Ways to kick the habit
The statewide smoking ban is a little more than a week old, but its already changing rituals for many long-time and occasional smokers.
The ban has been an impetus for many to quit, while others are still struggling to make the commitment.
A study performed in March by the University of Wisconsin Center for Tobacco Research and Intervention estimated that more than 110,000 City of Milwaukee residents smoked.
Smoking ban supporters are hoping the Wisconsin ban the same effect as Minnesota's, where the percentage of adult smokers has dropped from 20 to 17 percent since the statewide ban kicked in three years ago.
"We're hopeful and optimistic," says Dona Wininsky of the American Lung Association in Wisconsin. "It's been documented in other places and you hear anecdotally that things like a higher tax or a smoking ban gives people the motivation to quit."
Of course, quitting is easier said than done. Aside from the physical addiction to nicotine, smokers develop a strong psychological addiction, too.
Whether it's that first smoke after waking up; a cigarette with the morning coffee or a quick one after meals or on a work break, smoking becomes part of the daily habit and routine.
"The addiction, some doctors say, is as bad as heroin," Wininsky says. "Quitting is a major change to a person's behavioral patterns and the psychological part can still haunt you long after the nicotine has left the body."
Because of that barrier, using a smoking-cessation program, is the best method.
To assist smokers, the Lung Association has offered its Freedom From Smoking program for a number of years.
Freedom From Smoking groups meet several times over a few weeks. The programs are facilitated by former smokers themselves, who help the quitters-to-be understand why they smoke, when they smoke and prepare them mentally for quitting, which occurs midway through the program.
"It's a big ceremony," Wininsky says. "People throw away all their smoking paraphernalia. It's a big day for them.
Freedom From Smoking programs also help quitters -- a term the Lung Association uses in a positive light -- manage the stress that comes with quitting, avoid weight gain and make necessary lifestyle changes that ensure a person stays smoke-free for good.
For those wishing to avoid the group session, the program is also offered online and the Lung Association maintains a hot line (1-800-LUNG-USA), which is staffed by nurses, respiratory specialists and smoking-cessation counselors.
"These people are a great resource," Wininsky says. "They're here to help; having somebody you know you can call and reach out to, sometimes that's all it takes to keep you going."
The Wisconsin Quit Line, administered by the UW CTRI, was started in May 2001 to help people quit. The hotline (800-QUIT-NOW) has taken over 150,000 calls since then and has helped an estimated 100,000 people trying to quit.
Callers go through a quick intake process, during which an operator asks a series of background questions about their history of tobacco use and habits.
"The operators get a very thorough understanding of each caller's needs," says Quit Line Manager Kate Kobinsky.
After the inital screening, callers are referred to a specialist -- a "Quit Coach" -- who walks them through the quitting process, helps establish a quit date, and helps callers deal with situations that would otherwise trigger them to smoke.
Callers are then eligible for a two-week trial of nicotine replacement options like the patch, the gum or lozenge.
"We make sure there are no medical conditions that will negatively affect people," Kobinsky says. "And we make sure to provide instructions and support for all options."
Participants can also get 24-hour help online through the Quit Line's Web site. The Web Coach program has become popular, especially during the overnight hours when the phone line isn't staffed.
"The Quit Line and Web service is an access point to give people comprehensive help to quit smoking," Kobinsky says.
Not all smokers want to or are ready to quit, but don't want to spend money on cigarettes. Those people, too, have an option in e-cigarettes.
While they are not advertised as a smoking-cessation device, nor to makers claim any health advantages, e-cigarettes do not include the carcinogens and chemicals found in cigarettes, nor do they cause users to inhale smoke -- the device instead turns smoke juice (which includes nicotine) -- into a water vapor.
"We don't promote it as being healthy and it's important to note that its not FDA-approved yet," says Heidi Braun of Johnson Creek Smoke Juice (Note: Johnson Creek is an advertiser with OnMilwaukee.com), a company which provides the liquid in e-cigarettes. "But when you compare the ingredients, cigarettes have 4,000 and we have just seven; and ours are listed right on our Web site."
No matter which method a smoker uses, the most important part of any cessation program is to seek help. Whether it comes from friends, family members or trained professionals, studies have found that people are more likely to quit when they have some sort of counselling.
"It can feel like you're sitting in a vacuum," Wininsky says. "But by using a program, or having some sort of support group in your plan, you realize you're not all by yourself; you're not in it alone."
Another important thing for smokers to remember: it doesn't always happen the first time around.
"Very few people quit on their first attempt," Wininsky says. "It often takes six or eight concerted attempts. You can't put a limit on those attempts, you just have to try again.
"We're here to encourage and help you."
Here are a few tips for those looking to quit:
Pick a quit date: Quitting "cold turkey" is a difficult process because smokers need time to mentally prepare for the adjustment to their daily lives. Setting a date a few weeks ahead allows people to remove smoking accessories (lighters, ash trays) and adjust to a different routine.
"When people quit suddenly, without much thought, they haven't considered how they will deal with certain situations," Kobinsky says. "By setting a date, they have time to get their friends and family on board to give them the support they'll need.
"It's very tempting to start smoking again when you don't give yourself the time to think."
Don't do it alone: Whether it's a friend, a spouse or a trained counselor, chances of quitting for good are much higher with support. Many support options use former smokers, who can often relate to what callers or quitters are going through.
"They've gone through it and they've been successful," Wininsky says. "Sometimes, all it takes is a phone call to somebody who's been there and can remind you of what you've learned about the process."
Do it for yourself: While it's admirable to want to quit smoking because of a loved one or child, the smoker has to want to quit for his or herself to be successful.
"Just going through the motions reduce your chances," Wininsky says.
The American Lung Association in Wisconsin does not endorse e-cigarettes as a way to quit smoking as this article could be seen as implying. There is no scientific evidence that ecigarettes can help smokers quit or that they are even safe. In fact, the FDA conducted one limited study in July of 2009 and found that the products contained carcinogens and toxic chemicals, including the ingredients found in anti-freeze. The U.S. Public Health Service, part of the U.S. Department of Health and Human Services, has found that that the seven drugs approved by the FDA in combination with individual or group cessation counseling is the most effective way to help smokers quit. The health claims being made by ecigarette companies are misleading and we urge smokers who are interested in quitting to use methods that have been proven to be effective.
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