Friday, May 30, 2008

Quit Smoking for 1 Day for "No Tobacco Day"

Tomorrow, May 31st is No Tobacco Day celebrated by the World Health Organization. Maybe you've never heard of this celebration where every smoker is urged to stop just for the day or maybe you have it confused with The Great American Smokeout which is the thursday before Thanksgiving in November and is sponsored by the American Cancer Society. It is hoped that if a smoker quits for one day, they will have the courage and strength to try for another day, and another until they are quit for good. I think that ANY effort to get smokers to quit, even for a day, is fantatic!! What I would like to see is an effort to recognize that the battle to quit is one day at a time and in a short while, you will feel like a non-smoker. However, even years down the road, a former smoker needs to be diligent about not smoking even one. We forget that smoking is so ingrained within a person that it is easy to relapse back to smoking and just walking away from the first one is only the first step in a long road back to recovery and maintaining a smoke-free status. So remember to remind your smokers to stop just for today-No Tobacco Day, where they will be joining other smokers around the world and I also remember to celebrate with those who have already quit and have stayed quit--They have won the battle that others still are fighting.

Wednesday, May 28, 2008

Stop Smoking: A 100% Guarentee

I've just read another ad that claims 95% of smokers quit, if you buy their product. yesterday a website claimed a 55% quit rate. The reality is that you can say whatever you want and get away with it but it doesn't mean it's true. Every method will work for some people, NO method works for everyone.
Where my class is different, is that I know that quitting is a process that a smoker moves through, my job is to educate, motivate, encourage and support the smoker to finding what path works for them.
My Stop Smoking, Stay quit classes are close to a 100% quit rate but lets look at where that number comes from. That is the number of individuals, who completed all the classes, did what I suggested and on the last night of class, weren't smoking. That statistic doesn't tell you what the drop out rate is (10 - 25%). And it doesn't count the individuals who will relapse within the first 6 months (50%). I also know that if most of the participants are first time quitters, there is almost a 100% relapse rate but if everybody walks in and says, "You're my last resort, I've tried everything and nothing works!" I know that person is going to be successful and most likely will NOT relapse. Why??--I know they have a strong desire otherwise, they still wouldn't be trying to quit. I know they have learned alot about their connection to quit and with the proper education, motivation, support and tools, they can put together a plan that they will succeed with.
A big part is giving the smoker more tools at their disposal. If the only tool you have is a hammer, then every problem looks like a nail. I suggest different tools but it's the smoker that has to put it into use.

First time quitters relapse for different reasons that long time quitters. Often, they get cocky and think they can control their smoking, now that they have quit. I love getting smokers who repeat my class. Others wonder why they are back. The answer is always the same--"I quit but didn't listen about the relapsing part". So the relapsers do it again and this time they listen and don't relapse.
So the next time you read an ad that has such a high quit rate, be skeptical and be sure and ask for a money back guarentee!

Stop Smoking: Not Just a Problem for US

I have traveled to many countries international and have heard the same refrain that people want to be like the people in the "West" and this is one of the influences to encourage people to smoke. The US has glamourized smoking and women have increasing embraced smoking around the world, not just in the United States.
The following is a report that will be delivered at the Conference for the Committee on the Elimination of All Forms of Discrimination Against Women (CEDAW) along with international suggestions from The World Health Organization (WHO):

According to government reports submitted to CEDAW, in Iceland, Lithuania, Nigeria, Slovakia and the United Republic of Tanzania more girls now smoke than women. That is a worrisome trend. However, there is also good news. With stronger tobacco control measures put in place, Finland reports that the rate of smoking among females 15 to 16 years old has steadily declined. Similarly, in the United Kingdom of Great Britain and Northern Ireland, fewer girls now smoke than adult females.

