It has been said that quitting smoking represents the single most important step that smokers can take to improve the length and quality of their lives.

That's probably why Sister Mary Jean Ryan, president and chief executive officer of SSM HealthCare, is requiring that all 23 SSM campuses be smoke-free by Nov. 18, the same day as the American Cancer Society's Great American Smokeout. She said it was the responsibility of SSM HealthCare to take a leadership role on this major public health issue. The health care system provides cessation classes to help people trying to kick the habit. Roughly one-fourth of the population smokes. Mark Twain said, "Quitting smoking is easy. I've done it a thousand times." Maybe you've tried to quit, too. Why is quitting and staying free of cigarettes hard for so many people? The answer is the nicotine in tobacco. It is highly addictive - as addictive as heroin and cocaine, according to the American Cancer Society. Over time, the body becomes physically and psychologically dependent on nicotine. Studies have shown that smokers must overcome both of these to be successful at quitting. "When smoke is inhaled, nicotine is carried deep into the lungs, where it is absorbed quickly into the bloodstream and carried throughout the body," said Dr. Thomas Siler, who specializes in pulmonary disease at St. Joseph Health Center and St. Joseph Hospital West. "Nicotine affects many parts of the body, including your heart and blood vessels, your hormonal system, your metabolism and your brain." Health concerns usually top the list of reasons people give for wanting to quit smoking. Nearly everyone knows that smoking can cause lung cancer, but few people realize it is also a risk factor for many other kinds of cancer as well, including cancer of the mouth, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, liver, cervix, stomach, colon and rectum, and some leukemias. Smoking also increases the risk of lung diseases such as emphysema and chronic bronchitis, Siler said. These progressive lung diseases - grouped under the term COPD (chronic obstructive pulmonary disease) - are usually diagnosed in current or former smokers in their 60s and 70s. COPD causes chronic illness and disability and is eventually fatal. In addition, smokers are twice as likely to die from heart attacks as nonsmokers. And smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles. Smoking also causes premature wrinkling of the skin, bad breath, bad-smelling clothes and hair and yellow fingernails. No matter what your age or how long you've smoked, quitting will help you live longer. People who stop smoking before age 35 avoid 90 percent of the health risks attributable to tobacco, according to the American Cancer Society. Even those who quit later in life can significantly reduce their risk of dying at a younger age. "Ex-smokers also enjoy a higher quality of life with fewer illnesses from cold and flu viruses, better self-reported health status and reduced rates of bronchitis and pneumonia," Siler said. Regardless of your age or smoking history, quitting smoking has advantages. Benefits apply whether you are healthy, or you already have smoking-related diseases. So, just what are the benefits over time? According to the U.S. surgeon general's report: Twenty minutes after quitting: Your blood pressure drops to a level close to that before the last cigarette. The temperature of your hands and feet increases to normal. Eight hours after quitting: The carbon monoxide level in your blood drops to normal. Twenty-four hours after quitting: Your chance of a heart attack decreases. Two weeks to three months after quitting: Your circulation improves, and your lung function increases up to 30 percent. One to nine months after quitting: Coughing, sinus congestion, fatigue and shortness of breath decrease; cilia (tiny hairlike structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs and reduce infection. One year after quitting: The excess risk of coronary heart disease is half that of a smoker's. Ten years after quitting: The lung cancer death rate is about half that of a continuing smoker's. The risk of cancer of the mouth, throat, esophagus, bladder, kidney and pancreas decrease. Fifteen years after quitting: The risk of coronary heart disease is that of a nonsmoker's. As we can see, within 20 minutes of smoking that last cigarette, your body will begin a series of changes that continue for years. I urge you to take that most important step to improve the length and quality of your life.

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