A six-week summer vacation in Germany had 18-year-old Martha Louks hooked.
Her pack-a-day smoking habit followed her for seven years, down a slippery slope through college and afterward, when she lit up before work, after meetings, on smoke breaks and coffee runs, in her Lakeview apartment, and when she was bored, stressed, tired and even in a celebratory spirit.
“Nicotine is like the perfect drug. It brings you up, calms you down,” said Louks, an account executive who is now 25.
But the appeal of cigarettes started to fade for Louks, who realized how much her $8-pack-a-day habit was costing her — financially and physically. “I don’t like the tar stains on my teeth. I don’t like how my lungs feel. I don’t like that it’s harder to exercise than it should be,” she said. “So why do I like smoking a cigarette if I hate all these things about it? And it didn’t make any logical sense.”
Nearly 21 percent of U.S. adults, or 45.3 million people, are smokers, according to the Centers for Disease Control and Prevention.
Cigarette smoking is the leading preventable cause of death in the U.S., responsible for 438,000 deaths annually, the CDC said.
And quitting isn’t easy.
Approximately 44 percent of smokers try to quit each year, and most efforts are unaided and unsuccessful, according to the U.S. Public Health Service-sponsored update to its “Treating Tobacco Use and Dependence” clinical guidelines released last month. The document stated that only 4 percent to7 percent of the 19 million people who tried to quit in 2005 were likely successful.
Louks said she has difficulty breaking the habit. “Is there anything else you do 20 times a day?” she said.
She said she relied on cigarettes “for little tiny emotional things throughout the day, and that’s the hard part.”
Nicotine is as addictive as heroin, cocaine or alcohol, CDC research suggests. Yet there are plenty of tools to help smokers kick the habit that have been proven to be effective.
Food and Drug Administration-approved medications include nicotine replacement products: gum, patches and lozenges available over the counter and nasal sprays and inhalers by prescription. There also are non-nicotine prescription pills: Zyban (bupropion) and Chantix (varenicline). All have possible side effects.
Experts suggest medications combined with counseling can be an even more effective treatment. And a recent study found smokers tend to quit in groups and can be influenced to quit by people in their social networks.
To help smokers quit, registered nurse Carol Southard talks to them about physical, psychological and behavioral effects of smoking in an eight-week program at Northwestern Memorial Wellness Institute.
“It’s not that [smokers] are weak, or immoral, or lack willpower, or have a death wish. The fact is they have an addiction that is by far the hardest to take control over,” said Southard, a tobacco treatment specialist.
Southard said smokers face a daunting battle when they try to quit, with most smokers taking three to eight serious attempts before permanently kicking the habit.
“Don’t make your goal to stop wanting a cigarette. Make your goal to stop having a cigarette despite wanting one,” she said she tells her clients.
In November, Louks tried to quit for the first time, prompted by the looming city smoking ban and the fact that her boyfriend was trying to kick the habit too.
“You kind of owe it to yourself to at least try,” she said. “People do it all the time so it’s obviously doable.”
It took three months on a generic nicotine gum before Louks relapsed. She again tried to quit in April by chomping on cinnamon-flavored Nicorette and hasn’t had a puff since. The temptation to smoke is hard to turn down when she goes out to bars, but her friends, most of whom are ex-smokers, remind her how bad she’d feel the next day if she broke her streak.
Indeed, friends can help friends quit. A friend who stops smoking can decrease a person’s chance of smoking by 36 percent, according to a study published last month in the New England Journal of Medicine. The odds are boosted to 67 percent if a spouse stops smoking. If a co-worker at a small firm quits, then the person is 34 percent less likely to smoke, and 25 percent less likely if a sibling quits.
Combining counseling with medication also helps people quit, the U.S. Public Health Service said. Medications increase the odds of quitting because they decrease the physical withdrawal symptoms of nicotine. When smokers feel better physically, they will have more energy to put toward psychological and behavioral changes, said Southard, the tobacco treatment specialist.
Others swear by more controversial quitting methods, including hypnosis and acupuncture.
Both the gum and the patch made Laura Stoll nauseous, a prescribed bupropion made her feel anxious, and sheer willpower worked for only a week. Feeling desperate and frustrated, she tried acupuncture two years ago.
“I walked out of there and haven’t had a cigarette since,” said Stoll, 47, an interior designer who lives downtown. “It was sort of miraculous as far as I’m concerned.”
The American Cancer Society said it’s hard to determine the success rate for various methods because programs don’t define success in the same way. The society cites medical journal articles reporting that 25 percent to 33 percent of smokers who use medicines can remain smoke-free for over six months, compared to 5 percent to 16 percent who do it without medicine.
Loyanna Grierson, 35, of Roscoe Village, plans to make her third quitting attempt by going cold turkey after trying over-the-counter and prescribed medications and a smoking-cessation program. Cold turkey worked for her earlier this year, when she lasted six weeks by snacking on carrots.
Smoking-cessation products “would be another excuse, like it’s something else to hold on to,” she said. “When I say goodbye to it, I want to say goodbye forever. And I don’t want to have another crutch.”
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Want a new drug?
A study at the University of Chicago is examining whether a medication called naltrexone could improve quitting rates. Study participants — chronic smokers with past quitting attempts — take a placebo or naltrexone. It has been FDA-approved for treatment of other addictions such as alcohol and opiates in combination with the patch and behavioral counseling for three months, said Andrea King, director of the Clinical Addictions Research Laboratory, who is conducting the study.
The study, which will likely continue for another year and is funded by the National Institute on Drug Abuse, is designed to see if a larger sample will replicate results of a small clinical trial, which showed naltrexone improved quit rates in some smokers.
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lvivanco@tribune.com
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Thank you for not smoking
Smokers are familiar with the symptoms of nicotine withdrawal. They can feel dizzy, depressed, frustrated, impatient and angry. They can have trouble sleeping and concentrating, get headaches and develop an increased appetite. But once they get through those feelings, they’ll notice how much better they feel. Smokers can feel health benefits as soon as 20 minutes after quitting.
20 minutes after quitting
Heart rate and blood pressure drop.
12 hours
Carbon monoxide level in blood drops to normal.
2-3 weeks
Circulation improves and lung function increases.
1-9 months
Coughing and shortness of breath decrease and cilia (above; tiny hair-like structures that move mucus out of lungs) regain normal function, increasing the ability to handle mucus, clean the lungs and reduce the risk of infection.
1 year
Excess risk of coronary heart disease is half that of a smoker’s.
5 years
Stroke risk is reduced to that of a nonsmoker 5-15 years after quitting.
10 years
Lung cancer death rate is about half that of a continuing smoker’s and risk of cancer of the mouth, throat, esophagus, bladder, cervix and pancreas decrease.
15 years
Risk of coronary heart disease is that of a nonsmoker’s.
Source: American Cancer Society
