Kicking the habit: N.D. Quitline and Quitnet combat nicotine addictionTwenty-five years ago, Theresa Knox gave up smoking for good. A smoker for 12 years, she quit cold turkey, as she said nicotine replacement medication like patches or lozenges were not common at the time. Now, Knox works as the tobacco prevention coordinator for Grand Forks Public Health Department, helping patients who smoke or chew learn about their addiction.
By: Erik Burgess, Grand Forks Herald
Cold turkey was her only option.
Twenty-five years ago, Theresa Knox gave up smoking for good. A smoker for 12 years, she quit cold turkey, as she said nicotine replacement medication like patches or lozenges were not common at the time.
Now, Knox works as the tobacco prevention coordinator for Grand Forks Public Health Department, helping patients who smoke or chew learn about their addiction. One service that she refers many patients to, she said, is the North Dakota Tobacco Quitline and Quitnet. She calls the counseling services provided by Quitline an important tool in the fight against nicotine addiction.
“You’re not going to go in and try to hammer a nail with your fist. You’re going to use a hammer,” she said. “When the right tool is needed, they can offer that support to you.”
Quitline, a telephone-based counseling service for quitting tobacco, has been operating in North Dakota since 2004. Quitnet, its online counterpart, has been operational since 2010.
In its seven years in the state, 2,616 North Dakota smokers have quit after working with Quitline counselors. Of those who enroll and complete the counseling program, 36 percent stay quit after six months, and 33 percent after one year.
According to Dr. Eric Johnson, an assistant medical director at Altru since 1998 and the physician consultant for Quitline, these numbers are extraordinary.
“(Our numbers) are actually very high,” Johnson said. “Only three percent of smokers quit with no program.”
Johnson said in his experience traveling around the country, amongst similar programs, it’s more typical to find quit rate percentages in the twenties.
Nationally, 22.1 percent of smokers using quit lines stay quit after six months, according to the U.S. Department of Health and Human Services.
But why are the numbers here so high?
Knox said a major issue for many smokers becomes their triggers, or what actions set off a need for a smoke or nicotine fix. For some smokers it could be sitting at a computer or getting into the car that triggers the need for a cigarette, she said. The behavior you associate with smoking becomes just as important as the need for nicotine, she said.
Understanding these social triggers is something Quitline helps you do, she said.
It employs four fulltime and two part-time counselors who are specially trained at Mayo Clinic in Rochester, Minn., that go through a series of phone calls with users to help them understand their body and their addiction.
Michelle Walker, the cessation program director for Quitline and Quitnet, said counselors often spend a lot of time simply getting to know users on a personal level — what makes them as an individual smoke or chew — as a personalized plan is needed to defeat addiction.
"They do a really through background and try to work on an individualized plan for you,” she said. “What works for one person won't work for the next."
Counselors also discuss the physiological effects of nicotine withdrawal with the caller. This two-pronged approach is what makes Quitline services more effective than just trying to quit on your own, Knox said.
“People quit cold turkey every day,” she said. “It’s just a lot harder.”
Johnson also said that the Quitline in North Dakota houses their counselors in the state, something that is fairly unique to the program here. It provides a localized aspect to the service that the callers really enjoy, he said.
“We found out very early on that having counselors in North Dakota on site was very important to people who utilized our service,” he said.
The counselors currently set up shop in the UND School of Medicine and Health Sciences.
But “staying quit,” as they call it, is not only about great counseling, Walker said. “They have to be ready to quit for themselves,” she said. “They can’t be doing it because someone is nagging them.”
How it works
Those who wish to quit begin by calling the Quitline number. Unlike a pay-per-minute hotline, though, Quitline is free for North Dakota residents. During the first call, the tobacco user is scheduled for a callback from one of the counselors. When the counselor calls back, the two work together to set a “quit date.” The tobacco user is allowed up to six calls total.
Walker said usually the third call is the scheduled quit date, with the calls following to be used for any questions or support that may be needed.
Those who sign up for counseling have to be ready and committed to quitting within 30 days, but Walker said the counselors recognize the ongoing process of quitting.
“Everyone thinks it’s just quit and you’re done, when actually it’s something people struggle with for a really long time,” she said.
Quitline also offers two months of free nicotine replacement medication for those who enroll in counseling, but Walker emphasized that the program is effective because of how it tackles the nicotine addiction as a whole, not just because it gives out free nicotine patches.
“When people use both the counseling and the medication together, they more than double their chances of staying quit,” she said.
With her experience trying to quit, Knox echoed the idea that counseling and medication — two things she was without — work hand in hand in helping an addict to stop smoking.
“It took me two years of persevering,” she said. “And I don’t know if it would’ve taken me that long had I had more help.”
Unfortunately, now that summertime has hit, Walker said they receive significantly less calls than the during colder winter months.
“Our theory is that people don’t mind going outside in the summer to smoke,” she said, laughing.
For Knox, though, weather can just be another trigger that smokers need to understand before they conquer.
“Weather might be one of those tipping points,” she said. “But weather itself won’t make you quit.”
- Quitline counselors can be reached at 1-800-QUIT-NOW.
- Quitnet can be found online at www.nd.quitnet.com.
Reach Burgess at (701) 780-1269 or send e-mail to firstname.lastname@example.org.