Wed, Dec 31, 2008 - Page 9 News List

Lessons for fellow smokers in Obama’s attempts to quit

The US president-elect is not alone in ‘falling off the wagon’ in his efforts to give up smoking, as on average it takes eight to 10 attempts to succeed

By Denise Grady and Lawrence K. Altman  /  NY TIMES NEWS SERVICE

ILLUSTRATION: MOUNTAIN PEOPLE

Will one of US president-elect Barack Obama’s New Year’s resolutions be to quit smoking once and for all?

His good-humored waffling in various interviews about smoking made it plain that Obama, like many who have vowed to quit at this time of year, had not truly done so.

He told Tom Brokaw of NBC several weeks ago, for example, that he “had stopped” but that “there are times where I’ve fallen off the wagon.”

He promised to obey the no-smoking rules in the White House, but whether that meant he would be ducking out the back door for a smoke is not known. His transition team declined to answer any questions about his smoking, past or present, or his efforts to quit.

Anti-smoking activists would love to see him use his bully pulpit to inspire others to join him in trying to kick the habit, but he has not yet taken up their cause.

The last president to smoke more than occasionally was Gerald Ford, who was quite fond of his pipe. Jimmy Carter and both presidents George Bush were reportedly abstainers, but Bill Clinton liked cigars from time to time, though he may have chewed more than he smoked.

Obama’s heaviest smoking was seven or eight cigarettes a day, but three was more typical, according to an interview published in last month’s issue of Men’s Health magazine. In a letter given to reporters before the election, Obama’s doctor described his smoking history as “intermittent,” and said he had quit several times and was using Nicorette gum, a form of nicotine replacement, “with success.” Obama was often seen chewing gum during the campaign.

His pattern matches that of millions of other people who have resolved but stumbled in their efforts to give up cigarettes. Today, 21 percent of Americans smoke, down from 28 percent in 1988. Off-again, on-again smoking and serial quitting are common, as is the long-term use of nicotine gum and patches.

“It takes the average smoker 8 to 10 times before he is able to quit successfully,” said Steven Schroeder, director of the Smoking Cessation Leadership Center at the University of California, San Francisco.

Schroeder said that counseling was helpful, and that if Obama were his patient, he would urge him to try it, even if only by telephone (via 1-800-QUITNOW). With nicotine replacements and counseling, quit rates at one year are 15 percent to 30 percent, Schroeder said, about twice the rates of people who try to stop without help.

But Obama has apparently been chewing nicotine gum for quite a while. Is it safe? Neal Benowitz, another expert on nicotine addiction from the University of California, San Francisco, said that long-term use of the gum or patches, “if it keeps you off cigarettes, is OK.”

He said people had the best chances of quitting if they used more than one type of nicotine replacement at the same time — like wearing a patch every day, but also using the gum when cravings took hold.

Studies have found that 5 percent to 10 percent of people who tried nicotine replacements were still using them a year later, and nicotine itself appears not to be harmful, except possibly during pregnancy and for people at risk for diabetes, Benowitz said. The risks of cancer, other lung disease and heart problems come from other chemicals in cigarette smoke.

“If nicotine is harmful, it is a minuscule risk compared to cigarette smoking,” Benowitz said. “If people want to continue using gum or patches, and not cigarettes, their health will be enhanced.”

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