Lungs hurt from smoking

Contents

I Smoke, and I’m in Pain — Is It Lung Cancer?

On the other hand, there are many good reasons to stop smoking, and if you do, your risk of developing lung cancer later in life will go down significantly. If the X-ray you had recently was a chest X-ray and it was normal, it is extraordinarily unlikely that you have lung cancer now. But the answer to your last question is yes, you should be worried about your future risk for lung cancer — worried enough to quit smoking.

Q2. I have, for the past two weeks, had pain in my back toward my shoulder blade. It sometimes travels down the back of my left arm, and at times I feel a tightening under my left arm. I am concerned that it may be lung cancer as I am an ex-smoker. I have no health insurance, so am hesitant to go to a doctor. I have no cough or shortness of breath. In fact, aside from the pain, I feel great. Is there something other than lung cancer that this could be a symptom of?

I understand your concern about lung cancer, given your history of smoking. However, there are many things other than lung cancer that could cause the symptoms you are having. They range from something as minor as muscle soreness to serious conditions such as heart disease, blood clots in the lungs or aneurysms.

Ironically, lung cancer would be less likely than all of the other things I listed, as most lung cancers produce no symptoms at all until they are very advanced.

If your symptoms ease or go away within another week or two, it’s probably nothing serious. However, if they get worse or if they persist for more than two weeks, you really should have them checked out.

Congratulations on successfully quitting smoking, and good luck with your continued tobacco abstinence.

Q3. I stopped smoking three years ago. This year, my X-ray showed lung nodule spots. My follow-up CT scan is scheduled. How or what percentage may it be cancer after 45 years of smoking? I was up to two and a half packs a day when I stopped.

Congratulations on stopping smoking. Keep up the good work!

The likelihood of a nodule representing lung cancer depends on the size of the nodule. On a chest X-ray, multiple small nodules are less likely to be lung cancer than a single nodule or a “mass” (larger than 3 cm, or about 1.5 inches).

Other factors that increase the likelihood of lung cancer in a nodule include older age, upper versus lower lobe location, and how the edge of the nodule appears (spiculated or jagged-edged nodules are more likely to be cancer than nodules with smooth edges).

Q4. I do not have lung cancer, but I have smoked for 50 years. My question is, Peter Jennings quit smoking yet still got lung cancer. It seems that if one quits, it really doesn’t seem to make any difference if they were a previous smoker. Is there any evidence to show that even though one quits that their chances of getting lung cancer are the same, or even higher? I hear of all kinds of “former” smokers who still got lung cancer years later.

Even non-smokers can and do get lung cancer, but the short answer to your question is that quitting smoking greatly reduces your chances of getting lung cancer. The evidence for this is absolutely unequivocal.

Yes, it is true that many patients with lung cancer are ex-smokers, but the risk of developing lung cancer in any one individual is much greater if that person continues to smoke. Within 10 years of quitting, former smokers reduce their lung cancer risk to half that of continuing smokers, according to the American Lung Association. And after 15 years, the risk of death is similar to people who never smoked.

There are so many reasons to quit smoking cigarettes, only one of which is to reduce your likelihood of getting lung cancer.

Q5. Why does one want to smoke when they have lung cancer and they have had two different sessions of chemo (radiation with the first session). Got rid of the first spot and another one popped up. What do you tell them? Help me with a person who wants to stop smoking.

Why someone smokes after having lung cancer is a common question. I often tell my patients that cigarette smoking is a combination of two extremely difficult problems. One is a physical addiction to nicotine, a very addictive drug. The other is the psychological addiction, or the habit of picking up a cigarette and smoking it (sometimes in association with other habits like having a cup of coffee or an alcoholic beverage). This sounds odd, but they really are two distinct problems, and this is one reason why smoking cessation is so difficult, even for those affected with tobacco-related diseases like lung cancer.

Many people can stop smoking for several weeks (which is long enough for almost everyone to overcome nicotine withdrawal) yet go back to smoking after that for various reasons, usually attributed to stress. There are a variety of products available to help overcome the physical addition to nicotine including nicotine patches and gum. There are also several prescription medications available like Zyban (bupropion) and Chantix (varenicline). These products work best when combined with behavioral modification therapy. This can be individual or group, but it is an extremely important part of the quitting process.

Smoking after lung cancer treatment greatly increases the odds of the cancer reoccurring in the future, as you have learned from personal experience. It also can lead to a host of other medical problems, particularly heart and lung disease. It is never too late to quit and I urge you to seek medical help for this problem.

Q6. I recently started smoking cigars, but I never inhale smoke into my lungs. I just take the smoke in my mouth and blow it out. My son is a respiratory therapist, and he says that the cigar smoke is still getting into my lungs. So, my question is how much of a risk of getting lung cancer by smoking the cigars the way that I do?

Your son is correct to a point. Any smoke you inhale, no matter how shallow, will get into your lungs. Cigar smokers have an increased risk of lung cancer; the risk is just not as great as it is for heavy smokers of cigarettes.

Cigar smoke, though usually inhaled in smaller quantities, is especially dangerous in its ability to cause mouth and esophageal cancer, because of the habit you describe of keeping the smoke in your mouth. Also, you do not have the benefit of inhaling though a filter, so the level of cancer-causing chemicals is likely even greater than you would get if you inhaled an equivalent amount of cigarette smoke.

Cigarettes produce an acidic smoke, while cigar smoke is alkaline. This means that the nicotine in cigar smoke can be absorbed through the lining of the nose and mouth. A premium cigar exposes a smoker to the same amount of dangerous chemicals as about 10 cigarettes.

Q7. With COPD and suffering a very serious heart attack, I’ve been told I have terminal lung cancer (left side), so I really see many reasons to stop smoking and many not to. If they cannot fix the heart, they cannot operate, so I die. And if they operate and the stuff has spread to the right side, I’m dead anyway. Now I’m at the point of not caring. I go to several doctors, then go to a charity hospital. They want CT scans and needle biopsies. When I tell them I don’t have any insurance, they tell me they will call and they never have. So why the hell care? Seems that without the insurance nobody gives a damn and the doctor just says “breathe till you can’t.” I know that if I stop smoking, it will greatly help the problem but why care about it anymore? No, I’m not sorry for myself because I’ve had a very good life, just maybe angry that I’m not allowed to fly anymore, and the hospital doesn’t seem to care. When I had some insurance and my kidneys failed, the nurses and doctors were all over me. Now it seems to me they don’t care to waste their time on what they make me feel — just a walking dead man. So what else is there?

