Posted by: Steve | January 18, 2012

Keep trying to quit

By Stephen O’Brien

Dallas pulmonologist Dr. Gary Weinstein says people may have to try several times before successfully quitting the smoking habit.

Great story about the importance of quitting smoking in this week’s Dallas Morning News. Writer Nancy Churnin did a fantastic job . One of the takeaways is that however someone chooses to go about trying to quit, just try. Stats show it usually takes a couple of times before kicking the habit takes hold.

How to stay motivated to quit smoking  The Dallas Morning News —  Jan. 17, 2012  By Nancy Churnin

 If at first you don’t succeed, quit, quit again.

  That’s the approach that worked for Ron Bauman, 66, of Flower Mound as he enters the New Year as a former smoker for the third and, he hopes, final time.

 And that’s the attitude experts would like more smokers to take. Six out of 10 smokers don’t succeed the first time, according to the American Lung Association. So if you’ve failed in the past, or your resolve to quit this year has been flagging, make another resolution not to beat yourself up. Also consider that you may have a better shot if you take advantage of the many new techniques, support groups and medicines that can be customized to fit your needs.

   Nicotine is the most common form of chemical dependence in the United States, with 443,000 people dying each year from tobacco-related illnesses and second-hand smoke, according to the American Lung Association. It’s a tough habit to crack, ranking with heroin, cocaine and alcohol in terms of addictive properties, according to the Centers for Disease Control and Prevention.

  Dr. Richard Hurt, director of the Mayo Clinic Nicotine Dependence Center in Rochester, Minn., was a three-pack a day smoker through college and medical school. Motivated more than three decades ago by the birth of his children to become and continue smoke-free, he speaks from experience when he tells his patients that he understands how hard it can be to change.

 “If a smoker understands the neurochemistry of addiction, it takes away a lot of the guilt and helps the smoker understand it’s hard, but it can be done,” Hurt says. “These little white sticks look innocent, but they’re the holy grail of drug delivery devices, getting nicotine to the brain faster than shooting it intravenously. Most people think of a cigarette as crumpled up tobacco, but its design is as sophisticated as a space shuttle.”

 One of the newest inventions gaining steam is the e-cigarette, an electronic cigarette that delivers nicotine, but not tobacco, with “smoke” that is actually water vapor and propylene glycol. Many doctors don’t advocate them because conclusive studies are lacking.

 Some patients respond well to online support groups or text message reminders or prescription medications such as varenicline that block the pleasant effects of nicotine on the brain, which is what Bauman used.

 Nicotine replacement through a nicotine patch or gum, available over the counter, and prescriptions for a nicotine inhaler and the anti-depressant bupropion may prove helpful, too.

  The key is to address common patterns, such as the desire for a cigarette in the morning after a night of nicotine withdrawal, alongside each patient’s individual triggers, says Bauman’s physician, Dr. Gary Weinstein, chief of pulmonology and critical care medicine at Texas Health Presbyterian Hospital in Dallas.

 To improve the odds of success, Weinstein advises viewing smoking as a multiple addiction that has to be tackled on several fronts.

 “First is the chemical addiction of your body to the nicotine. Second is the physical habit of having a cigarette in your hand and in your mouth. And third is the automatic behavior that comes from many years of smoking … [such as] every time they drink a cup of coffee or read the paper.”

 Because many patients turn to smoking as a stress reliever, trying to avoid stress or finding new stress relievers can be critical, too, Weinstein says.

 Bauman, who had to break the habit of smoking while talking on the phone, or when drinking coffee or having a beer, says he was driven to quit in June when Weinstein told him he was starting to get emphysema.

 “I was scared,” Bauman acknowledges. “I do think it’s different for everyone, but for me the No. 1 key is a desire to quit — not just thinking you should, not someone telling you that you should. You have to want to quit yourself. You’ve got to win that battle with yourself before anything else really works.”

  Not only do doctors agree that tossing tobacco is the single best thing people can do for their health and for the health of those they love, smoking has become increasingly unwelcome in many areas with half of the states and the District of Columbia enacting smoke-free laws, banning smoking in workplaces, bars and restaurants, according to the CDC.

 Texas does not have a comprehensive smoke-free law, but many individual workplaces have been declared smoke-free in the last year, and many insurance companies charge higher rates for employees who smoke.

  Heavily addicted smokers can explore the option of a residential treatment program such as the one Hurt offers at the Mayo Clinic. Others may want to work with their individual doctors or explore some of the free and low-cost programs offered by the American Lung Association, Nicotine Anonymous, National Cancer Institute and other non-profit and government organizations.

 Experts say it’s important to remember that the early stage of withdrawal can be the hardest. That’s when group or individual support can make the biggest difference along with a healthy diet, exercise and sleep. The Foundation for a Smokefree America advises drinking more water, avoiding sugar, caffeine and alcohol and trying deep breathing and cigarette substitutes such as cinnamon sticks or chewing gum.

 Bauman says he kept a piece of nicotine gum in his pocket for an emergency, but never felt a need to open or chew it. He says he’s looking forward to marking one year of being smoke-free next January, which will qualify him for a reduction in his health insurance. In the meantime, he’s enjoying being smoke-free this January.

 “It gives me a feeling of freedom,” he says. “Also, I don’t have to step outside in the cold weather to smoke.”


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