Selected Podcast

Can You Really Quit Smoking? Yes You Can!

Smoking harms every organ in the body. Cigarette smoking causes more than 480,000 deaths each year in the United States.

This is about one in five deaths. Quitting smoking is the single most important step a smoker can take to improve the length and quality of his or her life.Smoking is the most preventable cause of premature death in the United States.

Smokers have a higher risk of developing a variety of cancers and many lung diseases, such as chronic obstructive pulmonary disease (COPD), and heart disorders that can lead to coronary heart disease and stroke.

Stopping smoking can be tough but smokers don’t have to quit alone.

Katherine DiDonato, Ph.D is here to discuss smoking and how quitting can help save your life.

Can You Really Quit Smoking? Yes You Can!
Featured Speaker:
Katherine DiDonato, Ph.D
Katherine DiDonato, PhD, ACT, is a clinical psychologist with expertise in cognitive behavioral therapy for anxiety disorders, including panic disorder, obsessive-compulsive disorder, and phobias. Dr. DiDonato also treats patients who have depression, relationship problems, stress, and anger management issues.
Before joining Summit Medical Group, Dr. DiDonato was Forensic Program Supervisor for the Bergen County Division of Family Guidance in Hackensack, New Jersey. She also has been a senior clinical psychologist for the Bergen County Division of Family Guidance. Her professional experience includes positions with New York Harbor Healthcare Veterans Affairs in Brooklyn, New York, the Center for Psychological Services in Hackensack, and the North Shore Hospital Anxiety Treatment Program in North Shore, Long Island.
Transcription:
Can You Really Quit Smoking? Yes You Can!

Melanie Cole (Host):  Smoking harms every organ in your body. Cigarette smoking causes more than 480,000 deaths each year in the United States. This is about one in five deaths. Quitting smoking is the single important step a smoker can take to improve the length and quality of his or her life. It’s also one of the most difficult. My guest today is Dr. Katherine DiDonato. She’s a clinical psychologist with expertise in cognitive behavioral therapy for anxiety disorders and more at Summit Medical Group. Welcome to the show, Dr. DiDonato. Smoking is a really, really hard thing to quit. How do you first decide to quit smoking, and what is the first step that you take? 

Dr. Katherine DiDonato (Guest):  Yeah, thank you for having me. It’s an excellent question. I think that the decision to quit is so personal. With all of the different people that I’ve worked with, they each had two very obvious reasons, health impact and then financial, very expensive habit to keep up. I think the first step when people have finally decided to quit is to get more information about what might make it easier, what might make them more successful in quitting. 

Melanie:  How do you come up with those kinds of things? Do we think to ourselves, well, besides the expense, loved ones, the smell, what do you do? Do you make a list? 

Dr. DiDonato:  Yeah. I run a smoking cessation group on the main campus at Summit Medical Group, and one of the first things we do when I meet everyone is I say", “What are the reasons why you’re here? Why do you want to quit?” Very often, it is I want to be more active for my kids or my grandkids. My spouse is complaining about the smell. My doctor tells me it’s time. I know this is time because I can’t breathe anymore. We come up with a nice, long list. It’s helpful when we actually go through the process and I have them quit. When they decide to quit, quit week on the group is the fourth week, so when they start to quit, that’s fourth week. Oftentimes it’s helpful to revisit the reasons why they want to quit in the first place to keep motivating them. I now even have people download apps where you can download pictures of the motivators that you have. For example, maybe a picture of your kid or your grandkids. Or if you want to do something more graphic, you could do a picture of an unhealthy lung, something like that. It helps to remind people in those moments when they’re feeling frustrated with the process of quitting.

Melanie:  They’ve decided they’re going to. They’ve got those motivators. How do you prepare for the actual quitting? Do you pick one single day to quit? Or do you try some of those Chantix or patches or things to help you along, those tools that can help you? 

Dr. DiDonato:  Right. The research is pretty good. It seems to indicate that when people try to quit all by themselves, the percentage of quitting and staying quit is something really sad, like 7 percent. Very low. The percentage tripled when they are able to quit with some kind of support, whether it’s a group or using something like a patch or Chantix or a quit buddy. Even having someone with you is a great tool to use. I don’t advocate any particular tool or medication, but what I do instead is I ask people to consider what they’ve tried in the past to quit, what helped them and what didn’t. From that, we start to lay a blueprint for their quit plan and figure out what are going to be the things that will set them up for success. If a person comes into my group having already tried Chantix and it was really unsuccessful for them for whatever reasons, then I would say, okay, maybe if you want to try a different smoking cessation aid, try something else. Sometimes people come in and then they have already made up their mind that they definitely want to use a particular aid, like Chantix or one of the patches or something like that. We work with the pharmacy on campus to provide discounts for people if they do decide that they want to use one of those recovery aids. They certainly could. But I’ve had plenty of people go through my group successfully not using anything. I do think it helps to reduce before you quit. To me, it’s gentler on the body. I think it helps people to practice smoking less and to start to break some of the habits that they have established with cigarettes, with nicotine. Again, I’ve had people go through the group and successfully quit going cold turkey, picking one day to quit and that’s it. When they quit, they never go back. 

