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Treatment News
Smoking Cessation: One Day at a Time

By Gerry Hoyt

January/February 2004

Gerry Hoyt

Last April, I met with my predecessor, Dan Dunable, to review the upcoming forums for 2003. As we came to the end of the list and much to my chagrin, I saw Smoking Cessation was scheduled for November 20 -- The Great American Smoke-Out. Laughingly, I accused Dan of sticking this last forum on the calendar so I would have to face my own addiction to tobacco. Whether he even thought of this is immaterial, because in the planning of this Lunch & Learn, I did begin to take a serious look at why I continued to consume a product that brought me no pleasure anymore.

I would like to tell you that I just "bucked up" and quit "cold turkey," but that would be a big lie, and we will talk more about what helped me quit later. In the planning of this forum, I had several conversations with our speaker, Cheryl N. Page, who is the Program Manager for the Fulton County Department of Health and Wellness Tobacco Use Prevention Program. During these planning talks, I told her that we did not want to do the horror show of slides of cadavers' lungs blackened from decades of cigarette smoking that I remembered from high school health class. In fact, we promoted this as a "guilt-free" forum, presenting options for those considering quitting smoking. As a confirmed consumer of one of the poisonous products manufactured and marketed by the nation's most insidious industries, I knew no one would attend a gathering where guilt is served up with lunch.

Ms. Page did an outstanding job explaining how the tobacco industry targets teens now that most adults know better than to begin smoking. They have to maintain their market and are reaching out to an audience whose youth and need for acceptance clouds their choices (no pun intended). She asked the eighteen attendees at our forum to tell why they began smoking. I shared that I remember how cool I thought I looked at 15 smoking my first cigarette, but I didn't really get hooked until my early 20s in college. My reasoning was that everyone who wasn't a Bible-banger at Berry College smoked, and I guess I should, too. It was a symbol of being liberal and cool. So my 26-year relationship (and $18,982, if you figure $2.00/pack x 365 days x 26 years) with smoke began. I must say that I enjoyed most of those cigarettes. I think I channeled Bette Davis every time I lit one up, and I could blow smoke rings from my lips and suck them back up my nose with the same contempt as Ms. Davis. Cigarettes were also a useful tool at the bar back when I was young and pretty when some unwanted advances were made by a less-than-attractive suitor. Nothing will make someone leave you alone more than a direct hit of exhaled smoke right in their face.

But things are different today. I don't pretend to be young and pretty, and I am living with HIV and had a cardiac "incident" about three years ago. Additionally, my physician casually mentioned to me last August that my latest chest x-ray indicated the early stages of emphysema. All of these factors were neatly filed away in my memory until I had the opportunity to look at why I smoked. I suppose that is a polite way of expressing how I came out of denial.

I was determined that when Ms. Page began her presentation, I would not have had a cigarette for at least 24 hours. Fortunately, about three weeks earlier, my physician added Wellbutrin XL to my daily regimen to treat depression, which was presenting in spite of 100 mg of Zoloft. My previous experience with Wellbutrin was horrible, with panic attacks and mood swings. However, in combination with Zoloft, I found I was less depressed and I had the added benefit of a tool that might help me quit smoking. Following the directions for Zyban, GlaxoSmithKline's repackaging of Wellbutrin as a medication to help you stop smoking, I waited a couple of weeks and set a quit date. This allowed me to psychologically prepare for a behavioral change, as well as allowing enough of the medication to build up in my system to effect this change. What I found was that as my quit date approached, I had already cut back to less than ½ pack per day and the cigarettes had begun to taste bad. Apparently, Wellbutrin interacts with a receptor in the brain that is connected with the pleasure derived from nicotine ingestion. The PDR says that it is not known exactly how this drug works with smoking cessation. For me, that is not an issue. I have found that as I approach Day 12 without a cigarette, the cravings are fewer and if I ignore them or eat a piece of candy, they don't last long. I find this amazing.

What we wanted folks to take away from this smoking cessation forum was the knowledge that there are tools to help one quit and very few smokers are successful if they don't take advantage of these tools. Only about 2% of those who stay smoke-free do so "cold turkey." There are five choices of medications, including pills, gums, nasal inhalers and sprays, as well as patches that are shown to be effective in helping smokers who are motivated to quit.

At www.surgeongeneral.gov/tobacco, there is a list of the "Five Common Myths About Smoking." I think these may be helpful to anyone who is entertaining kicking the habit.

Myth 1: Smoking is just a bad habit.
Fact: Tobacco use is an addiction. According to the U.S. Public Health Service Clinical Practice Guideline Treating Tobacco Use and Dependence, nicotine is a very addictive drug. For some people, it's as addictive as heroin or cocaine.

Myth 2: Quitting is just a matter of willpower.
Fact: Because smoking is an addiction, quitting is often very difficult. A number of treatments are available, however.

Myth 3: If you can't quit the first time you try, you will never be able to quit for good.
Fact: Quitting is hard. Usually, people make two or three tries or more before being able to quit for good. (This was my second attempt, the first lasting 18 months about ten years ago.)

Myth 4: The best way to quit is "cold turkey."
Fact: The most effective way to quit smoking is by using a combination of counseling and nicotine replacement therapy or non-nicotine medicines (such as Zyban). Your health care provider can advise which is best for you.

Myth 5: Quitting is expensive.
Fact: Treatments cost from $3 to $10 a day. A pack-a-day smoker spends almost $1,000 per year. Check with your health insurance plan to find out if smoking cessation medications and/or counseling are covered.

A few other interesting facts I found doing research for my journey into a smokeless and ashless existence include:

I quit because I was ready and because I utilized a tool available to me. I already feel better and I know that as with any addiction, one must take it one day at a time. Now, with all the money I am saving, I may just get those new hardwood floors I have wanted by next summer!

Our thanks to GlaxoSmithKline, who partially sponsored this forum. Also, many thanks to Cheryl Page from the Fulton County Department of Health and Wellness Tobacco Use Prevention Program; AIDS Treatment Initiatives (ATI), who cosponsored this forum; and The Myrbacks, a husband-and-wife hypnotherapist enterprise. The Myrbacks shared how this complementary therapy can help one to stop smoking (as well as a plethora of other things).

Fulton County has a help line for those who want to quit smoking or who need to talk to a real live person for support with staying smoke-free. The number is 1-877-270-STOP (7867) and is available Monday-Thursday, 8:00 a.m.-11:00 p.m.; Friday, 8:00 a.m.-10:00 p.m.; Saturday and Sunday, 9:00 a.m.-8:00 p.m. I called this number and Karen was very helpful in giving me this information.

For more information about hypnotherapy, contact Maria Myrback, CH, Holistic South, Inc., www.holisticsouth.com, (770) 713-2804. They even have CDs that help with several health issues. These are available at ATI or at their web site.




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