Still Smoking? Want to Quit?

It's the fourth week of 2001 and a few New Year's resolutions may already have been broken. Of those who made the decision to quit smoking, many have succumbed to the urge to light up again.

"I tried to stop smoking, but after three days I just can't resist the temptation, especially when people around me light up during lunch breaks," confessed Lee Se-yong, a 33- year-old businessman. Finding it extremely difficult to quit, he began to reduce the daily number of cigarettes he smokes instead of kicking his two-pack-a-day habit altogether.

However, a recent study suggests that Mr. Lee will have to quit completely if he hopes to reap any health benefits. Last month, the Mayo Clinic released research suggesting that merely cutting back, instead of quitting, will not help your health. The study, which looked at 23 heavy smokers who smoked more than 40 cigarettes a day, found that the levels of toxins in their bodies did not decrease when they reduced their smoking by half.

About 12.4 million Koreans smoke and last year an estimated 25,000 deaths － approximately 11 percent of all mortalities － were due to smoking-related illnesses, according to the Korean Association of Smoking and Health.

The health risks posed by cigarette smoking are well documented. Smoking has been linked with heart disease, lung diseases like emphysema and lung cancer and is also said to increase the risk of seven other kinds of cancer.

At the Five-Day Smoking Cessation School run by the Seoul Adventist Hospital, smokers are reminded constantly of the damage caused by cigarettes. "Nicotine can kill," says the lecturer, holding up a mouse that has been injected with nicotine to a class of some 40 middle school and high school students. The attending students are sent to the program after being caught smoking at school. The helpless lab mouse goes into a spasm before dying and the students watch in shocked silence as the weight of the message sinks in.

"When a cigarette is lit, 3,000 to 4,000 chemicals are released into the body of the smoker," said Lim Kwan-hyuk, who oversees the program that has been in operation since 1972. Once people understand that toxic substances enter the body and build up there, most come to the conclusion that they would like to quit.

"Deciding to quit is the easy part," continued Mr Lim. "Sticking to it may be one of the most difficult things you ever attempt to do."

The hospital's program relies solely on the smoker's determination to quit. "We do not encourage the use of aids such as nicotine patches because they just create another dependency," Mr. Lim explained. The goal is to teach the participants about what prompts the urge to smoke and what they should do to counter this.

Alas, if only quitting smoking were that easy. A 17-year-old girl attending the lecture, who wanted to be identified only as Ms. Lee, was not sure if she could do it. "I want to stop, but I've already had three cigarettes this morning," said Ms. Lee, who has been smoking for two years now. "I smoke when I am bored and I don't know if I have the necessary willpower to stop."

For those who have made the big decision to quit, there are more hurdles to clear yet. When smokers go cold-turkey, they complain of insomnia, headaches and inability to concentrate. "These are classic withdrawal symptoms. Nicotine, after all, is an addictive substance," Mr. Lim said. Those symptoms should clear up within two to three days.

For those who feel the need to isolate themselves from their usual environment in their effort to avoid smoking, the hospital has a five-day in-patient program. Smokers can check into the hospital for an intensive course that includes a health assessment, talks on a healthy lifestyle as well as classes on how to stop smoking and avoid relapse. The hospital's survey shows that over 80 per cent of the participants are able to stay smoke-free six months after completion of the program.

If you find that you just do not have the iron will to quit, there are many aids available to help you gradually kick the habit. Placing an acupuncture needle on your ear is one option. The premise of this therapy is that particular areas of the ear correspond to various parts of the body. So, stimulating the reflex points in the ear will alleviate symptoms elsewhere.

"The aim is to mitigate the symptoms of nicotine withdrawal," explained Chang Hyung-suk, who runs a special clinic which helps people to quit smoking at Hospital of Jaseng Oriental Medicine, Sinsa-dong, Seoul. A tiny pin stuck to a tape is placed on the reflex point which controls the urge to smoke. The idea is to press the pin whenever you feel like reaching for a cigarette. The patient's progress is evaluated every month. "It really takes about six months or more of the treatment to see if you have succeeded," said Mr. Chang.

"All smoking experts agree that quitting all at once is the best way to go but acupuncture can help those who just find they don't have the required discipline," he said.

Other options include cigarette substitutes made from herbs used in Oriental medicine. Smoked like cigarettes, they contain herbs that help moderate withdrawal symptoms. Also popular are nicotine patches that are placed on the skin to deliver nicotine in smaller amounts than those present in cigarettes. Smokers can use these to decrease the level of nicotine slowly, making the withdrawal symptoms less severe.

"It is difficult to say which tool is the most effective in helping people to quit. However, people should remember that these are only aids. The most important thing is their will," Mr. Chang pointed out.

For those who have resolved to quit smoking, here are some pointers that may help in their battle to stay smoke-free:

Avoid stressful situations and worry as both of these will increase the temptation to smoke.

Declare to your associates that you have quit and solicit help from friends and colleagues.

Drink water, shower or bathe when you feel like smoking.

Eat lots of fruits and vegetables; avoid greasy, salty and spicy food. Avoid alcohol and caffeine.

Do not overeat, brush your teeth after every meal and go for walks.

Get plenty of rest and regular exercise.

by Kim Hoo-ran