How Many Carbs Should I Eat in a Day?

Everyone eats carbohydrates. You pretty much can not get around it. We need carbs for energy after all. But the question still remains: how many carbs should I eat in a day? Are there drawbacks from eat too little or too many carbs? What are the side effects of eating carbs or abstaining from eating carbs? Well once again, as with protein, it depends on what you do on a daily basis. Furthermore, ingestion of carbs should be focused more around the question: WHEN should I eat carbs during the day?

As with how much fat to eat in a day and how much protein to eat in a day, it all depends on a couple factors:

* job
* insulin resistance
* activity level
* target body weight
* exercise goals
* lifestyle

The most recent Dietary Guidelines for Americans, as stated by the Department of Health and Human Services, suggest that roughly 50% of your daily calories come from carbs. Thus, a person who eats approximately 2,500 calories per day should take in about about 300 grams of carbs. This number is not altogether bad for the average American, but we have to take into consideration the sources of those carbs.

These are the kinds of carbs to avoid at all costs:

* sugary snacks and pastries
* sugar-sweetened soft drinks or fruit juice
* candy
* cookies
* regular fried greasy chips
* processed, packaged snack foods
* high sugar kids cereals
* processed white flour products such as white bread and pasta

These foods offer virtually no nutritional value, and they contain far too many calories. Some of these foods also contain saturated and trans-fats that are bad for your heart, and sugary foods can lead to such maladies as type II diabetes and cardiovascular disease. Specifically if you are already insulin resistant, you should avoid these bad carbs as they will just ruin your day by making you tired, slow, dumb, and hungry.
Instead choose these kinds of carbs:

* fresh fruit
* vegetables
* whole wheat and whole grain products
* beans, nuts, and other legumes

When Do I Need More Carbs?

People that exercise with high intensity or with prolonged endurance, can benefit from a high carbohydrate intake before exercise. It is feasible to consume a high carbohydrate meal before a marathon, or a moderately high carbohydrate meal before lifting weights or martial arts training. It is not a good idea to consume too many carbs in one sitting, but 50 grams is not out of the question if you are preparing for a physically draining event.

During and after exercise is also a key time to consume carbs. In fact this is the only time it is recommended to consume sugary carbs. I tend to sip on Gatorade during a workout and my post-workout drink contains about 40 grams of carbs in the form of dextrose. If allowed to choose, I would choose Biotest Surge as my post-workout drink of choice. This is a product that is specially formulated to replenish lost glycogen stores and restart protein synthesis after a demanding workout.

When Do I Need Fewer Carbs?

There is no need to eat carbohydrates at night. Ever. Some folks believe in consuming a high-carb meal the night before an event like a marathon, but I just don't see it. I would say eat that meal in the morning if the event is in the late morning or early afternoon. The best time for a high carbohydrate meal is in the morning, when your body is prepared to uptake glycogen for energy for the day. Lunch should be a moderate carb meal as you don't want to get that 'bonk' feeling in the middle of the afternoon. Also consider that if you don't plan to exercise during the day then there is really no need to gulp down many carbs at any point in the day.

Carbs and Fat Loss

If you are on a fat loss diet, then there is definitely no need to eat more than 100 grams of carbs in any one day. I don't necessarily support Atkins, but there are valid points to that diet. When I am in the middle of a hardcore cutting phase, trying to get as lean as possible in a given time frame, I will only consume 20-30 grams of low glycemic index carbs for breakfast.

For lunch I will try to avoid most carbs, opting for whole grain bread or a salad if necessary. My pre-workout drink is typically 1/2 a serving of Biotest Surge, I sip on Gatorade during the workout, then finish off with 1 serving of Biotest Surge after the workout. On non-workout days, I skip all of that and choose a protein bar, cheese, or a meat snack instead.

