Frankie Rentas smoked on and off through his 20s. About a year ago, he quit for what he hopes will be the last time.
“Quitting and staying quit was easy when things were going well in my life, but my triggers for smoking were depression and stress,” he said. “Eventually, something bad or stressful would happen ... and soon I’d be smoking a lot.”
Rentas, 31, is now a smoking cessation counselor on the National Cancer Institute Smoking Quitline, one of two smoking cessation quitlines powered by NCI’s Cancer Information Service at Fred Hutchinson Cancer Research Center.
The quitlines were staffed and ready Thursday, Nov. 21, which marked the 37th annual Great American Smokeout, sponsored by the American Cancer Society. The event encourages the nearly 44 million American smokers to quit for 24 hours in hopes that some will permanently break their habit.
While most smokers are aware of their habit’s health risks, many say they just can’t stop. And those who break their physical addiction to nicotine still face psychological associations that are hard to overcome.
“Research shows that people are most successful at quitting when they get help, and that’s where we come in,” said Nancy Zbaren, who directs the Cancer Information Service (CIS), which provides free cancer information and oversees the quitlines.
Nonjudgmental help and guidance
The quitlines’ smoking cessation specialists work in a friendly, non-judgmental manner to help smokers come up with a quit plan, and a typical counseling session lasts between 12 and 20 minutes.
“We’re trained to meet smokers where they are in their quitting process and help them move to the next step,” said Kara Gluhm Queirolo, a contact center supervisor.
Quitline specialists try to help people come up with ways to modify their behavior.
“We walk them through a craving scenario, such as wanting a cigarette after a meal, and then figure out a strategy to keep from smoking that they can transfer to when they experience cravings at other times,” said Kaila Ann Thomas, another contact center supervisor.
Quitline specialists draw from the Department of Health and Human Services’ Treating Tobacco Use and Dependence Clinical Practice Guidelines, which follow the established science on quitting and include all therapies that are known to be effective, from nicotine patches to prescription drugs.
“We let our clients know the range of scientifically-based treatments available and feel out what matches their lifestyle and habits,” Queirolo said. “It’s not a one-size fits all situation.”
In addition to the NCI quitline, which is open to the general public, CIS operates a quitline for veterans. The veteran quitline, which launched four months ago, is funded through the Veteran’s Administration. It was created to help veterans kick a habit that many of them developed in the military. Cigarettes were issued in daily rations during World Wars I and II, and even into the Vietnam War, and smoking is still pervasive in military life.
Through the VA, veterans have free access to resources including doctors and nicotine replacement therapies. One of the most significant benefits is that cessation specialists can place follow-up calls to veterans, which they aren’t able to do with the NCI line.
“Callbacks are scientifically shown to increase the chances of successful quitting…and people like the extra level of support,” Thomas said.
There are no data about exactly how many quitline clients end up breaking their habit, and cessation specialists say it’s common for people to quit smoking and start again later. Many callers are discouraged about their failed attempts to quit, but counselors encourage them to see the failure as a step toward success.
“We try to reframe it as a learning experience so people don’t have a negative feeling of ‘why bother’ when they try to quit again,” Thomas said. “We can’t make someone quit, but if we give them a non-judgmental, warm experience and they don’t quit successfully, they’ll call next time.”
For Rentas, working for the quitline helps him resist the urge to light up – and his personal struggle informs his work.
“Coming from the perspective of someone who’s been a smoker, I know how hard it can be to quit,” Rentas said. “There’s nothing simple or easy about it.”
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