bone (mastoiditis). The mastoid bone is located behind the ear, and its air spaces play a major role in voice resonance, acoustic insulation and dissipation among other functions. Both conditions can lead to hearing loss.
• Throat infection such as strep throat can cause the formation of pus or abscesses that can spread to other areas of the head and throat. Strep throat, if remain untreated, can also damage the heart, nerves, skin, and joints.
• Infections by certain bacteria can sometimes lead to rheumatic fever or post-streptococcal glomerulonephritis when left untreated. Post-streptococcal glomerulonephritis is a condition that can eventually cause kidney damage; fortunately its occurrence is quite rare.

While there is no certainty that ear infections would occur with each throat infection (in fact, the chances of more severe ear infections happening as a consequence of a throat infection are pretty rare), it is still an indicator that we should not take our sore throats lightly. Nipping the problem in the bud – or in the throat, in this case – may prevent us from having problems with our ears later on.

Therefore, consider seeing a doctor if we have a sore throat that persists over a period of time despite repeated over-the-counter treatments (lozenges, etc). We may need something stronger, such as antibiotics, especially if the pain is intense, persistent ulcers are present, and we experience other worrying symptoms such as fever and swollen lymph nodes (which can appear as small hard lumps around the neck and behind the ears).

References:

MD Health. Available at www.md-health.com

WebMD. Available at www.webmd.com

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From L-R: Dr Annathurai Ranganathan (Head of Corporate Social Responsibility Unit, Asian Football Confederation), Assoc. Prof Dr Amer Siddiq Amer Nordin (Nicotine Addiction Specialist, University of Malaya), YB Dato’ Seri Dr Hilmi Bin Haji Yahaya (Deputy Minister, Ministry of Health Malaysia), Assoc. Prof Dr Helmy Haja Mydin (Respiratory Physician, University of Malaya), Stuart Crabb (Country Director, Retail Group, Johnson & Johnson), and Mr S. Sivanasvaran (Head of Sports Science, Football Association Malaysia) at the official launch of “Do Something Amazing” campaign.

Let’s “Do Something Amazing”! The campaign, an initiative from Johnson & Johnson Malaysia to encourage smokers to quit smoking, was officially launched by Deputy Minister of Health Malaysia, YB Dato’ Seri Dr Hilmi Bin Haji Yahaya. In attendance were experts from University Malaya (Assoc Prof Dr Amer Siddiq and Assoc Prof Dr Helmy) and key personnel from prominent football associations (Dr Annathurai Ranganathan from Asian Football Confederation and Mr S. Sivanasvaran from  Football Association Malaysia). Representing Johnson & Johnson Malaysia was Stuart Crabb, the Country Director, Retail Group.

During the discussion panel, it was acknowledged that quitting the smoking habit is not easy. “Smoking cessation is both psychologically and physiologically challenging,” said Assoc Prof Dr. Amer.  According to him, nicotine addiction is a medical condition that requires the involvement of qualified healthcare professionals for quitting success. This requires goal-setting strategies and proper motivational techniques.

Dr Annathurai and Mr S. Sivanasvaran agreed, adding that such strategies can be helpful in educating young footballers about the dangers of smoking.

• It may take 8-11 attempts to quit successfully.  (Global Adult Tobacco Survey, 2011)2
• 80% of smokers attempted to quit without assistance.3
• Withdrawal symptoms ( irritability, concentration difficulties, etc) can arise.2 They are greatest during the first few days; relapses are common during this period.4,5
• The first week of abstinence is an important determinant for long-term success.4,5

A Strong Commitment

 ‘Do Something Amazing’ is Johnson & Johnson’s effort, through its Nicorette brand, to provide smokers with the right support and encouragement to discuss quitting matters with a healthcare professional. Nicorette intends to work with the Ministry of Health to promote better smoking cessation counseling among healthcare professionals. 

Stuart stresses that ‘Do Something Amazing’ is just the beginning. “We are dedicated to continuously discover and develop solutions for better health and life quality,” says Stuart. 

