The Enid News and Eagle, Enid, OK

January 5, 2013

Culture of tobacco: Prevention, education key to curtail cigarette smoking

By Robert Barron, Staff Writer
Enid News and Eagle

— The cigarette goes between your lips. You hold the flame close, cupping your hands against the breeze. As you draw on the cigarette, you feel the smoke going deep into your lungs, relaxing your nerves and calming your body.

That simple act can create an addiction to a deadly drug. Although there are occasional declines, more and more young adults are becoming addicted to tobacco products today, said the Centers for Disease Control and Prevention. CDC said any cessation programs, both nationally and locally, have varying success; even though some numbers are down, others have stagnated, and tobacco usage continues to claim lives every year.

Tobacco use is an epidemic, said the CDC. The epidemic continues because youth and young adults begin to use — and become addicted to — cigarettes and smokeless tobacco products, even though there are numerous warnings.

Trying to be ‘cool’

Larry Boyer of Enid knows about quitting smoking. Boyer tried his first cigarette in grade school and started smoking full time when he was about 15 years old. He started smoking for several reasons: First, his parents did not want him to, plus he thought it was cool.

“I saw older friends smoking, and people smoked in the movies,” Boyer said.

He had several false starts before finally quitting. Boyer said he woke up in the morning and started coughing. It felt like he was “coughing his lungs out.” He would smoke a cigarette, and it went away.

At the time, he was studying to be a drug and alcohol counselor, and was scheduled to go to a seminar in Oklahoma City. While preparing for the seminar, a friend called who was quitting smoking. She was attending a program sponsored by the Seventh-day Adventist Church, and asked him to accompany her. Boyer said he went to support her, but did not think he would quit. He walked into the hospital and put his cigarette out before entering the lecture, and never smoked another cigarette.

Boyer attended the program for five evenings, originally in support of his friend. He partnered with her to provide support, and she stopped answering her phone. He said she still smokes.

“Smoking helped me feel more relaxed, not like a tranquilizer, but it helped me feel relaxed. It was just like taking a breath of fresh air and holding it. Cigarettes had the same effect,” Boyer said.

Boyer kept a partial pack in his pocket for several days, in the event he wanted to start smoking again. Boyer’s wife, Carol, smoked when they were first married, but he encouraged her to quit, and she did. Boyer’s friends encouraged him to quit during the stopping process, he said.

The first night of the class, the instructor showed pictures of lungs with cancer, but Boyer said that did not have much effect.

“Every smoker knows they are jeopardizing their health,” Boyer said.

The class taught techniques to replace smoking with healthy habits, like taking a breath of fresh air when they wanted a cigarette. After a meal, when most smokers want to light up, they suggested taking a walk, jogging or riding a bicycle. Boyer owned a business at the time, and lived in an apartment above it. He had smoked in the apartment and realized how bad the cigarettes smelled. In the middle of a very cold winter, he opened his windows for a couple of days to get the smell out.

Among the techniques he learned was to remember the urge to smoke was temporary. The third day was the most difficult. Boyer said he felt like he was on another planet because of the withdrawals.

“I was out of it. I don’t even remember parts of that day. I’m sure people had to tell me things several times,” he said. “My brain wasn’t working 100 percent.”

The fourth day and afterward was easier. Boyer has not smoked since that time, and after the first week, does not recall feeling any type of desire to smoke.

“ I feel if anyone can make it a week they can quit for a lifetime. They just have to ride out the first few days,” Boyer said. “The bottom line is, the smoker has to want to quit himself — he can’t do it for anyone else.”

Last hugs

 Jeff Rust, of Enid, commented about his 54-year-old mother, Carol, a longtime smoker. After being placed on a list, Mrs. Rust received a lung transplant and now is recovering in an Oklahoma City hospital.

Finally, after finding a perfect match, Rust said his mother’s body is trying to reject the lung, and has been in the hospital since Dec. 16. During the surgery, Mrs. Rust died three times and doctors and nurses saved her, breaking three ribs in their attempts. She was scheduled to be moved to a rehabilitation area, but blood tests showed her body trying to attack the new lung, and physicians are taking steps to counter that.

“It’s all from smoking. Right now, there’s a nurse in there and mom is preaching to her that she should quit smoking,” Rust said. He said the long-term effect of smoking is traumatic and is very hard on family members.

“I wish everyone would get the word. We’ll be in Oklahoma City several months. If anyone has any questions, they can come here and look at her,” he said. Rust urged people to make a good decision and not smoke.

“If you want to see before and after picture of the long-term effect, we have proof ... start a new year off good: Quit smoking,” he said.

In favor of breathing

Diana Karbs, of Okeene, could not breathe and stopped smoking. Karbs started smoking at age 18 and puffed for 34 years at a rate of about a pack a day. She started smoking to be cool, and had friends who smoked. She became ill with asthma Memorial Day weekend and had difficulty breathing. She tried electronic cigarettes, and they did not work. At that point, Karbs said she put the cigarettes down and quit. She has now been off cigarettes for six months.

“I laid them down and walked away in favor of breathing,” she said. “Every time I tried to smoke, I would cough. I have an overwhelming need to breathe,” Karbs said.