It sounds like you have had to deal with a lot of health problems, and are rightfully frustrated. I cannot blame you for how you feel, and having to deal with all this without the benefit of insurance no doubt adds to your sense of frustration.

Let me suggest a couple things. First, not being able to tolerate surgery does not mean that you cannot get treatment, even curative treatment, for your lung cancer. I cannot say what that treatment would be without knowing what stage lung cancer you have, but inoperable does not mean incurable.

Nobody can make you care if you don’t already care, but saying you are “dead anyway” suggests to me that you have another (very understandable given your circumstances) medical problem: depression. Getting treated for these other problems will be difficult, if not impossible, if you are also suffering from depression.

There is assistance available to people without health insurance, and you should begin by not giving up on yourself, and seeking whatever resources are available to you. Start with your own state’s department of public health, and search for local resources available to uninsured persons for assistance in finding providers who serve uninsured, or underinsured individuals.

You already know that smoking is hurting you, and I agree with that.

Learn more in the Everyday Health Lung Cancer Center.

Everything you need to know about smoker’s cough

There are many complications associated with smoking and smoker’s cough, with many issues arising from damage to the cilia. The likelihood of developing one or more complications depends on how frequently someone smokes, the severity of their cough, and their overall health status.

Complications include:

  • increased risk of bacterial and viral respiratory infections
  • damage to the throat
  • changes to the voice, such as hoarseness
  • long-term cough and irritation

Damage to the cilia may lead to a build-up of chemicals in the lungs and airways, which can play a role in the development of:

Bronchitis

Bronchitis is an inflammation of the lining of the bronchial tubes – the tubes connecting the lungs to the nose and mouth. Symptoms include breathing difficulties due to a reduced capacity to carry air, and phlegm in the airways.

If bronchitis persists for 3 months or more, or is recurrent for at least 2 years, it’s known as chronic bronchitis. In 2015, 9.3 million people in the United States were diagnosed with chronic bronchitis. Smoking is the most common cause of this condition.

Chronic obstructive pulmonary disease (COPD)

COPD is a progressive disease characterized by difficulty breathing. The term COPD includes both emphysema and chronic bronchitis. Symptoms include cough, phlegm, wheezing, and tightness in the chest.

According to the National Heart, Lung, and Blood Institute, COPD – which is primarily caused by smoking – is the third leading cause of death in the U.S.

Emphysema

A form of COPD caused by damage to the alveoli – the air sacs in the lungs. As a result, the body struggles to get the oxygen it requires. Symptoms include breathing difficulties and chronic cough.

Incontinence

In women, smoker’s cough may trigger stress urinary incontinence. Some research suggests that women who smoke heavily are much more likely to experience a sudden and strong need to urinate than non-smoking women.

Lung cancer

Lung cancer is the leading cause of cancer death in America, and smoking cigarettes is the number one cause of lung cancer. According to the Centers for Disease Control and Prevention (CDC), up to 90 percent of lung cancers in the United States are linked to smoking with even occasional smoking increasing cancer risk.

Pneumonia

Tobacco use increases susceptibility to bacterial lung infections such as pneumonia. Symptoms of pneumonia include cough, fever, and difficulty breathing.

Some people, particularly those with underlying health problems, require hospitalization for pneumonia. Emphysema and certain other conditions can be exacerbated by this infection.

Social and emotional impact

Aside from physical effects, having a chronic smoker’s cough can impact emotional and social functioning.

For example, constant coughing can interfere with sleep and disturb others. It may interfere with socializing, and may be disruptive to family, friends, and colleagues.

The Wisconsin health officials also said that patients reported using open-tank systems and devices with interchangeable cartridges. Open systems allow users to concoct their own brews of vaping liquids, if they want.

Dr. Emily Chapman, chief medical officer for the Children’s Minnesota hospital system, said that in the last month or so, it had treated four cases of acute, severe lung damage — including respiratory failure — in teenagers who had been vaping. Although the hospitals’ patients have each shown improvement, Dr. Chapman said, it’s not clear if they will fully recover.

She also noted that investigating a teenager’s vaping patterns can be tricky.

“The risk here is that if people are presenting to hospital emergency rooms, or urgent cares, they either may not think of vaping as something that is threatening and may not include it in their history,” Dr. Chapman said. “Or if asked directly, they may not be comfortable sharing that.”

Dr. Chapman also said she was concerned about how much of the public believes that vaping is safe.

“The truth of the matter is, we have so little experience with vaping, relative to the experience we have with cigarettes and cigars. Recall how long it took us to figure out that cigarettes were linked to lung cancer. There is so much we don’t know.”

One recent study from Yale and Duke identified chemicals called acetals in some Juul e-cigarette liquids. Those chemicals, the researchers said, may be especially irritating to the lungs and can cause damage when inhaled.

Juul disagreed with the study’s conclusions.

“The researchers’ hypothetical exposure analysis failed to take into account real world conditions, including realistic human exposure to vapor products like Juul,” said Lindsay Andrews, a Juul spokeswoman.

Juul pods contain high levels of nicotine, which can cause addiction and health problems. Some experts worry about the effects of nicotine on a developing teenager’s brain, and some studies have suggested that nicotine ingestion can also affect the heart and arteries.

Why Does My Chest Hurt After I Smoke Cannabis?

In recent years marijuana has grown in popularity, with claims about its medicinal benefits being well-publicized. Because it is often used as a medicine, many people consider using weed as relatively safe, especially compared with dangerous drugs such as opioids.

However, like any medicine, weed can cause some unpleasant side effects. The infamous herb is probably best known for its effects on the brain, which range from mildly impaired coordination and memory to full-blown paranoia in some people. Cannabis can also cause some physical side effects. The most common of these include a dry mouth, dry eyes, and dizziness. One of the more unusual, but potentially serious, side effects is chest pain.

Of course, millions of people across the globe disregard the potential respiratory health concerns of marijuana consumption for its recreational (and/or medical) benefits. But on an actual physiological level, why do some people find that their chest hurts after smoking weed? Let’s take a closer look…

The Anatomy of the Chest – and Why Smoking Weed Might Hurt It

To understand why marijuana may cause chest pain, first we need to be familiar with the anatomy of the chest. And to be sure, you probably don’t recall much from your high school anatomy days, so let’s take a little bit of a refresher.

