Clinic helps snuff out addiction

Jul 6, 2010 — Milwaukee Journal Sentinel

Tia Ghose

Jul. 6, 2010 (McClatchy-Tribune Regional News delivered by Newstex) -- Tom Grohmann never thought twice about puffing away at a cigarette while watering his lawn.

But about a year ago, something started to change. He'd scramble to hide his cigarette when a child walked by.

"It really became an embarrassment that I was chained to something so stupid," he said.

So when a doctor at the Sixteenth Street Community Health Center suggested his wife, Cathy, kick her 35-year habit, he was on board, too.

On the heels of the statewide smoking ban, the south side clinic's pilot smoking cessation program is having some success helping people leave their Marlboros behind.

Grohmann is one of 232 patients referred to the program by clinic doctors since October. Of the 53 who were interested enough to come back for a planning visit, 49 have successfully quit, said Holly Manus, the director of the asthma and diabetes program at the clinic. On average, smokers try to quit seven to 10 times before they are successful, she said.

Asthma trigger

The smoking cessation program grew out of the clinic's work managing asthma, Manus said. In the neighborhoods the clinic serves, asthma is common. And more than 4 out of every 10 adults in Milwaukee's low-income neighborhoods smoke, according to a University of Wisconsin-Madison Center for Tobacco Research and Intervention phone survey.

Cigarette smoke triggers asthma attacks, so the clinic realized that helping parents quit would make children healthier as well, Manus said. And they wouldn't have to build a smoking cessation program from scratch.

"We knew we could build on a system that was already in place to treat chronic health conditions like asthma," she said.

At regular check-ups, doctors check in with smokers and ask if they've thought about quitting. They refer receptive clients to the smoking cessation program.

The program combines materials from the Legacy Foundation, a national organization that helps smokers quit, with an approach tailor-made for each patient. Flavien LeClere, the clinic's smoking cessation counselor, sits down with each patient and maps out a strategy that works for them, has patients call when they have urges and checks in with them every few months to see how they're doing after they quit.

The in-person approach tends to work well for their predominantly Latino community, because many Spanish-speakers shy away from using the English-language toll-free quit line, Manus said.

For the Grohmanns, LeClere arranged prescriptions for nicotine patches, gum and lozenges to ease the physical symptoms of withdrawal.

"But medication is not as important as the plan," LeClere said.

A key to the plan is helping people identify their triggers -- the things they do while smoking that underpin the psychological addiction, he said. Quitting wasn't just about kicking the itch for nicotine, but about phasing the habit out of his daily routine, Tom Grohmann said.

He realized he always lit up with his morning coffee and while driving his truck to work.

So for three weeks before a "quit date" the Grohmanns set, Tom Grohmann practiced by delaying that cigarette by tiny amounts. A minute. Five minutes. Ten minutes. After his drive. By the time he reached his June 11 quit date, he'd broken the link between his normal routine and the urge to smoke.

Firsthand knowledge

It also helped that LeClere has firsthand knowledge of the cravings, Grohmann said. The counselor smoked for 13 years, sometimes up to two packs a day.

To quit, "I went to the extreme," LeClere said, shunning bars and clubs, then moving to Africa for a year.

The Grohmanns didn't have to move to another continent to quit. Knowing that they could always call LeClere when they were struggling with cravings got them through the toughest parts.

"Flavien's a great comfort. We knew he was there if we needed him," Cathy Grohmann said.

So far, Tom Grohmann's doing well as an ex-smoker. "I really just totally lost the desire," he said.

Cathy Grohmann still misses her smoke breaks occasionally, but knows quitting was the right decision.

"It was almost like your best friend, it was always there for you," she said. "But when a friendship isn't good for you, you have to break away from it."

Quit Line

Wisconsin Tobacco Quit Line: (800) QUIT-NOW (800-784-8669)

On the Web: www.ctri.wisc.edu/quitline2.html

Newstex ID: KRTB-0130-46735751