Women and smoking: Breaking up is hard to do

Diane Neal gets through the winter now without bouts of bronchitis. She can run up the stairs to her fifth-floor walk-up. She actually can taste her food.

After eight years as a two-pack-a-day smoker, Neal, a model and actress who lives in Jersey City, N.J., finally said goodbye to her cigarettes and now is spokeswoman for the American Legacy Foundation's Circle of Friends, a self-guided Web program to help women quit smoking by surrounding themselves with supporters.

Her efforts come as scientists are learning more about the gender differences in cigarette addiction. Quitting can be more difficult for women than for men. Women, surveys and research show, expect more from cigarettes than men do.

They expect their cigarettes to cheer them up, calm them down and keep them slim. Women are more likely to become addicted to the psychological habits of smoking, not just the physical addiction to nicotine. Researchers say women, more than men, need the ritual of lighting up, the movement of the cigarette from hand to mouth, the savoring of a cigarette in a special chair.

Neal, two years after quitting, occasionally craves a cigarette.

"I loved smoking, but I don't want to do it anymore," said the 28-year-old, who plays assistant district attorney Casey Novak on TV's "Law & Order: Special Victims Unit."

"I watched my Great Aunt Jesse die of lung cancer. It's a disgusting death to watch."

Information

Circle of Friends:
www.join-the-circle.org

American Lung Association's Women and Smoking fact sheet: www.lungusa.org/site

Neal said it feels good to be free from her addiction: "I'm enjoying what it's like not to be burdened down by constantly wanting a cigarette."

Help is out there

Experts say anyone who wants to quit should have a plan and not just get up one day and decide to stop smoking. Some pick a child's first birthday or other milestone.

"It's a myth that 'cold turkey' is the way to go," said Ella Watson-Stryker, a researcher for the American Legacy Foundation, an anti-smoking organization created by the 1999 settlement between American tobacco companies and state attorneys general.

The foundation's Circle of Friends Web site (www.join-the-circle.org) gives tips on gathering support from friends and family. The site sells a sunburst necklace for friends to wear as a show of support.

Experts say anyone trying to quit should consider taking over-the-counter nicotine replacement therapies, such as gum, or seeing a doctor for prescription medications. There is a prescription nasal spray. Antidepressants, such as Zyban and Wellbutrin, can help women who are quitting. Some people may need a combination of medications.

Quitting can be more difficult for women. A Texas A&M study last year found that equal numbers of men and women quit with nicotine replacement, but long term, women were more likely to resume smoking.

One reason is that women fear gaining weight. Women who quit may gain up to 10 pounds because nicotine is a stimulant that affects metabolism. In addition, women who cannot smoke may instead turn to sweets and fats. Plus, their food may suddenly taste better and they enjoy it more.

Lifestyle must be altered

Bess Marcus, an addiction researcher at the Brown University Center for Behavioral and Preventive Medicine, urges women who quit to adopt an overall healthful lifestyle.

"We don't just talk about quitting," Marcus said. "We talk about adding fruits and vegetables to the diet and hard candy instead of chocolate donuts," she said. Exercise is key. Marcus studied 281 healthy but sedentary smokers and found that women who exercised vigorously were twice as likely to quit and gained half as much weight as women who did not exercise. After 12 weeks, nearly 20 percent of the women who exercised were able to quit, while 10 percent of the control group quit. Of those who exercised the most, nearly 47 percent quit.

For Neal, nicotine replacement gum was key. She chose the day after Thanksgiving, two years ago, to quit. Encouragement by friends, especially her husband, Irish model Marcus Fitzgerald, helped her enormously, she said.

She felt better very soon after quitting.

"My sense of smell returned. I remember thinking, 'Wow, I can smell that!' I could taste my food," she recalled. She said she felt happier, noting that nicotine has been linked to depression.

"I became an exercise freak once my lungs started recuperating," she said.

Women often decide to quit because they worry about the people around them, but Neal said her friends never nagged.

Her husband didn't nag, either. "He just told me how much he loved me and how much he wanted me around to see our kids grow up."