Your chest contains some of your most crucial organs, your heart and lungs. These are housed by your rib cage, which protects them from external damage and trauma. Small muscles intersperse the ribs themselves, called the intercostal muscles. These allow your ribcage to move in and out as you breathe.

Your lungs are connected to your nose and mouth by a tube called the trachea. At its base, this divides into two smaller tubes called the bronchi. In the lungs, the bronchi divide further into smaller tubes called bronchioles, and at the end of each one is a tiny air sac called an alveolus. Although these air sacs are very small, there are so many of them that they have a vast surface area, around 70m²! This massive surface area allows oxygen to effectively diffuse into the bloodstream, where it is transported to the heart.

Blood enters the heart through a vein called the pulmonary vein. It travels through the chambers of the heart and exits through the aorta, which transports oxygenated blood to the arteries and around the body. Once the oxygen has reached its target tissues and organs, blood is returned to the heart via the veins. It is then returned to the lungs for another dose of oxygen, and the whole process starts again.

Potential Causes of Non-Marijuana Related Chest Pain

If you are suffering from chest pain, your first instinct may be to panic. However, there are many different reasons for chest pain, and most are no major cause for concern. Although chest pain could be due to a serious problem such as a heart attack, it could just as easily be something as trivial as indigestion. Lung infections, pulled muscles, and panic attacks can all cause chest pain too, and the symptoms can be very similar.

Because of this, it can be hard to know whether your chest pain is a sign of something serious and requires medical attention. As a general rule, you should contact your physician urgently or call 911 if your chest pain:

  • Is severe
  • Comes on suddenly
  • Lasts longer than 15 minutes
  • Happens during exercise
  • Spreads to your left arm, jaw, or upper back
  • Is accompanied by palpitations, shortness of breath, nausea, dizziness, or sweating

If you have chest pain which does not fit the above criteria, it is still worth getting it checked out, especially if you have a family history of heart disease.

Down to Brass Tax… Why Does My Chest Hurt After I Smoke Weed?

There are several different reasons why weed can cause chest pain. It may seem obvious that smoking anything can cause problems in your lungs, but did you know that cannabis can cause heart problems too? Well, it can. Let’s take a look at some of the things that might be going on “under the hood” when you roast that bone…

Smoking Weed May Affect the Heart

In low doses, marijuana activates your sympathetic nervous system, causing your heart rate and blood pressure to increase. This reduces the amount of oxygen which is able to reach your heart muscle, and in susceptible people could lead to a heart attack.

In higher doses, it has the opposite effect. Your parasympathetic nervous system is activated causing your heart rate and blood pressure to decrease. This increases carbon dioxide production to rise, and oxygenation to fall, again raising the risk of a heart attack.

One report published in the Journal of Emergencies, Trauma, and Shock describes the cases of two men who were admitted to hospital following chest pain that came on shortly after smoking marijuana. Neither man was found to have any other risk factors for cardiovascular disease, but both had dangerous blood clots in one of the arteries that supply the heart muscles. One of the men went on to have a heart attack, but thankfully he was saved by his medical team.

Another report from the French Addictovigilance Network found that between 2006 and 2010, 1.8% of people who experienced adverse effects from marijuana had some form of cardiovascular disease. During this timeframe, there were 22 cardiac complications, 9 of which led to death. Almost half of these people had a family history of heart disease.

So it seems that cannabis use can contribute to heart problems, especially if they are written into your genes. But how about lung problems?

Chest Pain From Smoking Weed – Is It a Real Thing?

These days it is a well-known fact that smoking is bad for your lungs, but surprisingly it seems that weed could be even worse than tobacco on this front! Most people do not realize that cannabis contains many of the same harmful chemicals that are in tobacco. And because in many places it is still illegal, marijuana is not well regulated or subject to rigorous testing.

This unfortunate situation means that pesticides, bacteria, or mold could very well contaminate your weed. One particularly common contaminant is the Aspergillus mold, which can cause severe lung infections when inhaled. These infections can cause chest pain and may lead to pneumonia or even death if left untreated.

Another reason why smoking weed is worse than cigarettes is the way in which it is smoked. It is thought that when smoking cannabis, people inhale 66% longer and 33% deeper than tobacco smokers, and also hold their smoke in up to four times longer!

Because of this, it is estimated that a single joint could cause as much damage as 2.5–5 cigarettes! Smoking cannabis causes irritation and inflammation in your airways and increases your risk of bronchitis. Heavy users could even end up with lung conditions such as chronic obstructive pulmonary disease (COPD). However, the risk of developing emphysema is lower with weed than tobacco, and the link between cannabis and lung cancer remains uncertain.

Smoking weed has also been associated with an increased risk of pneumothorax (collapsed lung). This risk is higher in people under the age of 45. Cannabis can also cause chest pain due to coughing fits which could strain the intercostal muscles between the ribs.

Chest Pain from Smoking Marijuana… Not Your Only Pot-Related Health Concern

One of the most common downsides of marijuana use is anxiety. For most people, this is quite mild, but for others, it could lead to a full on panic attack. The classic symptoms of a panic attack can be very similar to those of a heart attack – difficulty breathing, clammy skin, a sense of impending doom, and of course, chest pain.

If you regularly suffer from panic attacks, you will probably be able to recognize the signs immediately. However, when this happens for the first time, it can be incredibly frightening, especially if you happen to be high.

The plus side of panic attacks (if there are any) is that they usually don’t last too long. They will generally pass within a few minutes, perhaps aided by some deep breathing and calming thoughts. If you find yourself in any doubt as to what is causing your symptoms, contact your doctor immediately.

Final Thoughts on Why Your Chest Might Hurt After Smoking Weed

Smoking pot is generally considered safe, but marijuana can hurt your lungs — and your heart — as well as having the potential to cause panic attacks. All of these conditions can cause chest pain which can be scary – especially if it is happening for the first time.

The chances are that if you are suffering from chest pain after smoking weed, you have probably just strained a muscle coughing or given yourself indigestion by hitting the munchies too hard. However, there is a small possibility that you may be suffering from a more serious problem such as a lung infection, bronchitis, or worst case scenario, a heart attack.

It is always worth getting any chest pain investigated, although in most cases a routine appointment will suffice. Be sure to be honest with your doctor about your marijuana use and any family history of heart disease so that they can make an accurate diagnosis.

