Quitters never win? Sometimes they do
MD Anderson’s tobacco treatment program is helping smokers beat the physical and psychological aspects of addiction
Loretta Preston kicked her cigarette addiction two years ago.
“Quitting wasn’t easy,” she says. “I’d smoked for 40 years.” Then, the unthinkable happened. Her beloved pit bull, Tip, who she’d raised from a puppy, was stolen in a carjacking. I thought my life was over,” she says.
Unable to cope with the pain, the MD Anderson patient and four-time cancer survivor started smoking again.
Breaking a tobacco addiction isn’t easy. Quitting tobacco while dealing with the stress of battling cancer is twice as hard.
Tobacco is the single most preventable cause of cancer, and is responsible for more than 30% of all cancer-related deaths. Each year, smoking causes one of every five deaths in the United States.
In cancer patients, tobacco use can limit treatment effectiveness, complicate healing and lead to relapse or additional cancers.
“I decided I was tired and I didn’t want to die,” Preston says.
The program helped her stop smoking two years ago, and she would use it again to help her quit after losing Tip.
The Tobacco Treatment Program was established in 2006 to help all MD Anderson patients who use tobacco to quit, free of charge. It’s also open to patients’ families as well as MD Anderson employees and their dependents.
All patients who list themselves as current smokers or recent quitters are automatically referred to the program.
“This is a radical shift from traditional programs that require patients to be referred by a physician,” says Paul Cinciripini, Ph.D., the program’s director.
The patient’s journey begins with a phone call from a program staffer who discusses the benefits of tobacco cessation and gauges the patient’s interest in participating in the program.
Some may be ready to kick the habit right away. Those who are more hesitant receive sustained support with regular follow-ups and phone calls.
“One way or another, we touch the lives of all these patients,” says Cinciripini, who also is chair of Behavioral Science.
New patients first receive an in-person consultation, followed by six to eight counseling sessions, with medications given to ease withdrawal symptoms and help participants stick to the program. Those unable to participate in person may phone in.
“We do everything possible to help people quit smoking,” says Maher Karam-Hage, M.D., the program’s associate medical director. “That includes regular phone calls and aggressive medication management. We want to give every participant the best possible chance to quit.”
“If you’re willing to work, you can have success,” says Preston. “They gave me the tools that I needed and a number to call to talk to someone if I wasn’t feeling complete. They called, they checked on me, and they made sure I was OK.”
Psychological support is key to the program’s success. Medications ease cravings, but counselors teach patients how to cope with behavioral triggers that stimulate cravings.
“We leave patients with tools to use after their medications are completed,” explains Karam-Hage, an addiction psychiatrist.
Some patients participate in clinical trials that help researchers identify new and improved interventions.
Since the program began, more than 6,400 patients have received in-person or phone-based counseling, with an average of eight follow-up appointments each. Almost 10,000 more have benefited from literature and other resources distributed through the program. All totaled, that’s nearly 70,000 patient contacts in just over nine years.
Thirty-five to 46% of people remain tobacco-free nine months after treatment ends. Most others have cut their tobacco use by more than half.
“That’s as good as, or better, than the best-reported outcomes from pivotal clinical trials in tobacco cessation,” says Cinciripini.
Participants who are unsuccessful the first time are able to try again.
When Preston relapsed, she was welcomed back. After her second round, she’s once again tobacco-free. And she has a new pit bull named Dallas.
She urges others never to give up hope.
“After smoking for almost 40 years, life is good. I have a new puppy, and I’m finally free from those nasty cigarettes.”