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The tough times for Marty Merrick — the moments when
temptation looms — are when he's not working.
I had
a few cigarettes that first weekend," admits Merrick, 56, a
veteran of 30 years with the city Fire Department — most of
them with Engine 156, Ladder 79, on Staten Island — and,
until now, a pack-a-day smoker. "It's when I sit home, in
front of the TV or after eating."
Taking
it a day, even a minute, at a time, Merrick is the face of a
new FDNY anti-smoking program, spurred in part by the
dangers New York's Bravest endured on Sept. 11 and in the
months that followed at Ground Zero.
Like
most smokers, he started young, "when I was 13, maybe 14,"
and living in Brooklyn. Now on light duty at the FDNY Health
Bureau, he's paying the price: "I have high blood pressure,
a little chest pain, some bronchitis."
All of
which, unfortunately, are typical of too many firefighters.
"The top causes of nontraumatic death among firemen are lung
and heart disease," says Dr. David Prezant, the FDNY's
deputy chief medical officer. The smoke of burning buildings
increases their risk; cigarettes compound the danger. Sept.
11 made the problem worse.
"Every
one of those firefighters ran into the buildings, then spent
weeks and months in the recovery effort," Prezant says.
"They didn't think of the exposure." No one knows what
toxins they may have inhaled, "but whatever it is, if you
stop smoking, you can lower the risk." For example, smokers
are 50 to 100 times more likely to get cancer after exposure
to asbestos.
And
so, again, the Bravest are setting an example. "The
elimination of tobacco is the single most important thing to
do after exposure, for them and for everyone in New York,"
Prezant says.
Strength in numbers
Some
2,000 city firefighters smoke. Most started young; many
haven't even tried quitting, Prezant explains, because it's
their job to rush into smoky places and breathe the stuff.
But a
study after Sept. 11 led by Prezant and his FDNY chief, Dr.
Kerry Kelly, found that 29% of firefighters are smoking
more, and more than 400 ex-smokers in the department have
started again. One reason: Onlookers at the World Trade
Center site gave free smokes to recovery workers.
"We
were appalled, but now we have to deal with it," says
Prezant. Also, long months at the site, and the emergence of
"WTC cough" as a recognized syndrome, made the firefighters
wonder what they could do to prevent longterm damage.
"This
is a window of opportunity, when firefighters are thinking
about their health," Prezant says. The new program is
voluntary, and it offers "everything they need to quit
smoking, for as long as they need it."
It's
an effort that involves doctors from all over the city as
well as FDNY Health Bureau staffers who donate time for
individual consultations and tests. CHEST, a national
medical group, raised $55,000 to cover expenses.
Open
to anyone who works for the FDNY, EMS workers and everyone's
spouses, the FDNY's Comprehensive Tobacco Cessation Program
is tailored to suit the comfort levels of the close-knit
group of heroes.
It
offers education, personal screening and consultations,
group sessions and free medications that squelch nicotine
cravings, says Matt Bars of Smoking Consultation Services, a
New Jersey group working with the FDNY.
Quitters have access to E-mail and phone support, as well as
to Nicotrol patches and inhalers donated by Pharmacia. Also
available is Zyban, an anti-depressant that curbs nicotine
dependence.
About
half of the 300 firefighters who signed up for the first
meetings are staying the course. Most — like Merrick, now
four weeks into the 12-week program — are completely
smoke-free.
They
meet four times, finishing Nov. 21, the day of the American
Cancer Society's Great American Smokeout. Each session
starts with a no-nonsense pep talk. The goals are clear,
Bars tells them: "To stop, to remain smoke-free, to feel
normal when you're not smoking, to understand how the meds
work."
Bars
recites facts: Cigarettes contain 4,000 chemicals, 69 of
them known to cause cancer. Nicotine is highly addictive,
"and the fastest way to get it is smoking ... it's in your
brain in seven seconds."
He
offers context: "Every day, 1,200 Americans die as a direct
result of smoking; every year, 4,000 are killed by fires."
Tobacco kills more people than do murder, AIDS, heart
disease and cancer — "and not just of the lung."
