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Smoking Cessation Health Center

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The Romance of a Good Smoke

How the program begins

In the first of 10 counseling sessions, spread over three to six months, the team assesses how, and to what extent, smoking fits into a couple's relationship. Is smoking seen as an ally, an invader, or both?

Drawing on medical literature that has studied problem drinkers and how they interact in an intimate relationship, Rohrbaugh's team notes that researchers find drinking can be "a kind of lubricant that promotes positive relationship stability, at least in the short run." Smoking, he says, sometimes serves the same function.

The relationship dynamics are different, the Arizona researchers have found, if only one partner smokes. With two smokers, they have found, smoking serves functions not just for the individual (stress reduction, boredom relief) but can be "the glue that holds the relationship together."

When both partners smoke, Rohrbaugh has found, they can have a mentality of "It's us against the world," especially as fewer Americans smoke. About 28% of the U.S. population, age 12 and older, smoked in 1998, according to the National Institute on Drug Abuse.

On the other hand, when just one partner smokes, the habit can become a source of tension, with the nonsmoker nagging the other to quit, and the smoker defiantly refusing.

Finding new rituals

In the early sessions, "we try to plant seeds of how things can be different,'' Rohrbaugh says. They suggest that couples who smoke together envision a smoke-free life and what it might mean. Better health? An easier time socializing with nonsmoking friends? No more pressure from family members or friends to quit?

The couples also might think about what could replace their smoking habit in specific situations. Instead of a post-sex smoke, perhaps a soak in the Jacuzzi, a warm shower, special music, or aromatherapy candles would suffice.

Partners who use cigarettes to signal to a nonsmoking spouse that some time alone is needed must develop another strategy to communicate that need.

By session three, Rohrbaugh's team hopes the couples or smoking partner are ready to set a quit date. They offer advice on tapering-down aids such as nicotine patches and other medications.

Smokers call the study leaders daily to report in, informing the research team about how many cigarettes they smoked the day before, what their feelings were, what their relationship experiences were, and other details.

Other authorities weigh in

Those who work with smoking cessation programs and couples counseling say the concept makes a lot of sense. For years, Harriet Braiker, PhD, a Los Angeles therapist, has told smoking couples she counsels: "You need to understand the function smoking is playing in the relationship."

The possible scenarios are many, she says. Two smokers who quit together may have a hard time trusting that the other is not cheating by smoking in private. If one partner quits, the reformed smoker may have a holier-than-thou attitude. Nagging also can affect the relationship.

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