It seemed that whenever Monecia Boozer viewed herself - in photos, in the mirror, even in her mind - a cigarette dangled from her lips. It might as well have been attached.
"Back then," she says, "giving up smoking would have been like giving up an arm. How are you going to take my arm?"
"Back then" means before last September, which is all but a lifetime ago for Boozer. That's when she began to shed the unwanted appendage she thought would always be her curse. That's when she traded her old self for a new and improved model.
"I sure feel like a different person," says Boozer, 41, of Centralia, Illinois. "I remember when I smoked, I used to say, 'I wish I had more energy,' and now I have that energy. My sense of smell is better; I feel so clean. I even sleep better."
And when Boozer envisions herself today?
"I certainly can't see myself smoking," she says. "Not ever again."
Boozer is not alone in her triumph over an addiction to cigarettes, but her story does offer insights into a sometimes trying journey that the U.S. Surgeon General's Office says has been attempted without success by 70 percent of America's 50 million smokers.
Boozer made it past the physical cravings, the psychological hurdles and the threat of weight gain, using tools she borrowed from other people and ones she developed on her own. And all along the way, she drew strength from a friend she has never met in person.
It' s a journey she's very glad she made but one she hopes never to have to make again.
"It's definitely the hardest thing I've ever done," she says. "And I have four children."
Several Attempts to Quit Failed
Boozer had tried to quit several times before during her 26 years as a smoker. Once she vowed to quit after she got pneumonia and was coughing up blood. "I didn't smoke until the blood was gone, then I went right back to it," she says.
Another time she tried wearing nicotine-replacement patches and quit for 10 days, but again the effort failed. Then there was the time a friend paid for her to see a hypnotist. "He spent all this money, and I went right back to smoking," she says.
Boozer decided she was "one of those people who would always smoke." Of the seven kids in her family, six grew up to be smokers, so who was she to buck the statistics?
Then last September, a friend suggested she phone the American Lung Association Call Center in Springfield, Illinois, for advice and counseling about kicking the habit. Boozer's skeptical attitude changed almost as soon as she started talking to counselor Michael Mark.
His reassuring words supported her husband and children's longtime pleas for her to quit. She took note, perhaps for the first time, when he recited statistics such as these from the Surgeon General's Office:
- Smoking is the No. 1 cause of disease and premature death in America.
- Cigarettes contain 4,000 chemicals, 40 of which have been found to cause cancer.
- An estimated 430,000 Americans die each year from diseases caused by smoking.
Giving the Effort Her All
Mark helped her focus on how much she had to gain by stopping smoking -- and how much she had to lose by not. And suddenly the memories of her past failures were snuffed out cold. For the first time, she felt as if she could conquer her addiction. Her urge to stop was finally stronger than her urge to smoke.
"I decided to give it 100 percent, whatever he asked," Boozer recalled.
By developing such a strong source of personal motivation, Boozer had cleared what counselors and other health professionals say is the first big barrier in any person's struggle to break free of smoking.
"If someone isn't ready, all the outside forces in the world aren't going to get them to quit," says Ric Church, executive director of the Preventive Health Medical Center in Irvine, California, and formerly a lieutenant in then-Surgeon General C. Everett Koop's war on smoking in the early 1980s.
"At the same time," Church added, "if a person is ready, they may need some help, but chances are they're going to succeed."
Mark, who figures he's fielded about 1,000 calls since the American Lung Association launched its phone counseling service in Illinois two years ago, says that the longer he and Boozer talked, the clearer it became that she was really interested in quitting.
So they worked to set up a program to step her down from her 30 cigarettes a day. For two days, Boozer smoked her usual number, then for the next two days, she smoked 29. Boozer kept cutting back by one cigarette every two days until she was smoking 15 a day.
Enter the Nicotine Patch
"Since each cigarette has 1 milligram of nicotine, she was ready to go on the 15-milligram patch," says Mark, a registered nurse and respiratory therapist.
The patch is worn like an adhesive bandage and provides the body with a constant supply of nicotine, which is absorbed through the skin. Studies have shown that the patch is easier to give up than smoking, because its flow of nicotine is consistent as opposed to the "rush" that cigarettes provide. Plus, the patch is usually changed just once a day, so there's less of a habit to break.
To start using the nicotine-replacement therapy, Boozer had to stop smoking altogether, because using the patch while smoking can overload the body with nicotine. "There have been cardiac deaths," Mark said.
Making the leap from 15 cigarettes a day to zero was the hard part, Boozer says.
"The first day I wore the patch, I said, 'What have I done?' Boozer recalls. "So I called Michael, and he calmed me down. I don't know what he said, but he had a way of making me think everything was my idea. By the end of the weekend, I was ready to put on that patch."
Throughout the tapering-down process, Mark and Boozer talked at least once a week. "I'd have some small success, like I'd cut down by one cigarette, and he'd praise me like I was this little kid," Boozer says. "In a way, I'd feel silly. But it also felt good."
After several weeks, Boozer was clear of most of the physical cravings, but she still had to deal with the psychological aspects of her addiction. Over her 26 years of smoking, she'd become programmed to want a cigarette after every meal or anytime she poured a cup of coffee. She learned to keep a water bottle handy, so she could substitute its hand-to-mouth action for that of smoking.
She also developed an affinity for Red Hots, little candies that stimulated her mouth without piling on the calories.
Myths About Smoking
Boozer and other callers quickly learn that Mark has an answer for just about any excuse for not sticking to the program, such as stress and weight gain.
Stress? "Hogwash," he says. "Smoking doesn't treat stress. You're simply playing to your pleasure centers. Meanwhile, when you smoke, your heart rate goes up, your blood pressure goes up. Now is that any way to handle stress?"
Weight gain? The average is only about seven to 10 pounds, he says, and that can be mitigated by a mild exercise regimen. "I guarantee you cigarettes will kill you quicker than being overweight," he says.
A Changed Monecia
Exercise has become a key element of Boozer's program. When she first started, she couldn't climb stairs without feeling winded and without her chest hurting. Then she started walking a few blocks at a time, and eventually she joined a gym. Now she can pound the treadmill for 2-1/2 miles without stopping.
"Basically, she's re-engineered her body," Mark says proudly. "When I talk about exercise, I use her as an example."
More than five months after she began the program, Boozer has put the cravings, the patches, most of the psychological effects and, she hopes, 26 years of smoking behind her. But she still calls Mark, just to check in and to hear his reassurances.
"It's like I'm talking with an old friend," she says. "I don't know how many times I've called and sounded so stupid, on edge. He just dealt with it."
Now Boozer deals with things like an increased energy level, the good wishes of a grateful family and even a healthy dose of self-satisfaction.
"Sometimes," she says, "I can't help but think, 'Wow. I did it.'"
The American Lung Association Call Center is available weekdays 7 a.m. to 6 p.m. Central Standard Time for any questions or concerns related to lung health. Call (800) 548-8252.