Dinner is always low carb during a diet. Soup, meat and vegetables, and salad are all great choices for low carb dinners. Appropriate snacks are meats, cheeses, protein bars or shakes, veggies, and other super-low carb foods. Typically in the midst of a diet phase, I eat around 75 grams of carbs on a non-workout day, and maybe 120-140 grams of carbs on a workout day.

In conclusion, I recommend that if you are moderately active, you should derive maybe 30% of your daily calories from carbs. Sure, my opinion differs from specialist government agencies, but that is only because I have seen low carb diets work. I have also seen Americans grow obese and suffer from a long list of carbohydrate induced diseases.

A 200 lb man on a 2500 calorie diet would probably eat maybe 180 grams of carbs in a day, all from unprocessed whole food sources. A 140 lb woman on a 1500 calorie diet might only eat 100 grams of carbs in a day.

Someone on a strict diet might limit themselves to 50 grams of carbohydrates a day regardless of sex or weight. Just remember to avoid those nasty sugary processed carbs so that you can stay healthy, avoiding energy crashes and adult-onset type II diabetes.

Women Can Get Great Benefits From Whey Protein

Are you concerned about taking care of your body before and after strenuous activities or workouts? Do you try to avoid supplements that contain additives and possible side effects? I am very particular about what I am putting into my body at all times. I hate the idea of eating or taking something that I am not sure about what it is suppose to do or what side effects may be caused.

If you are interested in better health and improved physical fitness you have surely heard that bodybuilders and other athletes are turning to a simple, natural supplement called whey protein. Whey is the only supplement I take besides my daily multivitamin that I feel safe taking. So lets cover a few questions or concerns many women have about taking protein.

WHY DO ATHLETES USE WHEY PROTEIN?

Protein levels are depleted through exercise. Muscles require amino acids to prevent deterioration, give endurance and build mass. Proteins supply these amino acids to the muscles which is why athletes use whey protein. If you want to gain muscle you have to make sure you have the building blocks for it. Women need protein the same ways that men do so do not be afraid of it.

WHAT IS WHEY PROTEIN?

Commercial whey protein comes from cow's milk. Whey is the by-product of making cheese and was usually thrown away as a waste product. Now researchers know that whey protein is high quality, natural protein that is rich with amino acids essential for good health and muscle building. It is naturally found in mother's milk and also used in baby formula. It is being considered for use as a fortifier of grain products because of its considerable health benefits and bland flavor.
Although protein is also found in other foods such as meat, soy and vegetables, whey protein is proven to have the highest absorption (digestion) levels in comparison to all others.

WHO SHOULD CONSIDER USING WHEY PROTEIN?

Whey protein has many health benefits including immune support, bone health, sports health, weight management and overall well being. And as women, we need all the help we can get to keep out bones strong and supportive. Plus overall health is not a bad thing either. The better nutrition you have in your life the less likely that the flu or other bugs will come knocking on your door.

Because amino acids are 'building blocks' for the human body it is sometimes used by patients to speed up the healing of wounds or burns.

The high quality protein that comes from whey makes it a recommended choice for those who need optimal benefits from restricted diets including diabetics, those on weight management diets and even ill patients not able to consume enough protein in their diet to assist with healing.

CAN WHEY PROTEIN BE DANGEROUS?

Whey protein is a food and so it does not have have the risks associated with other supplements. That said, too much of anything carries risks. Extremely high use of whey protein can overload the liver which can cause serious problems. Moderation is always recommended.

If you are lactose intolerant you might try whey protein isolate which has less than 1% lactose and should be tolerable for most users.

Whey protein is a natural and healthy way to bring protein into your diet and increase well being.

WILL WHEY BULK ME UP?

No, women lack the hormones that men have that allow them to get those large bulky muscles. Women will get an overall toned appearance without looking like the Hulk. Those women you see in body building competitions more often than not achieve their unusual frame by injecting additional hormones or supplements into their body. But no, with the use of whey you will not look like these women.

