Smoking Cessation Matters Even More for Men

By Deborah Jeanne Sergeant

Aside from higher risk of lung cancer, men who smoke are more prone to develop early impotence, lower sperm count and greater risk of prostate cancer and cardiovascular diseases, say experts

In addition to the increased risks for health issues that both genders experience, smoking also raises risks exclusive to men — including erectile dysfunction, impotence, lower sperm count and greater risk of recurrence and dying for those diagnosed with prostate cancer.

In addition, smoking “is a causative factor in not only lung diseases but cardiovascular diseases. It affects the circulatory system and contributes to heart attacks,” said Albert Rizzo, chief medical officer of the American Lung Association.

Heart disease remains the leading cause of death in the US, followed by cancer and in fourth place, stroke. Of American men aged 18 and older, 14.1% smoke cigarettes, according to the Centers for Disease Control and Prevention. Rizzo said that 80% of lung cancers are related to smoking. In addition to allowing carcinogens into the lungs and subsequently other tissues, smoking compromises blood flow, which adds greater risk for bad outcomes to people with many health conditions, including cardiovascular disease, diabetes, high blood pressure and more.

“Some studies I’ve run across show there may be differences relating to sex,” Rizzo said.

Some theorize that overall, men may be affected by cigarette smoking worse than women because they smoke more often, inhale deeper or smoke longer in duration than women.

The psychology behind smoking matters when it comes to cessation. Although many women began smoking to stay slim—smoking can depress appetite—or deal with stress, men tend to smoke for different, more complex reasons that are harder to shake. Embracing a healthful diet and exercise regimen can help control weight and engaging in self-care can help manage stress. Advertising campaigns for cigarette companies have made smoking appear rugged, manly and appealing to men, such as the long run of the Marlboro Man. The self-image of rebellion and independence hooked many men decades ago and made quitting more difficult. Smoking became part of their personality.

“It’s an addiction, one of the strongest known of, and rather than giving lip service to the fact that it’s a bad habit that will kill you, what will we offer can help you quit,” Rizzo said.

He recommends checking into the seven FDA-approved cessation medications to support an effort to quit, along with counseling to address the psychological reasons people smoke. A supportive environment at home and work can also promote success.

“Most have to try 10 to11 times before they’re successful,” Rizzo said. “They need a strong support group of family friends and counseling. They need support from those they live with. If your wife or husband smokes, it’s a great time for both of you to quit.”

The American Lung Association’s Freedom from Smoking program has proven helpful for many people who want to quit. It “uses techniques based on pharmacological and psychological principles and methods designed to help tobacco users gain control over their behavior and break their addiction,” according to its website. “Because no single quit method is effective for all tobacco users, the program includes a comprehensive variety of evidence-based, proven-effective cessation techniques. The curriculum also includes information about nicotine replacement therapy (gum, inhalers, patches, lozenges and nasal spray) and other FDA-approved smoking cessation medications such as Zyban and Chantix.”

Maciej Dryjski would like to see more men quit smoking.

“It raises the risk of heart disease and arterial disease,” he said. “It’s clear that cigarette smoking correlates significant with cardiovascular disease.”

Dryjski is a vascular surgeon at UBMD Surgery, director of Vascular & Endovascular Surgery at Kaleida Health and professor at Jacobs School of Medicine and Biomedical Sciences at University at Buffalo.

Dryjski said that not receiving regular check-ups can mean that health issues worsen far more than they would have, such as for the stereotypical men who won’t see a doctor until something hurts or won’t work anymore. Receiving a lecture from their doctor on smoking raising heart attack risk typically does not convince many men to quit. He also shares with patients that smoking is related to chronic obstructive pulmonary disease and cancers of the larynx, pancreas, bladder and lung. For some, learning they can lose limbs provides motivation.

While developing arterial plaque has genetic factors, smoking can accelerate its development by 10 years.

“As the disease progresses, people lose limbs because of the obstruction of the arteries,” Dryjski said.

Interventions such as stents and bypasses can spare life and limb. Continuing to smoke often causes the interventions to fail.

“The main factor is smoking,” Dryjski said. “When they quit smoking, we may salvage their limbs. Young men keep smoking and they are losing lower extremities and even arms.”