cancer patients provide incentive for relatives to quit smoking
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[JAN. 20, 2006]
N.C. -- Addiction is a powerful force: Even the fear of watching a
loved one succumb to lung cancer is not enough to cause most
smokers to quit. Just 15 percent of smokers stop when a relative
is diagnosed with lung cancer, said Lori Bastian, M.D., an internist
at Duke University Medical Center.
Bastian is trying to
change those odds through a new program aimed at smoking relatives
of lung cancer patients at Duke, the University of North Carolina at
Chapel Hill and the Durham VA Medical Center. The Family Ties
smoking cessation program provides stress management and coping
skills to family members of lung cancer patients, with the goal of
helping relatives quit the habit.
Bastian's hypothesis is that people who receive counseling will
be more likely to quit smoking than people who attempt to quit
without such interventions. The physical addiction is but one
component of tobacco use, she says, while the psychological and
social components often go ignored in a smoking cessation attempt.
"A nicotine patch may not be enough," said Bastian. "We have a
group of smokers who are often interested in stopping but don't have
the tools needed to be successful. Family members often tell us they
are motivated to quit, but the stress of caring for their relative
with lung cancer makes it the worst time in their lives to try."
Bastian's team identifies participants by asking lung cancer
patients to provide the names of relatives who are willing to
attempt quitting smoking. Half the relatives receive brochures and a
cassette that provide education on the deleterious effects of
smoking and how to quit, along with a free supply of nicotine
The other half receive these same materials in addition to a
series of telephone counseling sessions in which they are taught
coping skills and stress management tools. The six counseling
sessions teach strategies such as progressive muscle relaxation; the
use of imagery to help smokers mentally gravitate to a relaxing and
safe haven; positive self-talk and rewards that help smokers reframe
their negative thoughts into positive ones; and practice sessions to
incorporate these skills into daily living.
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Thus far, the feedback has been positive, said Bastian.
"People love the progressive relaxation; they say it really
helps," she said. With guided imagery, smokers are encouraged to
focus upon an image, symbol, place or experience that brings about
calming feelings, with the goal of improving their mental, physical
and emotional health. Such techniques are used with considerable
success among seriously ill patients in hospitals nationwide, said
Bastian's team follows up with smokers for a year after the
12-week intervention has ended to determine their success rates.
Saliva samples are taken to ensure the accuracy of self-reports from
smokers who have quit.
"Our hypothesis is that smokers who receive counseling will be
more likely to quit smoking," said Bastian. "We are hoping for a 25
percent to 30 percent success rate, which appears to be low but
would be a significant improvement over the current rate."
[Duke University news release]