Kicking the Habit

Search the internet or skim those pamphlets you find in the doctor's office and you'll see a lot of scary smoking statistics. Tobacco is the leading cause of preventable disease and premature death in the United States.

Here’s another scary statistic: $96 billion--that's how much Americans are paying annually in smoking-related healthcare costs.

About half of smokers try to quit. Less than 10 percent succeed.

But why?

I caught up with Lawrence Caswell, a producer here at the station.

I chat with him on the curb sometimes and he was preparing to light up.

I asked him what cigarettes do for him.

CASWELL: It's weird to respond to that. I'm not sure. It doesn't do a whole lot for me honestly. I think small satisfaction is it. I don't know. It gives me something to do, is a placeholder, I think.

It’s the nicotine in cigarettes that make them so addictive.

Nicotine is a stimulant that causes us to temporarily feel good or energized.

Ruth Golladay, a Physician Assistant at the Cleveland Clinic's Tobacco Treatment Center, says the pull of nicotine is intense, but addiction is about more than chemistry.

One of the first things she’ll ask a new patient is why do you smoke?

GOLLADAY: And many people say, I don't really know, but I think it's largely habit.

The Clinic program, and others, use the science of habits, and what we know about the brain, to help a person quit.

Golladay says a smoker needs to figure out why they're turning to cigarettes--what's prompting them.

GOLLADAY: It's so ingrained and many smokers are on autopilot.

Autopilot can be good, for things like brushing your teeth and making toast.

Humans are creatures of habit: habits allow us to save time, be efficient.

But they can be an obstacle to change.

As Golladay explains, even harmless parts of our daily routines can help feed addiction.

As an example, she cites the daily commute to work, for some of her patients.

GOLLADAY: They will have another cigarette at the exact moment that they pass under such and such a bridge or where they hit a certain mile marker and they know they need to have another cigarette and that's how habit it is.

So she digs into her patient's routines.

With the patient’s permission, I joined her during a counseling session:

GOLLADAY: What is your routine? JENKINS: Once I get ready for work, as soon as I'm ready, I sit back and smoke me a cigarette and drink a cup of coffee and I'm out the door.

Just the act of sitting down is a cue for patient Renee Jenkens to smoke.

Golladay suggests she switch it up a bit.

Take the cigarette out of the routine, but also stand up, and drink the coffee.

Doing this simple thing breaks subtle but important links in the brain.

Patients keep a smoking diary, where they track each and every smoke break on a given day.

GOLLADAY: So you'll write down each cigarette that you have and what you were doing at the time that you smoked that--were you just getting up, was it after a meal, were you feeling stressed, were you feeling sad…

This journaling helps turn off the autopilot.

Smokers figure out why they're using cigarettes.

Then the goal is to find alternatives to meet those needs.

Stress is often a huge reason people smoke, so counselors teach coping skills, like exercise.

Golladay suggests her patients take short walk breaks every day.

Medications are also available to help people quit.

Nicotine replacement therapy--in the form of gum, a patch, or a lozenge--can help a people taper off cigarettes.

There's also two FDA-approved drugs: one, Zyban, is an antidepressant that's been shown to reduce cravings.

The other, Chantix, blocks nicotine receptors in the brain.

Both can have side-effects.

The Clinic’s Ruth Golladay says the best odds for success come by understanding the nature of addiction, counseling, having social supports and really wanting to quit.

Back at the curb, Lawrence Caswell says he's gonna quit.

His wife wants him to; he's got a baby girl. He just hasn't yet.

GLAUSSER: So when's the quit date? CASWELL: Oh, we've passed a number of those already. So I have no set quit date at this point.

Golladay offers one more incentive.

GOLLADAY: So down the road, as a nonsmoker down the road, years to come, your body repairs itself to nearly the status of a nonsmoker. So it's never too late to quit.

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