Smoking & Tobacco-Related Studies

I was just 11 when I started smoking in the 1980s. Finding cigarettes was easy. My mom was a smoker, and when she reached the end of a pack, she’d send me with a dollar to the corner store to buy more. Back then, there were no laws against selling tobacco products to kids, so the store clerk thought nothing of it.

Sometimes, I’d sneak cigarettes from my mom’s supply. Other times, I’d get them from the “cool” kids at school who let me join their clandestine smoking sessions.

By the time I graduated from college, I was smoking a pack a day.

Children motivated me to quit smoking

I wanted to quit, but my job as a social worker for abused and neglected children often left me emotionally drained. Cigarettes helped ease the stress. I tried several times to quit cold turkey, but those attempts never lasted.

That changed when I got married and had children. During both of my pregnancies, I quit smoking. It wasn’t that difficult – it was as though my mind instructed my body to protect my babies. But as soon as my sons were born, I started smoking again to de-stress from the pressures of motherhood and my job.

Working with so many children in the foster care system sometimes made me sad and frustrated. They didn’t deserve to be in this position. As a social worker, I did what I could to help, but I wanted to do more.

Then I had an epiphany. I could apply to become a foster parent. One of the rules of fostering is that you’re not permitted to smoke around children. I quit again, and for the next eight years, I fostered a succession of children in my smoke-free home. I adopted two little girls – one with special needs – whose chances of finding a family were slim.

Weight gain and nicotine addiction

As my family grew, my marriage crumbled. I tried hard to balance everything, but it was a challenge. Since cigarettes were off-limits, I used food as a de-stressor. I’d always been heavy, even as a child. But now I weighed more than 350 pounds. I was exhausted, depressed and overwhelmed.

Then one magical day, I said “enough.” I was tired of feeling tired. I got on the treadmill. I started eating healthy foods. I lost over 200 pounds. And I filed for divorce. I’m a redhead, and my dad always said redheads are stubborn as mules. I lost the weight and got my life back on track out of sheer determination.

Losing so much weight left me with saggy, excess skin. My doctor said surgery was the only way to get rid of it, so I underwent a full-body lift. During the 17-hour operation, plastic surgeons worked on my neck, breasts, stomach, arms, legs … everything.

My recovery was very painful. One day, when I was hurting worse than usual, my mother handed me a cigarette and said, “Here, this will help.” I took one long puff, and BAM! I was hooked again. Nicotine addiction is powerful.

I was disappointed to resume smoking, but in the back of my mind, I rationalized that smoking would help me keep off the weight I’d fought so hard to lose. I conveniently “forgot” that cigarettes could harm my body and take years off my life.

A new start

With my divorce finalized, I decided to leave my home state of Illinois for a fresh start in Texas. I packed up my children and headed to Houston, where I was hired as a social worker for difficult-to-place foster children with advanced needs.

I carry a case load of 30 kids, and I view them all as my kids. My goal is to place each one in a loving foster family or permanent home. When that happens, there’s no greater joy. But getting to that point can be very stressful.

Sometimes my days are intense. When I first arrived in Houston with no family or friends to turn to, cigarettes once again became my way to de-stress. I hated them, but I needed them.

Participating in a smoking cessation study

That changed one day when a radio advertisement caught my attention. “Are you tired of smoking?” the announcer asked. I yelled “YES,” though I was alone in the room. The ad was recruiting smokers for an MD Anderson tobacco-cessation clinical trial called PISCES, which stands for “Precision-Implemented Smoking Cessation Evaluation Study.”

The program was free of charge, the ad said. I didn’t believe it. I thought surely there must be a program fee, or I’d have to reimburse MD Anderson if I failed to stop smoking during the study. I decided to call anyway, and I’m glad I did.

The research coordinator explained that, unlike many other tobacco-cessation studies, PISCES is conducted remotely. I’d never have to go in person for a single visit. Everything would be done by phone and with video visits over the computer. That sounded great to me, especially since I live an hour away from MD Anderson.

During the study, I would be asked to collect my saliva and urine samples at home, and submit them to MD Anderson by courier. These, along with samples from other PISCES participants, would be analyzed for genetic markers which could potentially be used to tailor smoking cessation treatments for people based on their genetics.

I was eager to quit smoking and happy to contribute to the research, so I joined the study.

How I quit smoking

My plan was simple to follow. I took a daily oral medication named varenicline for 12 weeks. The medicine was mailed to my home. It was so convenient. Other participants received nicotine replacement therapy in the form of a patch, gum or lozenges. The study was randomized, meaning neither the researchers nor the participants chose who would receive which treatment.

