ABC News' Dr. Tim Answers Questions About Smoking

Nov. 2, 2005 — -- Question: I am 65-year-old female and quit smoking after 40 years ago with Zyban. I quit on my 60th birthday. My dad died of lung cancer. I have some breathing problems. If my dad died with lung cancer, does it mean I will? I haven't had bronchitis since I quit smoking. If I could quit, anyone can.
- Helene Brownstead of Syracuse, NY

Answer: Congratulations for quitting. It's never too late to reap the health benefits of quitting smoking. Smokers who quit realize greater life extensions. Even those who quit much later in life gain some benefits. Recent research published in the British Medical Journal by Dr. Richard Doll showed smokers who quit at age 60 years added 3 years to their life expectancy. While individuals with a family history of lung cancer may be at increased risk of this disease, quitting smoking was a positive step in reducing this risk. Doll's research found that there is substantial protection against developing lung cancer for those individuals who stop smoking at your age.

While there are a few familial cases of lung cancer, it is not as commonly considered a genetically transmitted disease in the same sense as colon or breast cancer. The best thing that you did was stop smoking which substantially reduces the risk. Screening CT scans are being studied to determine whether they can catch lung cancer early in patients with an extensive prior smoking history (analogous to mammograms), but very large studies to determine whether they improve survival are ongoing. I would urge an evaluation from your primary doctor or a pulmonologist if you have breathing problems.
Consultation: Johns Hopkins Medical Institutions, Memorial Sloan-Kettering Cancer Center

Question: I have two parents who smoke: one heavily and one occasionally. My dad, the heavy smoker, has a lot of issues to deal with such as work, headaches worse than migraines, and knee troubles from football. He quit smoking once for a long time when he was hospitalized after head surgery, but due to the lack of cigars in N.C. on a trip he went back to smoking. I'd have to say he smokes more than a pack-and-a-half a day and not the lights either. If I can get him to quit, I can easily get my mom to, as well. He tried the patch, he tried the gum. What can I do? Is there anything out there strong enough to work if he can't mentally do it himself? What are some ways for him to relieve stress so as not to turn to smoking? - Ray Megill, Clark, NJ

Answer: Most smokers attempt quitting several times before they make it for good. The key to quitting is to keep trying. Practice will help your father better plan what to do the next time he quits and gets an urge to smoke. There are many new treatments in addition to nicotine replacement. Your father should talk to his doctor about some of these methods, including medications such as bupropion and joining a support group. Remind your father, it's never too late to reap the health benefits of quitting smoking.
Consultation: Johns Hopkins Medical Institutions

Question: Exactly how many of the quoted 160,000 lung cancer-related deaths are directly caused by smoking?- Terri Hergins, Kansas City, MO

Answer: Smoking is directly responsible for more than 80 percent of lung cancer deaths, which total more than 160,000 annually, according to the American Cancer Society. Lung cancer is one of the most difficult cancers to treat, but one of the most preventable. Cigarettes contain more than 4,000 chemicals, many of which are known to cause cancer.
Consultation: Johns Hopkins Medical Institutions

Question: I began smoking at age 19 and smoked about a pack a day for 20 years. For the last 13 years I've smoked maybe 4 to 5 a day with one entire year in abstinence. (I am 53). I have quit for good in the last month, but I'm concerned because I have a "shadow" on my right middle lung lobe. I get annual CAT scans to make sure it's not changing, but I'm worried. Should I get a second opinion or more frequent CAT scans?- Judy Daggett, Kansas City, MO

Answer: When a radiologist reads a CAT scan, they can usually be more specific than calling it a "shadow." A second opinion would be quite reasonable, and I would suggest seeing a pulmonologist. The pulmonologist might recommend continuing with CAT scans, possibly more frequently, like every 3 to 6 months. The pulmonologist might recommend getting a sample of tissue from the problem area, if he suspects it is a cancer. With your smoking history, there is an increased risk of cancer and this finding should definitely not be ignored.
Consulation: Fox Chase Cancer Center, Philadelphia

Question: Why does everyone jump to lung cancer? There are many other effects on the lungs from smoking, such as: emphysema, asthma and related problems. Could you address these also?- T. Solomito, Oviedo, Fla.

Answer: Emphysema, asthma, and other lung ailments, as well as heart disease and other health problems are a result of smoking. All of these conditions together create an enormous burden on the health care system in America and their aggregate cost is tremendous. Though the numbers of people affected by asthma, emphysema and heart disease is greater than the number of people with lung cancer, these conditions are often chronic, and unlike lung cancer, are not usually fatal within a short period of time. Most people who are diagnosed with lung cancer are already in an advanced stage of the disease and their clinical course is often more dramatic, and their decline more precipitous.
Consultation: Fox Chase Cancer Center