Help with Quitting Smoking After 47 Years

July 11, 2008 1:07 PM

My Mom is trying to quit smoking after 47 years... Ideas about how I can help appreciated.

Backstory: My mom's older sister died of lung cancer a few months ago. Until then, she had never really made a serious effort to quit. But now I think the writing is really on the wall. My grandmother quit at 65 and lived to be 93 and my grandfather died from lung cancer at 70. My mother's turning 66 this week, so we're hoping maybe she can follow my grandmother's path rather than my aunt's and my grandfather's.

Her progress is being monitored very closely by her physician and a psychiatrist, so I think she's covered on the medical front. They've prescribed the patch for but I don't think she wants to use it until she cuts down her smoking more - she's currently at about 10 cigarretes a day which for her is a significant reduction. I've not been fighting her on that since I think she probably knows what's best for her.

She's been making significant progress (she tried cold turkey yesterday and made it to about 8 p.m.) but she's having problems with depression caused by nicotine withdrawal. I've sent her brownies, books, and I plan to send her flowers. Anything else my brother or I can do to help? I live 3,000 miles away but my brother lives close by. She's receives social security disability and it's kind of difficult for her to get out of the house so inexpensive suggestions that don't involve a lot of traveling would be good. I will make sure my brother takes her out for her birthday, but he's busy with a family crisis with his wife's family, so I don't know that he'll have a lot time to help her.

posted by bananafish to Health & Fitness (29 answers total)

The whole point of the patch is to taper off the nicotine withdrawal. She needs to get off the smokes and onto the patch- otherwise, this is just playacting and rationalization.

(smoked marlboro reds for 10 years, clean for 10).
posted by jenkinsEar at 1:13 PM on July 11, 2008

My father, 76, is having a great experience with Chantix. My wife, a physician, says that her patients who can get it think it's an amazing product. If it's possible to get her off the patch and onto that, I'd pursue it.

(There was evidence of an increased suicide risk with Chantix.)
posted by These Premises Are Alarmed at 1:13 PM on July 11, 2008

I would recommend the book "The Easy Way To Stop Smoking" by Allen Carr.

I never thought a book could help me quit, but this one is simply amazing. He takes a very unique approach to quitting, and I must say (having tried just about every method) that Allen has indeed found the "easy way".
posted by ISeemToBeAVerb at 1:15 PM on July 11, 2008 [1 favorite]

Frequent deep breaths. Every time she feels the need for a cigarette, she can take a deep breath. Cheap, simple and worked for me (along with the patch!)
posted by kuujjuarapik at 1:21 PM on July 11, 2008

She might ask her physician about the viability of using the patch in combination with a prescription for Welllbutrin. At 75mg it's used as an antidepressant. At 150mg it's used for smoking cessation. That's the method I used and it worked wonders.

Also, set a quit date and STICK TO IT. It's recommended (or at least it was for me) to take the Wellbutrin for two weeks while continuing to smoke (also about 10 cigarettes a day.) Then when you hit your quit date, continue with the Wellbutrin but stop the cigarettes and started the patch.

I followed the patch instructions TO THE LETTER, and made sure to see the program the whole way through, even though I was sure I didn't need them anymore. It's now been 6+ years for me without a cigarette (after smoking for 10) and I don't miss them at all.

Good Luck!
posted by Rewind at 1:28 PM on July 11, 2008

I'll second the Chantix recommendation.

I smoked for thirty years and tried the patch. All I did was poison myself by smoking with a patch on. I doubled the patches and only got sicker. The patch is great for nicotine replacement but unless tapered off, medically, does little for the addiction. It's a replacement and akin to a drunk swapping beer for vodka. It may minimize the short-term effects of the addiction but that's about it. I wasn't killing my lungs with tar but was still fiending for nicotine.

Chantix stopped the cravings. I simply didn't want to smoke and in retrospect, the psychological component was far more significant than the physical.

Keep in mind that it doesn't work at all for some, it's about 50-50; but for half the people who try, those are pretty good odds.
posted by cedar at 1:32 PM on July 11, 2008

What about snus? I've successfully stopped smoking using it, its a harm reduction strategy rather then a complete cessation of tobacco, and it's been shown in a few large scale studies to not increase any rates of cancer, except for a small increase in pancreatic cancer. It's a product that's been around for 300 years in Sweden. Here's a mefi link about it. I use it because I'd much rather use some natural pasteurized (not fermented like chewing tobacco) tobacco then some sort of pharmaceutical.
posted by Mach5 at 1:33 PM on July 11, 2008

snus totally worked for a friend of mine, next step get off the snus. A word of caution, it can be hard to find some places, so if you really need it be careful not to run out.
posted by StickyCarpet at 1:45 PM on July 11, 2008

My Dad dropped a 40 year habit with Chantix. Said it worked great for him, but the dreams were a little disturbing. Overall the physical addiction goes away pretty quick, it's the mental things and the routines you really have to work at.
posted by sanka at 1:45 PM on July 11, 2008

I'm close to three people who quit using nicotine patches, and they all swear by them. It's a bad idea to dismiss the patch out of hand; whether it's useful/advisable or not completely depends on who's using it, and how.

