Smoking and health insurers

The official stance of health insurers is quite clear: smoking is a choice on the part of the individual, and it is therefore up to him to assume his own responsibility. This stance is, of course, reflected in the fact that health insurance does not usually cover the cost of “nicotine substitutes” (patches, chewing-gums, inhalations, etc.) These costs are not reimbursed by the basic health insurance and rarely in the private sector, either. There are, however, certain insurers that have opted not to pursue this policy. They consider – quite rightly – that encouraging people to give up smoking has beneficial effects for their health – and therefore also on what they will have to spend on health care.

A handful of companies (very few, it has to be said) have therefore chosen to include nicotine substitutes in some of their complementary health insurance schemes. This is the case with Helsana, for example, who are now offering to cover these charges (at least up to a certain limit) as part of their complementary cover dedicated to illness prevention.

There are other methods to stop smoking, such as those that use acupuncture and hypnosis. Here again, the cost of these sessions is not reimbursed unless you have a complementary insurance policy that includes this type of payment.

In short then, the costs of aids to help smokers give up are only reimbursed as part of complementary health insurance policies. If the health insurance company that provides your basic insurance does not offer this type of cover, you can easily take out a policy with another company that does. It’s your decision . . . We look forward to seeing some results from the debate launched at national level by different anti-smoking bodies…

Smoking cigars is just as harmful.

The nicotine concentration in a big cigar is equivalent to that found in three packets of cigarettes. And even though it is often claimed that cigar smokers don’t inhale all of the smoke, what about the risks of mouth cancers and sidestream smoke?

Smoking is a right and a liberty.

WRONG. Unfortunately, tobacco is a potent addictive drug, and not a liberty. If smokers were really free, they would all stop smoking, since most of them say that they wish to free themselves from this habit. Smoking is a bad lifestyle habit that is developed during adolescence at a time when choices are made by imitating others or through peer pressure. This choice is not based on knowledge. Furthermore, it is extremely rare for an adult to start smoking. According to certain studies as well, it is often more difficult to stop smoking cigarettes than it is to give up using heroine or cocaine!

Cigarettes are really good for calming the nerves.

WRONG. A smoker often has the impression that his dose of tobacco enables him to manage his stress. In reality, though, smoking merely satisfies the need for nicotine which the body feels. After the first inhalation, the nicotine takes about seven seconds to reach the brain and to satisfy the need to smoke. This drug then leaves the brain at about the same speed. And this is why smokers feel the need to smoke approximately every 20 minutes.

If a smoker is not able to respond immediately to this physical demand, his body starts to become agitated; this in turn automatically increases his stress level. As our body is designed to face up to stress, it is possible to for us to stop smoking and to manage our stress in a way that is healthy for both body and mind


What can we gain by giving up smoking?

Giving up does produce results. As soon as you give up smoking, your body will start to heal.

Giving up smoking is by far the most efficient way for smokers to improve the quality and the length of their life. All smokers – men and women, young and old, those in good health or those already suffering from a smoking-related illness – can gain from the advantages for their health of kicking the habit.

Ex-smokers live longer than those who haven’t given up. For those people who give up before reaching 50, the risk of dying in the subsequent 15 years is half that of those who continue to smoke.

Giving up does produce results.

Here is a rundown of what happens after you’ve smoked the last cigarette:

After 20 minutes:
Arterial pressure and the pulse return to normal.
Body temperature increases to its normal rate.

After 8 hours:
The carbon monoxide level in the blood decreases and the level of oxygen increases to its normal rate.

After 24 hours:
The danger of a heart attack is reduced.

After 48 hours:
Food tastes and smells better.

Between two weeks and nine months after:
The coughing, congestion, tiredness and breathlessness are reduced.
The general energy level increases.

After 1 year:
The danger of suffering a heart attack is now half of that for a smoker.

Between five years and 10 to 15 years later*:
The danger of developing lung cancer reduces by nearly half.
The danger of dying is the same as that for a person who has never smoked.

* The time varies according to how long and how intensively you have smoked.

Do cigarettes have an effect on the sense of smell?