The implementation of strong tobacco control policies in most countries still lags far behind. The impact on women’s health is devastating. Smokers have gender-specific risks and are at an increased risk of lung cancer, breast and cervical cancers and coronary heart disease. Young women may think that they can easily quit during pregnancy. But research indicates it is harder for women to quit than men. Parental smoking endangers the health of newborns, contributes to infant death syndrome and middle-ear infection in young children.
Reversing this trend is possible. The World Health Organization’s Report on the Global Tobacco Epidemic, 2008 outlines a roadmap to success. The “MPOWER” package includes:
● Monitor tobacco use and prevention policies. Except for Yemen, all State parties reporting provide data on smoking prevalence for adult females and for girls. Finland, Iceland and the United Kingdom also monitor the impact of prevention policies. Iceland reports campaigns directed specifically to girls. The United Kingdom provides gender data by socio-economic groups and ethnicity. Nigeria, Slovakia, Yemen Lithuania and Tanzania must give more attention to improving gender-sensitive indicators.
● Protect people from tobacco smoke. Only 5 % of the global population is currently protected by comprehensive smoke-free legislation. Among the State parties reporting, the United Kingdom is the only one providing women with 100 % smoke-free policies, covering work places, restaurants and pubs/bars. Nigeria is heading in the right direction as are Slovakia and Yemen.
● Offer help to quit tobacco use. Services to treat tobacco dependence are fully available in only a few countries with 5 % of the world’s population. Nigeria and United Republic of Tanzania have cessation programs, but do they reach disadvantaged women?
● Warn about the dangers of tobacco. Misleading and deceptive terms such as “light” and “low-tar” are allowed in nearly 60 % of countries worldwide, even though scientific evidence shows that such products do not reduce health risks. Women often choose these products, under the false assumption that they are healthier. Stronger health warnings—including picture warnings—must be improved in all reporting States.
● Enforce bans on tobacco advertising, promotion and sponsorship. Only 5 % of the world’s population live in countries with comprehensive bans on tobacco advertising, promotion and sponsorship. Yemen stands out as the only State party that has a complete ban on advertising that also includes the internet. As the internet increasingly sells to young people, all State parties should implement bans on internet advertising and sales.
● Raise taxes on tobacco. A 10 % price increase can cause a 4 % drop in tobacco consumption in high-income countries. It also brings badly needed new revenues to government coffers—monies that can be used in anti-tobacco campaigns. While some governments have steadily increased taxation for this purpose, Nigeria and Tanzania would benefit from increased taxation.
The WHO Framework Convention on Tobacco Control, ratified by more than 150 countries, supports the above measures. Together with the CEDAW, the WHO FCTC promises to help protect women and girl’s rights to health as a human right. A comprehensive tobacco control program is making progress in some countries. It is time to push harder for more speedy compliance with human rights standards and address the urgent public health issue of tobacco use among women and girls.

Monday, May 26, 2008

Stop Smoking: Side Effects from Chantix?

I was reading in the LA Times about driving accidents that are being linked to the new stop smoking drug-Chantix:

http://www.latimes.com/features/health/la-na-smokedrug25-2008may25,0,4540550.story

The US Public Health Service recommends that all smokers wanting to quit, be offered medications. Currently there are 7 FDA approved drugs to stop smoking. But with any medication that is taken, there can be side effects. There have been reports of increased suicide ideation with the use of Chantix. But which came first? Because of the high number of smokers that already have a mental disorder, smokers are already at a higher suicide risk. Is this effect due to taking the drug or an underlying problem? Or a combination of both?
Different people are going to have different reactions to medications. So is the right choice to take a medication? Or go cold turkey without any medicinal help?
Smokers should be fully informed about their options and should fully inform their doctors about any underlying mental disorders, substance use, and other medications that are being taken. Every factor that is undisclosed could cause potential problems. The FDA needs a better system of reviewing the possible side effects from drugs that have been approved and what kinds of other factors product prominent side effects. And finally the FDA needs a better reporting system, so that side effects can be communicated to the public quickly.
What are your thoughts?

Friday, May 23, 2008

Stop Smoking: Is there a Right to Smoke?

Smokers will often shout about their right to smoke but their right to smoke ends where my nose begins. They do not have the right to endanger my health or the health of anyone except themselves. Smokers are in the minority and it's time to stand up for the rights of non-smokers throughout our country. 27 states how have 100% smokefree work environments. We are at the tipping point to protect the rights of non-smokers. I encourage those of you who live in states without a law that protects the health of it's citizens from secondhand smoke, a Class A carcinogen, to write or call your representatives and urge them to pass a smokefree law.
When hearing smokers yell for their right to smoke, I often want to say that they have the right to play russian roulette too, but it is kind of dumb but at least with russian roulette you have less chance of dying, with russian roulette there is a 1 in 6 chance of dying or 16.66%, with smoking, 50% will die from using tobacco as intended.

Thursday, May 22, 2008

Stop Smoking: Quit with a Friend

A new study suggests that if you quit smoking, this may influence your family and friends to quit also. I think it depends on the motivation of the person. If someone really wants to quit, they can find it very difficult when someone they live with or someone close to them smokes. It inhibits their success, so when this other person makes the decision to go smoke free, the smoker that had been wanted to quit, will do so also beccause they had wanted to all along and now the temptation of being around another smoker is gone also. Having support from someone going through the same struggle makes it easier for both parties. If you want to quit but live with a smoker or have smoking friends, why not talk to them now about your reasons for wanting to quit and ask for their support. Maybe they have been thinking the same thing but have been afraid to approach you. Talking about what we want is another step on the road to becoming smokefree. Have you quit with a friend or loved one. How did you do it?