If you have an ongoing problem with chest pain after smoking, you might also want to consider switching to another method of taking marijuana such as topical creams or edibles. Doing this might not necessarily prevent anxiety or protect your heart, but at least it will give your lungs a much-needed break!

Also, remember, if you experience any problems, always consult with your primary physician.

Article Sources: PC9wPgo8dWw+CjxsaT48c3BhbiBzdHlsZT0idGV4dC1kZWNvcmF0aW9uOiB1bmRlcmxpbmU7Ij48YSBocmVmPSJodHRwczovL3d3dy5oZWFsdGguaGFydmFyZC5lZHUvaGVhcnQtaGVhbHRoL21hcmlqdWFuYS1hbmQtaGVhcnQtaGVhbHRoLXdoYXQteW91LW5lZWQtdG8ta25vdyIgdGFyZ2V0PSJfYmxhbmsiIHJlbD0ibm9mb2xsb3cgbm9vcGVuZXIgbm9yZWZlcnJlciI+aHR0cHM6Ly93d3cuaGVhbHRoLmhhcnZhcmQuZWR1L2hlYXJ0LWhlYWx0aC9tYXJpanVhbmEtYW5kLWhlYXJ0LWhlYWx0aC13aGF0LXlvdS1uZWVkLXRvLWtub3c8L2E+PC9zcGFuPjwvbGk+CjxsaT48c3BhbiBzdHlsZT0idGV4dC1kZWNvcmF0aW9uOiB1bmRlcmxpbmU7Ij48YSBocmVmPSJodHRwczovL3d3dy5jZGMuZ292L21hcmlqdWFuYS9uYXMvaGVhcnQuaHRtbCIgdGFyZ2V0PSJfYmxhbmsiIHJlbD0ibm9mb2xsb3cgbm9vcGVuZXIgbm9yZWZlcnJlciI+aHR0cHM6Ly93d3cuY2RjLmdvdi9tYXJpanVhbmEvbmFzL2hlYXJ0Lmh0bWw8L2E+PC9zcGFuPjwvbGk+CjxsaT48c3BhbiBzdHlsZT0idGV4dC1kZWNvcmF0aW9uOiB1bmRlcmxpbmU7Ij48YSBocmVmPSJodHRwczovL3d3dy5uY2JpLm5sbS5uaWguZ292L3B1Ym1lZC8yNDM4NDU3NSIgdGFyZ2V0PSJfYmxhbmsiIHJlbD0ibm9mb2xsb3cgbm9vcGVuZXIgbm9yZWZlcnJlciI+aHR0cHM6Ly93d3cubmNiaS5ubG0ubmloLmdvdi9wdWJtZWQvMjQzODQ1NzU8L2E+PC9zcGFuPjwvbGk+CjwvdWw+CjxwPg==

Marijuana and Lung Health

The American Lung Association is concerned about the health impacts of marijuana use, especially on lung health. We caution the public against smoking marijuana because of the risks it poses to the lungs.

Scientists are researching marijuana now, and the American Lung Association encourages continued research into the effects of marijuana use on lung health.

Marijuana

The health effects of marijuana are determined in large part by how it’s consumed. Marijuana is most commonly smoked using pipes, bongs, paper-wrapped joints, blunts and other devices including those that heat or vaporize marijuana. Marijuana can also be consumed through dozens of different products including e-cigarettes, candy, brownies and other baked goods, capsules, beverages and many more.

While this statement focuses on marijuana and lung health, it’s important to note that there are other health concerns outside the lungs attributed to marijuana use that are not addressed here, including neurological and cognitive effects.1,2

Additionally, there are significant public health concerns associated with pediatric poisonings caused by accidental ingestion of edible marijuana products.3

Marijuana Smoke

Smoke is harmful to lung health. Whether from burning wood, tobacco or marijuana, toxins and carcinogens are released from the combustion of materials. Smoke from marijuana combustion has been shown to contain many of the same toxins, irritants and carcinogens as tobacco smoke.4-7

Beyond just what’s in the smoke alone, marijuana is typically smoked differently than tobacco. Marijuana smokers tend to inhale more deeply and hold their breath longer than cigarette smokers, which leads to a greater exposure per breath to tar.8

Secondhand marijuana smoke contains many of the same toxins and carcinogens found in directly-inhaled marijuana smoke, in similar amounts if not more.5 While there is no data on the health consequences of breathing secondhand marijuana smoke, there is concern that it could cause harmful health effects, especially among vulnerable children in the home. Additional research on the health effects of secondhand marijuana smoke is needed.

Lung Health and Marijuana Smoke

Smoking marijuana clearly damages the human lung. Research shows that smoking marijuana causes chronic bronchitis and marijuana smoke has been shown to injure the cell linings of the large airways, which could explain why smoking marijuana leads to symptoms such as chronic cough, phlegm production, wheeze and acute bronchitis.4,9

Smoking marijuana has also been linked to cases of air pockets in between both lungs and between the lungs and the chest wall, as well as large air bubbles in the lungs among young to middle-aged adults, mostly heavy smokers of marijuana.

However, it’s not possible to establish whether these occur more frequently among marijuana smokers than the general population.4

Smoking marijuana can harm more than just the lungs and respiratory system—it can also affect the immune system and the body’s ability to fight disease, especially for those whose immune systems are already weakened from immunosuppressive drugs or diseases, such as HIV infection.4,9

Smoking marijuana hurts the lungs’ first line of defense against infection by killing cells that help remove dust and germs as well as causing more mucus to be formed. In addition, it also suppresses the immune system. These effects could lead to an increased risk of lower respiratory tract infections among marijuana smokers, although there is no clear evidence of such actual infections being more common among marijuana smokers.4,9 However, frequent marijuana-only smokers have more healthcare visits for respiratory conditions compared to nonsmokers.10

Studies have shown that smoking marijuana may increase the risk of opportunistic infections among those who are HIV positive, although it does not seem to affect the development of AIDS or lower white cell counts.4,9

Another potential threat to those with weakened immune systems is Aspergillus, a mold that can cause lung disorders. It can grow on marijuana, which if then smoked exposes the lungs to this fungus.4 However, it rarely causes problems in people with healthy immune systems.

“Vaping” Marijuana

There is little known on the potential lung health effects of inhaling marijuana or products made from it through routes other than smoking. However:

  • Use of “vape-pens” to inhale cannabis concentrates or liquids may have similar respiratory health effects as e-cigarette use.
  • “Dabbing” (inhaling flash-vaporized cannabis concentrates) may also cause respiratory problems.

