For most people, it takes several tries to quit smoking. For breast cancer survivor Marla Peterson, it only took one try – with the help of the Tobacco Treatment Program at Smilow Cancer Hospital.
Last year, Marla, a married mother of four grown children, including an oldest son who passed away, was in the position of the typical Sandwich Generation member – living out of state while caring for her ailing parents. Marla, who is from eastern Connecticut, had a standing order at Lawrence + Memorial Hospital for a mammogram every six months due to a previous issue, but skipped an appointment while with her parents. When she finally got her mammogram, she learned she had invasive breast cancer. That was October 2023.
“I was like, ‘What do I do?’ “Marla said. “I Googled it and Smilow (Cancer Hospital) came up. I had a couple of appointments at different places, but Yale was the first place I called. And the nurse I spoke to was so amazing and so empathetic. She asked me about my health and I told her I smoked.”
Marla said that even before receiving the diagnosis, she felt like she had cancer, so, as a smoker for 20-plus years, she was trying to cut back and was down to five cigarettes a day. She also knew she would have to quit before undergoing surgery. Margaret Antenucci, APRN, of the Smilow Cancer Hospital Tobacco Treatment Program, told her that even five were too many, and encouraged Marla to join the program.
“They were so helpful and supportive,” Marla said. “The tips they gave me were great. I had never gone through any sort of therapy for all of my losses – my son, my parents – and they helped me with that. It was amazing. I haven’t picked up another cigarette since December 3. That was my last cigarette. I never cheated.”
The Tobacco Treatment team includes psychologists, a physician, nurse practitioners, a tobacco treatment specialist counselor, and psychology fellows.
“What we really try to do is tailor the program to the patient and what would work for them in terms of medication and counseling,” Margaret said “We also ask why they are coming to see us. We have a lot of patients with cancer but we also get other patients referred.”
Counseling plays a major role in the program, Margaret said.
“Everyone on the team has a background in psychology because it’s a mental health issue – it’s an addiction, and working on helping people stop is psychological. If these people have been using it as a coping skill – a maladaptive coping mechanism – it is hard to quit. So we work on other coping skills, giving them a support network and other people to lean on, other activities and distractions.”
One of the tips Marla got was to hide her cigarettes in a place that would take some effort to retrieve them. Marla hid them in the basement for one day, then got rid of them. Marla said she was able to quit smoking, in part, because she is a disciplined person and the type of student who doesn’t want to disappoint her teacher – in this case, Margaret.
“We would have regular phone calls, and I never wanted to have to say, I cheated, I messed up with something that I could control,” Marla said. “And I didn’t want to let them down. All the little tips they gave me also helped. I wouldn’t have ever thought to use nicotine gum and the patch, and they definitely helped. The information and the tips were super helpful. But when I put my mind to something, I am not going to cheat. I only tried to quit smoking once before, and it was the most half-hearted effort that I don’t even consider it quitting. I needed to get surgery and they weren’t going to do it if I smoked. So that played into it.”
The program stresses that quitting smoking makes cancer treatments more effective. A study published May 2022 in The Journal of Thoracic Oncology showed that quitting smoking at or around diagnosis was significantly associated with improved overall survival, consistently among patients with lung cancer. Doctors stress that quitting improves survival for patients with all types of cancer.
Margaret, who has worked in the Tobacco Treatment Program for six years, said she loves her job.
“You’re meeting someone at an important juncture in their life and you can help make a difference in their outcome and how things go for them,” she said. “It’s incredibly rewarding.”
Marla said her medical treatment at Smilow was amazing. She had considered going to Boston, given its proximity to eastern Connecticut, but chose Smilow after speaking with Margaret. She had surgery in March, went through chemotherapy, and is now receiving drug treatment.
“One of the things you learn from the program is that stopping smoking makes cancer treatments more effective, lessens treatment complications, and lowers the chances of cancer returning,” she said. “I feel fine and everything is fine.”
For more information on the Tobacco Treatment Program or to schedule an appointment, call 203-688-1378.