Butt out: Plenty of options available to help kick smoking habit

Monday, Nov. 12, 2001 | 8:26 a.m.

Sitting in an office at the Nevada Tobacco Users Helpline on West Charleston Boulevard, Tom Tripp looks back on the 50 years that he spent with his "close friend" whom he kicked from his life six weeks ago.

"We grew up together, went to high school (and) the Navy together. Got married (and) divorced together, had children," Tripp says with little remorse about the relationship he once held near to his heart, both metaphorically and literally.

"Whatever I wanted to do, I could depend on 'Mr. Nicotine.'"

Wearing a black nylon warm-up suit and filled with a born-again style of splendor, the 66-year-old Las Vegan retells the events leading up to his final goodbye to cigarettes, interjected with stories of his morning laps at a local fitness center where he now swims a mile each day.

As the American Cancer Society celebrates its 25th Great American Smokeout on Thursday, millions of smokers are expected to snuff out their butts even if just for one day.

In the 25 years since the smokeout began in California, millions of Americans have been inspired to quit, said Daniele Dreitzer, spokeswoman at the Las Vegas office of the American Cancer Society.

The effort, she said, has also helped highlight the dangers of smoking and initiated support from family and friends of smokers.

Today nearly 47 million Americans smoke, and more than 400,000 deaths are caused each year by tobacco-related illnesses.

Tripp said he decided to quit smoking when he developed a burning cough that kept him up nights and frequently dehydrated him, causing symptoms so grim that he began sorting his personal belongings and preparing for the worst: terminal lung cancer.

When he finally saw a doctor, he was told he didn't have cancer, but was facing early stages of emphysema and would be soon be wearing portable oxygen gear if he didn't quit smoking.

To help him quit, he sought help through counseling and the weekly No-Nic classes both of which are offered by the Nevada Tobacco Users' Helpline as well as support from Nicotine Anonymous meetings. He also adheres to meditative breathing exercises and a lifestyle change.

"You have to replace (smoking) with something," Tripp said. "You've got to change habits. You get done eating, get up from the table, put the leash on the dog, go for a walk, do the dishes, go out in the backyard and scream."

Dreitzer said the Great American Smokeout initially began as a wake-up call to smokers about the addictive nature of tobacco.

"People didn't realize how addicted they were," she said. "When they were actually challenged to go a day without smoking, they realized."

But Dreitzer and other local anti-smoking advocates say that getting people to quit smoking or keeping them from ever starting is a challenge in Nevada, which has the highest rate of smokers nationally (31.5 percent).

Nevada's pre-emptive legislation that prevents local governments from passing tougher tobacco laws, such as smoking in public places, also affects the mentality surrounding smoking, Dreitzer said. The high rate of smoking allowed in public places creates a social norm that doesn't encourage people to quit, Dreitzer said. "It makes it more difficult."

Nicole Bungum, program coordinator for the Clark County Health District's tobacco control program, said that Nevada has the fewest smoke-free work places in the country -- 49 percent. But according to a recent poll conducted by the Gallup Organization (contracted by the health district), not everybody in Clark County wants to be among smokers.

Among adults surveyed, 83.5 percent said they agreed that people should be protected from second-hand smoke, and nearly 40 percent reported that they avoided going somewhere in the last year because they would have been exposed to second-hand smoke.

To highlight restaurants that are smoke free, the health district is hosting its third annual "Smoke-Free Dining Experience," which this year is promoting smoke-free restaurants on the radio and by listing them in local newspapers. The list can be accessed on the health district's website, cchd.org.

Teen advocates

Because of the lax attitude toward smoking in Southern Nevada, Bungum said that keeping local teens smoke free is an ongoing challenge.

"You could have the most effective (anti-smoking) curriculum in the schools but when (kids) go to the convenience stores and grocery stores, that doesn't reinforce it."

In an effort to curb teen smoking, the health district created XPOZ, a local organization of youth advocates who speak out against smoking and the tobacco industry in taped messages directed at tobacco companies.

The messages have been played on local radio stations KLUC 98.5-FM and KXTE 107.5-FM, Maria Azzarelli, youth tobacco coordinator for XPOZ, said.

Cable networks MTV, BET and ESPN and the national network FOX have also aired the messages, she said. Messages can be heard via the group's website, xpozcoalition.org.

