Health Q&A: chronic obstructive pulmonary disease and nicotine gum addiction

Dr David Roche / 30 July 2013

Saga Magazine’s GP on chronic obstructive pulmonary disease and nicotine replacement gum addiction.



Chronic obstructive pulmonary disease

Following a severe cough for a year, my GP has told me I have COPD (Chronic obstructive pulmonary disease) and asthma. [I have to take two inhalers, Seretide 500 Accuhaler and Tiotropium each day.] I have not smoked for 40 years, so am really upset to have been given this diagnosis. Will the condition shorten my life? Does the fact that the lungs do not work properly weaken the heart? I also have high blood pressure. What can I do to try and stop the COPD damaging my health?

 

COPD is a degenerative lung diseases caused by a breakdown in the structure of the lungs. Most, but not all, cases occur in smokers or ex-smokers or those who have been exposed to a lot of air pollution.

Once it has occurred the structural damage is permanent and tends to progress with time, the emphasis then moves on to controlling the problems it causes, such as breathlessness, cough, mucus production and episodes of infection.

Inhalers are used to maximise the air getting into the lungs and will also reduce the frequency of infections and the amount of mucus produced. Poorly-controlled COPD can shorten your life but, with care and appropriate treatment, it does not need to, though it may impose limitations.

In its advanced stages the condition can indeed put extra strain on the heart leading to heart failure, where the heart does not pump very effectively. All the more reason to control the condition as well as possible.

The most under-used treatment for COPD is regular exercise. It has been shown that structured exercise programmes can improve the ability and breathlessness of patients and many areas now have ‘pulmonary rehabilitation’ classes. You should explore if you can get access to classes such as these.

Nicotine replacement gum addiction

 I started chewing Nicorette gum (2mg) in 2001 to help me stop smoking, but became addicted to it. I now chew 17-25 pieces a day. For the past three years I’ve suffered acute nervousness, difficulty concentrating, poor memory, woolly feeling in my head, depression, my eyes are too light-sensitive and I have an itchy scalp. I’m sure these problems are all caused by the gum.

A brain scan was said to be ‘all clear’ and a neurologist prescribed anti-depressants. I haven’t taken these as I don’t want to become addicted to them as well. Any advice?

 

Nicotine is, of course, very addictive. Fortunately, it is much less of a health risk than smoking since it is the additional chemicals in the tobacco that carry the risk of cancer, of damage to lung tissue and the acceleration in the development of blood vessel diseases. It is clearly a big problem for you and has become very well established. Your brain has become accustomed to having nicotine around and is not prepared to consider the alternative.

Over time it is possible to convert the brain to a new belief! The easiest way is to very slowly reduce the amount of nicotine present. Set yourself a limit on the amount of gum per day and reduce this by two pieces every month. Take the long view, it may take a year or two to slowly wean yourself off, any withdrawal effects will be minimised by this slow approach.

If you cannot make progress yourself then try contacting the addiction services in your area (search on the net), they have expertise in helping patients break the habit with a variety of substances. It will still take an iron will, but it can be done. Good luck.



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