How to Stop Smoking
We talked with Linda Thomas, manager of Tobacco Consultation Services for U-M’s M-Healthy Program, about kicking the addiction.
Q: How do you respond to people who think that because they already have cancer, there’s no point in quitting?
A: The research shows two things: First, people who have any type of cancer who quit smoking have better quality of life. Inflammation in the lungs decreases, allowing more oxygen to flow, which helps with fatigue. Second, if you look at studies examining the effects of lung cancer treatment, regardless of whether it’s chemotherapy, surgery or radiation, life expectancy is longer for those who quit smoking.
Q: How do you know when you’re ready to stop smoking?
A: People who are addicted to a substance are never going to be 100 percent ready to quit. We tell people it’s OK to love smoking and to want to continue to enjoy it, but if there’s 51 percent of you that recognizes it’s not good for you and you don’t want to smoke, then it’s time to start quitting.
Q: What do you mean by “start quitting”?
A: The average smoker makes nine to 11 quit attempts before becoming an ex-smoker. It’s important to realize you’re not weak if you’ve tried a couple times and haven’t been successful. Nicotine is a real addiction; staying off it requires management similar to any chronic disease. The only failure in quitting smoking is when a person quits trying to quit.
Q: What kinds of medications are available to help?
A: Nicotine replacement in the form of patches, gums, lozenges or inhalers can help prevent symptoms of withdrawal without exposing a person to the 4,000 other chemicals in cigarettes. Other options are Chantix, which blocks nicotine receptors in the brain, or the antidepressant Zyban, which has been shown to stave off cravings.
Q: Why would someone need an antidepressant to help quit?
A: The nicotine in cigarettes, sadly, serves pretty well as an antidepressant. And studies have shown that 45 percent to 55 percent of smokers may have an underlying depressive disorder they’re self-medicating with nicotine. Smoking becomes a coping mechanism: “I feel bad, but when I smoke a cigarette, I feel better.”
Q: So it may become a way to cope with a cancer diagnosis then, too?
A: Guilt is a nasty emotion, and it’s something that can get in the way of the quitting. It’s very easy for people to get caught in a cycle of “I did this to myself, so why should I quit smoking?” But it’s a matter of learning to deal with the negative aspects of life the way nonsmokers or ex-smokers deal with them. Instead of a cigarette, maybe you seek out a friend to talk to or learn to meditate.
Q: Smoking is often social. How do you handle couples where only one person wants to quit?
A: There needs to be some negotiation between the person trying to quit and the person still smoking to make sure both feel like the other is being respectful. Maybe you create smoking and non-smoking areas in your home, or you agree never to offer cigarettes to someone trying to quit.
Q: Do you have any suggestions for ways to cope with triggers that cause someone to crave a cigarette?
A: It’s not uncommon for me to have someone come into my office and say, “I’m ready to quit and I’m going to exercise instead.” Well, if you smoke a pack a day, it’s estimated that you spend about three hours and 20 minutes on smoking or smoking-related behavior; very few people are ready to exercise that much. It’s important to develop a new menu of behaviors to replace smoking. Adjusting the daily routine is important, too. If you’re used to reading the morning paper with a cigarette, maybe sit in a different chair or take a shower first instead.
Q: Finally, if people you love smoke, how do you encourage them to stop?
A: Motivation has to come from inside. Lectures and guilt trips don’t work, and if anything, may cause a smoker to become more entrenched in the habit. For some, money may be a motivator: a pack-a-day smoker could save over $2,000 a year on cigarettes. Get them to start talking about what they want for the future; try to help them see that smoking won’t help them achieve those goals. Most importantly, tell them how much you love them and that you’re there to support them when they’re ready to quit.