When you’re a smoker, especially in California, which boasts the second-lowest number of adult smokers in the country next to Utah, very few sweet voices greet you throughout your day.
Most people just want to get away from you.
There’s no smoking indoors in public places or outside in parks or playgrounds.
In some cities, like in Oakland, you can’t smoke in ATM lines or at bus stops. And in Belmont, smokers soon will not be allowed to smoke inside their own apartment or condominium.
So maybe there’s no time like the present to quit.
And if you do try, as thousands of Americans will Nov. 15 during the Great American Smokeout, you will hear one friendly voice on the other end of the line at 1-800-NO-BUTTS (1-800-662-8887), the California Smokers’ Helpline.
If you’re lucky, you might reach Loraine, a former smoker whose mission is to help others quit. She sweetly asks her clients the tough questions, like how many cigarettes they smoke per day and how smoking makes them feel.
She then walks them through the ways in which they can break the habit, either cold turkey or by using nonsmoking aids.
“We want you to be as comfortable as possible when you do this,” she says, as she coaches a client into a nonsmoking plan. At the end of a 30-minute conversation, Loraine sends her client a certificate and promises to call on the quit date. A week or two after the quit date, Loraine will call again.
There is no magic bullet to quit smoking, no miracle cure that will take away cravings or erase smoking behavior, no matter what new drug comes out. “As Yoda would say, the magic bullet resides within you,” says Dr. Steven Schroeder, director of the Smoking Cessation Leadership Center at the University of California, San Francisco.
Despite an occasional “Star Wars” quote, Schroeder minces no words when he talks about the grasp the habit has on smokers.
“Nicotine is more addictive than heroin or crack cocaine,” he says. The good news is, the number of smokers in the United States is decreasing. For the first time, there are more former smokers than current smokers out there. Just 12 percent of California adults smoke, compared to about 20 percent of the American population as a whole.
Schroeder has been working with smokers for about 15 years and writes papers on the subject of quitting. He says first, smokers need to want to quit. They then need to find the right time to do it and set a quit date. Next, smokers need to bolster the reasons why they want to quit and figure out the temptation triggers and try to erase them.
Then, he says, smokers should decide which cessation aids are right for them.
There are a variety of such products on the market, from over-the-counter nicotine replacement therapy (NRT) aids such as nicotine gum and the nicotine skin patch to prescription NRTs and non-nicotine prescription medications such as bupropion and the newer medication, Chantix. (which comes with some pretty severe side effects.)
The bad news is, none of these aids is 100 percent effective. In fact, none is 50 percent effective. Drug company Pfizer’s own studies on Chantix say it’s 44 percent successful, the highest of all. “We think it is the best drug so far,” says Dr. Kolawole Okuyemi of the University of Minnesota Medical School, who wrote a paper on the subject titled “Interventions to Facilitate Smoking Cessation” and studies multi-ethnic populations and their smoking habits.
Other drugs, including nicotine gum and the patch, have success rates of about 20 percent. About 2.5 to 5 percent of smokers are successful at quitting without any aids.
Drugs act differently on people of different races, depending on the type of cigarette used, such as mentholated versus non-mentholated, Okuyemi says, so it is not easy to predict what will work on whom.
It takes a combination of products and counseling to really help people quit, says Dr. Jodi Prochaska, clinical psychologist and assistant professor at the University of California, San Francisco.
While alternative therapies are sometimes touted as a cure to help people quit, Prochaska says there is no good evidence that acupuncture helps smokers quit. There is some evidence that stop smoking hypnosis can be helpful.
Kaiser Permanente of Northern California’s patients smoke at a rate of about 9 percent, compared to 12 percent of the general California population. This is due, in part, to the nonprofit health care provider’s proactive stance, says Jeanne Reisman, chief of health education for Kaiser Permanente’s Oakland Medical Center and anti-tobacco champion.
Kaiser physicians identify smokers during visits and encourage them to quit. The company offers smoking cessation classes to its patients and offers discounts on stop-smoking aids. “There are a lot of messages that smokers receive about being asked whether they smoke and about being advised to quit,” Reisman says.
Say you’ve tried to quit smoking before, and it just hasn’t stuck. Reisman and other experts we interviewed say most people fail the first time, but the likelihood of being successful gets higher after several tries.
Quitting smoking, they say, is the best single thing anyone can do for his or her health. Smoking causes lung cancer, heart disease, respiratory problems, and can harm others who are exposed to the smoke.
The first step is up to you.
Reach Laura Casey at 925-952-2697 or lcasey@bayareanewsgroup.com.
Source: Laura Casey, Contra Costa Times
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