Credit: Edwina White/Kate Larkworthy Ltd.

Edwina White/Kate Larkworthy Ltd.

Q: I occasionally have a cigarette when Im out with my friends, but none of us smokes regularly. Is it OK to just have one now and then?

A: Its really not. Theres no safe level of smoking. Whether youre talking two packs a day or a few drags once in a blue moon, youre doing yourself harm by lighting up at all. Casual puffing is actually a dangerous slippery slope: Recent studies show that “social” smokers are at risk for becoming heavier smokers over time (a few puffs really can lead to a few packs a week). Whats more, social smokers may be at greater risk for heart disease and lung disease than nonsmokers.

We also know that secondhand smoke is dangerous to people who dont smoke— in fact, a panel of researchers recently determined that regular exposure to secondhand smoke may be linked to an increased risk for breast cancer. So, if youre around friends and theyre lighting up, youre upping your risk anyway.

Many social smokers light up more often if alcohol is present. If that sounds like you, offer to be the designated driver and sip soda or a virgin drink to avoid temptation.

Q: I recently discovered a tiny growth of what looks like extra skin under my left breast. Could it be cancer?

A: Its more likely a skin tag: a common and harmless type of growth that tends to first pop up in your 30s, often on the neck, underarms, groin, eyelids, or, yes, beneath the breasts. A dermatologist or primary care doc can easily remove an annoying skin tag either by snipping it off with scissors (dont try this at home!) or with liquid nitrogen or medical cauterization. Your insurance may cover it, but check first.

Skin tags arent a sign of any diseases or other conditions , and they shouldnt cause pain (unless theyre in an area where they can get caught in a zipper or be frequently irritated).

If you want a reassuring opinion—or if the spot in question is oozing or bleeding, in which case it probably isnt a skin tag—, have it checked out by your doctor as soon as you can to rule out skin cancer. Find out how to spot skin cancer.

[ pagebreak ]Q: Sleeping through the night is getting harder and harder. I wake up around 4 a.m. and cant go back to sleep. Do I need sleeping pills?

A: Sleeping pills can be lifesavers in certain circumstances, but, remember, these drugs can have significant side effects like daytime sleepiness, poor motor coordination, and reduced short-term memory. I only prescribe them for short-term relief if behavioral changes dont work and if a patients insomnia is disrupting her life. Here are some things to try first.

  • Ditch the drink. Though a glass of wine before bed may help you nod off, it can actually make your sleep woes worse by disrupting your normal sleeping-and-waking cycle. Alcohol-aided sleep is shallower, non-REM sleep, which could cause you to wake up well before your alarm goes off.
  • Get active. Make it a point to exercise at least three times a week (a brisk walk, light cardio class, or bike ride all fill the bill). Exercise timed right—at least four hours before bedtime—helps you fall asleep faster and sleep more deeply.
  • De-stress. An overtasked mind can keep you up. The proven antidote? Stress-relief methods like journaling, yoga, meditation, and progressive relaxation. Make a daily habit of the one that works best for you.

If these changes dont help, ask your doc if your sleeplessness might be a side effect of meds youre taking, such as a stimulant, an antidepressant, or a blood pressure medication. A full workup may detect other health issues, such as hypothyroidism or heart disease, that could be interrupting your sleep cycle. If your doc suspects sleep apnea, restless legs syndrome, or insomnia, she may refer you to a sleep specialist.

Finally, if she does recommend a sleeping pill, you should try the lowest possible dosage first.