Dr. Cheryl Healton

on Quitting Smoking

President and CEO of the American Legacy Foundation

Dr. Cheryl Healton on Quitting Smoking

Dr. Cheryl Healton has dedicated her career to helping people quit smoking. She is the president and CEO of the American Legacy Foundation, an independent, national public-health foundation whose mission is to reduce U.S. smoking rates. The Foundation is responsible for the award-winning “Truth” campaigns aimed at reducing smoking among young people. Healton has more than 25 years experience in research and policy making related to tobacco and other addictions, and is widely respected for her contributions to this field. Among the agencies and organizations that have honored her work are the American Lung Association, the U.S. Department of Health and Human Services and the New York Department of Health. As a former smoker whose mother and several other family members lost their lives to smoking-related diseases, Healton also has a strong personal commitment to helping people quit smoking. She shares her thoughts on what it takes to stop smoking.

Why do so many people find it so difficult to quit smoking?

A unique characteristic of smoking is that the habit is reinforced repeatedly throughout the day. The average smoker uses tobacco anywhere between 15 and 50 times a day, which is far more frequent than most users of other substances. This reinforces the behavior and therefore the addiction.

There is also a very strong psycho-social element in smoking. Most smokers have organized their lives around friendships and acquaintanceships with other smokers. Their best friends at work are likely to be other smokers, and they may have a spouse who also smokes. When other smokers comprise one’s social circle, not only does that normalize the behavior, but it also can necessitate a need for quitters to change those relationships.

Also, despite the fact that some laws and cultural standards have changed, smoking is still highly glamorized in society. As most people know, when actions are considered glamorous, penalties, such as increased taxes, may not be enough to change the behavior.

What options are available to someone who wants to quit smoking?

It’s important to consider all of the available options in helping you quit. For example, many people assume that nicotine-replacement therapy is just as dangerous as continuing to smoke, and this is just not true. Tar, not nicotine, is actually the property in smoke that contributes so strongly to cancer and heart disease.

Using any of the nicotine-replacement therapies, such as the patch or gum, is far safer than continuing to smoke. And, if these therapies help with the transition to becoming a non-smoker, they’re definitely worthwhile.

The use of combination therapies [more than one quitting method] can also be enormously helpful. Many people limit themselves to using only Zyban or the nicotine patch, when in fact they could use both at the same time. Many of the new medications on the market can be very effective, particularly when used along with nicotine-replacement therapy, support groups or both. Some of these medications block the nicotinic receptors, which may reduce the cravings, and offer a bit of assistance for the first two to six months after quitting. There is no reason to rule out any of these options when all could be helpful.

How can people thrive in the first 30 days of quitting smoking?

One of the most important things is just to keep trying. We know that the average former smoker makes eight attempts to quit before she succeeds. Examining the approaches you use in previous unsuccessful attempts can help you identify strategies that helped you before, and to identify potential pitfalls to avoid this time.

Having a great plan in place for quitting can be the best thing you do for making the process easier. Trying any combination of the therapies already mentioned will make your process much easier. We know that people who use more than one method are more likely to succeed. We recommend following a hierarchical system, in which you try the simplest approaches first, only adding more as necessary.

Also, don’t underestimate the need for social support; people who have support are 50% more likely to succeed. You need the type of people who can offer you unconditional support and offer endless encouragement for your success, regardless of any experience you have had in the past. Whether you already have those kinds of individuals in your life, it’s important to get counseling as well. Whether counseling comes in the form of calling a quit line, one-on-one talk therapy with a psychologist or group therapy with others also in the process of quitting, you will benefit from having those types of support.

Considering your years of policymaking experience, what role do you think the government and/or the media should play in helping people quit smoking?

At present most Americans who smoke don’t have the resources to quit, such as comprehensive cessation coverage in their health plans—if they have a health plan at all. We need to use mass-media public education and other means to educate the public broadly about the importance of quitting smoking and help motivate the public to try to quit. If the public isn’t successful, then we should try again and again.

What is your best advice for people who want to quit smoking?

Quit often and early. Never give up. I like to say that we should never use the “F” word—failure—because every quit attempt is valuable. If you tried to quit before and didn’t succeed last time, don’t be discouraged about trying again. For however long you may have managed to go without smoking during previous attempts, you taught yourself that you can live without cigarettes. You can find courage and confidence in knowing that millions of people have already quit smoking successfully. You can do it too, and you will feel so much better knowing that you have given yourself the best chance possible for a longer, healthier life.