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Quitting ain’t easy
She knows.
Shelley MacAllister knows what it’s like to be a smoker.
She knows about the need in the morning. And after a meal. And with a cup of coffee. Or a drink.
She knows about standing in the cold or in the snow, shivering in some alcove with some other hapless soul, puffing away, knowing that every drag from every cigarette should be the last.
But it isn’t.
There’s always something else. And then the morning to stop doesn’t come. Not for smokers. The lungs don’t lie. Nor do the statistics on the number of smokers.
MacAllister quit when she became pregnant. She had smoked about a pack a day for seven years. And now she has been clean for the last ten — the age of her son.
“I know, without a doubt, I will never smoke again,” she said. “Never. I know there is enjoyment in smoking. But it’s an albatross. You feel like an idiot. It’s almost like a prison.”
It’s a burden all right. The smell. The little exaggerated coughs from non-smokers — or their rapidly fanning hands — as if inhaling a little cigarette smoke was the same thing as breathing in the E. coli virus.
Geez.
Unfortunately, they are more right than wrong. Second-hand smoke is a killer too. But then again, we already knew that.
So just how does one quit these days?
MacAllister answers that question almost every day. She works at a telephone counseling service to help smokers. She started as a counselor and is now a manager at Quitline, a service that is part of the American Cancer Society’s National Cancer Information Center (1-800-227-2345). The Quitline is available seven days a week, 24 hours a day.
“I know how hard it is to quit,” she said. “I have asthma, and I can remember sitting in the emergency room, barely able to breathe, and the only thought that I had in my head was when I could go home and a have a cigarette.”
The first step, she said, is understanding that quitting requires several serious attempts.
“People are very surprised to learn that it takes on an average three or five quit attempts,” she said before explaining that running out of a pack of cigarettes is not a “serious” quit attempt.
It’s serious when you pick a date — say one month from today — and have what MacAllister described as an action plan.
“People need to stop and think about how much smoking is a part of their lives,” she said. “You have to break it down. What are the toughest situations? Is it the first thing in the morning? Is it before a job interview? The next step is to then figure out what you are going to do to replace having that cigarette. It could be little things like take a shower first before smoking. Or removing the ashtray from the car and having a straw or chewing gum nearby.”
The point, MacAllister explains, is that smoking is an addiction and a habit. The chemical dependency will go away over time. But breaking bad habits requires establishing new ones, healthier ones.
“The good thing is that most people already have thought about quitting and have good ideas about how to stop,” MacAllister says. “There is no one-size-fits-all solution.”
The telephone counseling service comprises four or five telephone calls that last anywhere from 20 to 40 minutes, depending on the session.
“We tailor our counseling sessions for the individual and what the smoker needs,” she said. “Some people just need to talk. Others need a lot of information and education. But the bottom line is that most people already know the reasons. They just need to know how to quit. They need support.”
MacAllister said the counselors don’t randomly call and interrogate clients. When you call you are assigned a counselor who then calls you according to your arrangements.
“They are not judgmental,” she said. “They will ask how’s it going and if the person says they have slipped then the counselors will say that’s OK but when are we going to get back on track? They are there to help, not be another person who does not understand why it’s taking so long for you to quit. Most people feel that they have an ally.”
So far, the program is working. At one point in Massachusetts alone, MacAllister said, they were receiving about 100 new telephone calls a month.
The benefits of quitting today are enormous. Within 20 minutes, your heart rate goes down. Within 12 hours, the carbon monoxide level in your blood drops to normal. Between three weeks and three months, your circulation improves and lung function increases.
It gets better. A year after quitting, the risk of coronary heart disease is half that of smokers. Ten years after quitting, the lung cancer death rate is about half that of a continuing smoker. In addition, the risk of cancer of the mouth, throat, esophagus, bladder, cervix and pancreas decreases. Fifteen years after quitting, the risk of coronary heart disease is that of a non-smoker.
These statistics are not hearsay. They come from a report of the Surgeon General, published in 1990.
But quitting is tough.
MacAllister said withdrawal is very real, and for most people, using an over the counter Nicotine Replacement Therapy (NRT) — gum, lozenge, or the patch — can ease the pain. Other drugs, such as Zyban and Chantix, are also available, but only with a doctor’s prescription. Fortunately, smoking cessation drugs are now covered by many health plans, including MassHealth.
With a nicotine replacement, the smoker is twice as likely to quit. However, when relying on the quitline alone, the quit rate is only 20 percent greater than going cold turkey. Of course the combination of the telephone service and a NRT improves even further the chance of successfully quitting — and staying quit.
It wasn’t easy for MacAllister. Her boyfriend at the time smoked as well. And when she became pregnant — and had to quit — the stench of cigarette smoke made her ill. He eventually quit, but it took time.
“It has to be in your head,” she said. “You can’t quit because of your parents or your children or your friends. You have to quit for you.”
She has heard the wheezing over the telephone lines. She has heard the coughing. She had one lady tell her about a disease she had contracted from smoking and doctors were forced to remove part of one of her lungs. She still smoked.
“Cigarettes have a powerful hold on people,” she said.
She has also heard the good stories.
“One woman must have been about 60 years old,” MacAllister said. “She said she smoked about three packs a day. She just always had a cigarette either in her hand or in an ashtray.’
The woman smoked liked that for about 30 years.
She quit.
It didn’t happen the first time. Nor the second.
But she quit.
“She just couldn’t believe that she would be able to do it,” MacAllister said. “She is so pleased with herself.” |
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