SOME TRICKS WITH WHEY

If you buy the powder you will be able to do a lot more than just simple shakes. But for shakes be create.
Mix the whey with milk and maybe add some strawberries or blueberries to make the best shakes around!
When you bake cookies scoop some whey in for a power cookie
If you drink coffee but some chocolate whey in to make a great mocha

The possibilities are endless, get your creative juices going!

Smoking and Weight Loss

The average person who quits smoking gains between 4 and 10 pounds. It turns out that the average smoker weighs 4-10 pounds less than the average non-smoker–even if they have the same levels of exercise and food intake. Thus, it seems that the weight gained by
quitting smoking brings most ex-smokers up to what they would weigh if they had never smoked.

One of the reasons we gain weight is that we eat more calories than we use. There are 3500 calories in a pound of body fat. When a person eats 3500 more calories than he or she can use, the person will gain one pound. When a person burns 3500 more calories than he or she eats, the person will lose a pound. The number of calories that a person burns
each day depends on age, sex, body weight, metabolism, and amount of exercise. These factors determine how many calories a person can eat without gaining weight, or while losing weight.
Smoking increases your metabolism rate; I will not explain how it does it. Bottom line is that the people who smoke, their body needs more energy therefore their rate which calories burn is also very fast. Because of high calorie burn rate, their metabolism rate is also higher.

Nicotine also delays gastric-emptying of the stomach, therefore the food stays in the stomach for long, and people do not feel and urge to eat, definitely, when people will eat less they will gain less weight or actually will lose weight.

Studies show that most of the women, who start smoking, do this to lose weight. While most of the people who do not quit smoking think that if they will quit smoking, they will gain weight. Losing weight and being slim has become such an obsession that people can take any road, they think will lead to being thin.

People do not see the harmful effects of cigarrettes; they just see the weight loss. Well, let me remind you that cigarette can cause cancer and many other diseases that are fatal. Is it not better to be fat then to be dead?

While it is true that if one stops smoking they will most likely gain weight but at the same time it is also true that if they do not stop smoking a cigarette they are risking their life with such devastating disease they cannot even imagine of.

More about Smoking and Women’s Health

Smoking Risk Factors in Women

Women who receive less formal education are more likely to become smokers, and smoking rates decrease with higher levels of formal education. In a 1995 study of women between 25 and 44 years of age, the percentages of smokers were as follows:

• Did not finish high school—40%
• Graduated from high school—34%
• Some college education—24%
• Graduated from college—14%

Living in poverty and suffering from a mental health disorder (e.g., depression, other substance dependence) are other risk factors.

Effects of Smoking on Women's Health

Cigarette smoking is associated with a range of serious illnesses in women and men, including the following:

• Cardiovascular disease (e.g., stroke, heart attack)
• Pulmonary disorders (e.g., emphysema, chronic obstructive pulmonary disorder (COPD), lung cancer)
• Reproductive system disorders
• Several types of cancer

Smoking also increases the risk for and may worsen the symptoms of other conditions that commonly affect women (e.g., osteoporosis, macular degeneration).

Smoking & Cancer

Cigarette smoking is the major cause of lung cancer in women. Since 1950, the mortality rate for lung cancer in women has increased an estimated 60% in the United States.

In 1950, lung cancer represented only 3% of all cancer deaths among women; by 2000, lung cancer accounted for nearly 25%. Today, lung cancer remains the leading cause of cancer deaths among women. In 1987, lung cancer surpassed breast cancer as the leading cause of cancer death among women. In the year 2000, about 67,000 women died of lung cancer compared to 40,800 who died of breast cancer. This increase can be directly attributed to an increase in the number of women who smoke.

