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Addiction Specialist Answers a Few Simple Questions for Smokers

12/18/2012 04:24 pm ET | Updated Feb 17, 2013

Dr. James H. Berry, DO, medical director of Chestnut Ridge Inpatient Acute Dual Diagnosis Program and assistant professor at the Department of Behavioral Medicine and Psychiatry, West Virginia Health Science Center, answers a few short questions for smokers.

Barbara: What's the difference between nicotine dependence and nicotine addiction?

Dr. James Berry: "Dependence" is a medical term that refers to a pathological condition of substance use to the point that using has significantly affected a person's life and marked by impaired control over use, cravings to use, using despite consequences, preoccupied with use, etc. Often someone has been using the substance long enough and to such a degree that they will experience a predictable withdrawal syndrome when they stop using. "Addiction" is more of a common, pedestrian term.

Barbara: Companies are using punitive strategies for employees with unhealthy lifestyles such as smoking by increasing insurance premiums; are companies unjustly discriminating against smokers?

Dr. James Berry: I don't believe that companies are unjustly discriminating against smokers because it is a behavior that is treatable. The medical-financial consequences of smoking are astronomical, and one could argue that non-smokers are being unjustly discriminated with higher premiums to pay for those who continue to choose to smoke.

Barbara: Companies like Wal-Mart will allow their employees to avoid the surcharge if a doctor confirms that it's "medically inadvisable or impossible to quit smoking." What reasons would there be that would to justify that it would be impossible for an individual to quit smoking?

Dr. James Berry: There are no medically advisable reasons to continue smoking. Timing could be an issue; however, if someone is severely depressed and suicidal, this would not be a good time to quit smoking.

Barbara: Are increased insurance premiums incentive enough to get individuals to stop smoking? In your experience, what is the typical reason individuals want to quit smoking? What are the steps they need to engage in to become successful? What's involved in smoking cessation? What types of smoking cessation programs are safe and effective?

Dr. James Berry: Usually, there is not just one reason that is "enough" to get somebody to quit smoking but, a host of reasons that begin working together. Cost is a big reason for people to quit and family insistence is another common one. There are a number of behavioral interventions and also medications that are safe and effective.

Barbara: (Note: More to come on treatments in a future post.) What are your thoughts on wellness programs within companies that focus on positive rewards for individuals who stop smoking on their own and not because they are forced to by a company?

Dr. James Berry: Wellness programs are fantastic, and [in my professional experience] any behavior change is more likely to occur based on positive reinforcement than negative.

Barbara: What's the most important thing a smoker should know who is about to embark in a smoking cessation program?

Dr. James Berry: To quote Winston Churchill, "Never, never, never give up..." quitting smoking. Generally it takes seven to 10 quit attempts before someone finally quits. This is why it is important to not be discouraged and give up trying.

For more information on smoking:

Centers for Disease Control (CDC)

National Institutes of Health (NIH)

U.S. Department of Health and Human Services (HHS)

Your Turn

We would love to hear your thoughts in the comments section below. Are you a smoker? Have your insurance premiums increased? Have you tried to quit smoking? If you have successfully quit smoking, what steps did you take to achieve your goal?

As always, thank you for your very valuable time.

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