"Quitting smoking is easy -- I've done it hundreds of times," said a rueful Mark Twain. Like many would-be ex-smokers, he had trouble "staying quit," but MIT Medical is helping smokers stop for good with a program that's free for anyone in the MIT community.
Since early 2008, Lauren Mayhew has worked with about 30 employees, students and others at MIT on kicking the habit. Mayhew, a tobacco treatment program manager who works in MIT Medical's Center for Health Promotion and Wellness, uses classes and one-on-one counseling sessions to help smokers develop a plan for quitting and then to manage stress and cravings after they put down their cigarettes.
"I would not have made it if it wasn't for Lauren," says Stacy Pyron, financial officer and executive assistant for the Lemelson-MIT Program, who smoked her last cigarette on Sept. 30, 2008. At MIT Medical's Nov. 20 Kick Butt competition --Â where elaborate student-built machines tried to stub out a lit cigarette -- she wore a "Day 51" T-shirt she made for herself. "I celebrate every chance I get," she says.
Mayhew helps smokers pick a "quit date" within a few weeks of their first meeting, and then meets with them regularly to develop methods for coping with cravings and strategies for dealing with potentially "triggering" situations. A typical treatment plan involves some combination of a medication (an over-the-counter nicotine patch or gum, or a prescription drug such as Zyban or Chantix) plus stress reduction techniques and other cognitive and behavioral approaches.
"Some people just want some information but they're not really ready to quit; they're still contemplating the decision," says Mayhew, who received tobacco treatment training at the University of Massachusetts Medical School's Division of Preventive and Behavioral Medicine. "I work with them to help them understand and resolve their ambivalence, and to hopefully get to the point where they're ready to make a quit attempt. Everyone is ambivalent to some degree; no one runs in here and says, 'Yay, I really want to quit and I'm completely ready!'" Adds Pyron, "It's a common misconception that you have to really want to quit to succeed. There's a difference between wanting to quit and being ready to."
A medical issue, not a moral one
Though Mayhew has plenty of data on the unhealthy effects of smoking, that's not why people consult her. "Anyone who smokes knows it's bad for them," she says. "They don't necessarily need any more information about that; they need someone who understands the addiction and shows them that there are effective approaches to quitting. It's good if they hear from their doctor that they should quit smoking, but they still need help and guidance on how to go about it."
As one form of encouragement, Mayhew reminds clients that smoking is powerfully addictive both physically and psychologically. "Cigarettes are a highly engineered nicotine delivery system designed to get people addicted," she says, noting that nicotine gets to a smoker's brain just seven seconds after inhaling. "It's also a major coping tool for anger, anxiety and depression. And the habit is reinforced by associations like always having a cigarette after dinner or with a glass of wine."
"That five o'clock cigarette was a hard one to quit because I looked forward to it so much," says Pyron. "I'd go hide behind the Marriott to smoke it."
Mayhew explains to clients that unsuccessful attempts to quit are not a moral issue and that tobacco addiction is a chronic medical condition. "A lot of smokers feel ashamed. There can be a real sense of failure if they've tried to quit before," she says. Studies show it takes five to eight attempts on average for most smokers to quit for good, Mayhew adds.
"It's a drug, and no one expects anyone to quit any other drug on the first try all by themselves," says Stacie Slotnick, writer and editor at the Media Lab and another ex-smoker. She smoked a pack a day of Camel filters but used a nicotine patch (which delivers nicotine more slowly and in lower quantities) along with frequent visits to Mayhew after quitting in January 2008. "It was an enormous help to have someone I could call or e-mail," Slotnick says. "Lauren is very supportive and nonjudgmental. She just really gets it. I can't stress enough how I wouldn't have been successful without her."
One of Mayhew's techniques is having clients focus on their breathing as a way to combat cravings. "I discovered that one thing I liked about smoking was just taking the deep breaths," says Pyron, who started running short distances after quitting and now runs four and a half miles every morning. "I love just being able to do it without feeling like my lungs are going to explode," she adds with a laugh. Also helpful, Slotnick and Pyron say, was Quitnet.com, an online forum that sends members daily e-mails with figures on how much money they've saved and how many days they've added to their lives by quitting.
Along with helping current smokers, Mayhew hopes to do more work on smoking prevention. MIT, like any other university, has its share of "occasional smokers," but even one to four cigarettes a week is bad for your health, "and every time you have nicotine, you're setting yourself up for addiction," she says.
For more information on MIT Medical's free tobacco treatment program, go to http://medweb.mit.edu/wellness/topics/smoking.html, call 617-258-6965 or e-mail helpmequit@med.mit.edu.
A version of this article appeared in MIT Tech Talk on May 13, 2009 (download PDF).
