The American Lung Association recommends a low-dose CT scan (LDCT) for some people to screen for lung cancer.

Lung cancer has traditionally had a worse life expectancy because it is often diagnosed at a later stage than some other cancers. If lung cancer is diagnosed before it spreads, more people can be cured.

People may be eligible for lung cancer screening if they meet all of the following criteria:

• Ages 50-80
• Have a 20 pack-year history of smoking (for example: one pack a day for 20 years, or two packs a day for 10 years), and
• Currently smoke or quit within the last 15 years

If a person meets these guidelines, they are considered at high risk for developing lung cancer, so an annual LDCT screening is recommended.

For more information (including where to get screened and insurance coverage), visit the American Lung Association website.

Some people start to experience symptoms of depression, anxiety and/or ADHD in their preteen and teenage years. During those same ages, people often experiment with nicotine products. One reason some people move beyond experimentation into daily use and dependence is that nicotine can temporarily reduce or “numb” some negative symptoms of depression, anxiety and ADHD.

Often, people using nicotine may be unaware of why they continue to use it and may not be able to quit despite wanting to quit. If someone has been self-medicating symptoms, they may never have reported them to a health care provider or had an underlying concern diagnosed and treated. We know that when a person inhales from a cigarette, nicotine enters the lungs, moves into the bloodstream, crosses the blood-brain barrier and reaches the brain within about 10 seconds. That is remarkably fast in terms of changing how a person feels.

Imagine if every time you reduced or stopped nicotine use, you began feeling depressed, anxious or more symptomatic ADHD, and once you used nicotine again, you felt relief within about 10 seconds. That would make it incredibly difficult to get through the first weeks of withdrawal, which can feel lousy for anyone. For people experiencing depression, anxiety or ADHD symptoms, withdrawal may feel much worse, and it can be easy to believe those feelings will last forever unless they return to nicotine.

In this writer’s experience counseling nicotine users at the Colorado Quitline 15 years ago, there is far less stigma today around acknowledging a mental health concern and seeking treatment. This cultural shift is important because people can better recognize symptoms, seek health care, and use talk therapy, support groups and/or medications to manage depression, anxiety or ADHD. When symptoms are better managed, the process of quitting nicotine can become easier.

A 2021 Cochrane Library meta-analysis reviewed studies of people who smoked tobacco and measured mental health at baseline and at least six weeks after quitting. The authors concluded that “mental health does not worsen as a result of quitting smoking,” and found low- to moderate-certainty evidence that quitting is associated with small to moderate improvements in mental health.

This is promising information because if someone knew their anxiety or depression symptoms would not stay at the intense “first-week” level and might be the same or even a little better after six weeks, it could increase the likelihood of staying quit.

Clarification: This meta-analysis did not include studies of people using other forms of tobacco (such as chewing tobacco), e-cigarettes or nicotine pouches. It also did not include studies measuring ADHD symptoms.