Monday, May 19, 2008

Stops Smoking: Are We Losing the War on Drugs?

In our War on Drugs, we do everything we can to protect our children from illegal substances, we destroy the crops, execute the pushers and rehabilitate the users, yet with tobacco we subsidize the crops, exonerate the pushers and blame the users.

The Desert Sun newspaper in Palm Springs, CA reported on May 17th that 22% of retail businesses in the City of Palm Desert sold cigarettes to underage decoys (Businesses cited for selling tobacco products to teens). While it is illegal to sell cigarettes to minors in all 50 states, this law is being ignored in Palm Desert.

Would we ignore these statistics if it were alcohol that was being sold to minors? As a society, we see teen smoking as a right of passage and say “Thank God it’s only cigarettes and not something worse.” Yet tobacco kills more alcoholics and substance abusers than all other drugs put together and is more addictive than heroin.

Where is the outrage?

Underage smoking is the first addictive substance for individuals who later become addicted to alcohol and other substances. Smoking kills 50% of it’s habitual users. Those with mental illness are more likely to start using tobacco early in life. Most smokers start before they are legally able to buy them. We need to do everything we can to stop this.

It is time for society to step up to the plate and stop teens from buying a substance that is likely to kill them. It's time to stop thinking of smoking as a bad habit and recognize the killer it is. It's time for all parents to truly protect their children from tobacco.

Tobacco is the only deadly substance that is almost totally unregulated. In California, as an effort to stop sales to minors and enforce compliance, cities, statewide have partnered with the local Health Departments to set up sting operations and catch those selling to minors. Each city or county has set up a procedure to license the right to sell tobacco and when retailers fail to comply, that right can be revoked. This has worked so well for the City of Desert Hot Springs, that in less than a year they went from 48% of retail stores selling to underage decoys to ZERO selling tobacco to minors.

It can be said that if they want to smoke, they will find a way but it's time for us to stop making it easy for them.

Sunday, May 18, 2008

Stop Smoking: Help for Closet Smokers

When Steve took the trash out, his wife would comment that he smelled like smoke. It was always from a neighbor that he ran into. After Richard's heart surgery, his wife found a pack of cigarettes in his bathrobe. She thought he had quit.

After my cancer experience, even smokers would bug me to quit, after all, I had been treated for cancer. When I relapsed again, I didn't want to hear any comments from my fellow workers, so I would take any opportunity to run errands, so I could smoke.

I was a closet smoker and so are Steve and Richard. They hide their behavior because they do not want their friends and family to nag them about their smoking. Every smoker knows it's bad for their health but the addiction to nicotine is a powerful one.

Don't get angry at the closet smoker, get angry at the product that has caused their addiction. Closet smokers feel a range of emotions from failure and guilt to indignation and self-righteousness. What you don't want to do is escalate the situation. If confronted, the closet smoker will likely tell you to "BUTT OUT!"
But that doesn't mean that they don't want to quit but they don't feel comfortable talking to you about it.

I was a closet smoker and I eventually was able to quit. Steve also quit but unfortunately, Richard died a smoker. So how can you help? There are many ways to help a closet smoker, but nagging isn't one of them.

In my book, "Butt Out" there are many ideas that you can start to help your closet smoker move towards quitting. There are also scripts that give you the words that won't offend, threaten or alienate the person you love.

Believe in progress, not perfection.

Saturday, May 17, 2008

Best Beauty Tip-Quit Smoking

Forget the facelift, the best tip to get rid of those wrinkles or to prevent from getting them, is to quit smoking.

The carbon monxoide in cigarette smoke binds to red blood cells faster than oyxgen, leavng the body without enough oxygen. So the body rations the oxygen, sending it to vital organs first, such as the brain and heart. Smoking also closes off the small capillaries. The result of all this is that the skin of a smoker will wrinkle more than a non-smoker.

So besides yellow teeth, stained fingers, bad breathe, and stinking of cigarettes, a smoker will often look years older than they should. Quit smoking and look better. Within a few weeks, the color in the skin improves and the former smoker looks so much better.

Friday, May 16, 2008

Stop Smoking: Hookahs More Dangerous than Cigarettes

Many young people have taken up the habit of smoking tobacco through a hookah. Hookah lounges are seen as a way to socialize with friends and a fun way to relax. Often the smokers think that this form of tobacco is safer than smoking cigarettes because the water filters out the toxins in the tobacco smoke or because the tobacco is touted as organic or not containing additives or containing less tar and nicotine than cigarettes or because the smoke doesn’t smell bad and it doesn’t leave a bad taste in the mouth. However, smoking from a hookah may be even more dangerous than smoking cigarettes.

