Smoking studies help curb addictive habit for many

TV host and nighttime icon Johnny Carson said he knew a man who gave up smoking, drinking, sex and rich food. “The man was healthy right up to the time he killed himself,” Carson said.

Most people — like Peter Baranowski — refuse to pay that price. Instead, when making their new year’s resolutions they opt for a safer, more logical approach.

UConn Health Center, which became a smoke-free campus on Nov. 18, is taking smoking, the addiction, seriously. In fact, Dr. William White, who heads up one of UCHC’s smoking cessation programs, expects a plethora of smokers to sign up this month.

“January is resolution time,” White says. “Usually, it’s a busy time for us.” Several ongoing health center smoking studies have reported impressive results.

Baranowski, 49, of Wethersfield, a radiology worker at the Health Center, participated in a program in 2010 conducted by White, professor of medicine at the Center’s Calhoun Cardiology Center.

Baranowski’s blood pressure was elevated, and he was smoking two packs a day.

At times, his blood pressure read 180 over 130. He had tried the medication Chantix (varenicline) at home, but with little success. However, when he heard White’s program featured counseling, he decided to enroll. The year-long program included counseling two times a week from trained therapists at first, then once a week, then once a month. “I think it worked for me because I realized I needed to be held accountable to someone,” Baranowski says. “I didn’t want to let them or myself down. Reporting to someone made a difference to me.”

With the help of a round-the-clock monitor a little larger than an iPod his blood pressure dropped and his craving for cigarettes eased. Today, he is no longer a smoker, and his blood pressure is under control.

“There are a number of goals for this study,” says White, an internationally recognized expert in the treatment of hypertension and related complications.

White’s program looks at how smoking and smoking cessation affects blood pressure and the impact counseling has on helping people stay away from cigarettes.

All participants undergo 24-hour blood pressure monitoring to look for fluctuations before and after they stop smoking. In addition, the study randomly divides participants into two treatment groups.

Both are treated with Chantix, an FDA-approved smoking cessation medication. Several studies have shown that Chantix can more than double the chances of successfully quitting, compared to other types of treatment.

The difference between the groups determines the kind of counseling participants receive in conjunction with the medication. One group participates in traditional, individual counseling; the other receives a “contingency management” counseling approach.

Contingency management is an incentive-based intervention in which participants receive prizes such as vouchers or small gifts for compliance — in this case, for not smoking. It has been used to treat of variety of addictive disorders and in recent years, its success rates have gained national attention, as well as increased credibility in the medical community. “In essence, contingency management is the same technique parents use with children every day by rewarding good behavior,” Dr.Nancy Petry MD explains. “It’s behavior modification and behavior shaping.”

Petry is professor of medicine and an investigator of the study along with Sheila Alessi, assistant professor of medicine. A prominent researcher in the field of addiction treatments, including drug and gambling addictions, Petry is a leader in contingency management research.

“Several studies have indicated that combining medical approaches with counseling can vastly improve a smoker’s chance to quit for good,” says Petry.”

This study answers questions about the role of contingency management counseling in motivating smokers to say away from cigarettes over the short term as well as the long run.”

White’s program will be in its third year in January. Supported by a federal grant, it determines the best strategies not only for quitting smoking, but helping people stay off cigarettes. The few who experience a relapse tend to smoke less than before. “We’re using medication plus behavioral therapy to treat high blood pressure,” says White. “Nicotine increases the heart rate and can raise a person’s blood pressure.”

The first few weeks, White and his staff took readings every 15 minutes during the day, 30 minutes at night of the 50 people enrolled in the program.

White’s program targets smokers who have 10 or more cigarettes a day. The participants are 18 or older. Cigar smokers also are considered for acceptance in the program.

To date, 139 smokers have gone through the program. White says he can take up to 260 participants. Everybody gets a cardiogram and blood test at the start of the program. Participants also receive Chantix free of charge.

White has praise for the addiction therapists who do the counseling.

“They’re great at encouraging participants to stick with the plan,” White says.If you want to join his program, call (860) 372-8418 or (860) 679-4116 and leave your name and telephone number. Someone from White’s staff will get back to you.

Though Baranowski trumpets the program’s success, like many people who quit smoking, weight gain became a problem. Since he stopped smoking he has put on 40 pounds. However, walking regularly has helped him lose 12.

His resolution for 2011: Lose the other 28 pounds. Maybe a boot camp like Average Joe’s is the answer.

Written by Scott Whipple, staff reporter of the New Britain Herald