Help to quit smoking

June 27, 2009 6:50:42 AM PDT
There are 4,000 chemicals in tobacco with 100 identified poisons and 63 known drugs which cause cancer. Yet, approximately 25 percent of the population in the United States smokes cigarettes. Dr. Chris Kotsen, the Program Manager of the Tobacco Quitcenter in New Jersey and former smoker Patrick Cashman, joined us with tips to help you quit. Why is quitting and staying quit hard for so many people?
First, nicotine is a highly addictive substance found naturally in tobacco. It is as addictive as heroin or cocaine. Breaking the physical addiction to nicotine is difficult, but that is only one aspect of the smoker's addiction. Smoking creates a powerful psychological and behavioral dependence as well. We call this "the three faces of tobacco dependence." Without addressing all three aspects of this addiction, most smokers fail to quit for good.

Why Quit?
Smoking harms nearly every organ in the body. Although the health risks of smoking are dire, smokers can reap health benefits almost immediately upon quitting. No matter how long they have been smoking, much of the risk from smoking may be reversed. Clinical studies show that the health benefits that smokers gain by quitting are both immediate and long term, and there are effective tools to help smokers succeed in quitting.

Are there steps to follow when quitting smoking?
If smokers try to quit without help, only about three percent will succeed. There is no one right way to quit, but there are some key strategies to quitting:
Make the decision to quit
Get help from a structured smoking cessation program such as New Jersey's free or low-cost Quit Services: NJ QuitNet, NJ Quitline and NJ Quitcenters. They provide resources and counseling to help smokers set a quit date and choose a quit plan, deal with withdrawal, and quit for good.

What should you look for in a Stop Smoking Program?
Stop smoking programs (also called tobacco dependence treatment or cessation programs) are designed to help smokers recognize and cope with problems that come up during quitting and to provide support and encouragement in staying quit.

What Does New Jersey Offer?
New Jersey QuitNet: a free, online information, counseling and referral service that offers a variety of resources to help people break the control of nicotine. This service is available 24 hours a day, seven days a week. NJ QuitNet users have access to trained counselors. Online chat rooms provide real-time support from other smokers using NJ QuitNet to quit smoking. Other tools include a quitting calendar, quitting strategies, and a directory of local treatment programs and support groups.

New Jersey Quitline: (1-866-NJ-STOPS) a free, telephone-based counseling and referral service, available six days a week in 26 different languages. NJ Quitline counselors have been trained by the American Cancer Society and work with clients to develop an individualized treatment plan, including ongoing support and follow-up. Using NJ Quitline, smokers are three times as likely to succeed - with more than 30 percent of registered users reporting they were tobacco free after six months.

New Jersey Quitcenters: New Jersey QuitCenters are a network of seven smoking cessation clinics located across the state that offers a customized, face-to-face approach to quitting. The NJ Quitcenter program combines intensive individual or group counseling, with the supervised use of nicotine patches, gum and inhalers. Centers provide services on a sliding fee scale according to income, and clients can purchase over-the-counter nicotine replacement therapy products at a reduced cost. For NJ Quitcenter locations, log onto or call 1-866-NJ -STOPS.

How do you stay quit?
Staying quit is the final, and most important, stage of the process. Smokers can use the same methods to stay quit as they did to help them through withdrawal. Smokers should think ahead to those times when they may be tempted to smoke, and plan on how they will use alternatives and activities to cope with these situations.

What if you do smoke after quitting?
A slip is a one-time mistake that is quickly corrected, whereas a relapse is going back to smoking. Smokers can use the slip as an excuse to go back to smoking, or they can look at what went wrong and renew their commitment to staying away from smoking for good. Professional smoking cessation counselors and the resources available through programs such as the New Jersey's Quit Services can help them stay on track.

When did you begin smoking and how much did you smoke?
I began smoking when I was 20 while serving in the US Navy. I quickly reached a two pack per day habit - sometimes more. I smoked for more than two decades and developed a persistent cough.

How many times did you try to quit smoking?
Over the last 10 years, I attempted quitting numerous times, but with little success. I knew intellectually that smoking was very bad for my health. However, that was still not enough to make me give up nicotine. Like clockwork, each Monday morning I would make my resolution to quit. Inevitably of course, I would rarely make it through the first day without smoking, and certainly never past day two.

After many failed attempts, what made you finally follow through with quitting?
In addition to being a husband, I am a father. Before my oldest daughter Cara could talk, I would hear her imitating my smoker's cough through the baby monitor in the mornings; this really made me pause. Then, one day at age two, she came to me with a pack of cigarettes and said, "Here, these are yours Daddy". Even though I had never smoked in the house and had made all attempts to not smoke in front of my daughter, I realized then what a horrible example I was setting.

So you sought help, realizing that quitting smoking was a difficult thing to do, and that you might not accomplish it simply by willpower?
That's right. So, I went to a New Jersey Quitcenter, which was a smoking cessation clinic that offered a customized, face-to-face approach to quitting. The Quitcenter treatment combines intensive individual or group counseling, with the supervised use of nicotine patches, gum and inhalers. Currently there are seven centers across the state that provide services on a sliding fee scale. Clients can purchase over the counter nicotine replacement therapy products at a reduced cost.

How did the QuitCenter help you quit?
My initial meeting was a one-on-one session with Dr. Chris Kotsen, the center's director. He tested my lungs to determine the extent of the physical damage my 20 years of smoking had created. Then, we discussed the triggers that make quitting a challenge, and the places and times of day when I was more inclined to smoke. I also met the rest of my group - eight smokers focused as I was to quit. Everyone was very supportive and had their different reasons for quitting. Some only smoked occasionally. Others were heavy smokers.

Did it help to be part of a community of people who were trying to quit smoking together, to realize that you were not going at it alone?
It truly helped. When our group's quit date arrived, we were all determined to succeed. Over the course of the next few weeks, we continued to meet and discuss the daily challenges we faced trying to quit. Sharing our experiences and receiving the guidance from Dr. Kotsen made all the difference for our group. Although everyone stumbled at least once, no one lost sight of the ultimate goal. At week six, we even had a small party to celebrate our individual and group accomplishments, and acknowledge the new foundation we had built for our lives.

How long have you been smoke free?
I have been smoke-free for more than two years, and feel good about the example I am setting for my daughter and now my other three children. I am convinced I could not have quit without the support of the team at my NJ Quitcenter, my group members and my family.

Other links:

-- In New Jersey,, or call the New Jersey Quitline at 1-866-NJ-STOPS.

-- In New York, or call 1-866-NY-QUITS.