A hookah is a glass based water pipe where a large quantity of pure, shredded, flavored tobacco is used. The tobacco used can contain 2 to 4 percent nicotine as opposed to 1 to 3 percent in cigarettes. The hookah is lit with a piece of quick lighting commercial charcoal. A typical smoking session lasts about an hour. The smoke is filtered through water or other favored liquid and does filter out some of the large particles contained in smoke. However, the smoke from a hookah contains the same amount of tar and almost three times the amount of nicotine. When lit by charcoal, this increases the amount of carbon monoxide in the smoke, which is a colorless, odorless gas that can affect the heart and cause brain damage. The water cools the smoke down and the tobacco burns at a lower temperature. The smoker must suck harder to force the smoke through the water which causes the smoker to inhale deeper into their lungs and longer, causing additional exposure to the deadly components of smoke. In a typical session of one half hour to an hour, a smoker may be exposed to the equivalent of a pack of cigarettes and larger amounts of nicotine, carbon monoxide and other toxins.

Studies have shown that smoking through a hookah can cause cellular chromosomal damage in the mouth and periodontal disease at rates similar or higher to smoking cigarettes.

Regardless of the source, cigarettes, pipes, cigars, or hookahs, no one who smokes is healthy. Is it time to quit? What are the issues that you are facing?

Tuesday, May 13, 2008

To Use or Not to Use Medications to Stop Smoking

" I tried (...fill in the blank... the patch, the gum, Zyban, Chantix...) and it didn't work."

"How long were you off cigarettes?"

"6 months."

"Then what happened?"

"I got a divorce (or lost my job or.....some other stressful event)."

This is a typical conversation I have had with many people trying to quit smoking. The medications DID work, but the smoker needed more tools in his tool box to be successful. When the only tool you have is a hammer, then every problem looks like a nail. Medications are used to help lessen the withdrawals from nicotine or to block the receptors in the brain, so that nicotine is not as reinforcing. They do NOT relieve stress, a different tool is needed for that trigger.

If you were an early relapser, meaning quitting for less than one month, you may have been using the medication incorrectly. It is not uncommon for those using nicotine replacement products (NRP) to under dose themselves or not use enough of the medication. Or to quit using it too early.

If you were a late relapser, it was probably not because of using the medication but from stress, thinking that smoking "just one" won't hurt, being around other smokers, drinking or using other substances, or gaining weight.

So if you have quit before but relapsed, don't blame the medication, look to see what additional tools you need to learn to be successful.

Tell me what your experience has been with medications to quit. Maybe you just need to try again, this time with a little more knowledge and you will be successful.

Monday, May 12, 2008

Stop Smoking:The Carrot or The Stick Approach

The Carrot or The Stick Approach

Jim couldn’t walk up a flight of stairs without gasping for breath. He wanted to quit smoking because his doctor said that his breathing would improve if he quit smoking (the carrot). Within a very short period of time after quitting, Jim could see a dramatic improvement in his breathing. He was very excited and happy with his condition. He called me nine months later and said that he wanted to go back to smoking because his doctor said his lungs were damaged from smoking and his lungs were as good as they were going to get. His doctor told him that if he started smoking again, that within six months, Jim would be carting an oxygen tank (the stick).

Two factors motivate us to do anything in life, we pursue things that please us (the carrot) or we seek to avoid physical or psychological pain (the stick). Often the carrot or the stick can be opposite sides of the same coin but one side is more motivating than the other.

At first Jim was motivated by the carrot, better breathing and later when the carrot was no longer available the stick or having his breathing become worse, was not as motivating and Jim started smoking again. For Jim, his motivation was a carrot, not a stick.

But instead of finding out what is motivating to the smoker, we tell them what would motivate us. You need to listen to the smoker to find out what carrot or what stick motivates them and then build upon that motivation which plants the seed of desire. Until this happens, the smoker is unlikely to change.

Sunday, May 11, 2008

Stop Smoking: The Brain on Nicotine

Regardless of the reason why smokers say they smoke, the main reason is to experience the effects that nicotine has on the brain. Cigarettes are a very efficient nicotine delivery system. Inhaling smoke into the lungs is the fastest way to get nicotine to the brain. The lungs have a large surface area and the capillary walls are very accessible. Up to 90% of the nicotine in mainstream smoke is absorbed and it enters the arterial system and moves fairly directly to the brain, arriving within 7 to 10 seconds. The concentration of nicotine can be three times higher than if the nicotine was injected into the veins of a smoker because first the blood is pumped to the heart, then to the lungs, back to the heart before finally going to the brain. Even using medicinal nicotine replacement products does not give the same kick to the smokers brain because of the delivery system. Smoking or inhalation of nicotine gives higher, faster, and shorter surges of nicotine to the brain when compared to the nicotine replacement products.