Melanie:  Whether they reduce or pick one day and go cold turkey, what about after they have stopped? What advice do you have for handling that quitting and staying quit? There’s the behavior, there’s the nicotine addition, there’s a lot of factors that go into this. What do you recommend they do with their hands, with that feeling? How do they get past it? 

Dr. DiDonato:  Yeah, excellent question. All very good points because nicotine hits on several different issues, the behavioral habits, the physical addiction to nicotine, and then just the triggers that people have that encourage them and make it easier for them to smoke. One of the things I talk to people about is the maintenance phase of staying quit. I really break it down into two different categories. The first three days, the nicotine is coming out of your body. For those days, I have a lot of different behavioral strategies. You want to substitute something else for the cigarette, like lollipops or swizzle sticks or toothpicks, whatever works for you. You want to avoid all of the triggers. If you’re a coffee drinker, maybe you’d switch to tea those first few days. Or maybe you don’t go into the QuickChek to get your coffee in the morning because it would be too easy to then buy a pack. Maybe you get your coffee someplace else. Or get it at the office once you get in. You start to switch off a lot of the habits in the first couple of days to just try to avoid the triggers, put as many barriers between you and the nicotine as you can. Your body is cleared of all the nicotine. Once you’ve kind of waded through that period, then life slowly returns back to normal. And I find that at that point, it’s a lot of cognitive strategies. It’s a lot of strategies at what are you thinking. What kind of thoughts are you having about the urges that you have to go back and smoke again? Are you having any thoughts that make it easier for you to decide to pick up again any excuses or rationalizations that might make it easier for you to bum a cigarette off a friend or stop in to Wawa for some other reason and then you might as well grab a pack while you’re there, something like that? So we talk a lot more about the thought process after they quit and they’re trying to maintain being quit. 

Melanie:  Do you find that people need to continue that support for a good long time? Is there some hope you can give reformed smokers that after a certain amount of time, it’s going to get a little bit easier?

Dr. DiDonato:  Yeah, I think it’s very realistic to let people know that there’s really two things they need to look out for. One is that it definitely gets better the farther away from nicotine you get. Your body gets healthier. You enjoy being more active. The cravings go way down, and less and less and less urges. That’s very true, and I think that if you have people around you that are encouraging and they can be your buddy, I’ve had people who’ve had success when they put their quit status on Facebook and then they got so many accolades and praise and it really helped them and encouraged them to keep going. Those kinds of strategies are great, getting extra support from loved ones and friends. But realistically, we’ve all heard those stories about people who quit for long stretches and then went back. That’s really got very little to do with the physical addiction to nicotine and has a lot more to do with the thought process, which is why I try to teach people strategies for catching those very subtle thoughts. Like, “Well, I’ll just have one. I’m not really gonna go back to smoking entirely. And I haven’t smoked for so long, so I kinda deserve to have one,” or whatever the thought might be to try to catch yourself in those moments. I find that stressful moments seem to make people even more vulnerable to returning to quitting. Those thoughts, I think, become more subtle and simultaneously become more intense in crisis moments. The “I just need a cigarette,” becomes like an imperative in those moments. It’s really helpful to catch yourself in it and already have a plan of action. “No, no, no, no, I know that thought. I’m not falling for it. Let me call my quit buddy. Let me go do this other thing that helps me to de-stress instead,” like go for a walk or have a cup of coffee or a glass of water or talk to somebody to get my mind off of the urge, whatever strategy it is that we’ve sort of developed in the group towards the end of the group. 

Melanie:  In just the last few minutes, if you would, Dr. DiDonato, and it’s great information with really good usable tips, give us your best advice for smoking cessation and why they should come to your group at Summit Medical Group. 

Dr. DiDonato:  I think the feedback that I’ve gotten from people who’ve gone through the group successfully is that they came with an intention to quit, and what the group provided them was not only the support but also a couple of strategies that they hadn’t quite thought of before, that we take a broader perspective. I think the group seems helpful in sort of taking a step back and really looking at what made you successful in the past, what kind of barriers are there, let’s see if we can come up with some strategies to avoid those barriers in the future. I’ve gotten a lot of feedback from people that the group provides really nice support, that it’s hard for them to find a group of people who are all struggling and trying to quit and that the collegiality of it is very helpful. People have even said that their urge to smoke goes down when they’re in the group and then for the rest of the time after they leave, which is great feedback for me. I think my best advice would be get some kind of support, whether it’s a group at Summit Medical Group or, like I say, a loved one or a friend. The New Jersey Quitline is available for people who live in New Jersey. Anything that you think is going to help to give you that extra support and boost. Because quitting is really hard, but it can be done. It absolutely can be done. And with support, your chances of success are even better. 

Melanie:  Thank you so much, Dr. DiDonato. You’re listening to SMG Radio. For more information on smoking cessation, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.