It’s tough to be a smoker these days. State and local laws, as well as individual company policies, have severely restricted when and where a person can smoke.
The resulting aggravation may be enough to make some smokers want to kick the habit. And this week they’ll have the perfect opportunity to throw away those coffin nails.
Thursday marks the American Cancer Society’s 31st annual Great American Smokeout, during which smokers are encouraged to give up cigarettes for at least one day.
It’s the first step toward a healthier lifestyle, though the average smoker will attempt to quit several times before achieving permanent success.
"We tell people, ‘You learned how to smoke, and you have to learn how to quit,’" said June Deen, spokeswoman for the Georgia chapter of the American Lung Association.
Different methods work for different people. Some quit cold turkey; others taper off. Some rely on nicotine-replacement products or prescription medications; others fight off the cravings by finding something else to focus on.
What those who succeed all have in common is that they really want to become nonsmokers.
"You’re more likely to quit if you do it for positive reasons, such as you want to improve your health, or save money, or be a good example to your grandchildren," Deen said. "You’re less likely to be successful if you feel that someone is forcing you to quit."
Registered nurse Wanda Edwards, who teaches smoking cessation classes at Northeast Georgia Medical Center based on the Lung Association’s seven-week "Freedom from Smoking" course, said self-motivation is critical.
"The ones who don’t have the best success rate (in our classes) are those whose employers paid them to come," she said.
But if outside pressures don’t motivate smokers to quit, it’s debatable whether anti-tobacco laws can deter people from smoking.
Since Georgia’s Smokefree Air Act went into effect in July 2005, smoking has been banned in almost all indoor places open to the public. Eric Bailey, a spokesman with the American Cancer Society’s Atlanta office, said while the law has reduced nonsmokers’ exposure to secondhand smoke, it does not seem to have decreased the number of smokers.
"Smoking rates in both youth and adults (in Georgia) have either remained stagnant or gone up," he said.
But that trend may be due to something unrelated to the smoking ban. Bailey said since 2004, Georgia has not been using its share of the national tobacco settlement money to pay for smoking prevention.
"Those programs are basically nonexistent now," he said.
There is some evidence that in the long term, anti-smoking laws can have an effect on smoking rates. The prevalence of smoking in New York City dropped by 11 percent after a strict local ordinance was passed in 2002. And the Centers for Disease Control and Prevention cites numerous studies showing that workplace smoking bans increase the number of employees who try to quit.
Deen said when circumstances force a smoker to abstain for most of the day, "it creates more opportunities to practice non-smoking behaviors."
And that’s the theory behind the Smokeout: If a person is able to go for 24 hours without smoking, he may become more confident that he can do it for another 24 hours.
On Jan. 1, 2006, Northeast Georgia Medical Center made its entire campus tobacco-free, both indoors and out. Employees were warned about the change a year in advance, and were offered free smoking cessation classes.
Hospital spokeswoman Katie Dubnik said there are no statistics on how many employees still smoke. But the ban has definitely made life more difficult for those who continue to light up.
"To smoke, employees must leave campus, and to do that you have to clock out," she said.
If nothing else, smoking employees are getting a bit more exercise, because they have to walk all the way out to the edge of the parking lot, grab a few drags on a cigarette, and hurry back inside before their 15-minute break ends.
In May 2003, Gainesville State College became the first school in Georgia’s university system to declare a tobacco-free campus. GSC spokeswoman Sloan Jones said the change did not stir much dissent among students or the school’s approximately 600 full- or part-time employees.
"We have free (smoking cessation) counseling available for both students and employees, though not many have taken advantage of it," she said.
At the medical center, spokeswoman Cathy Bowers said free cessation classes are no longer offered to employees. "That was an incentive at the beginning (before the new policy went into effect)," she said.
However, anyone can take the Freedom from Smoking course that Edwards teaches. It costs $100, but participants get a $25 rebate if they attend all eight sessions.
Edwards said the classes are offered on an as-needed basis, and a new class will probably begin within a few weeks.
"The last class I taught had 12 people, and all of them completed the entire course," she said. "When we followed up six months later, six of them were still not smoking."
In the field of addiction treatment, a 50 percent success rate is considered very high. The Freedom from Smoking class addresses smoking as both an addiction and a habit.
"We recommend going cold turkey," Edwards said. "But if people need something to help them get through the cravings, (the prescription drug) Chantix seems to have been successful for a lot of people recently."
She starts the course by showing videos of old TV commercials advertising cigarettes, which helps longtime smokers understand how their addiction was marketed to them.
Then she has the students add up how much they’ve spent on cigarettes over the years. "For most people, the cost of smoking is a big factor in wanting to quit," she said.
Just as each person in Alcoholics Anonymous has a "sponsor," Edwards pairs up each class member with a "buddy" whom they can call if the nicotine cravings get bad.
That helps prepare them for "quit day," which takes place in the third week. Students are told to bring in all their ashtrays that day. And though the class normally meets only on Mondays, that third week there is a second session because it’s such a critical period for the participants.
"After the third week, we start referring to them as non-smokers, because that’s how we want them to identify themselves," Edwards said.
In the fourth session, she brings in a panel of former smokers who can answer questions and show the class that it is possible to quit for the long term.
Realistically, she knows that many of the students will backslide. "When people relapse, it’s usually because of stress," Edwards said. "So we teach them other ways of dealing with stress, such as listening to a relaxation therapy CD."
Those who are unable to attend a cessation class or can’t afford it may use the Lung Association’s Freedom from Smoking online program (www.ffsonline.org), which Deen said many people have found helpful.
The American Cancer Society’s Web site, www.cancer.org, also offers extensive resources for smokers who are trying to quit.
And if the online approach seems too impersonal, you can pick up the phone and talk to a real person. The Georgia Tobacco Quit Line, a partnership between the Georgia Cancer Coalition and the Georgia Department of Human Resources, is open from 8 a.m. to midnight, Monday through Saturday.
By Debbie Gilbert