It
also promotes wrinkles, emphysema, low birth weight and
asthma. It's a factor in osteoporosis, worsens diabetes and
slows the healing of wounds — "very important for firemen."
Most
of his listeners at the first meeting, already on edge,
stepped out beforehand for a quick smoke. How many, he asks,
have been smoking "light" cigarettes? Half raise their
hands.
"The
idea of a light cigarette is a fraud," Bars booms. Light
smokes have tiny vents placed in such a way that a smoker's
fingers and lips cover them and they don't work, he says.
"Light" smokers draw harder, too.
Before
the second meeting, Merrick's group — all the men with short
haircuts, the women neat and intense — kid around, compare
symptoms and how often they use inhalers.
All in
it together
After
the pep talk, smaller groups go for screenings, doctor
visits, medicine pickups and support meetings. The communal
approach might turn some off, Prezant concedes. But "this is
the environment they like. At the second meeting, there was
a competition for who had the lowest carbon-monoxide
readings."
Two
weeks into quitting, Merrick sees Dr. Thomas Aldrich, chief
of pulmonary medicine at Montefiore Medical Center, where
Prezant also works when he's not at the FDNY. "I'm his boss
there, and he's mine here," says Aldrich.
"Yeah?" says Merrick.
"Yep.
So how you doing?"
"Can
we talk about this weekend problem?" the fireman asks
urgently. With nothing to do, he has had "a couple" of
smokes. Also: "I've gotta point out here, my daughter, she
lives with me, and she smokes." And he has gained weight.
Aldrich says that "having a cigarette signals the end of a
meal — without it, the meal never ends." Also, people crave
the familiar hand-to-mouth motion. His advice: "Try to
develop new habits."
"I
know what my bad habits are," Merrick sighs. "What I don't
know is what my good habits are."
Aldrich suggests that Merrick add Nicotrol patches to the
six inhalers he's using each day. The fireman agrees — but
later, he tells the News he's making do with the inhalers
and has given the patches to his son-in-law.
Merrick's support group has a dozen members and three
counselors. They discuss symptoms: coughing (common as the
system clears toxins), insomnia, craving. Those tingling
sensations? Probably because the circulation is improving.
While
the strong, silent types hang on every word, the women seem
to speak for everyone. "Being around smokers isn't hard, the
problem is my mood," says one. Also, normal tensions seem
worse. The guys nod in unison.
The
men are most comfortable cracking jokes. A counselor asks
one what he's going to do with all the money he's saving by
not buying cigarettes.
"Go
drinkin'," he replies laconically. More laughter. Slipping
the nicotine noose isn't fun, but for now, at this moment,
this group is happy — and not smoking.
Motives vary. Some are quitting because of the WTC exposure.
Like so many, Merrick is loyal to the department and its
aims: "I know I'm not supposed to, on the job at the FDNY
Health Bureau, so I don't."
For
Merrick, there's a little boy named Shawn, 8 months old, his
first grandchild. "My daughter doesn't want me near him when
I'm smoking. This is not only to see him grow up, but to see
him at all!" he says.
How to give it up
Here
are some of the ways to relieve the symptoms of nicotine
withdrawal:
-
Craving
— Ask about nicotine-withdrawal supplements or Zyban, an
antidepressant that eases craving. Throw out tobacco
products and lighters: The urge can pass fast.
-
Irritability — Exercise. Increase doses of medication with
a doctor's approval. Meditate.
-
Hunger
— Finish meals with a new personal ritual (a walk); find
something to chew (diet candy) or hold (a pen).
-
Cough,
scratchy throat — Drink water, suck hard candies. The
problem will pass as the body recovers from tobacco's
assault.
-
Fatigue, lack of focus — Give yourself time to return to
normal without nicotine stimulation. Take breaks.
-
Insomnia — Avoid caffeinated tea, coffee and soda,
especially after midday. Exercise, but finish workouts at
least two hours before bed.
Originally published on
September 9, 2002
All contents © 2002 Daily News, L.P. |
