HEALTH

Taking on tobacco

Smokers are trying new ways to butt out

NORA UNDERWOOD April 9 1990
HEALTH

Taking on tobacco

Smokers are trying new ways to butt out

NORA UNDERWOOD April 9 1990

Taking on tobacco

HEALTH

Smokers are trying new ways to butt out

Like most cigarette smokers, Barbara Young says that she has tried to quit her pack-a-day habit many times, but repeatedly failed. Last October, the 30-year-old Vancouver sales representative, who has been smoking since she was 12, decided to try an exotic cure: high-tech laser therapy. For half an hour, Young sat in a chair at a doctor’s office while a technician directed red laser beams at special points in her ears and hands. Proponents of laser treatment say that its beams relieve the physical cravings for nicotine by triggering a release of the brain’s natural opiates, called endorphins. Young said that the therapy helped her quit for three months. But, during a sailing holiday in January, she started smoking again.

Now, she says that she plans another session with the laser therapist. “It's mind over matter,” said Young. “You can believe in anything you want.”

Like Barbara Young, thousands of Canadians are looking for ways to butt out—and stay off—cigarettes and other tobacco products. According to estimates prepared by the Torontobased Non-Smokers Rights Association, about five million Canadians currently smoke cigarettes, down from 7.2 million in 1980. And with increasing public concern over the harmful effects of smoking, doctors, private companies and nonprofit organizations have begun offering a wide assortment of programs, products and counselling to help smokers quit. Besides laser therapy, addicted smokers have been turning to acupuncture, hypnosis and Alcoholics Anonymous-style group therapy for help. But addiction experts say that the advertised success rates should be treated with skepticism. Said Dr. Roberta Ferrence, a researcher at the Addiction Research Foundation in Toronto: “There are a lot of methods that have made these incredible claims, but they can’t back them up.”

Giving up smoking involves overcoming both physical and psychological addictions, according to Ferrence. She added that a former smoker may experience physical symptoms of nicotine withdrawal, including difficulty concentrating and sleeping, or become irritable and excessively emotional. The symptoms will usually disappear within a month of quitting. But the psychological symptoms are harder to eliminate. “In some ways,” she said, “it’s comparable to a grief reaction. It’s almost like your best friend is gone and you’re missing them.”

Quitting smoking for Brian O’Malley meant breaking a 25-year, 30-cigarette-a-day habit. The 39-year-old electrical contractor in Halifax says that he finally succeeded about three months ago by participating in a program conducted by the Nova Scotia Lung Association. Called Countdown, the program costs $95 and involves a self-help approach to quitting. In seven 90-minute sessions over five weeks, groups of 12 to 20 smokers learn how to handle normal stress, anger and other types of pressure without lighting up a cigarette. Lung associations in the other nine provinces offer similar programs. O’Malley said that his first few days without cigarettes were “miserable.” But, for the first time, he managed to quit for more than a day.

Some methods primarily help smokers through the effects of physical addiction. The theory behind acupuncture, a 3,000-year-old Oriental medical practice, is that smoking upsets the body’s natural balance of energies. With relatively little discomfort to the patient, acupuncturists insert thin two-inch needles into the earlobes and hands, at roughly the same spots that the laser therapists focus on. Provincial health-care plans do not cover either treatment. Laser therapy, which is available in clinics operated by doctors or private businessmen in most major cities, costs about $75 for a half-hour session. Individual smokers may require varying numbers of follow-up sessions, usually within a three-month period. Acupuncture costs about $35 a session.

One product designed to help smokers cope with physical withdrawal symptoms is Nicorette, a chewing gum that contains nicotine. The product is tasteless, but creates a stinging sensation at the back of the tongue when chewed. Dr. Anders Lundell, medical director of Toronto-based Merrell Dow Pharmaceuticals (Canada) Inc., said that Nicorette, which is manufactured by a Swedish company, provides an individual with a supply of nicotine that he would normally acquire through smoking. Doc-

tors must prescribe Nicorette because nicotine is a drug. In 1989, Canadian physicians issued 350,000 prescriptions for Nicorette, 300,000 of them to new users. Lundell added that clinical tests have shown that, after one year, 40 per cent of users are still not smoking. Ferrence said that Nicorette is less harmful than tobacco because it does not contain tar and carbon monoxide.

