Five Steps to Freedom From Tobacco
The average smoker starts at age 13 and develops a daily habit at 14.
More than 430,000 people in the United States die annually of illnesses
related to tobacco. But the good news is, nearly 1.2 million Americans each
year become smoke-free. These former smokers are living proof that people
can overcome one of the toughest addictions.
Kick the habit
There's no doubt that smoking creates addiction. Nicotine acts on the
same sites in the brain as dopamine, a chemical that produces pleasurable
feelings. Dopamine is the neurotransmitter involved in addition to cocaine
and heroin.
The Centers for Disease Control and Prevention report that about 48 million
Americans still smoke, nearly one of every four adults. This figure held
through much of the 1990's despite public health warnings about tobacco.
Smoking rates vary by ethnic group. Native Americans have a high rate of
tobacco use, with about 40 percent of adults smoking. African-Americans and
Caucasians also use tobacco in rates above the national average. In all
ethnic groups, smoking is a major cause of disease and death.
You don't have to smoke to feel its effects. Research shows that secondhand
smoke can cause breathing problems in children and heart disease in adults.
But enough of the bad news. Focus instead on the possibilities. Today
there's an impressive array of tools and techniques that you can use to quit
smoking. Begin with the five listed below.
1. Admit you have an addiction.
Stuart Hanson, M.D., a specialist in pulmonary medicine at Park Nicollet
Clinic in Minneapolis, recommends one simple step before trying anything
else: Tell the truth.
"People need to set a goal of lifelong abstinence and accept that what
they have is an addition," Hanson says. "Until people accept this,
they continue to delude themselves with the thought, 'I can quit
anytime.'"
James Fuller - who quit successfully after 45 years of smoking - echoes this
idea. "You have to be reasonably sure that quitting is what you want to
do. If your waffling, it doesn't work."
Admitting the fact of addition is the cornerstone of Nicotine Anonymous.
Step One of the program puts it succinctly: "We admitted we were
powerless over nicotine - that our lives had become unmanageable."
2. Set a date.
Set a specific date to become smoke-free. Fuller, of Minneapolis,
suggests timing that date to coincide with a significant event. In his case,
it was a trip to Italy with his wife. Fuller knew they'd be on non-smoking
flights all the way, and he wanted to be smoke-free before they set foot on
the plane.
3. Go public.
"Tell at least 10 other people that you see regularly - family
members, co-workers, friends - that your goal is to quit tobacco use,"
says Hanson. "Tell them your quit date and ask them to be your support
group."
4. Consider treatment.
Perhaps the most-publicized treatment is nicotine replacement therapy.
The theory is simple: You can break the cigarette habit by taking a
carefully controlled dose of nicotine that gradually decreases to zero. You
get just enough nicotine to ease cravings - minus all the tar and toxic
gases from a burning cigarette.
There are several NRT devices:
· The nicotine patch delivers a constant dose of nicotine through the skin.
· Nicotine gum releases nicotine into the lining of the cheek.
· The nicotine inhaler, a plastic cylinder that looks like a cigarette,
delivers nicotine when you puff on it.
· Nicotine nasal spray, packaged in a pump bottle, delivers nicotine
directly to your nasal membranes.
Remember that these treatments have side effects. Consult with your doctor
before trying any of them.
Another medication that may help is bupropion hydrochloride (Zyban), an
antidepressant that stimulates the brain to release dopamine.
You can also take classes that offer group support and techniques for
behavior change. The American Cancer Society and American Lung Association
offer such classes, as do many public health departments.
What's more, there's a variety of alternative approaches, such as hypnosis,
acupuncture and medication. Advocates for these strategies say that they
take the edge off nicotine cravings. Skeptics say that we need more research
on their effectiveness.
While all these options can be useful, they're more apt to work if you
complete the first three steps mentioned above. If you do, says Hanson, you
may not need ant other treatment.
5. Keep doing it your way.
When it comes to quitting cigarettes, there's no
"one-size-fits-all" approach. The experience is different for
everyone. Fuller says that he felt cravings even while using the patch. Yet
he became smoke-free.
You may try to quit several times before succeeding; that's normal. Each
time you try, you'll learn something about what doesn't work for you - and
what does.
And don't let concerns of gaining weight stop you from trying to quit. It's
true that nicotine can raise metabolism - the speed with which your body
burns calories. However, many healthful activities do the same, especially
regular aerobic exercise. And not everyone gains weight after quitting
cigarettes. Even if you do, your body can cope with a few extra pounds far
more easily than the daily chemicals in cigarettes.
For more information:
American Cancer Society (404) 320-3333 - www.cancer.org/tobacco/index.html
American Heart Association (800) 242-8721 - www.americanheart.org/Heart_and_Stroke_A_Z_Guide/Smokecp.html
American Lung Association (212) 315-8700 - www.lungusa.org/tobacco/
Centers for Disease Control and Prevention (800) 311-3435 - www.cdc.gov/tobacco/
National Safety Council - www.nsc.org
