Where There's a Will: Free Programs Help Smokers Quit
Network - Winter 2009
By Mary Brolley
Ask smokers why they want to quit, and the answers come readily.
For my health. To protect my loved ones from secondhand smoke. To stop the detrimental effects on my breath, teeth and skin.
But smoking is among the most difficult addictions to shake, comparable to cocaine, opiates and amphetamines in its effects on the brain. Many who try to quit make several attempts before they are successful.
“I hate when people say smoking is a habit,” says Paul Cinciripini, Ph.D., professor and director of M. D. Anderson’s Tobacco Treatment Program and deputy chair of the Department of Behavioral Science. “That implies that it’s an acquired behavior that’s easy to change. It’s not — smoking is an addictive process.”
Yet, quitting smoking is one of the smartest decisions a person can make. Besides the obvious connections between tobacco use and lung cancer, smoking also is associated with the development of cervical, head and neck, esophageal and bladder cancers.
Coupled with the known risks of developing emphysema, chronic obstructive pulmonary disease, stroke, heart disease and other ailments, quitting makes even more sense.
Multiple approaches help patients, public quit
M. D. Anderson offers several free programs to help patients, employees and members of the public quit smoking through the Department of Behavioral Science in the Division of Cancer Prevention and Population Sciences.
Though the audiences differ, each program acknowledges the difficulty of quitting and offers strong encouragement and the latest medications to help conquer the physical and behavioral challenges involved.
Patient- and employee-focused programs feature a combination of counseling and medication — all tailored to the individual.
M. D. Anderson patients are referred to the Tobacco Treatment Program when they identify themselves as tobacco users on the electronic patient needs assessment. Patients also may refer themselves.
“We emphasize that quitting helps wounds heal and lowers infection rates,” says Jermaine McMillan, program coordinator of the Tobacco Treatment Program for patients. “In fact, some M. D. Anderson physicians insist that patients stop smoking before they can receive operative care.”
M. D. Anderson employees who smoke are eligible for this program as well. The 12-week program for patients and employees is tailored to their needs; participants receive support, counseling and either over-the-counter nicotine replacement therapy or prescription medications such as Zyban® or Chantix®.
Also known as Wellbutrin®, a treatment for depression, Zyban accidentally was discovered to be effective in helping smokers quit when smokers reported a reduced urge to smoke while on the medication.
Chantix, also known as Varenicline®, is another non-nicotine medication that works by binding to the brain’s nicotine receptor sites, reducing the urge to smoke and making smoking less pleasurable.
McMillan is proud of the tobacco treatment programs at M. D. Anderson, which boast a 44% success rate. Most important, he says, are patients’ and employees’ motivation and commitment to weaning themselves off nicotine.
Targeting youth with puppet shows
Because of the difficulty of quitting smoking once addicted, there’s a strong focus in M. D. Anderson’s public tobacco treatment programs to convince children and young adults never to begin smoking.
Smoking usually begins in the teen years, so one popular program tries to reach children with an antismoking message much earlier — in elementary school.
The “Too Cool to Smoke” puppet shows offered by the Public Education Office are tailored to students from kindergarten to fourth grade. The free 30-minute shows feature a colorful cast of puppet actors, engaging scripts and an interactive format that encourages children to resist peer pressure and avoid tobacco. In 2007, 131 puppet shows entertained more than 20,000 children in the Houston area.
Helping adults conquer addiction
As part of M. D. Anderson’s cancer prevention efforts in the greater Houston community, Victoria Brown, Ph.D., oversees tobacco programs targeted to community members who want to quit.
One such smoking cessation research study is QuitRx, funded by the National Institute on Drug Abuse. Using functional magnetic resonance imaging, QuitRx researchers compare how medications affect participants’ brain responses to smoking cues. Patients stay on the medications Chantix or Zyban or a placebo for 12 weeks, with three-month and six-month follow-ups.
“Medications are an aid, but they’re no magic bullet,” Brown says. “They help take care of cravings, but counseling is also important. Those who really connect with their counselor are more likely to feel empowered that they can do it.”
The future may hold even more innovative approaches to drug therapies, as researchers delve ever deeper into how an individual’s genes interact with certain types of drugs, allowing precise tailoring of medications.
So, whether they are current or former patients, employees or members of the community, smokers who have made a commitment to quit have a wide and growing array of options to help them overcome this powerful addiction.
For more information or to make an appointment, current or former patients may contact M. D. Anderson’s Tobacco Treatment Program at 713-792-QUIT. Members of the public may call 713-792-2265 for more information on QuitRx and other studies.