There is also significant evidence that smoking is responsible for or associated with these other cancers:

• Bladder cancer
• Cervical cancer
• Colon cancer
• Kidney cancer
• Liver cancer
• Oropharynx (mouth and throat) cancer
• Pancreatic cancer
• Rectal cancer
• Skin cancer

Postsurgical Complications—Women who smoke after being treated for cervical cancer double their risk for postsurgical complications, including bleeding in the bowel, rectum, and bladder. Women who have been treated for breast cancer experience lower survival rates, if they smoke.

Smoking & Cardiovascular Disease

Smoking is the primary cause of heart disease, the number one killer of women in the United States. Women who smoke are 2 to 6 times more likely to have a heart attack (i.e., myocardial infarction) than women who do not smoke, and the risk increases with the number of cigarettes smoked.

Women smokers are also at high risk for ischemic stroke (deficiency of blood in an area of the brain),subarachnoid hemorrhage (ruptured blood vessel in the area surrounding the brain), and peripheral vascularatherosclerosis (clogging of the arteries that supply blood to arms or legs).

Smoking & Lung Disease

Smoking seriously decreases lung function over time. Girls who begin smoking at an early age reduce lung growth and function, and women who begin smoking at any age experience some decline in lung function. The primary symptom of decreased lung function is dyspnea or shortness of breath.

Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD). COPD involves emphysema, chronic bronchitis, and sometimes asthma. Mortality rates for COPD among women have risen for the past 20 to 30 years. Today, an estimated 90% of deaths from COPD among women in the United States is attributable to smoking.

Smoking & Reproductive System Disorders

Smoking may have an adverse effect on menstrual function and has been linked with an increase inmenstrual pain and irregular periods. Women who smoke may experience early onset menopause (1 or 2 years earlier than nonsmokers) and menopause symptoms may be more severe.

Women who smoke may experience fertility problems including difficulty conceiving, primary infertility (inability to conceive), and secondary infertility (inability to conceive again after having a child). Components in cigarette smoke, such as the heavy metal cadmium and nicotine, damage the ovaries and interfere with estrogen production, causing the eggs to be prone to genetic abnormality. Second-hand smoke may also contribute to reproductive function abnormalities.

Pregnant smokers risk complications of pregnancy, including premature birth, low birth weight, stillbirth, and infant mortality. Carbon monoxide and nicotine in the smoke inhaled by a pregnant woman may prevent as much as 25% of oxygen from reaching the placenta, which depletes the fetus's oxygen supply. Nicotine passes easily through the placenta and becomes concentrated in amniotic fluid and fetal blood to levels as much as 15% higher than in the mother.

Smoking during pregnancy increases the risk for ectopic pregnancy (development of the embryo outside the uterus, usually in the fallopian tube) and miscarriage. Sudden infant death syndrome (SIDS) occurs twice as often in babies of mothers who smoked during pregnancy.

Smoking & Eye Disorders

Smoking increases a woman's risk for age-related macular degeneration, a progressive disease that affects the macula (central area of the retina) and destroys central vision. Macular degeneration is most common in women who have smoked for over 40 years. Women smokers are also at higher risk for cataracts(clouding of the eye's lens).

Second-Hand Smoke and Children

Smoking during pregnancy can affect the behavior of children during the toddler years and beyond. The effects can include childhood depression, anxiety, rebelliousness, and aggressive behavior. Some learning disabilities have also been associated with maternal smoking during pregnancy.

Children of mothers who smoke during pregnancy are also more likely to begin smoking at an early age. Research indicates that teenagers whose mothers smoked during pregnancy are at greater risk for drug abuse and conduct disorders. The effect appears greatest when the mother smokes more than 10 cigarettes a day while pregnant.

These behavioral effects may be caused by prenatal exposure to tobacco smoke, although more research is needed to understand exactly how this may affect a child's future behavior.

Second-hand Smoke Effects on Children's Health

Exposure to second-hand maternal smoke has negative health effects on children from infancy through adolescence. Infants, young children, and adolescents may experience reduced lung function. Second-hand smoke has been linked to SIDS (sudden infant death syndrome).

