Stop Smoking!

Q: Now that I have decided to stop smoking, what impact might smoking-cessation medications have on my return to diving?

A: The benefits of quitting smoking will generally outweigh any side effects or complications from drugs used to help you quit. According to the Mayo Clinic, “Your health will benefit almost immediately if you stop smoking. Just 20 minutes after your last cigarette, your heart rate goes down. Twelve hours later, levels of carbon monoxide, a toxic gas, in your blood return to normal. Your lung function improves, and your circulation starts to get better within three months. After a year, your risk of having a heart attack drops by half. And after five to 15 years, your stroke risk will be the same as that of a nonsmoker.”

Before quitting successfully, most smokers make several unsuccessful attempts; it’s rare to succeed on your first try. Both counseling and medications have been shown to help smokers quit. Some medications provide nicotine to help reduce cravings and limit withdrawal symptoms, which include irritability and anxiety. These medications are available over the counter in the form of patches, gum and lozenges.

Prescription medications such as bupropion (Zyban or Wellbutrin) and varenicline (Chantix) are also used to support smokers’ attempts to stop. Neither these medications nor the nicotine-replacement therapies have been tested in the context of diving. But as with other medications, it is a good idea to take any drug for a significant period (30 days, for example) before diving with it. This helps minimize the risk of unexpected side effects occurring for the first time underwater; it also ensures the dosage adequately treats the symptoms of nicotine withdrawal. Serious side effects with bupropion and varenicline are not common, but they are possible.
If you experience any unusual symptoms during a dive, end the dive and discuss them with your doctor before diving again. The doctor may be able to work with you to find a more suitable medication.
— John U. Lee, EMT, DMT, CHT