Two of these people also loved having a quit-smoking meter on the desktop of their computer, to keep a running count of days since they last smoked. They said that sometimes the only thing that kept them from smoking was the thought of having to reset that meter. If your mother uses a computer regularly, she might want to try such a program. Here's a page that offers several, and a google search will yield more.

If she tries Zyban/Wellbutrin, she should know that the side effects are often a lot worse suring the first eight days-- and she can ramp up slower than the package insert says. Still, that drug can be very difficult for those who react badly to it.
posted by wryly at 2:00 PM on July 11, 2008

Don't rule out doing it without medication/patches/gum. I quit at the age of 55, 1-2 packs a day, I just decided to quit, made sure I told everyone I knew, threw out the cigarettes and never had another one. The physical response was minimal, the hardest part was breaking the habits (lighting up after a meal, lighting when I get in the car, hanging out with other smokers, etc). Changing those key habits might also help.

After a week I had pretty much stopped thinking about it.

The best you can do is encourage her, ask her how she's doing, reward her in small ways....
posted by HuronBob at 2:09 PM on July 11, 2008

Almost five years ago, in my second serious attempt after 20 years, I tried to quit smoking using nicotine gum. A few days in and suddenly I couldn't stop crying. My mom convinced me to go see my doctor and that's when I was prescribed wellbutrin and told to use the patch as well and then chew the gum if I felt the need for it.

And it worked. The wellbutrin helped me keep on even keel emotionally and the patch/gum kept the physical cravings to a manageable level. A few months later I was off of everything and I've never looked back.

The main thing I'd like to get across is that the doctor said I could have been taking the wellbutrin before my quit day and that probably would have prevented my massive depression (as well as reducing my desire for cigarettes). Is there a reason why that's not an option for your Mom?

And also, I think it's really important to know that not succeeding once (or twice or...) doesn't mean she can't succeed ever. All of these suggestions are great and I'd bet one (or a combo of many) will work for her, just like it did for me.
posted by not.so.hip at 2:32 PM on July 11, 2008

I'll second ISeemToBeAVerb's suggestion of "The Easy Way To Stop Smoking", though it should be noted that Carr is against both cutting down and using the patch (or gum, or whatever).

He advises against cutting down because you are just making the cigarette precious in your mind, you are not getting over the addiction, you are just stretching out the times that you are suffering from nicotine withdrawal, and he doesn't like the gum and patches for the similar reason, that all your doing is prolonging the nicotine addiction after you've quit smoking.

It might work well for your mom, I read it a year ago and quit less than a week later, same thing for one of my co-workers. Another couldn't bring herself to finish the book because she admitted that she really didn't want to quit yet, so YMMV here.

Another coworker quit using Chantix, but I seem to remember hearing that there might be some unrelated health concerns with that, so I'd do some research before committing to it.
posted by quin at 2:35 PM on July 11, 2008

A few days in and suddenly I couldn't stop crying.

Weirdly, I noticed something similar. I was so happy to not be smoking, but I still found myself getting overly emotional about things even months later. A lot of people also seem to experience the dream; where you've been a non smoker for a couple of months and you start having dreams where you've unintentionally picked it back up. It's very aggravating and left me filled with shame.

Fortunately, you wake up and go "What the fuck was that?!" shake it off, and fall back asleep.
posted by quin at 2:40 PM on July 11, 2008

My aunt and her boyfriend quit after almost 40 years of smoking with an acumpucture session - I'm sorry I can't give many details, but I do remember it involved some electrical current (minimal, of course) going through the needles, which were placed on the ears. It took only one for her, and two for him, along with one previous consultation that was mostly chatting about the process, a bit of therapy, I guess. It's now about 2 years since, and they remain smokeless. I'm sure part of the reason it worked so well was because they really believed it would work. They had tried patches and meds before, and that didn't do it for them.
posted by neblina_matinal at 2:45 PM on July 11, 2008

(I meant acupuncture).
posted by neblina_matinal at 2:46 PM on July 11, 2008

It sounds weirdly New Age when you read it, but I found Dr. Andrew Weil's 4-7-8 breathing exercise (exercise #2 on the linked page) incredibly effective at getting past strong cravings in the first couple of weeks, when I "quit" again, a couple of years ago. It's good to have such a technique in mind and well practiced, for when strong spot cravings hit, as you can't always predict them, but you can always do practiced breathing. If you can delay acting on even the strongest cravings for just 3 minutes, by breathing or some other distraction technique, you can get past even the worst of them.
posted by paulsc at 2:54 PM on July 11, 2008 [1 favorite]

Yet more anecdotalness for you, but switching to a "no additives" brand helped me go from needing a cigarette to wanting one. It was a key distinction. From that point, it was easier to choose not to smoke rather than the compulsion I had felt before switching (I was a 20+ year smoker).