The question concerning the effects of cigarettes on the sense of smell is a controversial one, as cessation of smoking only alters sensitivity thresholds by a small amount. It does, however, greatly alter the smoker’s subjective impression of being able to appreciate smells and the taste of food again. A comparison of groups of smokers and of non-smokers produces varying results. A study conducted in 1990 showed that if we take into account the dosage of tobacco and the duration of intoxication, as we would for other drugs, we can see a correlation between the dosage received and an identification test, both with current smokers and ex-smokers. An “improvement” in performance among ex-smokers compared to smokers is observed among those ex-smokers who have gone the longest without smoking, and this “improvement” is proportional to the time that has elapsed since they gave up smoking. At the time of the test, smokers have twice as much chance of showing a deficit as those who have never smoked. These results indicate that:

· smoking does have long-term but nevertheless reversible effects on the sense of smell;
· the failure of previous studies to show that tobacco does have an effect might stem from the fact that ex-smokers were included in the non-smoker groups;
· the effects of smoking on the sense of smell are quantitatively less significant than those caused by ageing (but the effects of smoking do, of course, accumulate with these).

The exact mechanism of action on the mucus membranes and the receptors is not known. There are, however, effects in animals that are dose-dependent. As the neuroreceptors are in principle renewed within a few weeks, there is currently no explanation of recuperation over a long period. It is possible, however, that tobacco interferes with this natural renewal process, but there is no information available as to whether this process is as regular in old age as it is among young people.

In summary, then, tobacco kills its victims more rapidly than it makes them anosmic, but it does have certain effects on olfactory performance.

Are cigars or a pipe less dangerous than cigarettes?

Pipe tobacco, like cigar tobacco, produces an acrid smoke that is difficult to inhale, but less acidic; this means that it passes into the bloodstream more easily. Whether a smoker prefers cigars to cigarettes is only really of importance if he doesn’t inhale the smoke, but this is rarely the case if he was accustomed to doing so with cigarettes. If the smoker does inhale, the cigar is more toxic, in particular because of the very high carbon monoxide content in cigar smoke.

Is rolling tobacco less harmful?

Rolling tobacco is less expensive but four times more toxic than processed tobacco. A rolled cigarette contains more nicotine. Even if the rolled cigarette weighs less (on average half the weight of an ordinary cigarette), it is still at least twice as toxic. But the most serious thing is that a rolled cigarette has no other filter than your lungs.

What is passive smoking?

It is estimated that a person who is in the same room as someone smoking will inhale approximately 10% of the smoke. This is what is known as passive smoking, and it has clear repercussions for our health, as has been demonstrated by the studies that compare people who are subjected to a smoky environment and the complaints that they develop with people who have no smokers in their immediate vicinity.

Smoking relaxes me

The tension which you feel before smoking and which is relieved by smoking a cigarette is primarily due to a lack of nicotine. After a few weeks of not smoking, ex-smokers often experience a sense of calm, and they no long have withdrawal symptoms.

Smoking is a pleasure

Ex-smokers say that they rediscovered other pleasures when they stopped smoking: the smell of flowers, the taste of food, the feeling of being able to breathe fully. They also express a feeling of personal success and the satisfaction of having regained a form of liberty.

I’ve been smoking for such a long time. There’s no point in stopping now.

It doesn’t matter what quantity of tobacco you’ve smoked and how long you’ve smoked for; it’s never too late to stop. Indeed, the risk of developing a serious illness is reduced after cessation and gradually decreases to the same level as that of non-smokers. Within a year, it is the same as that of non-smokers for cardiovascular illnesses. And within five years it reduces by 60% for lung cancers.

I’ve made several attempts to stop, and each time I just start again.

Perhaps you’ve tried to give up smoking on several occasions, but without achieving any conclusive success. You should be aware that all these attempts you have made increase your chances of future success. Smokers often succeed in giving up cigarettes once and for all after several temporary cessations.

I’m afraid of putting on weight.

More often than not, weight gain is only moderate. But it’s not fatal (1/3 of smokers don’t put on any weight at all.) It is possible to limit weight gain by taking appropriate dietary or life-hygiene measures: eating just as much but differently (more fruit and vegetables…), increasing your level of physical activity (take the stairs instead of the lift…).

I only ever smoke mild cigarettes.

Mild cigarettes were created to reduce the quantity of toxic products inhaled by smokers, but they are still dangerous – despite what the tobacco industry would have the public believe. Indeed, the nicotine and tar quantities quoted on packets correspond to the yields achieved with smoking machines, but no smoker behaves in the same way as the reference machine. The quantity of toxic products absorbed varies considerably, depending on the manner in which a cigarette is smoked. When a person who has a nicotine addiction starts to smoke mild cigarettes, that person subconsciously changes his manner of smoking so as to absorb the same quantity of nicotine as before, as his body still feels the need for it.