Medical Marijuana

The American Lung Association encourages continued research into the health effects of marijuana use, as the benefits, risks and safety of marijuana use for medical purposes require further study. Patients considering using marijuana for medicinal purposes should make this decision in consultation with their doctor, and consider means of administration other than smoking.

Bottom Line

  • Smoking marijuana clearly damages the human lung, and regular use leads to chronic bronchitis and can cause an immune-compromised person to be more susceptible to lung infections.
  • No one should be exposed to secondhand marijuana smoke.
  • Due to the risks it poses to lung health, the American Lung Association strongly cautions the public against smoking marijuana as well as tobacco products.
  • More research is needed into the effects of marijuana on health, especially lung health.

See our public policy position on marijuana and lung health.

6 Effective Ways to Heal Your Lungs After Smoking

Smoking is still one of the most common ways to consume cannabis. Unfortunately, this method is also one of the most harmful.

While researchers have yet to confirm that moderate cannabis consumption increases the risk of lung cancer and lung diseases, it’s safe to say that smoking certainly is not the healthiest choice in the world.

Research has shown that cannabis smoking causes both visible and microscopic damage to the lungs.

Fortunately, the evidence suggests that this damage can heal after you stop smoking. However, as long as you continue, the smoke may contribute to lung infection and cause symptoms of inflammation and chronic bronchitis.

Switching to a low-temperature vaporizer made from high-quality materials (glass, ceramic, medical-grade metals) can provide a similar effect to smoking while reducing the risk of inhaling hot embers and carcinogens released by burning plant materials.

Changing your consumption method is necessary for anyone hoping to restore the health of their lungs. Edibles, tinctures, and capsules are great alternatives. However, there are a few tips and tricks that can help your lungs heal after smoking. Here are six of them:

1.) Exercise

Like every other part of your body, lungs need exercise. The U.S. Office of Disease Prevention and Health Promotion recommends at least two and a half hours of moderate exercise each week.

Not only does exercise break up chest congestion, but it also boosts immune function and increases blood circulation. Increased blood circulation and heavy breathing increase the amount of oxygen in your system.

The U.S. National Library of Medicine reports that exercise may help flush bacteria from the lungs and airways, and the body temperature increase after exercise may prevent bacterial infection.

All of these factors promote healing and can help your lungs recover faster after smoking.

2.) Deep breathing

Though exercise encourages deep breathing, setting aside at least 10 minutes a day for a breathing practice can be extremely beneficial for the lungs. Desk workers, those who are inactive, or anyone who spends substantial time sitting may struggle with shallow breathing.

Shallow breathing happens when you take small sips of air, rather than drinking in a full belly-expanding breath.

Deep breathing works fresh air deep into the lungs, which can help break up buildup, mucus, and inflammation from after prolonged smoking.

The American Lung Association explains that without regular breathing exercise, stale air can be trapped in the low lungs. This makes less room for fresh, healing oxygen and lowers your exercise tolerance.

Deep breathing cleans out this stale air. For a simple technique, stand up and inhale slowly into the belly for five seconds. Then, exhale slowly for another five seconds. Increase the time as you feel comfortable.

3.) Nature bathing

Nature bathing does not necessarily mean taking a bath in nature, though many may find that relaxing. Nature bathing refers to spending time soaking up nature.

Research shows that the Japanese practice of Shinrin-yoku (forest bathing) is helpful in relieving stress and reducing depression. Additional studies have found forest bathing boosts immune function, which may aid in recovery after smoking.

Taking a hike through a forest or a stroll through a botanical garden is not only great exercise, but these environments are rich in fresh oxygen.

Natural areas tend to have better air quality. This means that you are likely breathing in less environmental pollutants that can further irritate the lungs and make it more difficult for them to heal after smoking.

4.) Nutrient-dense diet

Eating a nutrient-rich diet is important when you are trying to detox from just about anything. Inhaling any kind of smoke deposits carcinogens directly into the lungs. These carcinogens are free radicals, which cause damage to cells and DNA.

A diet filled with antioxidant foods can aid in neutralizing free radicals. Antioxidants are most abundant in fruits and vegetables. Blueberries, blackberries, leafy green vegetables, and green tea are all particularly high in antioxidants.

Wild-caught fish like salmon are also a good choice for smoking recovery. Salmon is high in omega-3 fatty acids, which can improve immune function and reduce systemic inflammation.

The pink coloration in salmon also happens to be caused by one of the most powerful dietary antioxidants, a molecule called astaxanthin. In animal research, this compound is known to inhibit breast tumor cells.

5.) Reduce household irritants

The air quality in your home can be a major contributing factor to lung infection. Research suggests that some household cleaners are harsh enough to trigger asthma attacks.

Homes that have been exposed to water damage can contain molds and mildews which contribute to allergy and can further irritate the lungs.

Household pets, mites, and dust can also contribute to allergy, causing symptoms of chronic inflammation.

Reducing household irritants is a great way to improve recovery for just about any health condition, but especially conditions of the lungs. Investing in a HEPA air filter can help, as can cleaning furnace filters and vacuuming regularly.

Bringing plants into the home is another way to add more oxygen to your daily surroundings. One houseplant per 100 square feet is a good place to start.

6.) Steam and essential oils

When you first quit smoking, it’s not uncommon to experience some chest congestion or residual symptoms of bronchitis as your lungs and airways heal.

To help break up mucus and eliminate some of the buildup, a trip to the sauna or a few steamy showers might help. Though, steam is likely more beneficial for upper respiratory problems than eliminating buildup deep in the lungs.

Peppermint, eucalyptus, or pine essential oils can also help break up congestion. All three are expectorants. Expectorants are agents that help remove mucus from the body, especially the lungs and large airways.

To use these essential oils, simply mix several drops into a carrier oil, such as coconut or olive oil. Then, rub the expectorants on your chest and back. Sleeping with these oils on is a great way to help break up congestion through the night.

Knowledge of Cannabis Fundamentals Is Important for Everybody

The online Cannabis Fundamentals Certificate Program covers everything you need to know about the essentials of cannabis. Cannabis history, science, botany, products, effects, dosing, and much more.