She said cigarettes relaxed her and put her in what she called the “habitual zone.” Even now, the times she wants a cigarette most are moments when she would habitually have been smoking in the past — talking on the telephone, getting in a car — times she normally would have had a cigarette.

“I miss inhaling, I don’t know what that is, but that is what I miss the most,” Karbs said.

Tobacco road

Why does Oklahoma continue to be ranked 47th nationally in smoking cessation? With all these programs, shouldn’t there be more results?

“I think it has a lot to do with our culture, education and even tradition,” said Angie Luthye, program coordinator for Garfield County Tobacco Free Coalition. “Tobacco usage differs depending on what part of the country you are in. There are educational opportunities and resources that are available to help with cessation. Our helpline (800-QUITNOW) is a great resource, and is being used by Garfield County residents who wish to quit. We have a long way to go to see our usage rates drop even more, but more and more resources are being provided to Garfield County residents who wish to quit.”

Prevention efforts, said the CDC, must focus on both adolescents and young adults. Among adults who become daily smokers, 88 percent of first use of cigarettes occurs by 18, and 99 percent of first use by 26 years of age.

However, there have been some declines in youth tobacco use in Garfield County. The most recent statistics available cite a behavioral study from 2010. That report showed a 19.3 percent drop in the number of 10th-graders who used tobacco. That is down from the 2006 number of 22 percent, said Maggie Jackson, health educator for Garfield County Health Department. Among 12th-graders, there was a slight increase from 2006. Use in 2008 was very high, then dropped down again in the 2010 study, Jackson said.

“The number of adults who smoke has gone down 3 percent in the last four years, and there is a slight decrease in incidents of lung cancer.”

Garfield County has a lower rate than some other counties in the state, but is not the lowest. Garfield County’s smoking rate was 23.7 percent in 2011, according to a Health Department report.

The Health Department is targeting a number of programs toward tobacco use. One of the biggest tobacco cessation programs to aid in stopping tobacco use is the National Tobacco Settlement Endowment Trust. The trust was established as a result of lawsuits against tobacco companies, and the money won in lawsuits goes toward tobacco education and tobacco-use prevention programs.

“Nicotine is highly addictive,” Luthye said. “One in three people who try tobacco become addicted, and one in three that become addicted die from smoking-related causes.”

She said most people start smoking before they turn 18, and the targeting of youth by the tobacco industry has been very successful.

Garfield County Tobacco Free Coalition advocates for a tobacco-free lifestyle. The organization helps get clean air ordinances passed, and also works with youth through the Students Working Against Tobacco, SWAT program.

“SWAT kids are not against the smoker, but work against the practices of the tobacco industry, and work to expose those,” Luthye said.

They also advocate for clean indoor air ordinances, and are attempting to convince communities to mirror state law regarding indoor tobacco use, she said.

“SWAT programs are going great. As far as communities mirroring state law, we’ve heard from several and they are doing that voluntarily,” Luthye said. “We still have a lot of work to do.”

Jackson said the SWAT group sponsors periodic events to increase awareness, promotes changing social norms and attempts to convince young people using tobacco it’s “not cool.”SWAT is active in the public schools, Jackson said.

Garfield County Tobacco Free Coalition is part of a network, including Garfield County Health Department, that promotes smoking cessation. The coalition periodically will call and counsel individuals through the quitting process, and tell them where they can find programs to help them quit. There also are a number of private smoking cessation classes in the Enid area.

“Support is needed. We encourage physicians to refer their patients to the quit line also,” Jackson said.

Quitting once and for all

Stopping smoking is a lifestyle change, Jackson said. The primary barrier is a physical response. If the smoker feels anxious at any time of the day, they have formed the habit of lighting up a cigarette.

Jackson said as much as nicotine is addictive, the feeling that comes with smoking also is addictive, and often is used as a coping mechanism by smokers, because it is soothing.

“The biggest thing people deal with is replacing that feeling of coping. If at work, they get a 10-minute break and they smoke. They have to find a replacement for that activity, find something healthy that helps them relax,” Jackson said. “A lot of it is the challenge. They can get a patch or gum to help with nicotine addiction, but finding something that can replace the habit is the key — replacing the smoking with other things. It is a difficult road.”

Research now reports “strong causal associations” between active cigarette smoking in young people and addiction to nicotine, reduced lung function, reduced lung growth, asthma and early abdominal and aortic atherosclerosis — a condition in which an artery wall thickens as result of the accumulation of fatty materials such as cholesterol.

The CDC said smoking is the chief preventable cause of premature death in the United States.

There are many reasons to quit smoking and quitting can have immediate effects on individual health, and Tobacco Free Coalition said there are some benefits to quitting smoking:

• Decreased blood pressure within 20 minutes.

• Oxygen level in blood returning to normal within eight hours.

• Decreased chance of heart attack beginning within 24 hours.

• Improved ability to smell and taste within 48 hours.

• Improved circulation and lung function within three months.

• The risk of a smoker developing coronary heart disease is cut in half within one year.

Luthye said people forget that about 25 percent of the public are smokers, meaning 75 percent of them are not. Bars and pool halls are exempted from state laws, but she is aware of businesses that have gone smoke-free and are successful.