Smokers are also turning to hypnosis to help them overcome the initial physical craving for cigarettes. Hypnosis, which is a focused state of attention during which people become more responsive to suggestions that they wish to follow, helps to motivate smokers to change their habits and attitudes towards cigarettes. Many doctors, dentists and psychologists are trained by self-governing organizations in each province that regulate the practice of hypnosis. Some treatments are covered under provincial health-care plans. Dr. Laurence Deutsch, a family doctor in Ottawa who practises hypnotherapy, currently treats about 200 smokers a year, an increase from 50 about five years ago. Deutsch says that he teaches the hypnotized patient to achieve a state of pleasure by substituting such simple—and safe—patterns of behavior as breathing heavily for smoking. Usually, the treatment works in an hour-long session and a follow-up session, which together cost $225. Two out of three patients, Deutsch says, are still not smoking a year later.

Other programs offer stepby-step methods to break the habit. Toronto-based Smokenders Canada Ltd. organizes six-week seminars across the country that cost participants between $295 and $395. Seminar co-ordinator Jennifer Francisco said that, during the first four weeks, clients are allowed to smoke but they are encouraged to cut down. Smokenders tries to change such behavioral patterns as smoking immediately after a meal or while drinking coffee. In the last two weeks of the program, the participants are supposed to stop smoking altogether. They learn how to cope with emotional and physical stress, including anger and hunger, which will trigger the desire for a cigarette.

Smokenders, a 21-year-old company that employs about 80 people part time, has worked with employees of such corporate clients as Noranda Inc., General Motors of Canada Ltd. and Coca-Cola Ltd., as well as an estimated 50,000 individual clients. Francisco claims that 90 per cent of the participants have stopped smoking after completing the program and that up to 70 per cent are still smokeless a year later. Declared Francisco: “Our premise is that if you give any drug addict a chance not to quit, they won’t. You can’t be a little bit addicted.”

Other entrepreneurs who have moved into the business say that smokers can indeed be helped to cut back their consumption without quitting. Frederick Weston, president of the Toronto-based Addiction Management Systems Inc., said that his company has developed programs to help people to either quit or merely manage their smoking. Weston said that the management approach is aimed primarily at employees who can no longer smoke in the workplace. Currently, Weston’s four-year-old company has about 200 corporate clients, including the Royal Bank of Canada, IBM Canada Ltd. and Transport Canada, who offer programs of varying length to employees. “Nicotine addiction is not the same as alcohol or heroin addiction,” said Weston. “That’s a myth. It can be controlled. Smokers figure out very easily that if they can go for four hours without a cigarette, then they can go for five.”

A slow withdrawal from cigarettes is also the principle behind a computerized device called LifeSign, which is marketed by Health Innovations Inc. of Reston, Va. The device, which is the size of a credit card and as thick as a pocket calculator, contains a display panel with two windows. One tells the smoker how many days he has until he must quit, based on information the user punches into the device. The second window tells the smoker how long he must wait until his next cigarette, based on a schedule the user devises and feeds into the device. The user pushes a button every time he lights up. If he violates his schedule, a buzzer goes off. Health Innovations vice-president of corporate relations Scott MacKillop said that the company has sold 110,000 of the $75 devices in Canada. They are advertised on television, and buyers can order by mail or phone. MacKillop said that clinical tests have shown that 25 per cent of LifeSign users are still off cigarettes one year after using the device.

Addiction experts refuse to endorse any one method of quitting. For his part, George Duimovich, a researcher for the Ottawa-based resource centre called the National Clearing House on Tobacco and Health, says that consumers should be wary of statistics. He added, “Any course that offers success rates beyond 30 per cent within six to 12 months of quitting is probably questionable.”

At the same time, however, experts do not discourage people from using any method that might help them quit. “Most people have to try several times,” said Ferrence. “They learn what tripped them up, and their resolve increases.” Personal determination, O’Malley and other successful former smokers say, is really the key to giving up cigarettes. “The whole heart and soul of it is that you have to want to quit,” he said. “Even with a halfhearted effort, you’re not going to make it.”

NORA UNDERWOOD with TIM POWIS in Toronto

NORA UNDERWOOD

TIM POWIS