Everyone talks about nicotine being the culprit, and no doubt it is addictive, but don't forget all the additives in cigarettes, many of which are suspected to be there specifically to enhance addiction and even brand loyalty.

Best of luck to her, it's hard no matter how you kick it.
posted by quarterframer at 2:56 PM on July 11, 2008

I second the Allen Carr book. Sounds impossible, but, it worked for me and a good friend who was a hardcore smoker. I was pretty burly myself. After reading the book it just seemed easy. No lie. And I had tried quitting many times before over the almost 20 years I smoked. Just typing "20 years" freaked me out.
posted by trbrts at 3:47 PM on July 11, 2008

Response by poster: Thanks everyone for your responses so far. Keep them coming. As to the suggestion of Wellbutrin, it doesn't interact well with current medication. I think her doctor prescribed the patch precisely because it doesn't have a bad interaction with her medication. I think she's been avoiding the patch because she doesn't like the idea of putting additional chemicals in her body (as crazy as that sounds for someone who's been sucking on cancer sticks for 47 years). But it sounds like it might be time for her to start seriously considering the patch. I'll see if I can convince her. I'll buy her a copy of the Easy Way to Stop Smoking as well.
posted by bananafish at 3:59 PM on July 11, 2008

I'll second Allen Carr's book. It's amazing. I smoked for 10+ years and, with only mild thoughts of quitting, read the book, finished my last cigarette, and haven't smoked since. That was a year ago. The first thing Carr says in the book is don't quit until you finish reading. It's bizarre to be smoking while reading a book on how to quit smoking, but very liberating, and Carr makes a really good case for quitting. Highly recommended.
posted by zardoz at 4:16 PM on July 11, 2008

Oh, but one thing about Carr's book--he poo-poos the idea of patches and drugs; he doesn't even like the idea of a substitute like (regular) gum (one rule I broke, in any event, chewing gum helped a lot for me). So I would recommend your mom read the book first, and if it doesn't work for her, maybe she can try something else.
posted by zardoz at 4:23 PM on July 11, 2008

A lot of people like Carr's book, but its longterm success rate is only about equal to cold turkey and other programs - it's no more a magic bullet than anything else. There are many different paths to quitting, and different approaches are needed in the short term and in the long term. In the early days, the difficulty is getting through day by day without relapsing. In the later phases, it's more about setting up rewards, then about thinking ahead to predict potential relapse situations and have a plan to preclude relapse.

What worked for me is a wonderful program from the American Lung Association called "Freedom From Smoking" There is a free, online version, which I used and loved (and haven't smoked in 6 years, after a 15-year habit), and there is also a 7-class seminar version that hospitals often host - check the ALA website for that. FFS was good because it combines the cumulative wisdom of decades of different strategies that help people quit and stay smoke-free - it's more of an arsenal of artillery than a magic bullet.

But if she's not the "program" type, here are the main two things that I think might help right now:

1. Make sure that you and everyone around her lets her know that any weirdness she's feeling - depression, physical symptoms, listlessness, irritability, whatever - is TEMPORARY. All symptoms of the physical and then psychological withdrawal of a long-term habit. The body and mind will adjust and she will feel like herself again. Just have patience - tell her to have patience with herself, and reassure her that she will not be forever changed as a person.

2. Suggest that she write on an index card a list of her main reasons for wanting to quit - they can be 3 reasons, 5, 7, whatever. They should just be meaningful and serious. Once this is written, she can carry it in her wallet. It will be there to read if she ever gets the urge to smoke - she can pull it out and read it and get a little jolt, once again, of the very deep seriousness with which she wants to quit. I did this because of FFS, and though it sounded kinda stupid, it was one of the most useful tools I had. On the back it had the four "Ds" - things to Do before deciding to smoke - which were (if I remember) "Delay - Deep Breathe - Drink Water - Do Something Else, Anything Other THan Smoke." This little card was such a lifesaver that I continued to carry it for about five years. I finally retired it last year because I can't even imagine wanting to smoke ever again.

