Breaking the tobacco habit

Have you ever thought about quitting smoking? Whether you're tired of the smell on your clothes, worried about your health, or fed up with spending money on cigarettes, you're not alone&emdash;more than a million Americans quit smoking every year.

"Smoking is our number one public health problem," says Dr. Karen Benker, a family practitioner who sees patients at SUNY Downstate's Family Health Services center on Lefferts Avenue. One in every five deaths in the U.S. is caused by tobacco&emdash;accounting for some 4,000 preventable deaths every year in Brooklyn. And smoking is affecting women's health more than ever. In 1987, for the first time, lung cancer replaced breast cancer as the number one cause of cancer death among women.

Women and Smoking

Women as a group took up smoking later than men, but the gender gap has nearly closed. About 22 percent of women in the United States now smoke regularly, compared with about 27 percent of men. Girls in high school are just as likely to smoke as boys their age, with some 3,000 teenagers getting hooked every day.

Though African-American women smoke less than white women, they are more likely to get lung cancer. They also face a greater risk of dying from coronary artery disease and stroke.

In addition to respiratory and heart diseases, smoking hastens osteoporosis and can lead to cervical and other cancers. Researchers believe that the ingredients in tobacco may also make it more difficult to conceive. Even fertility drugs and in-vitro fertilization are less effective for smokers. And women who started smoking in their teens are more likely to have an early menopause. These facts make it clear: there's nothing sexy about smoking.

Kicking the Habit

Nicotine's effects are varied. It relaxes some people and helps others concentrate better. It is also a stimulant and can act as a mood enhancer for people who are depressed.

Because of nicotine's powerful effects, successfully quitting smoking means finding a replacement. For example, if you smoke to relax, practice deep breathing instead, or take a walk to unwind. If you smoke to lift your mood, exercise can accomplish the same thing.

Some people smoke because they are clinically depressed, a condition that is more likely to affect women. For these smokers, antidepressant medication may help. In fact, recent studies show that the most effective aid in quitting smoking is a combination of nicotine replacement, such as the patch or gum, and Zyban, an antidepressant that may also help suppress cigarette cravings. Such therapy is only available through prescription and must be discussed with your physician. As it is expensive and may not be covered by your medical insurance, you may want to find other ways to quit.

Getting Help

Each year SUNY Downstate participates in smoke-outs, such as Independence from Tobacco Day, when employees, patients, and students make a commitment to give up smoking for 24 hours. Lorraine Brooks, a certified tobacco addiction counselor who heads the Employee Assistance Program, points out that most people try to quit smoking an average of four times before they succeed.

"There is no magic bullet but like any addiction, smoking can be treated," she says. "Even a relapse does not mean failure. Look at it, instead, as an opportunity to discover what triggers your desire to light up. And get as much support as you can."

Dr. Roberta Temes, an assistant professor of psychiatry at SUNY Downstate and a trained medical hypnotist, says she has had good results using hypnosis to help smokers give up cigarettes. A single, one-hour group session is often all it takes.

She recommends changing your diet for a few days after you quit to lessen withdrawal symptoms. "Foods that have an alkaline effect on the body can make it easier to resist cravings by keeping nicotine in your system longer," she explains. Such foods include raisins, spinach, almonds, carrots, celery, grapefruit, sweet potatoes, and strawberries. She suggests avoiding foods that have an acidic effect, such as wheat germ, chicken, eggs, lamb chops, codfish, brown rice, cheddar cheese, and cottage cheese.

Like anything new, not smoking takes practice, especially in foreseeing and coping with what triggers the desire for a cigarette, Dr. Benker explains. "As an ex-smoker myself, I know how difficult it can be," she says, "but those who achieve a day without tobacco have a milestone they can build on for the future."


Freedom from Smoking Program • American Lung Association • (718) 624-8531

Freshstart Program • Stay Off Smoking Support Group American Cancer Society

(718) 237-7850

American Heart Association • (212) 373-6300

Nicotine Anonymous • (516) 665-0527

Tips for Quitting
Set a quit date three or four weeks in advance.
Make a list of all your reasons for wanting to quit: you don't like the smell, it gives you wrinkles, you'll live longer, you're embarrassed by the looks your kids give you, etc.
Keep a log of each cigarette you smoked during the day, noting when, why, and how much you wanted it. What triggered your desire to smoke?
Plan substitute activities and line up a friend or family member whom you can call for support when you get the urge to smoke.
On quit day, nibble on foods like carrots and celery. Drink less coffee than usual and relieve tension by working out or doing some deep breathing. Remember, the immediate urge to smoke will pass within a few minutes, whether you pick up a cigarette or not.