Day 78 in Jack Noel’s journal is just as important as Day 1. It means 78 days of being tobacco-free, after eight years of trying to kick a two-pack-a-day smoking habit. Even so, Jack knows that’s far short of his record 111 tobacco-free days before his last relapse.
“We don’t really want to quit, to begin with,” he said.
The 72-year-old Ann Arbor resident is the first to admit that he is defying the odds, one day at a time. And he’d be the first to tell anyone else trying to quit, that it’s never too late.
Jack’s self-proclaimed big break came in November 2016, when he received a phone call from a tobacco cessation counselor at St. Joseph Mercy Ann Arbor who asked him if he was interested in quitting smoking.
“It just so happened that day, for whatever reason, Jack was interested,” said Gina Walsh. Gina works in St. Joe’s grant-funded tobacco cessation program, which connects counselors with patients in the lung cancer screening program.
Jack said something about Gina’s phone call struck the right tone at the right time. It was shortly after he was informed that a low-dose CT scan detected a couple of nodules in his lungs. But even as a triple bypass surgery survivor, Jack said, he denied the fact that smoking was harming his health.
He said Gina’s words gave him the gentle nudge he needed.
“She has this knack of just striking up conversation and sticking to the point,” he said.
On that day Jack cut his daily smoking in half, and he agreed to restart his journey to become tobacco-free. To begin, Gina asked Jack to keep a log of every cigarette he smoked.
“It sounded so mundane, but it was something!” Jack said.
He heeded Gina’s advice and tried to keep as honest a log as possible, taking note of the time and place he had each cigarette throughout the day. It wasn’t long before Jack started noticing patterns. He smoked roughly every 20 minutes, and the cravings came any time he felt unease.
“Things like writing and email or phone calls or paying bills would trigger anxiety,” Jack described. The easy solution for coping with this anxiety was reaching for a pack of cigarettes, or – when in a bind – rolling his own at home.
Jack discussed these observations with Gina during their phone counseling sessions, and she helped him identify ways to divert the anxiety and find alternative activities to smoking.
“He knows cigarettes will always be an option for him, but he has to make himself realize that he doesn’t need the cigarette,” Gina said.
Jack said this conscientious logging and personal accountability with Gina helped keep him motivated to reduce his smoking. He set a firm quit date in late January, and has been tobacco-free ever since – 78 days and counting.
Gina said Jack’s success is a testament to not only his determination, but also to the valuable help tobacco cessation counselors can provide. She said while 70 to 80 percent of smokers want to quit, a mere three to four percent are actually successful on their own, without counseling or nicotine replacements. And she said research shows it can take up to 10 attempts to successfully quit smoking.
“Even when faced with lung cancer, they’re scared and want to quit, but it’s still really hard,” she added.
Gina said primary care physicians often refer smokers to cessation programs, but many don’t have the time or resources to ensure they get adequate follow-up calls, let alone individual counseling. And while doctors can prescribe medications, she said, it’s still a novel concept that pairing those medications with behavioral counseling can greatly increase the chance of successful cessation.
The state-funded grant through which Gina was hired at St. Joe’s is up for renewal this year. In the meantime, the tobacco cessation program is working with physician offices and hospital service lines – such as cardiac and pulmonary rehabilitation – so other patients who want to quit smoking have better access to resources.
Jack is enjoying a tobacco-free lifestyle again. He is feeling better, and his daughter pointed out he is much less out of breath on his walks from the bus stop. He also got a new pet parakeet, Dollar, who keeps him company and keeps him away from cigarettes.
“It’s so rewarding when you hear a patient like Jack talk about the fact that they can breathe easier. They have just a new outlook on life. They feel empowered that they are free from the addiction of tobacco,” Gina said.
Jack won’t take all the credit. For him, this has always been a team effort.
“Please appreciate my appreciation, because it’s genuine,” he said.
“When people work together, we make progress.”