Your Money / Your Health: Quitting smoking makes economic sense
For just about anyone, less than it does to keep smoking. Many smokers burn through thousands of dollars each year buying cigarettes alone. Then there are peripheral costs like breath mints, extra trips to the dry cleaner and higher premiums for health insurance.
Quitting costs money too, but it's a better long-term investment. Plus, much of what you'll need to get started — nicotine gum, patches and even counseling sessions — is often available free.
"The cost of quitting isn't typically the reason smokers give for not giving up the habit," says Dr. Cheryl Healton, president of the American Legacy Foundation, a smoking cessation advocacy group based in Washington, D.C. "But finding out that it can be a very manageable cost is good news for smokers who make the decision to stop."
Nationwide, the average cost of a pack of cigarettes (including the federal cigarette tax and state sales taxes) is about $5.51, according to the Campaign for Tobacco-Free Kids in Washington, D.C. For those who smoke a pack a day, that works out to about $155 a month, or just over $2,000 a year.
Quitting, on the other hand, generally costs $25 to $150 a month, according to Dr. Michael Fiore, director of the University of Wisconsin Center for Tobacco Research and Intervention. One-on-one counseling may add to the tab, he said.
Smokers may need to make several attempts before they kick the habit for good, and the final attempt at quitting generally takes two to three months, he said.
The very first step can cost nothing — call the toll-free number (800) QUIT-NOW (1-800-784-8669) for a referral to the quit-smoking line in your state. Staffers can mail you smoking cessation materials and refer you to support groups and free one-on-one phone counseling. In many cases, quit-line operators can even provide an initial supply of some nicotine replacement products.
Another free resource is Smokefree.gov, a Department of Health and Human Services website. You can get a free copy of the Quit Guide, which will walk you through steps to take on "Quit Day" and help you manage your cravings. The site's medication guide has detailed information on over-the-counter and prescription drugs to help wean yourself off cigarettes. You can also have an online chat with a smoking cessation counselor or find out how to enroll in a clinical trial.
Gum, lozenges, patches, inhalers and nasal sprays can all be used to deliver the nicotine hit you'd otherwise get from a cigarette. These typically run about $30 to $100 a month, though some insurers cover the monthly cost of inhalers and sprays, which must be prescribed by a physician. Doctors may also have some samples to share.
Two drugs, Chantix and Zyban, have been approved for smoking cessation. Chantix works by preventing the release of dopamine — a chemical associated with feelings of pleasure and desire — when nicotine from tobacco reaches nicotine receptors in the brain. As a result, the drug is designed to reduce the enjoyment of smoking. The mechanism of Zyban is less clear, but the drug is able to turn off nicotine cravings in many smokers.
Monthly prescriptions for these medications can cost $70 to $200, depending on the dose your doctor prescribes and whether you use Zyban or a generic version. (There is no generic alternative to Chantix.) If that's beyond your budget, prescription drug assistance programs such as Partnership for Prescription Assistance (http://www.pparx.org or  477-2669) and NeedyMeds (http://www.needymeds.org) may be able to help you get free or discounted drugs, depending on your income and insurance coverage.
You can also cut costs by asking your healthcare provider for coupons or searching for them online at sites like http://www.InternetDrugCoupons.com. The savings can be significant — one recent coupon offered up to $30 off the cost or co-pay for Chantix. Generic versions of the patches, gum and lozenges can reduce the price by up to half.
Telephone counseling and support groups are usually free or cost very little. Quit-lines, doctors and hospital community service departments can make referrals to these services.
Phone counseling is usually spread over four sessions, says Ines Parks of the American Legacy Foundation. A quit date will be set during the first session, and the others come after that date so the counselor can focus on managing cravings and smoking triggers, such as stress.
Support groups usually include eight to 12 people and are led by trained specialists. They typically meet once a week for about eight weeks, Parks says.
Each type of counseling has its own strengths, but a 1998 study in the Journal of Preventive Medicine found that when smokers were offered a choice of phone or support group counseling, 70% chose phone counseling.
To boost your odds of success, experts at the Office on Smoking and Health at the federal Centers for Disease Control and Prevention say it's best to attack your addiction from multiple angles. A 2007 study of 4,614 smokers published in the journal Tobacco Control found that 19% of people were able to go smoke-free for 30 days when they combined phone counseling with nicotine replacement therapy, compared with only 13% of those who relied on counseling alone.
For some people, one-on-one, face-to-face counseling works best. Sessions can cost $25 to $200 an hour depending on the type of professional you see. Insurance may cover some or all of the cost — as of Jan. 1, for instance, Medicare covers the cost of up to four counseling sessions for any beneficiary who tries to quit, and they can make two attempts per year. Previously, that benefit was available only to those who already had a tobacco-related disease.
Even if it gets pricey, quitting is still a bargain. According to the CDC, the total health costs of smoking work out to $10.47 per pack of cigarettes.
And that's money up in smoke.
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