Kicking the habit in a smoke-loving nation

Are you trying to quit smoking? One trick to help you cut down is to hide your cigarettes in the trunk of the car before you start driving. It’s one of the tips given by experts at clinics set up to help people break the habit. These tips paid off for Giorgos Zannakis, 32. A smoker since the age of 17, he decided to stop two years ago with the encouragement of a colleague who used to smoke like a chimney. «I remember telling myself that if he could, I could,» Zannakis told Kathimerini. It wasn’t just his colleague’s success but a dramatic deterioration in his own physical condition that made him finally decide. «I couldn’t walk up one flight of stairs, and I felt I was suffocating when I was in a closed, hot space,» he recalled. He went to the anti-smoking unit at the Evgenideio Clinic. The treatment took two weeks, followed by a month’s observation. «I remember the evening I smoked my last cigarette. I went out afterward with a friend who smoked heavily, to get used to the idea of being with smokers. I’m not one of those who go to the other extreme the minute they stop smoking, asking smokers who come to my place to go out on the balcony if they want to light up.» The biggest change he observed in his life was the improvement in his physical condition. «I don’t cough anymore and when I do fall ill I get better faster.» Those who cannot see any benefits in quitting should think about the money they will save. «With the money I saved, I took a trip to India. I had always wanted to see the Taj Mahal,» Zannakis said. For some it’s easy; for most, however, it’s hard. It’s a whole new chapter in their life when someone decides to give up smoking. And help is at hand for those who want to do it. For some years, public hospitals, municipalities and associations have run clinics to help people quit smoking. So far, however, specialists told Kathimerini, there is not enough staff to follow up on patients after treatment. «Doctors and nurses make a heroic effort to keep the project going,» said Yiannis Tountas, associate professor of social medicine and director of the Institute of Social and Preventive Medicine. «They get no substantive support; they have no computerized files,» he said. «Besides, the clinics are not well known to a large segment of the public who might decide to act if they knew about them.» Typically, three out of four smokers manage to give up cigarettes for a while, but only one in three manages to quit completely. The accepted view is that a combination of drugs and psychological support to prevent backsliding is the most effective method. A negative factor is the refusal of most insurance funds to pay for the drugs that are prescribed and which range in cost from 3 to 350 euros, depending on the treatment, as they are considered to be lifestyle drugs. Smokers will only succeed in the attempt if they make it a conscious decision. «Success does not depend on how much they smoke, but on how consciously they have decided to attend,» explained Christina Gratziou, head of the stop smoking clinic at the Evgenideio. Since 2001, it has dealt with more than 2,500 individuals, 35 percent of whom stopped smoking for more than a year. «The percentage of success varies according to how intensive the treatment is. Initially, it is one visit a week, and the treatment lasts at least two to three months. When it is over, each case is followed up for a year.» Most of the participants are over 40 years of age. The average age is gradually falling, however. «In the past two to three years, people aged 25-35 have started coming in,» said Gratziou. Some 2,900 people have attended the anti-smoking clinic at the G. Papanikolaou University Hospital in Thessaloniki, which has been running since 1999. «By the end of 2006, the annual success rate was 33-34 percent,» said Aphrodite Boutou, who collaborates with the Respiratory Deficiency Unit and the clinic. «Apart from bupropion and nicotine substitutes, which are the most widely used, since April 2007 we’ve started using Varenicline. The first data show that it is even more effective, but we will have more accurate data when it has been available for a year.» The new drug acts on nicotine receptors in the central nervous system and relieves the craving for nicotine and withdrawal symptoms. Bupropion was originally used as a mild anti-depressant, but studies showed that it put people off cigarettes. According to statistics from the anti-smoking clinic at the Papanikolaou Hospital, 62.1 of the participants smoked more than 26 cigarettes a day, with 78.6 of them lighting up within half an hour of waking. The average age they started smoking was 19 years old and they smoked cigarettes containing 0.6 mg of nicotine for about 25 years. The vast majority (77.2 percent) had tried to quit smoking unsuccessfully about four times in the past. Figures from the Greek Pneumonology Association showed some 8,000 smokers had visited these clinics by 2005. Their ages ranged from 16 to 75, though most were 35-55. Fifty percent of these were heavily nicotine dependent, rating between 7 and 10 on the 0-11 Fagerstrom nicotine dependence scale. In the general population of smokers, most are around 5 on the scale, explained Boutou.