For children with asthma, second-hand smoke increases the severity of symptoms. It may also be a risk factor for developing childhood asthma. The Centers for Disease Control estimates that second-hand smoke worsens the condition of between 400,000 and 1 million asthmatic children.

Why Do People Smoke?

Reasons People Smoke

The core reason people smoke is because they are addicted to nicotine and can't stop—it's a simple as that. Or is it? Though nicotine addiction is certainly the biological reason for why people smoke, there are a host of other factors that are also at play.

The Centers for Disease Control and Prevention (CDC) report that as of 2009, more than 46 million Americans smoke. About 443,000 people in the United States die from smoking-related illnesses each year. Smoking cigarettes causes more deaths than alcohol, car accidents, suicide, AIDS, homicide and illegal drugs combined. Despite this, one in five people still indulge—ome have attempted to quit smokingand failed, and others have not considered quitting at all.

The risks of smoking are well known—now let's dig into why people smoke despite them.

Understanding Nicotine Addiction

Nicotine addiction not only perpetuates one's desire to smoke, but it makes it difficult to try to apply mind over matter and quit. When smokers start to cut down on cigarettes, they begin to go into withdrawal, which causes a variety of unpleasant symptoms including headache, fatigue, irritability and cravings. The fastest way to mitigate them? Smoking another cigarette.

Most smokers attempting to quit imagine that they will experience those initial feelings of withdrawal for the rest of their lives. Actually, within a very short period of time after putting out that last cigarette, physical withdrawal symptoms will start to abate, with urges becoming weaker and shorter in duration. The intervals between urges will soon lengthen. Finally, they will become very infrequent before stopping altogether. Those who quit will eventually get past the discomfort, feel better and have renewed energy. The key, of course, is knowing that—and committing to ride it out.

Beyond Nicotine: Other Reasons Why People Smoke

Ask several smokers this question, and they're likely to have different answers. While generalities cannot be made, there are some factors that many people say are or have been at play in their picking up their first pack and establishing their smoking habit.

Many people start smoking in their teens and are addicted by the time they are adults. The most often reported reasons that teens take up smoking include looking mature, a desire to experiment with something "forbidden" and peer pressure.

Adults often smoke for other reasons. They may have personal or financial problems and pressures that cause them to seek the temporary escape and numbing of feelings that smoking can provide. Many adult smokers say that cigarettes can almost act like a crutch to lean on during difficult times.

Emotions beyond stress can also factor in. Loneliness, for example, is often cited as a reason for lighting up. You are never alone when you have your little "buddy" with you, some say—a comfort that comes as quickly as a flame can be lit. Some smokers even say that the act of having a cigarette in their mouth and taking a drag gives them a sense of pleasure and comfort not unlike sucking your thumb as a child.

Others say they "reward" themselves with smoking. Whenever they have accomplished a task, a cigarette can be like a pat on the back for a job well done. The first cigarette of the day can be a way to ease into the daily grind, while the last one before bed can serve as a sense of completion. In between are little rewards for taking care of all the tasks of everyday living.

There are those who may even smoke to control their weight. On average, smokers weigh seven pounds less than non-smokers. Smoking reduces appetite and decreases the sense of taste and smell.

The social aspect of smoking, of course, cannot be ignored. Many smokers feel part of a "club;" identifying with a group who, say, goes out for smoke breaks at work gives a sense of belonging and bonding.

Understanding all of the factors that go into why people choose to smoke can help you better understand someone who lights up despite all we know about how bad smoking is for us. If you are a smoker, you may or may not be acutely aware of these and other factors that may be factoring in to why you can't kick the habit. If you are trying to quit, consider the above and look for substitutes and changes that you can make to take cigarettes out of the equation.

Smoking & Treatment Options

Medications to Quit Smoking

Nicotine Replacement Therapy (NRT)

This treatment reduces dependency on nicotine by delivering it through less harmful methods, that is, through the skin in the transdermal method (nicotine patch) or through the oral or nasal tissues (nicotine gum, inhalers, and nasal sprays).

