Cancer Patients Get Help Quitting Tobacco

Like many longtime smokers, Wendell "Joe" Ussery has made several attempts to give up cigarettes on his own. During the 40 years that he has smoked, the longest he was able to quit was nine months.

Then, in early 2006, he was diagnosed with lung cancer. M. D. Anderson oncologists told Ussery that although he could not change the situation, he could help prevent it from getting worse by quitting smoking.

"I was told that if I continued smoking I would increase the chance of the cancer returning after I finished chemotherapy," Ussery says. Smoking also can affect cancer treatment and recovery, research shows.

Ussery decided to quit, but this time, his doctors said he would not have to do it alone. He could get help through a new smoking cessation program for M. D. Anderson patients called the Tobacco Treatment Program.

Many National Cancer Institute (NCI) cancer centers, like M. D. Anderson, offer smoking or tobacco cessation programs for patients as well as for nonpatients. A simple "smoking cessation" search on a center's website or the "prevention and screening" section of a website can direct smokers to those resources.

Program actively recruits tobacco users

What is unique about the new M. D. Anderson program is that instead of patients finding their way to the smoking cessation program, the program is finding its way to eligible patients. A questionnaire filled out during the patient admissions process is identifying eligible participants - current tobacco users or those who have quit within the previous 12 months.

As many as 350 patients a month may be served by the program, which is free to patients, when it becomes available throughout the cancer center, says Tobacco Treatment Program Director Paul Cinciripini, Ph.D., a professor in M. D. Anderson's Department of Behavioral Science.

"As far as I know, M. D. Anderson is the only cancer center in the nation that has instituted such a far-reaching program that will prospectively identify and offer treatment to all eligible patients," Cinciripini says.

The Tobacco Treatment Program was developed with the assistance of faculty and staff from the Psychiatry Section of the Department of Neuro-Oncology, the Department of Epidemiology, the Department of Behavioral Science and the Department of Health Disparities Research.

Identifying behavioral triggers helps counselors, patients

Funded by $1.3 million in State of Texas Tobacco Settlement funds, the program includes counselors, psychologists or psychiatrists who help patients quit through behavioral counseling sessions and pharmacological treatment (e.g., nicotine patches).

Before joining the program, Ussery smoked two packs a day. At the end of March, he was down to four or fewer cigarettes a day and working toward none.

The patch is allowing Ussery to reduce his nicotine intake gradually, and counseling sessions are helping him to identify smoking triggers. A counselor then helps him find ways to deal with those issues - without smoking.

"It's a very nonaggressive, informational type deal," Ussery says. "It's not condescending."
He also completes questionnaires with questions like "how many times this week have you become agitated?" to help identify healthy coping skills.

Most smokers need help quitting

Ussery started smoking when he was a 20-year-old basketball player for Texas Tech University.

"Every time we won, we'd smoke a cigar," he says. "After that I graduated from cigars to cigarettes."

At the time, everyone in Ussery's family smoked, which only reinforced his new habit. It grew more difficult to quit as an adult with a stressful career building power plants all over the world, says Ussery, who is semiretired.

When Ussery attempted to quit in the past, he would throw out his cigarettes, "then someone would hand me a cigarette, and I'd smoke one, and then two "

Although 70% of smokers want to quit smoking and 35% attempt to quit each year, fewer than 5% succeed, according to the American Cancer Society (ACS). The low rate of successful quitting and the high rate of relapse are due to the effects of nicotine addiction.

Research shows that quitting is best accomplished under the guidance of experts, Cinciripini adds.

Having support and keeping busy helps quitters

Ussery's wife and three daughters, who do not smoke, have been very supportive of his involvement in the Tobacco Treatment Program. So have his five grandkids.

Despite occasional relapses, Ussery is smoking less and feeling better. Once his counseling sessions end, he will be able to call or e-mail his counselor to receive guidance about relapse prevention and emotional support.

In the meantime, he will continue using his counselor's suggestions that include keeping busy. "I find some way to occupy my time, hands and energy," Ussery says. "I started painting again (oil paintings of landscapes, boats, seashells). I'm a lot calmer."