How to Quit

By DeNita S.B. Morris

Do you crave cigarettes when you're stressed out? Bored? After eating? Or, do you just light up with the girls or when hanging out with your hommies?

Whether you're a two-pack-a-day or social smoker, it's time to kick the habit. Here's what you need to know and do to quit smoking.

For Kimberly Davis, 30, cigarettes are long-time companions that seem to steel her nerves during tough times, such as her recent divorce. She wants to quit the habit that she began in high school but doesn't know if she can stop.

"I'm ashamed that smoking is something I cannot control," said Davis, mom to a 4-year-old son. "You think you'll be stronger, that you won't have a problem and that you can quit when you want. But, really, it's a habit that's hard to break."

Easy to Start, Hard to Quit!
In 2000, the US Centers for Disease Control reported that 70 percent of current smokers wanted to quit and 41 percent had tried the preceding year.

Black people found it hardest to kick the habit of all racial groups, suggesting that we should never begin.

Like Davis, most new smokers don't see addiction coming. The wake-me-up, pick-me-up, after-dinner and stress-relief smokes turn into must-have coping strategies, helping them to get through life's daily dramas.

The U.S. Department of Health and Human Services understands this behavioral and physical addiction connection.

As a result, HHS recommends that both "social" and "chain" smokers should be treated aggressively.

In its guide, "Treating Tobacco Use and Dependence: Quick Reference Guide for Clinicians," doctors, smoking cessation specialists, health care administrators and others are given guidelines to help smokers at varying stages of dependence:

For smokers who want to quit, doctors are advised to use the "5 A's" to help them reach their goal — "Ask" about smoking habits, "advise" smokers to quit, "assess" their readiness and motivation to quit, "assist" with stop-smoking aids and counseling and "arrange" to follow-up with patients, providing needed support for lasting results.

For smokers who're not ready to kick the habit, smoking cessation specialists are told to assist them with the "5 R's" of motivational intervention.

Smokers are encouraged to make personal connections to why quitting is "relevant" to their lives.

They're asked to identify the "risks" of smoking to their health (the doctor helps with identifying and explaining these risks). After noting the risks, the smoker is asked to highlight the "rewards" of quitting, such as setting a good example for children or performing better in physical activities.

The "roadblocks" to success are also discussed in order to find workable solutions. Lastly, these motivational interventions are advised to be "repeated" every time an unmotivated smoker visits the clinic setting.

Those who've recently stopped smoking are encouraged to take advantage of relapse prevention options as needed, too.

While the prescriptions above are helping smokers quit, there are many smokers without access to health care resources and smoking cessation programs.

And, even though the number of African American smokers is on the decline, Robert G. Robinson, the associate director for program development in the CDC's Office on Smoking and Health, worries about reaching those who slip through conventional means of outreach and can't kick the habit alone.

"As we get more people to quit, the people who'll be left smoking are those who can very well fall into the category of those hardest to quit. And, if the Black demographic parallels the White demographic, they will tend to be persons who are heavier smokers or those more addicted than those who were able to successfully quit," said Robinson.

Smoking: A Deadly Habit
According to the CDC, 20.9 percent of African American women smoke.

We prefer menthol cigarettes three to four, which some researchers believe may contribute to our increased morbidity rate.

Approximately 45,000 African Americans die annually from a preventable smoking-related disease.

And, if current trends continue, 1.6 million Black youths under the age of 18 now will become regular smokers. For that group, about 500,000 will die of smoking-related diseases.

Of course, the reasons Black people start the habit vary (to look cool or to act grown-up), but why we continue to smoke can be attributed to the stress-relief benefits, said Charyn Sutton, president of the Onyx Group, a marketing company that specializes in smoking cessation communication for African Americans.

"As Black women, stress is just all around us. It's so critical for us to find alternatives, substitutes and stand-ins [for smoking] that can do the job without 20 or 30 years down the road taking away years off our life, making what life we have left terribly painful and difficult to live," said Sutton.

Earline Coe, 46, tried the nicotine patch, hypnosis and simply going cold turkey in a bid to end her 30-year smoking habit — all without success.

"When I feel like I'm not in control of something, it makes me want to pick up a cigarette. It eases my tension, giving me a little relief," said Coe. "I know that smoking can kill me, but I guess I'll quit when I get to the point where I've really had enough."

Coe isn't alone in her struggle to stop smoking. While African American girls and young women smoke less than all other racial and ethnic groups (9.5 percent prevalence), this percentage increases dramatically at around age 25 and over, according to the CDC.

Once addicted, the 74.9 percent of Black women smokers who would like to quit don't have access to effective and culturally relevant smoking cessation resources, which are too limited, too costly or nonexistent.

"[This] also tells me that the women who still smoke, are in much worse situations," said Sutton. "They have a lot more to face and have [fewer] resources available to them to get out of the box of smoking."

Sutton suggested that many of these women may also be surrounded by family members who smoke; suffer from depression, illness or anxiety; or use alcohol and/or drugs to medicate themselves.

As a result, it's critical that smoking cessation programs address these types of complicated issues in compassionate and strategic ways, she said.

"We have to keep looking for messages that are going to work in [African American] communities," said Sutton.

Mama's House Rules
One such program is the "Not in Mama's Kitchen" campaign, which was developed by smoking cessation advocate Brenda Bell Caffee and funded by California's African American Tobacco Education Network.

This campaign uses the power of family, church and food to encourage African American women to prohibit smoking in their homes and cars.

The tagline: "Respect the lungs of those you love!" encourages a community-focused approach to dealing with African Americans who smoke. For example, if your mom, dad or grandma smokes, the program understands that it may be hard and disrespectful for you to tell a family member to smoke outside.

"We have to find a middle ground where we're not turning [smokers] out into the street, but at the same time we're not simply sitting on our concerns about what they're doing to their health, our health and the health of [our] children," said Sutton, who recently developed another culturally-relevant smoking cessation program titled "Getting & Staying on the Winning Path."

Both Sutton and Robinson agree that smoking is a community issue that the village must resolve together. And, if you smoke or love someone who does, here's what you can do right now:

Make sure that your loved ones who smoke understand that you accept them, but you don't accept their smoking.

Help your family, friends and co-workers who're struggling to stop smoking by accompanying them to smoking cessation meetings.

Provide smokers you know with information on smoking-cessation programs. (Tell-a-Friend about this story by clicking on the button at the top of this page.)

Don't allow people to smoke in your home, car or in your presence.

Make it your business to stop smoking and to help others who smoke.

And, most importantly, sister, if you're the one who's smoking, know that you're not alone in the struggle to quit. The National Black Women's Health Project and many other organizations are here to help you live a smoke-free life for better health.

Related Links:

Please visit BlackWomensHealth.ORG's Health Links & Hotlines guide in the "Learn" interest area for more resources and organizations that deal with smoking issues.

Check out the CDC's useful resources on smoking cessation. Click here.

Get in the know about second-hand smoke. It may help save the life of someone you love. Click here.

For those living in the UK, your local NHS and your doctor can help you quit smoking. Please see them for advice.

Learn about current clinical trials on smoking. Click here.

Please e-mail comments to comments@thenewblackmagazine.com