In 2006, Americans smoked 371,000,000 cigarettes. That’s 1,654 smokes for every man, woman and child in the U.S. In its annual report on trends in tobacco use, the American Lung Association estimated that slightly more than 45 million people in America are currently smokers – which means that on average, each smoker has more than 8,000 cigarettes a year. [cig1]
You try quitting that.
In the interest of full disclosure, this reporter has been a smoker since she was 15. My occasional cigarette slowly evolved into a pack-a-day habit. I started smoking because everyone I knew did – the most basic, stereotypical reason anyone can have to smoke. I kept smoking because I lived a high-stress life (full load of honors classes and extra-curricular activities, plus an incredibly dramatic personal life) and it helped me to feel relaxed, and in control of something. In 2004, two events contributed to a significant increase in my cigarette intake – my 18th birthday and my entrance into college.[yearly]
It goes without saying that being able to buy my own cigarettes only made my habit easier to sustain. In a new environment where I didn’t have to sneak my one daily cigarette on the porch after school, I smoked freely and whenever I wanted. As the stress of school began to mount, my smoking increased exponentially. My habit was even undeterred by a nasty bout of tonsillitis in 2005. Sure, I quit while I was sick, but after my tonsils came out, I was back to smoking a few days later. That was the last time I made a serious attempt at quitting smoking. I smoke, literally, from when I wake up until I go to bed at night. I can’t have coffee, drive my car, study or walk to class or work without cigarettes. This sort of routine is the biggest obstacle to smokers who want to become non-smokers. “I quit smoking 26 years ago,” said Dave Schroeder, a current Ph.D. student in MSU’s rehabilitation counselor studies program. “But even now, under certain circumstances – like when I’m making a long phone call – I kick back, put my feet up and look around for an ashtray.”
In addition to pursuing his doctorate in rehabilitation counselor’s education, Schroeder also is a graduate assistant for CEP 261, a class on substance abuse. “For me, the goal of teaching the class is to give factual information with the understanding that the individuals taking the class will make their own decisions,” he said.
I decided to quit smoking a few weeks ago, on a Monday. During the course of that day, I realized I had a midterm on Thursday of that week. “I can’t possibly quit before then,” I thought, knowing I’d have to spend long hours studying and drinking coffee – two things I couldn’t do without cigarettes. This behavior was anything but unusual. “Women smokers’ use of nicotine as stress relief is more highly endorsed than among male smokers,” said Zaje Harrell, doctor of psychology and assistant professor at MSU. [cig12]
Addiction of any type is usually recognized as a two-headed monster – physical addiction and psychological addiction. “Physical addiction is much easier to define because there are some really clear landmarks,” Schroeder said. “There are negative side effects to stopping, like DTs for alcohol.” DT stands for “delirium tremens”: the confusion, agitation and hallucinations caused by alcohol withdrawal. Opiates, like heroine or morphine, also have severely painful physical withdrawal. The physical withdrawal from nicotine includes distraction, irritability, dizziness and hunger, according to Harrell and Schroeder.[dave]
The psychological aspect of addiction is much more difficult to define, and much more difficult to overcome. “We simply believe we have to have it and we learn a series of behaviors related to using the product,” Schroeder said. Smokers in particular tend to do things such as ignore public health messages about the danger of their behaviors and minimize individual risk, according to Harrell. “A lot of people feel very powerless over the craving,” she said. Both Schroeder and Harrell characterize addiction of a psychological nature in a similar way – the willingness to make large sacrifices for the sake of using one’s drug of choice. “The behavior is so compelling that the addict is willing to suffer severe consequences,” Harrell said. These consequences can include risking personal safety by driving under the influence, jeopardizing relationships with family or poor performance at work.
But, for all the psychological obstacles for smokers wishing to quit, there are endless benefits. The American Heart Association lists easier breathing, increased energy and lack of a “smoker’s cough” among the reasons to kick the habit.
After my midterm, I did begin my attempt at quitting smoking. To compensate for my cravings, I wore a rubber band around my wrist, which I snapped each time I felt like smoking. The first few days were hard, to be sure, especially tailgating before a football game. The environment of being social and standing outside for hours was very closely linked to smoking. But with poking and prodding from my friends, I made it through the day without even one cigarette. After about three days smoke-free, I could definitely feel a change. At the gym, I could breathe more easily and I could taste food much better. I was doing well; I thought maybe this could be the time I quit for good.[bubble]
“Smoking shares common ground with other addictions in that you have to change a variety of behaviors,” Schroeder said. “In AA (Alcoholics Anonymous) and NA (Narcotics Anonymous), they say you have to change playgrounds and playmates – it’s hard to hang around people who still smoke.” Of smokers who attempt to quit, about 90 percent try to do it cold-turkey, using some sort of self-control method (like my snapping or gum-chewing), according to the American Lung Association. Less than 10 percent of these are successful. “The best approach is a combination of pharmacological therapy and behavior strategies,” Harrell said. “Snapping provides a negative stimulus – that [in] itself is not going to stop you from smoking.”
Not surprisingly, it didn’t.
Five days, or about 100 hours after I’d had my last cigarette, I was at the library, working on a paper. When I left and started walking toward the coffee shop where I spend my time between classes, I started to think about having a cigarette. A few days beforehand, I had given one of my roommates my driver’s license to keep me from buying cigarettes at the gas station; that morning, I had picked it back up from off the coffee table. Everything was in place for me to break, and once I had the idea in my head I was going to smoke, there wasn’t a whole lot I could do to stop it. I honestly felt like a junkie hustling to get her fix.[cig3]
“If you are doing something that you would rather not be doing, or that has negative consequences and you keep doing it, then you have an issue, whether it’s overspending, tobacco use or bad dating,” Schroeder said. Clearly, I have an issue with smoking – I’d always thought that I could quit fairly easily, but after that one pack of cigarettes, it was almost impossible for me to go back to not smoking. “At a certain point, an addict has a compelling need for the substance and they become solely focused on acquiring the substance,” Harrell said. Just as if I’d been jonesing for heroin or cocaine, I was exhibiting typical addict behavior. This was not encouraging.
Treatment for addiction is most effective when it uses an individualized approach, according to both Harrell and Schroeder. “AA is probably the most effective substance abuse program, because of its long-term support and the element of giving things over,” Schroeder said. Other forms of treatment, like checking into a rehabilitation facility, can be incredibly expensive and still run the risk of being unsuccessful.
[burned]For students at MSU who want to kick their bad habits, Olin Health Center offers a handful of services, according to Rebecca Allen, the health educator at Olin for A.T.O.D.E.S., an intervention program designed for certain alcohol, tobacco and drug users. The A.T.O.D.E.S. program (Alcohol, Tobacco and Other Drugs Seminar) is used primarily by students who are required to take it, due to violation of university policy.
To help students who wish to quit smoking specifically, Olin Health Center offers a program called “U Can Quit,” which provides students with a “Quit Kit” free of cost. The kit helps students devise an individualized plan for quitting and also provides resources online and in the Lansing/East Lansing area for developing a support system. For students with other types of addictions, the most effective programs available locally are NarcAnon and AA, according to Schroeder.
I got a lot of hassle for failing to quit smoking – my friends were really rooting for me, and I appreciated it. I didn’t manage to quit completely, but five days without cigarettes definitely allowed me to assess my habit. Now, I’m much less likely to smoke because I’m bored or to fill time, or because I need something to do with my hands while I’m talking. The cigarettes that go with my routine or come out of stress or emotion are much harder to get rid of. Maybe I’ll eventually figure out how to quit – but next time, I’m leaving out the rubber band.