PMC

Dear Sir,

Cannabis is considered as a common recreational drug generally thought to be a relatively safe substance. However, we have, in the past 6 months, noticed that there is a possible connection between cannabis consumption and coronary disease. We report two cases of young men with no previous medical history admitted to our University Hospital Emergency Department (ED) suffering from acute myocardial infarction (MI) after cannabis smoking 1 h before admission. A further complication occurred in one of them with a cardiac arrest. A 23-year-old man spontaneously presented himself to our ED, suffering from acute chest pain after having inhaled cannabis 1 h before admission. He is a smoker (half a packet of cigarettes daily for 10 years), with a daily consumption of cannabis cigars (at least twice daily). Thorax examination and initial vital parameters were normal. The initial electrocardiogram (ECG) showed sinus rhythm with anterior ST elevation (V2 to V4) with reciprocal ST segment depression in the inferior leads . Twenty minutes after admission, the patient had a sudden cardiac arrest due to ventricular fibrillation successfully reversed by electrical cardioversion. A coronary angiography was quickly carried out, which showed a unique thrombosis at the initial portion of the anterior interventricular artery. A mechanical desobstruction was successfully performed with stenting, and angiographic control showed no abnormality. The angiogram did not show any obstruction of the other coronary arteries. The initial biological findings were normal, in particular the serum troponine Ic level. Six hours after presentation, the troponine Ic rose from 101 ug/L (normal <0.4 ug/L) to 367 ug/L (after 12 h). The urine drug screen (cocaine, amphetamine, heroine, tetrahydrocannabinol ) was positive only for THC. Clinical evolution was satisfactory, with full recovery, and the patient was discharged 7 days later. Further blood tests showed normal cholesterol and lipid levels. Connective tissue disorder (protein C and S, antithrombin III and cardiolipin) were negative.

Initial electrocardiogram of Case 1, which shows anterior ST elevation (V2-V4) with reciprocal changes in the inferior leads

A 29-year-old man spontaneously presented himself to our ED 1.5 h after cannabis smoking with chest pain radiating to his left shoulder. He is a smoker (20 cigarettes a day for 10 years), using cannabis daily. He has a positive family history of hypercholesterolemia. The initial ECG showed sinus rhythm with anterior ST elevation (V2 to V4) . The initial serum troponine Ic level was at 1.1 ug/L (normal <0.4ug/L) and increased to 320 ug/L 6 h later. The urine drug screen was positive only for THC. Coronary angiogram showed a single thrombosis at the initial portion of the anterior interventricular artery. A mechanical desobstruction was successfully performed with stenting. The patient was discharged 5 days later. As for the previous patient, further blood tests investigating coronary risk factors were negative.

Electrocardiogram of Case 2, which shows anterior ST elevation (V2-V3)

Marijuana is the most widely used illicit drug in the Western countries. It has several well-known side-effects on the cardiovascular system, documented for three decades, and cannabis is suspected to cause sudden death. In a recent report, Caldicott et al. reviewed 43 patients affected by acute cardiovascular events associated with cannabis consumption and, among them, only six patients had MI. In the Determinant of Myocardial Infarction Onset Study (3882 patients), the risk of MI onset was multiplied by 4.8-times above the baseline in the first hour after the use of marijuana. However, the risk is less than the one observed with cocaine use (24 times), most likely due to more sympathetic stimulation. More recently, in a prospective cohort study of events after MI with an average follow-up of 3.8 years, Mukamal et al. found a mortality risk 4-times greater in cannabis users than in non-users in an age- and sex-adjusted model. Several mechanisms possibly explain why the drug can induce MI risk differently to atherosclerosis. In particular, smoking marijuana in a moderate dose is associated with a stimulation of sympathetic activity leading to an increase in the pulse rate and blood pressure with a decrease in the left ventricular ejection time. At high doses, the parasympathetic activity will also increase, leading to bradycardia and hypotension. Moreover, marijuana induces an increase of carboxyhemoglobin, leading to decreased oxygen-carrying capacity. This carboxyhemoglobin level is higher in cannabis users than in cigarette smokers. This high level induces an increase in the myocardial oxygen demand, with a simultaneous decrease in the oxygen supply. These adverse changes can trigger plaque rupture in vulnerable patients or may induce coronary vasospasm in the presence of normal coronary arteries.

In conclusion, several authors clearly indicate that cannabis smoking could be a trigger for cardiac ischemic events in young healthy users. Even though this risk factor is not as high as that in cocaine users, emergency physicians should not underestimate cannabis-addicted patients complaining of acute chest pain.

“It hurts when I smoke” – Tobacco’s effects on the lungs

Some smokers may have experienced feeling uneasy or feeling pain in the chest and lungs when they smoked.

Long-term smoking is known to impose a great burden on the lungs and bronchi, causing inflammation in respiratory organs and sometimes causing pain. This time we will introduce what influence smoking has on lungs, one of the key diseases (COPD) it can cause, and how to deal with light chest pains while smoking.

Cigarette smoking’s effect on lungs

Tobacco contains many substances that are harmful or downright toxic to the human body. When tobacco burns, the smoke generated contains several thousand chemical substances, such as nicotine, tar, dioxin and arsenic, which are generally quite bad for the body.

When people continue smoking, these harmful substances damage the bronchi (large airways carrying air to lungs) and alveoli (small air sacs in lungs that carry oxygen to blood), and inflammation gradually occurs. Generally, difference in breathing is not necessarily distinguishable from one day to the next, as smoking’s effect on the lungs is a very gradual process. However, after years of smoking, the alveoli are severely damaged and lung function is markedly reduced, leading to a drop in physical strength and even experiencing palpitations / shortness of breath.

What is COPD?

A typical example of a disease caused by tobacco is chronic obstructive pulmonary disease, or COPD. Symptoms of COPD are divided into the following four stages.

  1. Mild COPD or Stage 1: Mild COPD. Most people in this stage do not necessarily realize they have an issue, as they continue their daily activities without feeling much difference. Some people may notice a cough or that they have more phlegm.
  2. Moderate COPD or Stage 2: Moderate COPD. During this stage, most people notice more coughing and difficulty in breathing, with increased mucus production. People also tend at this stage to seek medical advice.
  3. Severe COPD or Stage 3: Severe emphysema. By this COPD stage, daily life is impacted to a great extent, as lung function is declining. People will likely have difficulty with exercise and may feel more fatigued.
  4. Very Severe COPD or Stage 4: Very severe or End-Stage COPD. People in this stage have low blood oxygen levels and may find that their quality of life is affected severely, with breathing issues now life-threatening.