Nicotine then needs to pass through the blood-brain barrier. Ammonia is added to tobacco to increase the PH of the cigarette because a higher PH allows nicotine to easier cross this barrier. Once in the brain nicotine binds to specific areas called nicotinic acetylcholine receptors. Every one is born with these receptors but when a person begins to smoke, then numbers of these specific receptors increases. We can say that nicotine is a brain disease because smoking changes the structure of the brain.Smokers have more receptors than non-smokers and smoking may allow the receptors to live longer.

Nicotine affects the different parts of the brain in different ways depending on the dosage. Smokers unconsciously regulate the amount of nicotine by either inhaling deeper or smoking more of the cigarette. Sometimes the smoker may use a cigarette to relax at other times as a stimulant depending on how deeply they inhale.

When nicotine occupies these receptors in the pleasure pathway, dopamine is released which causes pleasurable sensations (positive reinforcement) and removes unpleasant sensations of pain, anxiety or feelings of illness (negative reinforcement). When the brain has an increase in dopamine, it may be that this increases the attention that the individual places on external activities. These external activities become paired with the pleasurable sensations and become triggers themselves for smokers to light up. The brain becomes conditioned so that when a trigger such as answering the telephone, happens, the brain lights up and expects nicotine to occupy the receptors which the smoker experiences as “cravings”. So any event that a smoker does habitually can be paired with smoking and become a trigger to light up. The brain becomes conditioned to these pleasurable sensations and will “crave” nicotine when faced with these triggers even if they have just finished a cigarette.

Individuals smoke for a combination of both positive and negative reinforcement. When an individual starts smoking it is usually for the pleasurable effects and at some point the individual continues to smoke to avoid the unpleasant effects of withdrawals.

Individuals with depression, Attention-Deficit Hyper Activity, anxiety, schizophrenia and other mental conditions, will smoke to relieve negative sensations as a form of self-medication. Alcoholics and others substance abusers use nicotine in the same way also.

The other area of the brain that nicotine affects is the locus ceruleus which controls vigilance, arousal, concentration and stress reactions. It is also responsible for an individual’s response to stress, anxiety and panic, which may explain why smokers use tobacco in times of high stress and negative emotions.
During the quitting process, the smoker may experience withdrawals which are physical symptoms when a drug has not been used for a period of time. Withdrawals from nicotine includes insomnia, irritability, frustration, anger, anxiety, depression, difficulty concentrating, restlessness, decreased heart rate and a change in appetite. Medications can help with these symptoms.

Cravings are not the same as withdrawals. Cravings or powerful urges to smoke happen when the brain is conditioned to want nicotine either through positive or negative reinforcement. The brain is shouting, “Where is my nicotine?” Over time cravings become less intense and less frequent. Medications can help with these cravings. Relapse occurs when a smoker will reintroduce nicotine which immediately lights up the receptors in the smoker’s brain. Often only one cigarette is all it takes for the individual to relapse back to full time smoking again because of the strong effect nicotine has on the brain.

Just as with other addictive substance, nicotine changes the structure of the brain is is why it is so hard for a smoker to quit. As a society we need to understand that smokers smoke because they are addicted,not because they lack the willpower. They need our compassion, not nagging, and they need our support, not put-downs.

Friday, May 9, 2008

The Best "Green" Living is to Stop Smoking

Living "Green" is the latest in healthy living. Julia Roberts and Sandra Bullock were on Oprah's show, telling us how easy and beneficial it is to go green. One evening show compared the toxins in a "green" family versus a "normal" family. Going green is big business. For a smoker, the best way to start is to stop smoking.

Besides nicotine there are estimated to be 4000 chemicals in tobacco smoke, which 400of these chemicals in smoke are either poisonous, cancer causing, or cancer promoting. We really don't know for sure because while the tobacco companies are required to give a list of their ingredients to the government, the information is not released to the public because it is considered a "trade secret". Nicotine delivery systems are the least regulated consumer product, yet one of the most deadly. Here are just a few of the chemicals that are known to be in tobacco smoke:

Nicotine: A poisonous alkaloid that is the chief active principle of tobacco and was used as an insecticide but is currently banned as an insecticide due to it's toxicity.