Counselors and doctors regularly checked in with me by phone or over the computer. I got lots of support.

Anyone who failed to stop smoking after 12 weeks was switched to a different therapy or higher dose. That’s the beauty of MD Anderson – they don’t give up on you.

Today, I’m proud to call myself a nonsmoker. I haven’t touched a cigarette in over a year, and my cravings have disappeared.

I’ve learned that all those years of “self-medicating” with cigarettes to ease stress were actually causing more stress. The program taught me that while smoking makes you temporarily feel calmer by releasing a chemical into your brain, it wears off quickly and you feel worse than before you lit up. Today, I handle stress in healthier ways, like walking my dog, watching a movie or exercising.

I'm in a much better place now, in so many ways. If you want to quit, but you're afraid to try, contact MD Anderson. If it worked for me, it can work for you.

Learn more about smoking cessation studies at MD Anderson.

As a former competitive CrossFit athlete, Katherine Norman sees herself as a healthy person. Over the last year, she also saw herself as a smoker.

“During the pandemic, I reverted to old coping skills, like smoking,” she says. “I had this cognitive dissonance because I thought of myself as a healthy person and, at the same, I was smoking up to a pack a day.”

She recently quit smoking with the help of tobacco cessation study at MD Anderson. Now, she’s looking forward to entering her 30s smoke-free and healthier than ever.

Smoking to cope with COVID-19 pandemic stress

When Houston restaurants closed due to the COVID-19 pandemic in March 2020, Katherine was unable to work and had to deal with sudden fear and uncertainty about when she’d be able to return to her job. The fact that she recently moved and her girlfriend worked as a travel nurse added to Katherine’s anxiety. With gyms closed and social distancing in full effect, her healthy outlets were limited, too.

“I’d wake up every day with anxiety in the pit of my stomach, thinking, ‘Am I going to have a job to go back to? How long is this going to last?’” Katherine says. By the time her restaurant re-opened in June 2020, she was smoking more than ever and struggling to quit.

LGBT tobacco disparities

Although Katherine first began smoking intermittently in high school, she never considered herself a regular smoker until the pandemic.  

“My mother and grandmother were smokers, so cigarettes were definitely around the house growing up,” Katherine says. “I started smoking to deal with depression and anxiety from not knowing how to deal with being a lesbian in a Christian home.”

Studies have shown that the LGBTQ+ community is disproportionately affected by tobacco and that LGB female youth are more than three times as likely to smoke as straight females. The smoking cessation study Katherine joined at MD Anderson, called Project On-Track, was designed with tobacco disparities, including the LGBTQ+ community, in mind, to look at how different factors affect stress and smoking.

“I remember wanting to escape my feelings and not knowing how to manage them,” Katherine says. “Smoking was my way of regulating myself.” Eventually, Katherine found other outlets, like competitive CrossFit, that helped her smoke less.

Multiple quit attempts in the face of nicotine addiction

As businesses reopened, Katherine worked to return to healthier habits. “I’d go to the gym and meditate, so I looked like a person who takes care of herself, yet I was putting this poison in my body and trying to clear it out at the gym,” she says. “I have a lot of willpower, so I’d ask myself why I couldn’t just stop smoking. But it‘s an addiction.”

By the time she saw the advertisement for MD Anderson’s smoking cessation studies, Katherine had already tried to quit several times on her own. For most people, it takes multiple quit attempts and setbacks before successfully abstaining from cigarettes.

Study provides tools to successfully quit smoking  

Joining the study gave Katherine free access to nicotine patches (which she decided not use) and virtual behavioral counseling, as well as a stipend for participating. She supplemented the counseling sessions with books and podcasts from leading behavioral scientists to better understand her addiction.

“I started actually paying attention to how cigarettes made me feel, and I realized they’re expensive, they stink, and they make my lungs hurt,” Katherine says. “Cigarettes really just made me feel like crap.”

As she looked toward her 30^th birthday this summer, Katherine decided that quitting smoking wouldn’t be the only change she made for her new chapter of life. She started seeing a nutritionist, moved on from a breakup and dealt with other personal challenges.

“The past year was hard on all of us. It showed me the things I struggle with and how surprisingly deep they go,” Katherine says. “I decided to move forward on a lot of things, and being able to articulate that for myself was powerful. The difference with quitting smoking this time is that I was finally ready to be done.”

Learn more about participating in MD Anderson’s smoking and tobacco-related studies.

Related articles
Don’t let COVID-19 stress keep you from quitting smoking