COPD is also known as a “smoking disease,” and now it is dangerous as a lifestyle disease of the lung. In many cases, COPD can be avoidable by quitting smoking at the earliest opportunity.

What to do if your lungs hurt from smoking

When you are a smoker and feel pain or discomfort different from dry air or a cold, you may need to be careful as there is a possibility that COPD may be lurking. Even if you are not in a position to go to see a doctor immediately, you should consider seeing a medical professional just in case, especially if symptoms worsen or persist. For minor cases, we have three simple tips that can be followed.

1. Warm your body

If you feel pain in your lungs, or if you have a degree of discomfort in your bones or muscles, pain may be relieved by applying something warm around the affected area. This can be something like a blanket or heating pad. Especially during cold weather, it is important to keep the body warm to promote immunity. However, if you feel short of breath, be sure to relax and not overexert yourself.

2. Prop up your upper body slightly

When feeling not only pain but also breathlessness, try applying a cushion or a pillow to your back and bring your upper body 30 to 60 degrees and rest. By taking this posture, the diaphragm naturally spreads and can allow you to breathe more easily, so the sense of oppression on the chest can be alleviated.

3. Drink coffee

If you experience coughing spells or if the cough persists, having a cup of coffee may help. Immediately after drinking coffee, the trachea spreads for a while and breathing may become somewhat easier.

When you feel fatigue accumulating, portions of your body starting to feel cold, or chest pains worsening, you may have a more advanced condition, so by all means go consult your doctor.

Final word

The impact of tobacco on the lungs and bronchi is not a sudden hit, but as you continue to smoke your health is virtually guaranteed to deteriorate over time. Pain in the lungs and bronchi is nothing short of your body emitting an SOS. Looking for ways to cut down on and ultimately quit smoking may just save your life.

Tweet

Sometimes people only need oxygen in short bursts, during exacerbations. Others, with more advanced COPD, may benefit from Long-Term Oxygen Therapy or LTOT. It is NEVER too late.

Once approved, oxygen therapy is provided on prescription from the NHS. A machine called an oxygen concentrator is usually used to provide a fixed supply of oxygen for those who need LTOT at home. Ambulatory oxygen (using small cylinders or other devices) can be provided for those people on LTOT who need to get out of the home.

I have smoker’s lung – isn’t it too late to quit smoking?

Stopping smoking at any age will have a beneficial effect on your lungs.

Tips to help you quit

  • Write down your reasons to quit on a piece of paper.
  • Keep a diary of when and where you smoke.
  • Try to find a pattern in your smoking habits.
  • Find someone who can support you, such as your doctor or friend. There is a free NHS Quit Smoking Service in every area, which will provide you with psychological and medical support (including medications) – ask at your surgery for details.
  • Choose a method for quitting – remember, the only ‘safe’ amount to smoke is zero.
  • Nicotine patches or chewing gum may help.
  • Choose a date when you want to quit.
  • Tell people the date you’ve chosen, so you’ll stick to it.
  • Ask about side-effects from any medication that is prescribed.
  • Find out when you need to tell your doctor about side-effects.
  • Keep an eye on changes to your condition and find out what to do if you notice any.
  • Learn how to recognise warning signs of a problem.
  • Ask questions about anything you would like to know about the condition or about medication, diet, exercise or breathing techniques.
  • Ask if there’s a pulmonary rehabilitation course in your area. These courses, which usually last for about six weeks will teach you about COPD, how to control your symptoms and how to improve your general lung health.
  • Ask about non-prescription medicine.
  • Ask about your local Quit Smoking service

How to take medication

  • Take your medicine strictly according to the prescription.
  • You must never increase, cut down or stop any treatment with prescribed medicine without talking to your doctor first.
  • Never change a fixed oxygen supply.
  • Don’t use any medicines that aren’t prescribed without first consulting your pharmacist or doctor.

Quitting smoking

I have smoker’s lung – isn’t it too late to quit smoking?

Stopping smoking at any age will have a beneficial effect on your lungs. Its never too late, and even life long smokers often report a significant improvement in their quality of life if they manage to give up.

Tips to help you quit

  • Write down your reasons to quit on a piece of paper.
  • Keep a diary of when and where you smoke.
  • Try to find a pattern in your smoking habits.
  • Find someone who can support you, such as your doctor or friend. Or join a quit smoking group – research suggests that the highest quit rates can be achieved when a person combines the support of a group with the use of medications.
  • Choose a method for quitting – remember, the only ‘safe’ amount to smoke is zero.
  • Nicotine patches or chewing gum may help. Several other drugs are also now available to help reduce craving for nicotine.
  • Choose a date when you want to quit.
  • Tell people the date you’ve chosen, so you’ll stick to it.
  • Consider trying electronic cigarettes or other devices that mimic the feel of something in your hands. The research to prove they are useful is controversial at the moment, and some experts feel they are a waste of money but some people have had success with them.

How can I make breathing easier?

These techniques can help your lungs work more effectively and help you relax when you feel short of breath.

Breathe with the stomach

  • Place one hand on your chest. This hand should remain still when you breathe.
  • Place the other hand on your stomach with your thumb on your belly button. This hand should rise up and down when you breathe
  • Breathe in through your nose as you count to three. Breathe out as you count to six, holding your breath out for the last second or two.
  • Repeat this for approximately 15 minutes.
  • Practice this as often as possible – learning to coordinate stomach movements and breathing takes time. You can breathe with the stomach while you are sitting, standing or lying down.

Tight-lipped breathing technique

  • Breathe in slowly through your nose.
  • Tighten your lips a little. Now breathe out slowly with a soft, hissing sound.
  • Try combining tight-lipped breathing with the stomach breathing.

How can I get rid of phlegm?

Controlled coughing can help you cough up phlegm without getting short of breath or damaging your respiratory passages.

  • Take a slow, deep breath through the nose.
  • Hold your breath for a couple of seconds.
  • Open your mouth a little and cough two to three short, forceful coughs.
  • Relax and repeat.

Your nurse or physiotherapist will be able to teach you other techniques for loosening and getting rid of phlegm. Family members can also learn how to help you.

Does the food I eat make a difference?

Many people with smoker’s lung have difficulty eating large amounts of food. Therefore, the food you eat needs to be nutritious and provide you with enough calories. You can also do the following.