The effort is similar to the American Legacy Foundation's Truth campaign, which helped train members of the local group.

In an old milk truck wrapped with the XPOZ slogan, the group has embarked on a 30-stop tour throughout the valley that meets teens on their own turf -- at concerts and other teen events.

The group uses excerpts from the tobacco industry's marketing tools to fuel the local teens to become anti-smoking advocates. Known as the "Kick-Ash Tour," it was launched June 16, and has grown from 30 teenagers to having more than 600 registered in its database.

The group's mission is to "inform teens about the lies put before them by the tobacco industry," and to let the industry know that teens are "tired of being the target of their marketing."

"We like to keep it a very cool kind of thing," Azzarelli said.

"All youth know, even kindergartners know that smoking causes lung cancer. It's not about that anymore. It's about making teens feel a part of a national movement and making them aware of the fact that they are being manipulated."

Eighty percent of smokers begin smoking by age 18. Figures released this month by the Centers for Disease Control state 34 percent of teenagers nationwide currently use tobacco products, and that 15 percent of middle school students do. Half of those who admit to using tobacco products reported that they would like to quit.

"Most of my friends that did smoke are quitting now," said Jeff Jordan, a 17-year-old senior at Advanced Technologies Academy, who is the youth leader for XPOZ. "It helps that smoking isn't really that cool anymore.

"Teens do a lot of stupid things," Jordan added. "And without ... wanting to, they can stay addicted to (smoking)."

The cycle

Cindy Miller, director of client services for Nevada Nicotine Treatment Centers on South Rancho Drive, said that when people begin smoking, they feel more alert, focused and relaxed.

"Then they don't have it (so) they start to smoke more and more to get that feeling moving them from a dependency to an addiction."

When a smoker stops smoking, the cortisol drops and the initiation of nicotine withdrawal symptoms begins.

"Within 20 to 80 minutes of stopping nicotine your body starts craving it," Miller said, adding that there are 22 different nicotine withdrawal symptoms, including agitation, cravings and depression. "It can get quite traumatic for some people."

The center, headed by Dr. Edmund Pasimio, treats its clients using injections of adrenocorticotropic hormone (ACTH), which, Miller said, stimulates the body's adrenal cortex and increases the amount of cortisol, which then stops the nicotine withdrawal symptoms but the nicotine is still leaving the body.

The injections are given every 72 hours during a 12-day period and clients are counseled through the process.

These are chronic smokers who have engrained behaviors and those who have tried several times and different methods and have been unable to quit, Miller said. "We don't take somebody who doesn't smoke at least a pack a day."

Snuffing out

With the availability of nicotine replacement therapies -- including nicotine gum, the nicotine patch and the drug Zyban -- quit rates have improved among smokers, said Dr. Elizabeth Fildes, founder and clinical coordinator of the Nevada Tobacco User's Helpline.

The one-year success rate for a person who quits cold turkey is about 5 percent, she said.

"The quit-rate for smokers who quit because a doctor advised them to (citing health reasons) is 10 percent, and people who have quit with medications and counseling is at 21 percent."

Nevada Tobacco Users Helpline is a nonprofit affiliate of the University of Nevada School of Medicine, and provides free nicotine dependence treatment through telephonic counseling, a medication-assistance program and weekly classes that focus on the physical, emotional, mental and spiritual components associated with nicotine dependence.

Clients are taught to see withdrawal symptoms in a positive light -- a sign that the body is recovering from nicotine addiction -- and are assisted in breaking the psychological bonds with cigarettes.

Most smokers started when they were very young, Fildes said. "When you do that, you start to use cigarette smoking as your coping mechanism."

And, she said, for lifelong smokers, such as Tripp, who regard their dependency on nicotine as that of a "friendship," is not so uncommon among longtime smokers.

"It's always there," she said, referring to cigarettes and other tobacco products that smokers rely on. And for many smokers, the belief is that "I have somebody with me that's unconditionally accepting."

Fildes said that the average number of times a smoker tries to quit is between six and eight. The attempt to quit, not whether it lasted, is what matters, she said.

One of the reasons that keeps smokers from trying to quit is the fear of failure, she said.

"We tell them, 'You never failed. Failure is a judgment on your part. The result of your previous try is that you went back to smoking. Learn from previous episodes and apply what you learn the next time.' "

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