Tar: A particulate matter made up of dozens of compounds. Some are toxic, some are cancer-causing agents. Tar cools inside the lungs, forming a sticky mass and damaging lung tissue which can lead to emphysema. A quart of tar goes through the lungs of a pack a day smoker every year.

Carbon Monoxide: Deprives oxygen from reaching the red blood cells. It stays in the blood hemoglobin for up to six hours after exposure. It is related to heart attacks and strokes. Affects non-smokers in environment tobacco smoke AKA secondhand smoke. Binds to red blood cells in the lungs 230 times faster than oxygen.

Hydrogen Cyanide: Poison used in the gas chamber. EPA standards indicate that 10 parts per million as safe however cigarette smoke produces an average 1600 parts per million.

Arsenic: A metallic substance, poisonous to all life. The human body can build up a tolerance to arsenic.

Benzene: A poison that interferes with cellular metabolism.

Cadmium: A metal which accumulates in the lungs and stays there. Has an adverse effect on the protective immune devices of the body. Used in batteries.

Ammonia: This chemical is added to tobacco to increase the pH level to make it easier for nicotine to cross the blood brain barrier. Used as a household chemical.

Acetone: Used as nail polish remover. If you smoke, blow some smoke onto a cotton ball, then rub it on your fingernail polish.

Toluene: Industrial solvent.

Formaldehyde: Embalming fluid.

Methanol: Rocket fuel.

Naphthalene: Mothball Chemical.

Nitrobenzene: Gasoline additive.

Mercury: Found in thermometers.

Nitrous oxide: Disinfectant.

Stearic acid: Candle wax

Butane: Cigarette lighter fuel.

Vinyl Chloride: Component of PVC pipe.

DDT: Insecticide banned by most Western industrialized nations.

Hexamine: Barbecue lighter

So Go Green and Quit Smoking, the most effective way to stop introducing toxic chemicals into your body.

Thursday, May 8, 2008

Smoking Bans Encourage Smokers to Quit

In the past it was socially acceptable to smoke, it is now becoming not acceptable because of the effects of environmental tobacco smoke, which does affect the bodies of non-smokers that are exposed to it. There is NO controversy about the effects of environmental tobacco smoke, except from the tobacco companies, the same companies that for 50 years lied to us about nicotine being not addictive, lied in front of Congress and now admit they knew of the harmful effects since the 1950's but were protecting their profits. They are using the same arguments now for environmental tobacco smoke. don't believe them again.

Another city in California is extending the smoking ban to parks and beaches. Part of the reason is that smokers consider the outdoors a giant ashtray and at beaches, the butts make it into the water and can poison the wildlife, burn the feet of barefoot beach goers and expose our children to addictive behavior. Some smokers consider this an infringement of their "right to smoke" yet their "right to smoke" ends where my nose begins.

A recent study showed that in cities with bans on smoking in restaurants, teenagers are less likely to to become smokers. The theory is that these kids are being shown that as a society, smoking is unacceptable, while the perception in towns where smoking is allowed, the teens see smoking as the norm and that it is acceptable behavior.

Passing and enforcing laws limiting smoking encourages our kids not to start smoking and it encourages smokers to self reflect about their behavior and possibly encourages them to the think about quitting, if for no other reason than the hassle factor.

I would encourage all non-smokers to contract their local officials and encourage them to pass smoke-free areas for the health of everyone.

Wednesday, May 7, 2008

Stop Smoking: Message of Hope for Those trying to Quit

I was on a webinar today with the Center for Tobacco Cessation. The following is a highlight of the important points:

The most important advice to give a smoker is to try, try, try again. Give a message of hope since it takes the average smoker many attempts (maybe as high as 12-14) before they are successful at remaining smoke free.

Essentials when trying to help another quit:
1. Instill hope
2. Establish good rapport
3. Increase motivation
4. Boost self-efficacy
5. Encourage social support
6. Address ambivalence

Most smokers want to quit but they don't want to go through the quitting process. Stay positive, believe in progress, not perfection.

Building Desire to Stop Smoking, when all you want is another cigarette

uihzpEvery successful quitter has several attributes in common. First, they want to quit and are motivated. Even is they like to smoke, there is something that they want that is more important than continuing to smoke. But so many smokers will say that they don't want to quit. As they say: "You can lead a horse to water but you can’t make him drink."

The trick is to make the horse thirsty and help remove the obstacles so he can identify that he is thirsty. Wanting or desiring something is the first step to getting anything in life, this is also true for smokers. Until a smoker wants to quit or has a glimmer of a desire, they will not stop smoking. It isn’t important whether it is a desire to stop smoking or if the smoker identifies something that is more important or valuable to them that is in direct conflict with their smoking, either way, the horse becomes thirsty.