Nicotine patches (Nicoderm CQ®, Nicotrol®, and generic) are available over-the-counter. All patches are applied and worn in the same manner. At the start of each day of the treatment period, the smoker places a new patch on relatively hairless skin somewhere between the neck and waist.

Nicoderm CQ® is usually worn for 6 weeks for 16 or 24 hours a day at a dosage of 21 mg, then for 2 weeks at a dosage of 14 mg, then for 2 additional weeks at a dosage of 7 mg. Nicotrol® is worn for 6 weeks for 16 hours a day at a dosage of 15 mg.

People who have serious arrhythmia, serious or worsening angina pectoris, those with high blood pressure, depression, or asthma, or those who have recently suffered a heart attack should consult their health care provider before using a patch.

The most common side effect is a local skin reaction, experienced by 50% of patch users. This reaction is usually mild and easily treated by hydrocortisone or triamcinolone cream, or by rotating patch sites. Another common side effect is insomnia. In that case, the 24-hour patch may be removed before bedtime, or a change may be made to the 16-hour patch.

Nicotine gum (Nicorette® or Nicorrett Mint®) is available over-the-counter. The gum is chewed until a "peppermint" taste emerges and then held between the cheek and gums to allow the nicotine to be absorbed. It is alternately chewed and held between the cheek and gums for about 30 minutes until the taste dissipates.

Nicotine gum is available in 2 mg and 4 mg per piece doses. The 2 mg per piece gum is recommended for those who smoke less than 25 cigarettes per day and the 4 mg per piece gum is recommended for those who smoke more than 25 cigarettes per day. The gum is usually used for up to 12 weeks with no more than 24 pieces per day.

Nicotine gum therapy often fails if people chew too few pieces per day or do not continue chewing for a sufficient number of weeks. The U.S. Public Health Service recommends a fixed schedule of a minimum of one piece every 1–2 hours for at least 1–3 months.

Common side effects include soreness of the mouth, hiccups, indigestion, and jaw ache. Modifying the chewing technique can usually alleviate these effects.

Nicotine nasal spray (Nicotrol NS®) is available by prescription only. It is administered in one 0.5 mg dose to each nostril. Initially, the spray is administered in 1–2 doses per hour, and then increased as needed to relieve symptoms. A minimum of 8 doses per day and a maximum of 40 doses per day is recommended. Treatment usually lasts 3–6 months.

Ninety-four percent of people using nicotine nasal spray experience moderate to severe nasal irritation in the first 2 days of use. Eighty-one percent experience nasal irritation after 3 weeks, although the effect is much less severe.

Some users develop a dependency to nicotine nasal spray. About 15–20% of users reported using the spray for 3–6 months longer than recommended, and at a higher dose than recommended. Nicotine nasal sprays cannot be used in combination with other NRT (such as a patch).

Psychotropic Agents to Quit Smoking

Psychotropic agents (commonly used to treat depression) are sometimes used to treat nicotine addiction because they regulate receptors in the brain that are affected by nicotine.

Bupropion (Zyban®) is only available by prescription. Unlike nicotine replacement therapies, which typically begin on the smoker's quitting day, smokers begin taking bupropion 1–2 weeks before they quit smoking. The initial dose is 150 mg in the morning for 3 days, and then 150 mg twice a day, continuing for 7–12 weeks.

Bupropion should not be used by anyone with a history of a seizure or eating disorder. Patients who are using another form of bupropion or who have used a monoamine oxidase inhibitor (MAOI) in the past 14 days also should not use bupropion. People taking bupropion should limit alcohol consumption.

Side effects may include hypertension, tremor, insomnia, and dry mouth. Zyban is not recommended for women who are pregnant or nursing.

