Course pushes smokers to stub out habit

Addiction: Classes in Howard County funded by tobacco settlement money use every trick to help people stop smoking.

February 17, 2002|By Larry Carson | Larry Carson,SUN STAFF

Standing outside one day with a friend who was smoking, Howard County Fire Battalion Chief Sean Kelly remembers thinking that since he had stopped two years earlier, it wouldn't hurt to have just one.

"I was dead wrong," Kelly, a pack-a-day man, said -- eight years later at one of the Howard County Health Department's new stop-smoking classes at the Bureau of Utilities on Old Montgomery Road.

Now, he's gearing up to stop again -- Feb. 27 -- at the fifth class of the 12-week, $140,000 course, funded with state tobacco settlement money. County officials are hailing it as the "Cadillac model" for smoking-cessation efforts and the most effective new program of its kind locally.

Howard police Detective Anna Hollern hopes so. A 10-year smoker at 37, the mother of three said her children are after her to quit and she thinks it's time. "I've been thinking about it for a year," she said.

Health officials believe the new course gives her a good chance.

"We had a quit [smoking] rate at the end of the first course of 74 percent" of 77 who started the course, said Dr. Cynthia Lipsitz, director of clinical services for the county Health Department.

Dr. Penny Borenstein, acting county health officer, said the program, which began in September, may be expanded next year to include local companies and other groups. Borenstein and Lipsitz said that drawing participants from one group at a time helps -- by surrounding participants with people they know and from whom they can draw support.

Howard's program appears unique in offering virtually every possible medical, financial and emotional aid to participants, and because the course involves county employees who get free leave time to take it during work hours.

Other area government-sponsored programs typically offer some, but not all of these elements, and have quit rates in the 30 percent to 40 percent range, although Laurie Jones, a Carroll County official, said she believes nearly 80 percent quit during an eight-week, evening program offered there. Most of the courses are in the evening and open to the public, and often offer free tuition or nicotine-patch vouchers for smokers from low- and moderate-income families.

The Howard course is free to county employees. The tobacco settlement money also pays for Zyban, a mild antidepressant, nicotine-replacement patches in three strengths and screenings for carbon monoxide, oral cancer, blood pressure and breathing capacity. Officials plan to monitor results of the program at three-month intervals. The first course ended in late December.

"All of those things are techniques highly recommended over the last five years," said Debra Sutherland, director of advocacy for the Maryland chapter of the American Lung Association. "They are doing all the right things."

Sutherland said that after one year, programs using Zyban and nicotine patches typically achieve 40 percent success rates, compared with 28 percent for programs without the drugs.

Former Howard County health officer Dr. Diane Matuszak, who designed the course, said "nicotine is one of the most addictive substances for human beings. We need to bring to bear whatever tools there are out there to help people." With smoking levels already low in Howard County, "those adults with lower levels of addiction have already quit. Those left are more serious," she said.

For Howard County Executive James N. Robey, the mandate was simple, and based on his feelings about his mother's death in early middle age from a smoking-related illness.

"I told Dr. Matuszak: `Put together for me a program that will work,'" he said. "Fifty-two is just too young to die."

Smoking has been declining nationally for years, according to several studies. Cigarette consumption peaked at 640 billion in 1981, declining to 420 billion by 2000. Smokers declined as a proportion of the population from 43 percent in 1965 to 23 percent in 1998. Despite the decline, estimates from the American Lung Association are that 430,000 lives a year are lost to tobacco-related diseases in the United States, at an annual cost of $97.2 billion.

According to a state health department smoking study completed a year ago, 13.5 percent of Howard youths under age 18 smoke cigarettes, and 10.7 percent of adults do. Both figures are below the state averages of 16.3 percent for youths and 17.5 percent for adults.

But that doesn't make quitting any easier for those who are trying.

Kelly started smoking at age 12, and has tried quitting several times.

JoAnn Charlton, 45, began at age 15 and has also tried to quit. In recent years, she has cared for her dying father. "I want to be around to take care of my mother," she said. She quit in the first group to take the course and feels much more energetic now. Kelly said his food tastes much better when he is not smoking. "The beer tasted better and it went down easier too," he said during Wednesday's class.

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