Hence, Johnson & Johnson introduced the  Nicorette® Invisi 25mg PatchTM in hopes of addressing this issue. A once-a-day solution, it delivers a controlled dose of nicotine for up to 16 hours to combat nicotine cravings and withdrawal effects.6 It reduces nicotine adverse mood withdrawal symptoms from week 1.4 Additionally, the Nicorette® Invisi 25mg PatchTM is found to be 44% more effective with higher continuous abstinence rates compared to the 15mg patch after 12 weeks.7

For more information on how to quit smoking, call Infoline at 03-8883 4400

References:

1. University of Nevada, Smoke free and fit, goal setting and preparing to quit,htpp://www.unce.unr.edu/publications/files/hn/other/fs9889.pdf, last accessed 14th May 2015  2. Publichealthlawcenter.org, Nicotine Dependence, Relapse and quitting smoking, http://www.publichealthlawcenter.org, last accessed 8th May 2015  3. Global Adult Tobacco Survey Malaysia 2011, last accessed 16th March 2015   4. Tønnesen P, et al. Higher dosage nicotine patches increase one-year smoking cessation rates: results from the European CEASE trial. Eur Resp J 1999; 13:238-246 5. Henningfield JE. Nicotine medications for smoking cessation. N Engl J Med 1995; 333:1196-1203. 6. Data on file. MHRA PAR; NICORETTE INVISI 10 MG, 15 MG AND 25 MG PATCH, PL 15513/0159-61, last accessed 16th March 2015 7. Data on file –CEASE 3  8. Infoline Berhenti Merokok, http://www.infosihat.gov.my/infosihat/media/Risalah/I/pdf/17_Ris_InfolineBerhentiMerokok_BM.pdf, last accessed 5th June 2015 

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Professor John McMurray   British Heart Foundation Cardiovascular Research Centre, University of Glasgow, UK

How do you end up with heart failure?

When your heart fails, it fails because something happened in the past that damaged your heart muscles. Heart attack is the main cause of heart muscle damage. The coronary arteries – arteries that bring blood to the heart muscle – become narrowed or blocked leading to a heart attack. Basically, as the blood supply to that part of the heart muscle is cut off, it causes heart muscle damage.

Signs of heart failure may appear anytime from a week to many years after an episode of heart attack depending on the extent of the heart muscle damage. “Patients may notice they start to get breathless when they are doing things. They may notice their ankles starting to swell and that’s when they have developed heart failure,” says Prof McMurray.

There are other causes of heart damage such as genetic abnormality, drinking too much alcohol and some anticancer medications.

What to do?

“The first thing is to make the diagnosis. A patient will usually present with breathlessness and swollen ankles,” says Prof McMurray. You have to recognise that these symptoms are not just part of getting older or becoming unfit. You have to see your doctor.

Your doctor will ask you questions relating to your health and examine you for signs of heart failure. When he suspects that you have heart failure, he will refer you to a cardiologist.

The cardiologist will do further investigation including echocardiography, which is an ultrasound scan of the heart. As soon as heart failure is confirmed, you will be prescribed medications, i.e., an ACE inhibitor, a beta-blocker and a mineralocorticoid receptor antagonist. Before these medications were available, patients with heart failure were three times more likely to die within 1 year, says Prof McMurray.

He elaborates that the medications will make patients feel better, make them much less likely to be admitted to the hospital and will increase their survival. He adds that there is a new improved treatment, which is currently under regulatory review.

Patients with heart failure require life-long treatment. If they stop taking the treatment, they will deteriorate and unfortunately, may die, he explains.

The heart failure medications are well-tolerated even though they have side effects such as low blood pressure, which causes dizziness or light-headedness, and slight worsening of kidney function. Generally, patients can remain on these medications because they feel better and they know that treatment is their best chance of remaining alive and well in the future. “Identifying heart failure early and treating it promptly can make an enormous difference,” says Prof McMurray.

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