Programs help tobacco users quit for good

Friday, Aug. 13, 2010

Click here to enlarge this photo Staff photo by CHRISTINE BASHAM Jane Dodds explains the challenges former smokers face in their first days after quitting. E-Mail This Article | Print This Story

After 22 years of smoking, Julie, of Huntingtown, "was just truly tired of smoking."

Though she had gone without cigarettes during her pregnancies, Julie always started smoking again after the babies were born. Smoking was a part of her life.

Actually, it was a much bigger part of her life than she wanted it to be.

"When my husband and I travelled, I would book flights with a stop every two hours so I could hit the smoking lounge," Julie said. "It took us forever to get anywhere."

When Julie's husband decided to quit smoking, he had no real difficulty quitting on his own. Julie, however, knew she needed some information and support. In January 2008, Julie looked at the costs of smoking and the benefits of quitting, and the choice was clearer than it had ever been.

"It's a new year, and I'm gonna quit," Julie decided.

According to the Maryland Adult Tobacco Survey, that's an increasingly common decision among Southern Marylanders. In 2008, the most recent year for which statistics are available, just 16 percent of Calvert County adults and 15.6 percent of St. Mary's County adults smoked, down 4 percent in Calvert County and 4.4 percent in St. Mary's County since 2000.

Julie quit smoking with the help of a tobacco cessation class offered by the Calvert County Health Department.

According to Tammy Halterman, supervisor of Health Promotions for the Calvert County Health Department, the free classes are offered both day and evening, in community centers, work sites, libraries and the health department offices to make them convenient for residents no matter where they live or work. Smokers who enroll in the class can also receive free Chantix prescription anti-smoking tablets or nicotine replacement patches to help them start their new life after tobacco, with their doctors' approval.

Classes meet for eight weeks, and cover material developed by the American Lung Association and the Mayo Clinic. Patrick O'Malley, Calvert County's certified tobacco cessation facilitator, has been creating and teaching these classes in Calvert County since 2001, when they were first introduced as part of health education efforts funded by the state's Tobacco Restitution Fund.

The classes range in size from just two people to more than 40. According to O'Malley, the January classes are usually the largest, thanks to New Year's resolutions like Julie's.

O'Malley said that smoking cessation classes can help smokers understand their own behavior better, so they can make lasting changes that might not be as possible without education and outside support. His classes often help people who found quitting impossible, on their own.

The classes cover common withdrawal symptoms, lifestyle changes, stress management and relapse prevention, and provide support and encouragement as ex-smokers learn new ways to solve their problems and get past a habit that has become an addiction.

"Essentially what it is, is people have never tried to quit in this fashion," O'Malley said. "They put [their last cigarette] down, buy a patch and three days later they're smoking again and they don't understand why. We look at addiction and behavior. Without support it is harder to understand and follow through. Once they understand something, we're halfway there."

Terri Keefer of Lusby learned a lot about herself when she quit smoking.

"I had so many reasons to quit, but as a single mother of five children, I thought I needed that cigarette. The kids drive you crazy and you go out on the deck and smoke…When I was upset, I smoked. When I was tired, I smoked," Keefer said.

Keefer knew that her addiction to tobacco was something she could not afford to maintain. A recipient of state benefits at the time, cigarettes were monopolizing what little cash she had to spend. And since she always had to be certain she had cigarettes on hand, Keefer often made late-night runs to the store to buy a pack or two, just in case.

"I realize I am less moody and more stable without the cigarettes," Keefer said. Now, when she sees people smoking, "I wish I could give [them] what I have now."

Keefer calls O'Malley "the man who saved my life." She credits his classes with giving her the strength to do what she knew she needed to do.

"Everybody knows it's bad for you, everybody knows it kills you, everybody knows it costs a lot," Keefer said. "He made you feel like if you messed up, it's not the end of the world. Every time you don't smoke a cigarette puts you one step closer to quitting. The classes were funny and entertaining and it was only an hour a week."

For many smokers, making the decision to quit is the biggest challenge. O'Malley is quick to remind those considering quitting: It all starts with a phone call.

"All you have to do is call for a pre-interview," O'Malley said. "Sometimes that phone call is a big deal. We try to make it as easy as possible. Come to classes with an open heart and an open mind, and it's amazing what can happen."

Some smokers would prefer to quit without joining a group class. For those Marylanders older than the age of 18 who want to get help as they quit smoking, but can't make their schedule fit in with a group class, the Maryland Department of Health and Human Services offers a free, confidential telephone hotline.

The Quitline, used in Maryland since June 2006, is part of 28 states' tobacco cessation programs. The program is offered by Free and Clear, a Seattle-based organization recognized by the Centers for Disease Control and Prevention. Quit Coaches are available from 8 a.m. to 3 a.m. every day, and provide the same sort of information, education and support as a group class, but in a one-on-one format, over the phone.

According to Dawn Berkowitz, chief of the Division of Tobacco Control Initiatives of the Maryland Department of Health and Human Services, the Quitline's coaches help smokers understand why they want to quit, work around their special needs and pre-existing conditions, and learn skills to modify their behavior, providing education and support physicians may not have the time to offer.

"What's great about this service is, it's very individualized," Berkowitz said. "They talk about what works for you, and what doesn't. We have seen that phone counseling alone gives a 50 percent increase in quit rates."

Smokers call 1-800-QUIT-NOW, or go to smokingstopshere.com to set up that first call from a quit coach, when they feel ready to quit using tobacco within the coming 30 days. A quit coach gathers intake information, offers free self-help materials and online services and sets up the next call appointment.

According to Berkowitz, calls before and after the quit day follow "a very specific protocol of clinically proven guidelines," led by coaches with a master's level education and tobacco cessation certification. Many of the coaches are former smokers, themselves. Berkowitz also said that since Marylanders have had access to Quitline services, quit coaches have fielded nearly 56,000 calls from Maryland residents.

Tom Gray has been a quit coach since 2004, after years of working face-to-face with addicts and alcoholics through the criminal justice system.

"I enjoyed it, but you do burn out," Gray said of his time serving those populations. Over the years, he noticed that alcohol and drug rehabilitation programs often accept or even encourage tobacco use.

"There's a lot of different reasons; the severe legal consequences are for other drugs. Nobody's gonna arrest you for smoking a cigarette," Gray said. "But the ‘don't quit everything at once' theory is being proven wrong, and more and more treatment facilities are becoming tobacco-free."

According to Gray, the Quitline is not only more convenient than classes, it also provides a more intimate, immediate counseling experience.

"People are more open on the phone with their struggles than in person, because it feels more anonymous," Gray said. "You don't have to spend the first session building trust."

A former smoker and chewer, Gray said that when people are still using tobacco, "sometimes they have a hard time seeing the possibility that they can quit. One of the jobs of a coach is to help them see that possibility."

cbasham@somdnews.com

If you want help

If you think you may be ready to stop using tobacco, take advantage of the free programs offered through the Maryland Department of Health and Mental Hygiene. You may also be eligible for a free supply of Chantix or nicotine replacement patches to help you as you quit.

Call for information on tobacco cessation classes in Calvert County at 410-535-5400, or in St. Mary's County at 301-475-4074. Or, speak with a quit coach through the Maryland Tobacco Quitline at 1-800-QUIT-NOW.