Aging Well: More than willpower

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The Colorado QuitLine offers free coaching and nicotine patches to help people quit smoking or using tobacco. Call (800) 784-8669 or visit www.coquitline.or...

Mary Dike, 58, of Steamboat Springs remembers the moment 10 years ago when she decided to quit smoking.

She was "dressed to the nines" and huddled next to a Dumpster smoking a cigarette. It was the only place to smoke outside the party she was attending.

"I thought 'This has got to stop,'" she said.

Before that, Dike made three serious, but failed attempts to quit. Each time she quit cold turkey while trying other strategies - acupuncture, taping pictures of decrepit lungs on her bathroom mirror and even hypnotism. Nothing, including nagging from family members, kept her from smoking for longer than a month.

It wasn't until Dike recognized her habit as an addiction and sought help that she successfully ended her affair with cigarettes.

Her experience is common. It takes most people several tries before they are able to quit, and that success often comes with the aid of counseling or coaching, nicotine replacement therapy (the patch, gum, lozenges, etc.) and/or medications that treat nicotine addiction, said Heather Burchall, community health educator with the Visiting Nurse Association.

"It's challenging, but people do it," she said.

Dike established a plan and set a quit date on the first day of a family cruise - away from her routine and smoking triggers.

She also visited her doctor, who prescribed Zyban for three weeks leading up to the vacation. Nicotine patches replaced cigarettes in her suitcase, and she made sure to get rid of ashtrays in her home.

Perhaps most important, Dike shook off old feelings of inadequacy from past failures and decided to quit for herself and herself only. She kept her plan a secret from her family.

"That was the key - I didn't want any pressure," she said.

Ending an addiction

The good news is there are a lot of resources and products available to help people quit permanently. The bad news, of course, is that smoking continues to be very harmful to one's health.

Cigarette smoke causes several likely problems in the body, including oxidative stress, which is thought to be involved in the aging process, contributing to cancer, atherosclerosis (clogging, narrowing and hardening of arteries) and chronic obstructive pulmonary disease among other conditions, according to the 2004 Surgeon General's Report.

Smoking also is related to cataracts and reduced bone density among postmenopausal women.

Unfortunately, the addictive qualities of nicotine make cessation extremely difficult - as difficult as quitting cocaine or heroin for some people, according to the U.S. Public Health Service Clinical Practice Guideline, "Treating Tobacco Use and Dependence."

Resources such as the Colorado QuitLine help smokers face this uphill battle. The program is a free telephone service that offers enrollees free nicotine patches for two months as well as trained coaches to help smokers create a quit plan.

Smokers who take advantage of this service are seven times more likely to quit. The highest success rates result from a combination of coaching and nicotine replacement therapies or medications, Burchall said.

NRT products, which also include nasal sprays and inhalers, are generally safe for adults 18 and older though it's best to check with a doctor before starting NRT, especially if one is pregnant or has a heart condition.

Two common non-nicotine prescription medications work differently in treating nicotine addiction. Zyban is an anti-depressant while Chantix blocks the nicotine receptors so that a person may actually feel nauseous or disgusted by smoking, said Burchall, noting that a doctor's supervision is required for the medications.

Understanding triggers

During the quitting process, it's also important to recognize situations that spur cigarette cravings, Burchall said.

Gloria Burch, 50, of Craig and her husband were tired of smoke in their clothes and home and concerned about health risks, so they contacted the Colorado QuitLine for help. Using nicotine patches, the couple resisted cigarettes for a month. Then they began sneaking smokes here and there, eventually reverting to their former habits.

Mostly it was the urge to smoke in the morning with her coffee and especially in the evening after dinner that triggered relapses, Burch said.

"It's an awfully rough process," she said.

On the upside, Burch did experience a boost in energy and better sleep during cessation and plans to make another go at kicking cigarettes.

"I'll get there - it may not be tomorrow, but I'll get there," she said.

Once a person recognizes their triggers, they can work to change their behavior, Burchall said.

For example, instead of retreating with a cigarette every time she feels stressed, Dike now breathes deep, takes walks and power cleans when she is upset. She also chews nicotine gum to relieve the oral fixation once satisfied by smoking.

What works for one person may not work for another, but ultimately success is possible for anybody with the right help and mindset.

"You have to play it to win," Dike said.

Tamera Manzanares can be reached at tammarie74@yahoo.com.

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