How quitters can be winners in smoking

How quitters can be winners on smoking

Smokers are two to four times more likely to develop heart disease than nonsmokers.

That said, quitting can start to turn things around almost instantly. "It's really quite striking how rapidly you get benefits," says Russell Luepker, a cardiologist at the University of Minnesota and an expert on smoking cessation.

Within just two or three weeks, a former smoker's circulation improves. After just a year, the extra risk to his heart drops by half.

Smokers get it. Forty percent try to quit every year.
While the odds for success are long - less than 3 percent of quitters "stay quit" for a year, to use the voguish term for kicking the habit - research shows that several approaches can vastly improve the odds.

Cold, hard cash. Philadelphia researcher Kevin Volpp, director of the Center for Health Incentives at the University of Pennsylvania School of Medicine and the Wharton School, has gotten good results paying people to quit.

Last year, Volpp and his team reported a 9.4 percent long-term quit rate in a study of more than 800 General Electric Co. employees who were offered $750 each to stop smoking.
To help participants think long-term, "most of the money was held back," Volpp says.

The researchers awarded $100 to GE workers who complete a smoking-cessation program, a further $250 to those who stayed quit for six months, and $400 more to those who succeeded for at least nine months.

Volpp says he hasn't had any nibbles from local employers or health plans, but says GE has considered offering the program companywide.

Hand-holding and drugs. Smokers who get counseling and use smoking-cessation medication have better odds of quitting than those who try counseling or medicine alone, Luepker says.

An impressive 30 percent of former smokers who do both are able to quit for the long term.
In counseling, learning specific problem-solving skills, such as how to outlast a craving, has been shown to help quitters succeed. Getting help from a telephone "quit line" doubles the odds that they will.

Medicine alone has a long-term success rate of about 23 percent, according to a 2008 report from the surgeon general, which also found that some drugs are better in combination with other medications than alone.

Using nicotine patches along with either nicotine gum, nicotine nasal spray, or a nicotine inhaler is one combo that the report endorses.

Using nicotine patches plus the medicine buproprion SR (Zyban) is another.

On its own, the medicine varenicline (Chantix) has a success rate above 30 percent.
Both Zyban and Chantix carry black-box warnings from the FDA about a potential risk for "serious mental health events." The agency cautions patients and their doctors to watch for signs of suicidal thoughts, depression, hostility or other changes in behavior.

Emerging apps for that. A free iPhone app called My Quitline, developed by a consortium of health groups, connects directly to the National Cancer Institute's quit line, with live help in English and Spanish. (Search under "My Quitline" from an iPhone to find it.)

More ambitiously, researchers in the Game Research Lab at Columbia University Teachers College have begun to develop an app that aims to help smokers quit by giving them a near-smoking experience with their iPhones.

By breathing into the phone's microphone, they'll be able to control a video game called Lit, which can be played in either "rush" or "relax" mode.

Playing mimics the physiological effects that smokers get from cigarettes, including the relaxation response from breathing deeply.

"After you've played it, you don't need a cigarette so badly," claims researcher Jessica Hammer.
Beyond that, she says, "the game keeps your mind occupied" until a craving can pass. The Columbia group has already built some prototypes and hopes to go into large-scale testing by early next year.