Just wait for the beep, then light up

Web Posted: 03/27/2006 12:07 AM CST

Nicole Foy
San Antonio Express-News Medical Writer

Scott Leake used to get up every morning and light the first of many Marlboro Lights 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, Leake has tried everything to quit: hypnosis, nicotine patches and gum. Finally, the self-professed gadget guru says he's found something that works.

The program, known as Smoke Signals, 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, said Vesta Brue, founder of Smoke Signals, a San Antonio company.

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

"It's totally different than any smoking cessation program, because it allows the smoker to smoke," he said. "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.

Smoke Signals 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, said Rebecca Gray of the local American Lung Association chapter.

"Our lives are so busy," she said. "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 launched its own Freedom from Smoking online program. Many states, including Texas, also have free telephone "quitlines," 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. Brue said an ongoing study is looking at the effectiveness of Smoke Signals used alone or in conjunction with an antidepressant often used in tobacco cessation.

Smoke Signals 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, Brue said.

That means sometimes missing that favorite cigarette with your coffee or after work or hearing the beep during inconvenient times, she said.

"You're planting the notion of having to smoke in an unpleasant circumstance," she said.

The technique also indirectly encourages smokers to demonstrate control over their addiction, Brue said. If a craving hits, a user can check the small screen on the device to see when he is allowed have the next cigarette.

To Leake's amazement, he's actually 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 said.

"Sometimes, I'll find myself thinking about it, and then I'll see that I only have like 11 minutes left," he said. "I think, 'I can wait that long.' It breaks the repetitive cue."

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 Smoke Signals program specifically but helped pioneer the scheduled reduction technique.

In controlled studies, 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 they found the assigned schedule approach, along with the fact 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, Brue acknowledged. It takes an average of five attempts for a smoker to give up the habit, Gray said.

Leake, whose parents both smoked and whose mother died of emphysema, received his recent motivation the hard way. Last spring, blood clots in his leg broke free, cut off the circulation to his foot and produced a mild heart attack.

Doctors blamed his nearly three-pack-a-day habit.

Halfway into the Smoke Signals program, Leake is down to only 15 cigarettes a day. His "quit date" is April 14, although that could move a day or two, depending on his progress in the program.

"Even when you cheat, you're still going downhill, and you're still moving toward your goal," he said. "For me, this has been totally worth it, because it's been a total confidence booster."