Smoking an addiction, not a habit, lung association says

Leah Heneghan was so afraid of exposing others to the stench of cigarette smoke after she'd lit up that she took to carrying around a can of Febreze.

The smoker of 18 years, who had made several attempts to stop over the years, knew it was time to quit for good.

"This time it just feels like some-thing clicked in my head," she said. "My entire being agreed to it this time instead of fighting me."

It wasn't easy. Heneghan, 37, the creative director for Vancouver Craft Beer Week, had to stop drinking the very beverage she is paid to market because it made her want to smoke.

She switched from coffee - another trigger - to tea, drank lots of water and didn't go out as much.

Nicotine withdrawal caused her to be moody and short with people.

"You have to realize it's not you being angry at someone; it's this horrible little addiction trying to fight its way back."

And addiction, many are arguing, is exactly the word to describe chronic smoking. In recognition of Addictions Awareness Week, which started Mon-day, the BC Lung Association is calling for the term "addiction" to replace the word "habit" when referring to tobacco smokers.

"The amount of times that I've tried to quit and I haven't been able to over the years - you can't tell me that that's a habit," Heneghan said. "'Habit' doesn't seem like it's a serious enough word."

Nicotine dependence is included in the manual used by doctors to diagnose psychiatric disorders and has predictable withdrawal symptoms, including irritability, anxiety and cravings, said Dr. Milan Khara, clinical director of the tobacco dependence clinic for the Vancouver Coastal Health Authority. "So really, by many measures, this meets the standard for an addiction and not a habit or a life-style choice."

And although the withdrawal symptoms experienced by smokers are not as traumatic as for those addicted to "hard" drugs such as heroin or cocaine, nicotine is in many ways more addictive because it enters the brain within seconds of inhalation, Khara said.

"The brain is actually altered by exposure to nicotine. That change is what leads to withdrawal symptoms when, in fact, a smoker does stop smoking."

Introducing a change in terminology is important because smokers are much more likely to seek treatment when they think of it as an addiction rather than a question of willpower, Khara said. The two treatments that Khara says have been clinically proven to help smokers quit are counsel-ling from a health care provider and medications delivered via gum and patches.

The B.C. government began subsidizing nicotine-replacement therapies on Sept. 30. To get the gum and patches at no charge, patients must first call 8-1-1 and register for the pro-gram with a nurse. Two smoking-cessation drugs are also covered under Pharmacare.

But for Heneghan, it wasn't counsel-ling or gum that made the difference this time; it was apps. One told her how many cigarettes she would have smoked and how much she would have spent on them; the other provided access to a community of people who were trying to quit, where she could post how she was feeling and get positive reinforcement: "It makes you feel like you've got this real sup-port community. That probably was the thing that made the biggest difference to me."