Wednesday, April 12, 2006

Computerized device may help change the habit

cott Leake used to get up every morning and light the first of many cigarettes to boost the nicotine level in his blood.

These days, he gets out of bed and downloads a smoking-cessation program into his computerized cigarette case, helping track his now-waning habit.

A chain smoker for more than 30 years, Mr. Leake tried everything to quit: hypnosis, nicotine patches and gum. Finally, the self-professed gadget guru says he has found something that works.

The program, known as SmokeSignals, is built around the computerized metal case. It’s designed to record smoking patterns and gradually wean a user off cigarettes over a five- to eight-week period.

The unit tracks a person’s daily habit by counting the number of times its lid is opened and closed. Each week, fewer cigarettes are allowed. The steady reduction helps lessen a smoker’s nicotine withdrawals and cravings, says Vesta Brue, founder of SmokeSignals, a San Antonio company.

Mr. Leake, a 50-year-old private fire investigator who has tried to quit more than a dozen times, says he finds the program appealing.

“It’s totally different than any smoking-cessation program because it allows the smoker to smoke,” he says. “You’re pulled off so gently.”

The service costs $99 to $149 and includes the case — which beeps when it’s time for the user to light up. The program builds personalized, constantly updated Web pages with information about daily consumption and target goals. It also sends regular e-mail alerts with tips about quitting.

SmokeSignals represents the growing trend of high-tech tobacco cessation. Support groups and classes for quitting have been decreasing in popularity, and people are looking for novel and convenient ways to change their habits, says Rebecca Gray of the American Lung Association.

“Our lives are so busy,” she says. “Our experience is we would get a [class] teacher and a facility, do marketing to tell the community about it, and no one would show up. It was very defeating.”

The association has started its own Freedom From Smoking online program.

Many states also have free telephone “quit lines,” which link callers to counselors trained in tobacco cessation. Research shows most programs are successful when used with some type of nicotine drug or replacement therapy. Miss Brue says an ongoing study is looking at the effectiveness of SmokeSignals used alone or in conjunction with an antidepressant often used in tobacco cessation.

SmokeSignals is built around the principles of a technique known as “scheduled reduction.”

The device, which beeps to tell its user to smoke at times spaced throughout the day, forces smokers to give up their own discretion, Miss Brue says. That means sometimes missing that favorite cigarette with your coffee or after work or hearing the beep during inconvenient times, she says.

“You’re planting the notion of having to smoke in an unpleasant circumstance,” she says.

The technique also indirectly encourages smokers to demonstrate control over their addiction, she says. If a craving hits, a user can check the small screen on the device to see when he is allowed to have the next cigarette. To Mr. Leake’s amazement, he has been able to put off that morning coffee cigarette and wait until the device beeps. That’s half the battle — stopping the unconscious behavior of lighting up, he says.

“Sometimes, I’ll find myself thinking about it, and then I’ll see that I only have like 11 minutes left,” he says. “I think, ‘I can wait that long.’

“It breaks the repetitive cue.”

Not everyone supports the signals sent out by the latest high-tech gadget.

Dr. Andrew Shorr, associate director of pulmonary and critical care at the Washington Hospital Center in Northwest, says the makers of SmokeSignals offer “zero data that it has any sustained efficacy.”

“The last time I checked, smoking was a lifelong addiction,” Dr. Shorr says, critiquing the San Antonio company’s research data supporting its product. He adds that the findings cover just a short time and haven’t been published by any significant journals.

More promising, he says, is the emergence of new drugs that could provide smokers with a greater chance of kicking the habit.

The drug Rimonabant, which will go by the brand name Acomplia pending FDA approval, promises to help people stop smoking and lose weight.

Champix, Pfizer’s smoking-cessation medicine, which is undergoing FDA review, helps deflect a smoker’s craving.

Both could be available in six months or so, he says.

“None of these are cure-alls,” he says, adding that the best approach often involves both medicine and some sort of behavior therapy.

“[Quitting] cold turkey is very hard to do,” he says.

Paul Cinciripini, director of the Tobacco Research and Treatment Program at the University of Texas M.D. Anderson Cancer Center in Houston, studies treatments for nicotine dependence. He hasn’t studied the SmokeSignals program specifically, but he helped pioneer the scheduled-reduction technique.

In controlled studies, Mr. Cinciripini found smokers trying to kick the habit are more likely to be successful if they cut back gradually and smoke on a time-based schedule, disrupting their usual smoking pattern.

Smokers also reported that they found the assigned-schedule approach, along with the fact that they didn’t have to quit cold turkey, less intimidating than other techniques, he said.

No fancy program, drug or approach to stop smoking will work unless a person is fully committed, Miss Brue acknowledges. It takes an average of five attempts for a smoker to give up the habit, Miss Gray says.

Staff writer Christian Toto contributed to this story.

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