Tuesday, May 6, 2008

Stop Smoking: A Den of Addiction in California's Casinos

I was at the Mayo Clinic in Rochester last week for their annual Tobacco Conference. One of the presenters said that being in California is a such different world because of the laws about smoking in public areas. I guess those of us that live in California are spoiled and don't realize it. California was the first state to require that all businesses including restaurants and bars to be smoke free. It's been so long now that I don't notice that there isn't any smoke until I go to someplace where there is smoke.

Last night for Cinco de Mayo, some friends and I went to the local casino, which are exempt from California's smoking law. As soon as we walked in the door, I could smell the smoke. As I looked around, I didn't see that many people smoking and was surprised at how strong the smell was anyway. Until we walked by the bar, where almost every patron was smoking, drinking and playing video poker, what a den of addiction. When nicotine hits the brain, it activates the pleasure pathway and the release of dopamine. It heightens the external cues, which reinforces its use. The bar patrons had every sense simulated from the drinking, smoking, the noise from the slot machines, and the lights and bright colors every where. Over a quarter of all smokers are alcoholics and a heavy smoker is 10 times more likely to be an alcoholic than a nonsmoker. The reinforcement to continue addictive behavior is strong in that environment. Unfortunately these dens of addiction are more interested in the monies from the drinkers/smokers/gamblers instead of being interested in their health.

I left the casino, sick to my stomach, with a headache and my clothes stinking of stale cigarette smoke. I don't plan on returning as long as the smoke remains.

VJ Sleight, Queen of Quitting

Monday, May 5, 2008

Quitting Smoking is a Process, Not a One Time Event

“Why don’t you just put the cigarette down and walk away?”

“Don’t smokers know how bad it is for them?”

“If I can quit, anybody can quit.”

"If you had any willpower, you would quit."

Smokers are bombarded with messages every day, nagging them to quit smoking. Most smokers do want to quit but there are many reasons why they continue and nagging them to quit, just doesn’t work. Each year, almost half of smokers will try to stop yet less than 10% will be successful. Quitting is a not a one time event but a process that a person moves through. By understanding this process, it is easier for the smoker to go through the steps to becoming a non-smoker at their own pace. Often when trying to help, a loved one actually hinders the process and keeps the smoker smoking instead of motivating them to quit.

There is no magic wand to quitting and it can be one of the hardest things, a smoker ever accomplishes. By believing in progress, not perfection, step by step going through the process, a smoker will move towards the goal of becoming a former smoker.

If you have never smoked, you can not possibly understand how difficult it is to give up smoking and if you are a former smoker, the difficulties that you faced may be different than the difficulties that someone else faces. Quitting smoking is like walking down a road full of land mines. You have the best intention of avoiding the landmines but unless you know where they are hidden and also know what to do, it is easy to blow yourself up. Each smoker is walking a different road, the landmines are in different places and what worked for one person, may not work for another.

When a baby is learning to walk, they hold onto the side of the coffee table for support, then let go, take a step or two and plop on their butt. Their muscles are being developed and with a little practice they are off and running in a short time. It would be stupid to chastise the baby if he didn’t get up and walk perfectly the first time. Instead the parents provide a safe environment for the baby to practice, they provide encouragement and support. Quitting is the same thing. At one time a smoker had to learn how to smoke, it wasn’t natural but after years of practice, it feels natural. Now the smoker needs to learn how to become a non-smoker again.

Believe in progress, not perfection. By developing the skills to quit, step by step, anyone can be a former smoker.

