The Addiction That Defies Reason

Step away from the cigarettes: November is lung cancer awareness month, and there are myriad local resources for quitting.

(November 14, 2011)

A knot of people standing in a parking lot smoking is an unremarkable sight. But the specifics about the group are jarring—their relative is in the hospital, dying of lung cancer.

This scenario isn’t uncommon, said Richard Fischel, M.D., a thoracic surgeon and Orange County leadership board member for the American Lung Association in California. He sees families of cancer patients who smoke and has taken care of patients whose lung cancer was caught early, treated with surgery, chemotherapy, and radiation and whose prognosis could be positive, but who continue to smoke.

In spite of increasing limitations on where people can smoke, higher cigarette taxes, more vivid warnings on cigarette packages, and multiple campaigns graphically illustrating the hazards of smoking, 50 million Americans continue to light up. Each year, 443,000 people die prematurely from smoking or exposure to secondhand smoke, according to the Centers for Disease Control and Prevention.

“The addiction is very powerful,” Fischel said. “You can show people the scary blue guy in a wheelchair with oxygen, or put a skull and crossbones on cigarette packages with a warning that says, ‘This will absolutely, positively shorten your life and give you a terrible disease from which you will suffer,’ and smokers will read that while lighting up. It’s not a rational thing,” he said.

Can the Habit Be Taxed to Extinction?

According to the U.S. Department of Health and Human Services, 3,400 young people start smoking every day.

“They don’t know that they’re on a 40- to 50-year track of smoking,” Fischel said.

To curb this trend, he favors continuing to educate kids about the harm of smoking and raising cigarette taxes to the point where smoking is “so unaffordable, inconvenient, and uncomfortable that it goes away.”

In June 2012, Californians will vote on the California Cancer Research Act, which will increase cigarette taxes by an additional $1 per pack if passed. Fischel sounded exasperated when he described the wrangling that goes on among interest groups about how cigarette tax money should be allocated.

“The answer to that is, ‘Who cares where the money goes?’” he said. “Throw it in a big hole and bury it if it will keep kids from starting to smoke.”

Get Help Quitting

Parents who don’t smoke or who quit smoking model positive behavior that can help keep kids from developing the habit. If you or a family member is thinking about giving up smoking, you don’t need to go it alone—there is plenty of help. The Great American Smokeout is Nov. 17, the day when the American Cancer Society urges people to quit or make a plan to quit, and the entire month of November is Lung Cancer Awareness Month. You can also call 1-800-NOBUTTS (1-800-662-8887) for information and telephone support from the California Smoker’s Helpline.

Hoag Hospital offers an eight-week smoking-cessation program that meets Monday and Thursday from 7 to 9 p.m. Call 949-764-5511 for more information. There are no classes in December, but the program starts again in January for those who resolve to give up cigarettes in 2012.

The Memorial Care Todd Cancer Institute also provides stop-smoking programs at Long Beach Memorial Medical Center and Saddleback Memorial Medical Center. Call 562-933-0961 to find out more for more details.

E-Cigarette Controversy

Electronic cigarettes, or e-cigarettes, deliver a puff of vapor formed from liquid nicotine and aerosol mist, but no tar, formaldehyde, carbon monoxide, or other harmful chemicals in cigarettes. Some smokers rely on e-cigarettes, or “vaping,” to cut down on or quit smoking.

E-cigarette detractors argue that vaping actually diminishes people’s motivation to quit smoking, and that only nicotine gum and patches should be used as stop-smoking aids. The Food and Drug Administration’s attempt to have e-cigarettes labeled as drug-delivery devices failed last year, but the agency continues to warn that their safely has not been verified, and that they may entice young people to smoke.

E-cigarette proponents maintain that these devices may in some cases accomplish what no amount of hectoring, taxing, frightening images of people smoking through a tracheotomy, or banishing from public places can do: help people quit.

E-cigarettes worked for Darrin Gold, 41, a southern California real estate agent who happened upon an electronic cigarette kit at 7-11 almost a year ago when he stopped in to replenish his cigarette supply as had been his intractable habit for 27 years.

“The kit cost about 20 bucks, and I was spending 60 bucks on a carton of cigarettes, so I figured I’d try it,” he said.

Next month will mark one year since he has had a cigarette.

Like many smokers, Gold had tried to quit multiple times without success, using the nicotine patch and gum, and going cold turkey. Nicotine gum gave him headaches from chewing it too rapidly, which delivers too much nicotine too quickly. He said the nicotine patch produced a rash.

Gold still uses an electronic cigarette that delivers a small amount of nicotine, but said he will eventually dial the e-cigarette down until it delivers no nicotine. “I’ll continue to enjoy vaping for the flavor and the habit,” he said. Including e-cigarettes in stop-smoking ammunition is OK with Richard Fischel.

“Anything that can make people quit is a good thing,” he said. “Whether it’s gum, medication, hypnosis, or a support group so that you don’t feel alone. If that’s what you need to help you break the addiction to nicotine, fantastic. The more things there are to help people quit, the better.”

Have you quit smoking using the nicotine patch or gum, cold turkey, or e-cigarettes? What helped you the most? If you’re still a smoker but would like to quit, tell us what gets in your way.