At age 16, Janet Hale held great admiration for one of her dearest family members.

“She was so cool,” Hale, of Grandville, Michigan, said. “I wanted to be just like her.”

So when that family member started to smoke, “I started smoking, too,” Hale said.

That was more than 50 years ago.

Her family member later died from complications of cancer.

But Hale, now 71, continued to smoke—through her teen years, through her young adult years, and well into her 60s.

“I was the only other person in my family who smoked, but I couldn’t quit,” Hale said. “Everyone hated it.”

Not until Hale experienced relentless coughing fits did she begin to entertain the thought of quitting.

“That was about five years ago,” she said. “I changed from menthol cigarettes to non-menthol and I cut back from a pack a day to three cigarettes a day. But I just couldn’t quit those last three.”

Hale knew she would need help.

Overcoming tough odds

Cigarette smoking remains the leading cause of preventable disease, disability and death in the U.S., according to the Centers for Disease Control and Prevention. It’s estimated to cause about 480,000 deaths every year.

The good news: The number of smokers has declined in the U.S. in recent years. In 2005, about 21 in 100 adults were smokers. In 2020, that dropped to about 13 in 100 adults, according to the CDC.

Hale wanted to be counted among the non-smokers.

To that end, she met with Libby Stern, a licensed social worker and clinical program specialist who oversees the Tobacco and Nicotine Treatment program at Spectrum Health Lifestyle Medicine.

“Jan and I met about five years ago when she joined what was then our Quit 101 program,” Stern said. “She completed the program, participated in one-on-one counseling, and was able to quit. But after about five months, Jan relapsed and started smoking again.

“And that’s typical of people trying to quit. I like to reassure folks that, ‘Relapse is common, but not required.’”

Lifestyle Medicine offers a three-phase smoking cessation program that connects people to a support system that can help them on the path to quitting.

The three phases are Let’s Talk Tobacco, Let’s Quit Tobacco and Let’s Stay Quit.

“All of our tobacco and nicotine treatment programs are virtual. The starting point for all participants is a four-session series, called Let’s Talk Tobacco,” Stern said. “Whether you are looking for more information about the quit process or are considering or planning to quit, this is where it begins. These sessions provide information about nicotine addiction, medications, the quit process, along with behavioral and cognitive processes.”

Once that program is completed, participants can move to the Let’s Quit Tobacco program for group coaching. This series helps them get through the toughest part: quitting.

Let’s Quit is more intensive and includes an individual coaching session followed by five group coaching sessions. The goal in Let’s Quit is to create a comprehensive, personalized quit plan that will work.

Hale had already quit—again—when she joined the Let’s Stay Quit support group at Stern’s invitation. The Let’s Stay Quit support group meets twice a month.

“I was finally successful in January 2021,” Hale said. “It’s been almost two years. Libby thought I could offer some encouragement to others trying to stay quit.”

Hale said she understands relapses all too well.

The more important part, she said, is trying again—and again. That’s the advice she shares in the support group.

“One of the most important things for me was accountability,” Hale said. “I had my family keeping me accountable.”

During tough moments, she learned to reach out to family members for support.

“I knew if I was alone too much, I might light up a cigarette,” Hale said. “So when I had a 45-minute drive to a family gathering, I called my family to ask for someone to come out and give me a ride—to make sure I didn’t smoke along the way. They were happy to do so.”

Hale received encouraging texts from family members every day, applauding her daily success.

That support became important in her resolve.

“Years ago, I was diagnosed with ADD—attention deficit disorder—and an anxiety disorder,” Hale said. “My family would say I am a very laid-back person. But inside, I felt the anxiety. And cigarettes had become an incredibly ingrained way of coping with that kind of stress. They kept me calm.”

With the coping skills she learned in the Lifestyle Medicine smoking cessation program, and through counseling, Hale found ways to manage her anxiety and navigate the challenges of each day.

“That was the second thing that helped me succeed—the various aids,” she said. “What kinds of aids you choose to help you quit, that really depends on the individual. We are all different. There are medications, patches, nicotine gum and apps you can use on your phone.”

Delay and distract

Hale said she found that medications to curve nicotine cravings worked best for her.

Another approach she learned: delay and distract.

“Wait five minutes, distract yourself with something else and the craving will pass,” she said. “Change your routines from when you used to smoke.”

Stern and the team at Lifestyle Medicine are adding another tool to their toolbox: a smartphone app called Clickotine.

“It’s a very engaging app,” Stern said. “It sends you relevant information such as how much money you are saving, tips to manage stress, deep-breathing exercises, and all kinds of nudges to help keep you on track. We will be introducing it through Lifestyle Medicine this winter for smoking cessation participants and we’re excited about adding it.”

You have to find the aids that work for you, Hale said.

“Two years later, I have gained some weight from not smoking anymore, although I am now losing some of that again,” she said. “But my breathing is better and I feel better. I just had a checkup with my doctor and he said my lungs were clear.

“The best advice I have is, ‘Don’t quit quitting.'”