Calling It Quits

Tom Gilbert

Tom Gilbert, Associate Editor at TDWSYN, graduated from Yale and was previously Public Information Director for the New York State Office of Mental Health, NYC Region. The author of twelve books on various subjects, Tom has also been a reference editor at Harcourt, Brace, Jovanovich.

It turns out that those who keep trying to quit smoking really are making progress and are far more likely to be successful that those who don't.

This is just one of the findings of a new study on smoking published in the May issue of the medical journal Chest by the Mayo Clinic's Nicotine Dependence Center that focused on what made a person a good candidate for quitting.

So, who are the best candidates for quitting smoking? According to a recent study, the answers are 1) men and 2) those of either sex who take bupropion, a new, non-nicotine drug sold under the brand name Zyban^®.

The study also found that the first two weeks of any person's attempt to quit smoking are critical. If you can make it through this period without lapsing, you are much more likely to stay away from cigarettes for good.

There was some not-so-good news for women smokers. They're less successful at quitting. According to Lowell Dale, M.D., associate director of the Mayo Clinic Nicotine Dependence Center and principal author of the study, "While some studies have not found a gender difference in ability to stop smoking, other studies have noted that women have more trouble quitting than men. This has been attributed to women's greater concerns about weight gain when they stop. Women also have higher rates of depression than men and are more likely to use smoking as a means of managing mood."

As for the finding that total abstinence during the first two weeks after stopping was a good indicator of long-term success, Dr. Dale says, "Patients and physicians must put more effort into those first few weeks of treatment. The key is to aggressively treat patients during the first weeks of their stop attempt. This may need to include counseling, bupropion and nicotine replacement in order to help patients increase their likelihood of quitting for good."

Asked for comments on the report, TheDoctor's pulmonary expert, Dr. Neil Schachter, Dr. Maurice Hexter Professor of Medicine at the Mount Sinai School of Medicine, said, "This is an important study that confirms earlier data. One interesting finding of previous work is that the combination of Zyban^® and nicotine replacement therapy is more effective than either one by itself. The seriousness of the gender issue is underlined by a recent study that shows that, for equal amounts smoked, women may be more susceptible to developing lung cancer than men."

Other characteristics that the Mayo Clinic study found to be associated with greater success in quitting smoking are:

• Average number of cigarettes per day -- Lighter smokers were more likely to stop.
  
• Age -- Older people stopped at higher rates.
  
• Household smoking -- People living in smoke-free households were more successful.
  
• Repeated stop attempts -- People who kept trying to quit eventually succeeded.

Reviewed by: E. Neil Schachter, M.D.

June 20, 2001

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