Varenicline (Chantix®) is a non-nicotine medication that is available by prescription for smoking cessation. This drug attaches to nicotine receptors in the brain, helps block nicotine from reaching these receptors, and may reduce the release of dopamine triggered by nicotine. Varenicline also is taken for 1 week before the smoker's quitting day to allow the medicine to build up in the body.

Side effects may include nausea and vomiting, constipation, and difficulty sleeping. In some cases, a serious reaction can occur. Signs of a severe reaction include swelling of the face, mouth, and throat and redness, swelling, and peeling of the skin.

In 2009, the U.S. Food and Drug Administration (FDA) issued a black box warning for the smoking cessation drugs bupropion and varenicline. According to the FDA, these medications carry an increased risk for mental health side effects, such as depression, behavioral changes (e.g., hostility, irritability), and suicidal thoughts. Patients who use these drugs to stop smoking should be closely monitored while taking them and after the medication is discontinued.

In July 2011, the FDA updated labeling for Chantix to include new information about the effectiveness of the drug for people with stable heart disease and mild or moderate COPD who are trying to quit smoking. Studies have shown that Chantix is effective in these patients—in some cases, almost doubling the chance of quitting for at least one year. These same studies shown that a slight increased risk for adverse cardiovascular events is possible in people with heart disease who use Chantix.

Clonidine, a commonly used antihypertensive, is available only by prescription in oral and transdermal form. It has not been approved by the FDA for the treatment of smoking cessation and is used only as a second-line therapy if first-line therapies have been unsuccessful.

Clonidine doses vary from 0.15–0.75 mg per day (oral form) to 0.10–0.20 mg per day (transdermal form) and the duration of treatment varies from 3–10 weeks. Treatment begins up to 3 days before quitting or on the quit date. The patient puts a new patch (transdermal form) on relatively hairless skin between the neck and waist each week.

While clonidine is effective, its side effects limit its usefulness. The most common side effects include dry mouth, drowsiness, dizziness, sedation, and constipation. Because clonidine lowers blood pressure in most patients, any reduction in dosage must be done gradually over 2-4 days to reduce the risk for rebound hypertension, marked by a rapid increase in blood pressure, agitation, confusion, and tremor.

Nortriptyline (Nortriptyline HCl) is only available by prescription. This antidepressant has not been approved by the FDA for smoking cessation and is recommended only if first-line therapies have been unsuccessful.

Patients begin taking nortriptyline 10–28 days before quitting. It is taken orally in doses of 25 mg per day, increasing to 75–100 mg per day for 12 weeks. Side effects include sedation, dry mouth, blurred vision, urinary retention, lightheadedness, shaky hands, and constipation. Overdose with nortriptyline can have cardiotoxic effects and it should be used with extreme caution.

Psychotherapy to Quit Smoking

While drug treatments (e.g., nicotine patch, bupropion) can double women's chances for success when attempting to quit smoking, a combination of drug and psychotherapy can further increase the chance for success.

Cognitive and behavioral therapies are often practiced together for maximum effect in helping the smoker alter thinking and behavior. In both approaches, the smoker is encouraged to take an active role in analyzing and changing her thinking and behavior.

Cognitive Therapy to Quit Smoking

In cognitive therapy, thinking patterns that lead to smoking are identified and then altered for more healthy outcomes. For instance, someone who thinks "Smoking relieves my stress" will learn to think "I can relieve my stress another way." The therapist also gives practical instruction in biofeedback and other stress-reduction techniques.

Behavioral Therapy to Quit Smoking

Behavioral therapy helps people weaken the link between the stimuli that trigger habitual responses by prescribing specific acts or behaviors to replace smoking. For instance, a smoker may replace smoking with manual activities such as cooking or gardening.

Quit Smoking Support Groups

Support groups often incorporate elements of cognitive and behavior therapy, and have the additional advantage of providing a social network that encourages the smoker to quit. Women appear to benefit from participating in a support group and are more likely than men to join a group.