Sunday, May 4, 2008

Introduction to Stop Smoking, Stay Quit

"It's easy to quit smoking, I've done it a thousand times." -Mark Twain
I started helping others quit smoking for very selfish reasons. I thought if I was teaching others to quit, it would help me to stay quit too. I started smoking when I was 14 because I was very shy and self conscious. Smoking gave me something to do with my hands when I was hanging around with my friends.
The first time I quit was because of Mr. O’Kelly. I worked in a medical clinic and Mr. O’Kelly was an elderly gentleman with emphysema that came in for daily treatments. I could hear him gasping for breathe as he walked into the clinic. He died from breaking his back due to complications with his medication.
As I was driving to work one day, smoking my morning cigarette I was thinking of Mr. O’Kelly and that I didn’t want to die like he did. I looked at my cigarette and thought "This is really stupid". I put the it out and didn’t smoke one for a year. It seemed easy at the time, maybe too easy because eventually I was telling myself that I could control my smoking and only smoke when I wanted too. This time I was going to control my smoking but I was wrong. In a very short period of time I was back smoking the same amount I had been smoking before I had quit.
It was several years before I quit again. This time was because I was dating an adamant non-smoker. He wouldn’t allow me to smoke in his car, in his apartment, and finally I couldn't smoke around him. Having to put up with his ravings seemed more stressful than quitting but when the relationship ended, I went right back to my cigarettes. After that I always wanted to quit and I would stop for a day or two every once in a while but it wasn’t until July of 1987 that I made a serious attempt at quitting. I was determined to quit for good and I attended a smoking cessation workshop sponsored by the American Cancer Society. Three months later I was diagnosed with breast cancer. I was 32 years old and couldn’t handle the stress of chemotherapy, so I started smoking again.
No one ever told me my cancer was caused by smoking, yet I didn’t think that ingesting a cancer causing substance was a smart thing to do. I was at high risk for a cancer relapse and if I did have cancer again, I didn’t want to tell myself that it was something that I did to myself. What followed was a three year battle of me trying to give up my cigarettes. I quit several times but I always relapsed after a few months.
My last cigarette was August 19, 1990. I was down to the last one in the pack and I asked the friend I was driving with, to stop at a store. Very facetiously she said "So when are you going to quit again".
Her words struck a nerve with me. It became clear I needed to make a decision on what was more important to me, smoking a cigarette or quitting for good. Like a light switch being flipped on, I made the decision I did not want to smoke anymore and I was willing to do whatever it took to be successful.
I had attended a couple of stop smoking workshops and one of my facilitators had told me that the best way to quit for good was to teach someone else. I was already a volunteer with the American Cancer Society and I trained to facilitate their smoking cessation program. My first class started a month after my last cigarette. I was going to teach three classes over the next year and figured that at the end, I would have a good foundation to never smoke again. But I was hooked, I really related to others struggling to quit and discovered I could make a difference.
I became quite active with The American Cancer Society and the local Anti-Tobacco Coalition. I met many health educators, nurses and doctors teaching smoking cessation, but I couldn't understand how they teach other how to stop smoking when they had never smoked themselves. I disagreed with many of the principles being used. If I, as a former smoker, didn't believe what they were saying, why would another smoker? Although these professionals had medical or psychological backgrounds and I didn’t, I thought I knew more than they did about quitting.
Someone who has never smoked has no idea how embarrassing it is to explain how you singed your hair while lighting your cigarette on an electric stove because you couldn't find a match. Or how desperate you feel when waking up in the middle of the night, reaching for your package of cigarettes, only to find it empty. Then, going to the ashtray searching for a long butt, only to find it empty also. Grabbing the garbage can finding those long butts soaked by coffee grinds, but wanting a cigarette so bad, you get dressed and drive to an all night convenience store to buy a pack. I finally realized that most of those teaching others how to quit had no idea what it is like to be addicted to tobacco. But I do. I know the fears, the denial, and the rationalizations.
I started using different techniques in my class that I felt instinctively would work and I received favorable feedback from the participants. I thought that if I could say just the right thing at the right time to a smoker that I could get him or her to quit. My background was in sales and I had learned how to develop rapport with a client, establish a need, and overcome objections. I realized that I was selling good health and there was no objection that I could not overcome because there was no good reason to smoke.
I went back to college and received a BA in psychology. With every paper, every project, I tried to geared it towards additional knowledge about smoking. This blog is a combination of what I learned from helping others quit successfully and the psychological processes I learned from research. I have been trained as a Tobacco Treatment Specialist by the Mayo Clinic and just returned from a Nicotine conference there about smoking cessation for those individuals with a mental illness or substance abuse problem.
Quitting smoking is like walking down a street that is filled with landmines. Some landmines you know about and you avoid those, but others are hidden and if you step on one, you blow yourself up. You have the best intentions of staying quit but something happens and you blow yourself up or relapse back to smoking. What makes quitting hard is that the landmines are different for different people so what causes one person to relapse, may be avoidable with another person. The trick is finding out what will work for you, which may be different than anyone you know who has ever quit. It’s like putting together a jigsaw puzzle and everybody has a different puzzle so what worked for someone else may or may not work for you. When I hear that a method has 100% quit rate, I know that can’t be true. Every method will work for some, but no method works for everyone. The trick to quitting is to figure out which pieces of the puzzle affect you and then formulate a plan that works for you. You need an individualized plan to be successful. You don’t smoke exactly how anybody else smokes. Each person has their own individual triggers, emotions and connections to their cigarettes, and each person, needs a plan that will work for them. Let the Quitting begin!
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