Home > Prevention & Risk Assessment > Smoking
We all know smoking is bad for
your health. But even if harmful
effects are well known, it doesn’t
mean it’s easy to quit—even if you
have cancer.
We talked with Linda Thomas, manager of
Tobacco Consultation Services for U-M’s M-Healthy
Program, about kicking the addiction.
Q: How do you respond to people
who think that because they
already have cancer, there’s no
point in quitting?
A: The research shows two things: First,
people who have any type of cancer who quit
smoking have better quality of life. Inflammation
in the lungs decreases, allowing more oxygen
to flow, which helps with fatigue. Second,
if you look at studies examining the effects of
lung cancer treatment, regardless of whether
it’s chemotherapy, surgery or radiation, life expectancy
is longer for those who quit smoking.
Q: How do you know when you’re ready to stop smoking?
A: People who are addicted to a substance
are never going to be 100 percent ready to quit.
We tell people it’s OK to love smoking and to
want to continue to enjoy it, but if there’s 51
percent of you that recognizes it’s not good
for you and you don’t want to smoke, then it’s
time to start quitting.
Q: What do you mean by “start
quitting”?
A: The average smoker makes nine to 11
quit attempts before becoming an ex-smoker. It’s
important to realize you’re not weak if you’ve
tried a couple times and haven’t been successful.
Nicotine is a real addiction; staying off it requires
management similar to any chronic disease. The
only failure in quitting smoking is when a person
quits trying to quit.
Q: What kinds of medications
are available to help?
A: Nicotine replacement in the form of
patches, gums, lozenges or inhalers can help
prevent symptoms of withdrawal without
exposing a person to the 4,000 other chemicals
in cigarettes. Other options are Chantix, which
blocks nicotine receptors in the brain, or the
antidepressant Zyban, which has been shown
to stave off cravings.
Q: Why would someone need an
antidepressant to help quit?
A: The nicotine in cigarettes, sadly, serves
pretty well as an antidepressant. And studies
have shown that 45 percent to 55 percent of
smokers may have an underlying depressivedisorder they’re self-medicating with nicotine.
Smoking becomes a coping mechanism: “I feel
bad, but when I smoke a cigarette, I feel better.”
Q: So it may become a way to cope
with a cancer diagnosis then, too?
A: Guilt is a nasty emotion, and it’s something
that can get in the way of the quitting.
It’s very easy for people to get caught in a cycle
of “I did this to myself, so why should I quit
smoking?” But it’s a matter of learning to deal
with the negative aspects of life the way nonsmokers
or ex-smokers deal with them. Instead
of a cigarette, maybe you seek out a friend to
talk to or learn to meditate.
Q: Smoking is often social. How do
you handle couples where only
one person wants to quit?
A: There needs to be some negotiation between
the person trying to quit and the person
still smoking to make sure both feel like the
other is being respectful. Maybe you create
smoking and non-smoking areas in your home,
or you agree never to offer cigarettes to someone
trying to quit.
Q: Do you have any suggestions for
ways to cope with triggers that
cause someone to crave a cigarette?
A: It’s not uncommon for me to have someone
come into my office and say, “I’m ready to
quit and I’m going to exercise instead.” Well,
if you smoke a pack a day, it’s estimated that
you spend about three hours and 20 minutes
on smoking or smoking-related behavior; very
few people are ready to exercise that much. It’s
important to develop a new menu of behaviors
to replace smoking. Adjusting the daily routine
is important, too. If you’re used to reading th
morning paper with a cigarette, maybe sit in a
different chair or take a shower first instead.
Q: Finally, if people you love smoke,
how do you encourage them to
stop?
A: Motivation has to come from inside.
Lectures and guilt trips don’t work, and if
anything, may cause a smoker to become more
entrenched in the habit. For some, money may
be a motivator: a pack-a-day smoker could
save over $2,000 a year on cigarettes. Get them
to start talking about what they want for the
future; try to help them see that smoking won’t
help them achieve those goals. Most importantly,
tell them how much you love them and
that you’re there to support them when they’re
ready to quit.
Need help quitting? 