  • Vary the foods you eat every day and eat only healthy food
  • Have several small meals instead of a few big meals
  • Try to make sure you have a regular intake of good quality protein (such as red meat) which helps to prevent muscle loss than can occur in COPD
  • If you feel your diet is poor, consider taking a daily multivitamin supplement. Its difficult to get enough Vitamin D for example, but this is important for muscle strength and immune function.
  • Talk to your doctor if certain types of food give you problems. Cabbage, beans and corn may make breathing unpleasant
  • Drink lots of water, unless your doctor recommends otherwise.
  • Monitor your weight and talk to your doctor if you are losing weight.
  • Bear in mind that many smokers find that they get much more pleasure from food once they stop smoking.

Is exercise important?

People who are fit use less oxygen. Remaining active also helps you feel good about yourself. But remember to consult your doctor before starting an exercise programme – you will need to ask the following questions.

  • What kind of exercise do I need? (Walking is often recommended.)
  • How long and how often should I exercise?
  • Is it necessary to change doses of medication and/or oxygen when I exercise?

How can I avoid straining my lungs?

  • Try to avoid colds and influenza (the flu) by asking infected people to stay away until they’re better.
  • Ask your doctor about immunisations against influenza and pneumonia.
  • Avoid contact with people who have a cold or the flu.
  • Call your doctor at the first sign of a cold or influenza. Signs could be: increased coughing, a stuffed-up nose, fever and yellow or green phlegm.
  • Avoid things that may irritate your breathing. These could include smoke from cigarettes or fireplaces, dust and smells from paint, exhausts or perfume, cold air, very dry or moist air, or air pollution.
  • Ask your doctor about air cleaners or air dehumidifiers.

Can I lead an active life despite my condition?

At work

  • Your condition should not prevent you from working, unless it has become very severe.
  • Talk to your employer – a few changes in your workplace may be all it takes.
  • Consider training in another field if it is impossible to keep your present job.

Sex

  • Use a position that doesn’t take much energy (such as side by side).
  • Use tight-lipped breathing.
  • Consider other ways of being intimate, such as cuddling, kissing, etc.
  • Rest before and after intercourse.

Travel

  • Ask your doctor about medical facilities in the location you plan to visit.
  • Remember to take a supply of your medicines, as well as a list of them and prescriptions for further supplies if you will need them, with you.
  • Ask your oxygen supplier where you can buy oxygen.
  • Tell the airline in advance if you may need oxygen. Oxygen levels in the plane may drop, even though the air is pressurised, especially if flying at a high altitude. This may cause your oxygen saturation (levels in your body) to drop significantly. You are advised to check with your respiratory team before flying.
  • Take some extra medicine in your hand luggage, in case your main luggage gets lost.

When doing manual work or housework

  • Conserve your energy.
  • After a hard task, do an easy task.
  • Break hard tasks into smaller parts. Rest every now and then.
  • Try using the tight-lipped breathing technique. Breathe out when you strain yourself.
  • Sit down as much as possible.
  • Keep the things you need close to you, so that you don’t strain yourself more than necessary.
  • When possible, push and pull instead of lifting.
  • Use relaxation techniques.

How can family members help?

  • Share your emotions. You could be feeling the same way as the person with smoker’s lung. You also need to talk about your emotions.
  • Give your full support if the person wants to quit smoking.
  • If you smoke, don’t smoke anywhere near the person with smoker’s lung – passive smoking is harmful.
  • Consider quitting smoking for your own sake.
  • Don’t overprotect. Let the person who needs your help do as much as they can by themselves. Their self-confidence depends on it.
  • Help with the treatment. Ask the doctor or nurse how you can help at home.
  • Join a support group such as the British Lung Foundation. Talking to other families affected by smoker’s lung can help you cope.

Other people also read:

Chronic bronchitis, emphysema and COPD: What does chronic bronchitis feel like?

Lung cancer: What are the symptoms of lung cancer?

Smoking – methods for quitting: Why are success rates so low?

Smoking – this is what you gain: Here are the benefits.

Based on a text by Dr Carl J Brandt, GP

Last updated 01.07.2016

Patricia Macnair Hospital physician

5 Ways Smoking Hurts Your Heart

University of Michigan cardiovascular surgeon G. Michael Deeb, M.D., wants his patients to know something: Nicotine is toxic not only to the lungs, but also to the heart.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

“When most patients think of the dangers of smoking, they think about the lungs,” Deeb says. “But cardiovascular disease is the No. 1 killer in the world, and smoking is accelerating the problem.”

As many as 30 percent of coronary heart disease deaths in the United States each year are attributable to cigarette smoking, and the more you smoke, the greater your risk, according to the American Heart Association. Even teenage smokers can have early signs of cardiovascular disease, including atherosclerosis, a buildup of plaque in the artery walls that can restrict blood flow.

What smoking does to your heart

Cigarette smoke contains nicotine and carbon monoxide, both of which affect your heart and blood vessels. Here’s how:

  • Smoking increases blood clotting, which can result in blocked arteries that can lead to heart attack and stroke.

  • Smoking increases the risk of abnormal heart rhythms, which may cause sudden death.

  • Smoking damages blood vessels and can make them thicken and grow narrower, resulting in a faster heartbeat and increased blood pressure.

  • Smoking can lead to arteriosclerosis, a hardening of the arterial walls.

  • Smoking harms the body by raising cholesterol levels.

When combined with other major risk factors, cigarette smoking increases your risk for such heart issues as:

  • Angina: chest pain associated with a blockage in the arteries

  • Heart attack: damage to your heart muscle because of a lack of blood flow to your heart

  • Stroke: blockage in the blood flow to the brain because of a clot or a burst blood vessel in or around the brain

  • Aneurysm: a widening and leaking of the aorta

  • Peripheral arterial disease of the legs: narrowing or blockage of the peripheral arteries

  • Sudden death

What you gain when you quit

Even if you’ve smoked for a long time, quitting has immediate health benefits.

SEE ALSO: 5 Ways to Measure Your Heart Disease Risk

According to the American Cancer Society, when you stop:

  • Within 12 hours, the level of poisonous carbon monoxide in the body from cigarettes returns to normal.

  • After one year, your risk of heart attack is half that of a continuing smoker’s risk.

  • After 15 years, your risk of coronary heart disease is that of a nonsmoker’s risk.

For help with smoking cessation, check out the American Heart Association resources and the MHealthy Tobacco Consultation Service (TCS), which has developed a “virtual quit kit” full of tools and resources. TCS also provides free one-on-one counseling to give you the support and skills to quit for good.

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *