When smokers think of quitting, it can seem like everyone else is not smoking. But once they try to quit, or do quit, it’s easy to feel there are smokers all around them,” says Cynthia Cary, director of HealthLink and smoking cessation programs at SUNY Upstate Medical University. “It’s like telling someone not to see red cars and then all they can see is red cars.” A free six-week program at Upstate tries to alleviate that psychological drama.
The message Cary has for people who have tried to quit and failed is to not give up. “The latest guideline published by the Department of Health and Human Services recommends combination therapy,” she says. “Helping people understand what medications are out there to help them quit, how to correctly use them and how to add non-medication options, like counseling and behavior change to their plans to quit, can be especially empowering to someone who has failed in the past.”
Upstate’s six-week support program is a free service. “The first two weeks are planning and preparing to quit,” explains Cary. “The group quits together on the third week and reports back to the class two days after the quit day. Then the last three weeks work on stress management, relapse prevention and benefits of exercise.”
More than 40 years after Congress required cigarette packages distributed in the United States to carry a health warning, the facts are still staggering. According to the American Cancer Society, tobacco use accounts for at least 30 percent of all cancer deaths and 80 percent of lung cancer deaths. Tobacco kills more Americans each year than alcohol, cocaine, crack, heroin, homicide, suicide, car accidents, fire and AIDS combined.
“There is no safe level of tobacco use,” says Christopher Owens, an exercise physiologist and coordinator at the Tobacco Cessation Center at St. Joseph’s Hospital Health Center. “Any amount of direct use or exposure to secondhand smoke can cause damage. It is amazing how widespread the damage is, affecting every organ and system in the body,”
Smokeless tobacco products are also a major source of cancer-causing chemicals and increase the risk of developing cancer of the mouth and throat, esophagus and pancreas. Smoking has also been determined to increase risks for stomach, cervical and kidney cancer, and acute myeloid leukemia.
Secondhand smoke is particularly dangerous for children. Parents are responsible for 90 percent of children’s exposure to secondhand smoke. The developing lungs of young children are severely affected by secondhand smoke. Children receiving high doses of secondhand smoke, such as those with smoking mothers, run the greatest risk of damaging health effects.
While the facts on the dangers of smoking and tobacco products may be out there, tobacco company marketing is working to counter them. They are targeting young people to become “replacement smokers” to feed the market as current smokers become ill or die. Jackie Shostack of Tobacco Free Onondaga County says there is a higher density of tobacco retailers in lower income neighborhoods. Those at socioeconomic risk are more aggressively targeted to encourage the use of tobacco products.
While tobacco advertising is banned in American media, tobacco products behind the counter at gas stations, convenience stores and drug stores are not banned and entice youth and current buyers with colorful packages and displays. “Smokeless tobacco products now come in orbs, sticks and strips,” Shostack says, “some with fruit flavors and packaging that looks like candy. Kids are being manipulated.”
If tobacco companies are targeting the young and disadvantaged, and all others addicted to nicotine, what can be done to limit tobacco marketing? “We really need to change the social norm. We don’t want people to be complacent,” advises Shostack.
Businesses and organizations can help by adopting smoke-free workplace policies and sponsoring cessation programs. While our local hospitals have clear tobacco-free policies, some area healthcare facilities do not. Healthcare facilities, businesses, organizations, builders and building owners are urged to establish smoke-free policies for buildings and grounds. Tobacco Free Onondaga County (435-3280) can assist employers with such policies.
Upstate’s Tobacco Cessation Program provides worksite programs for employers who want to help employees quit. “The benefit of having Upstate’s program brought to their worksite is that people can attend during their workday without having to add yet one more thing to their busy after-hours schedules,” says Cary. “Many employers are adopting tobacco-free policies and this is a way to demonstrate support for their employees without making it feel like it’s a punitive policy change directed solely at smokers.”
In the front lines of the fight against tobacco use, are healthcare providers. The Public Health Service Clinical Practice Guidelines for providers suggest they follow the 5As with their patients: 1. Ask about their tobacco use; 2. Advise to quit; 3. Assess for willingness to quit ; 4. Assist in a quit attempt; 5. Arrange for a follow-up.
“We go into doctors’ offices in our area,” explains Owens of St. Joseph’s Center, which covers Onondaga, Oswego and Cayuga counties, “and provide training for the clinical staff, patient education materials for them to use with their patients and technical support for any issues which may arise.”
Helping people quit may be more important than ever. “The product they smoke today isn’t the same as the product they smoked 15 to 20 years ago,” points out Cary. “It’s far more addictive now due to the chemical manipulation of tobacco by the tobacco companies.”
If you are in the process of quitting, the Mayo Clinic suggests ways to deal with cravings. If you are feeling irritable, tense, have trouble concentrating, sleeping, experience constipation or headaches, try deep breathing, talking a brisk walk, drinking plenty of water to stay hydrated and avoiding caffeine. Tell yourself the urge to smoke will pass and remember these are “recovery symptoms.” The moment will pass and every moment without cigarettes is better for your health.
Stanley Gauris, a Central New Yorker who recently celebrated his fifth anniversary of quitting smoking, credits the Upstate program for his success. “I never thought that I would ever be able to stop smoking but thanks to the Tobacco Cessation program I have succeeded.”
To get help quitting or information on workplace programs, contact the Smoking Cessation Program at Upstate at 464-8668, or call the NYS Smokers’ Quitline at (866) NY-QUITS. Healthcare providers can contact the Tobacco Cessation Center, St. Joseph’s Hospital Health Center, 458-3600, Ext. 378.
Marnie Blount-Gowan is a member of the Crouse Hospital Integrative Health Alliance, Mind Body Health instructor and editor of Realewell.com.