Good luck. After a few months she'll be feeling and looking shockingly better. SOme people think "at my age, why bother quitting?" but I think people who quit when they're older are often surprised how much better/younger they feel once they're getting so much more oxygen and not gradually poisoning themselves. So the change is more dramatic than if you quit when you're younger, and it helps with quality of life.

CElebrate every anniversary with her, too - week, month, three month, year - it'll make her feel proud and reinforce the desire to get to the next anniversary.
posted by Miko at 8:11 PM on July 11, 2008 [1 favorite]

I can tell you what worked for my mom just after my uncle (her brother) died from lung cancer eight years ago (I'm sorry about the loss of your aunt). Her doctor prescribed Valium and the Nicotrol Inhaler, both as needed. The Valium calmed her nerves, and the inhaler gave her the nicotine plus a physical replacement, since you handle and "smoke" it like a cigarette.

In the beginning, she (not a person who uses medication of any kind on a normal basis) relied heavily on both, and as things grew easier for her, she tapered off (finally using the inhaler with the same cartridge for weeks on end instead of replacing it frequently). In time, she didn't need either. She was a smoker for 40 years, and now her lung x-rays are completely clear, as if she'd never smoked a single cigarette. She's really proud of herself, and I'm proud of her, too. She has said that quitting smoking was the most difficult thing she's ever done. I'm sure it's going to be similar for your mom, so be her biggest cheerleader.

Go Mom!
posted by mewithoutyou at 10:43 PM on July 11, 2008 [1 favorite]

Does your mum use the net? There are quit smoking support groups with people in her situation and age group that she can chat to all day long about how she feels, and they get it, because they feel the same way. One particularly successful one is http://www.quitnet.com/ (i used to be a member until I started my own quit smoking forum for people who like to swear). I found support groups to be enormously influential in my own success in quitting after smoking a pack a day for 20 years. (Unfortunately, I was quitting for half that time).

The people on the forum will offer practical solutions to any one craving, and long term ideas for behavioural changes. They all are ex-smokers or smokers trying to quit, so they understand in a way that some health professionals might not.
posted by b33j at 12:19 AM on July 12, 2008

I am a lifelong smoker, 52 years old, seriously looking for advice on how to quit myself. Thank you all. I have been inspired. My grandmother, who was also a lifelong smoker, quit at the age of 65, cold turkey, no medication or other aids. She is now 93, her mind is as sharp as a tack and for her age, her health is good. I want that to be me. From what I have read, observed and experienced, the key is to just make up your mind and do it! Best of luck to your mother.
posted by wv kay in ga at 12:26 AM on July 12, 2008

My father quit after being a 2 pack a day smoker for over 40 years. He used the patch a bit and the nicotine gum a bit as an aid during the initial difficult period, but eventually relied on regular gum to tide him over. My friend at work quit after many years by making a bet with his kids that he didn't want to lose. He tried tapering off but said just quitting and using the patch for a little while worked the best. He also relied on regular chewing gum to help in the transition.

Also, don't overlook the power of money. Cigarettes are quite expensive these days. I've know several people who helped themselves stay motivated while they were quitting by depositing the money they would have spent on cigarettes each day in a big glass jar, just to watch it accumulate. One person eventually took a nice vacation by continuing to save that money for a year.
posted by gudrun at 10:17 AM on July 12, 2008 [1 favorite]

My mom quit after 40+ plus years, and experienced some serious and unexpected side-effects: intense anxiety, depression, severe allergies and hives, to name a few. Her doctor prepared her for none of these possibilities, so she spent several months seeing various specialists, thinking she was suddenly falling apart for no apparent reason.

After doing some research and talking to informed professionals, she realized that smoking had been somehow been keeping certain problems (e.g., anxiety, allergies) in check.

If you mom is prepared for such possibilities and has a doctor who can help her prepare for them, it will really help.
posted by treepour at 11:25 AM on July 12, 2008

behind the ball on this as usual but i quit after 11 years smoking, cold turkey first try (not trying to toot my own horn or anything, i had a LOT OF REASON to do so). but anyway, i definitely second the "deep breathing" thing, i STILL have to utilize that when i crave. Also, drink lots and lots and lots of water. Sugar free candies or gum also help so not too much weight is put on. Also, perhaps keep a running tally of the money she's saving on cigarettes and dedicate a portion (or all) after certain milestones to treat herself to something healthy she wants (i bought an expensive quilt from anthropologie when i'd saved up 500 dollars on not smoking! brings me joy every night and i NEVER would have bought it but for the savings on cigarettes.)

Congratulations to her for making the choice and good luck!
posted by Soulbee at 6:10 AM on July 16, 2008