January is the time for New Year's resolutions and popular among them is quitting smoking. However, giving up smoking requires more than just throwing away the pack of cigarettes on the night stand or placing a patch on an arm. It requires a long-term commitment and, in most cases, a number of attempts to succeed.
"It's about lifestyle changes. Drugs might help for a while," said Laura Leskofski, a spokesperson for the American Lung Association (AMA). "You have to look at why you smoke."
ACCORDING TO THE AMA, smoking-related diseases claim an estimated 430,700 American lives each year. Smoking is directly responsible for 87 percent of lung cancer cases and causes most cases of emphysema and chronic bronchitis.
In Virginia, the adult smoking rate in 2000 — the most recent figures available — was 21.4 percent. Among men the figure jumps to 24.2 percent and drops to 18.8 percent in women, said Eric Walker, state Health Department public relations office. And the figures are dropping. In 1996, the overall rate was 25 percent, with 27.4 percent of men and 23.3 percent of women reportedly smoking.
"Stopping smoking is the gift of life someone can give to themselves," said Stacey Chantker, director of regional self-care and prevention programs for Kaiser Permanente. "Most important, when someone decides to quit, is internal reflection and commitment."
Before anyone tries to quit, that person needs to be committed to the idea and should take steps to prepare themselves to do so. That includes speaking with their doctor, looking at why and when they smoke, finding out what programs are available and creating a support network to help them through the process.
Both Kaiser and the AMA have smoking cessation programs that start with determining the person's readiness to give up tobacco products and offers tips to help reduce the withdrawal caused by the addiction to the nicotine.
"Withdrawal symptoms vary by person. You can have difficulty sleeping or concentrating," Chantker said. "Sucking on a lollipop or hard candy, or having a water bottle near by, for example, can help with dry mouth. Quitting smoking is like weight control. We all yo-yo up and down and try different things, but we keep trying until we find what works best for us."
"THERE ARE A LOT of tools that can help you quit and we usually see our patients use several at a time," said Susan Whyte Simon, public relations manager for Kaiser Permanente Mid-Atlantic States. "For our patients, what usually works includes a consultation with their doctor."
Nicotine replacement products, such as patches, gum and nasal sprays, can help, but only when lifestyle changes are also incorporated. These products, for example, can feed the person's addiction to the nicotine, while the smoker gradually reduces the number of tobacco products that are used each day.
"You have to be aware of environmental changes," Chantker said. "If you tend to smoke a lot at bars, you may have to avoid bars for a few months."
Chantker also said that there is evidence that people who smoke do put on some weight, but not more than what can be managed through exercise and diet.
In addition, it is not uncommon for someone to relapse and experts said it is actually helpful because it's like "practice." With each new attempt at quitting, the person is discovering what works best for them and what does not.
Chantker said that if a person can make it to one year smoke free, that person will probably remain smoke free.
Kaiser's stop smoking program consists of classes, access to medications and Internet resources including a pilot program that has the smoker fill out a questionnaire and receives personalized e-mails based on the answers. It is for Kaiser patients only.
The American Lung Association's program, "Freedom From Smoking," and other information about quitting is also available online at http://www.lungusa.org.