How can I persuade my mother, who has stomach cancer, to quit smoking?

A fellow caregiver asked...

My 78-year-old mother is being treated for stomach cancer, and her doctor keeps telling her she needs to stop smoking. She's tried unsuccessfully to quit many times over the years, so now she's very resistant and says she can't stop. How do I get her to listen to her doctor and try again?

Expert Answer

Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone with Cancer," "The Journey of Grief," "Handbook on Hospice and Palliative Care," and other titles on cancer diagnosis and end of life. She speaks regularly at cancer research and support functions, including PANCAN and Cancer Survivor's Network. She is a former member of the Executive Committee of the CSN at St. Joseph's Hospital of Atlanta and the Georgia Chapter of the Lymphoma Research Foundation.

Smoking is a tough one -- not only because it's an addiction but because it's a habit and a lifestyle. Smokers are used to having a prop in their hands and something to put in their mouths, and if they've been doing it all their lives and a lot of their friends smoke, it can be hard to change.

If you're going to help your mom carry out her doctor's recommendations, you'll have to be forthright about that. You might start by pointing out that smoking is counterproductive to fighting the cancer, since it accelerates the disease process.

If your mom is pursuing aggressive treatment of her cancer and hoping for a cure, then smoking will completely undermine her chances, and she has to understand that. Explain that if she's going to go through the hardship of aggressive treatment, it doesn't make sense to continue to do something that interferes with that treatment.

Once you've pointed out why your mom should stop, you can move on to how to stop and start discussing solutions. If your mother has tried to quit smoking before and become discouraged, explain that times have changed and there are a number of smoking cessation programs that weren't available before. There are patches, gums, medications, hypnotherapy, acupuncture, and all sorts of aids to help reduce cravings.

One of the best programs now available uses a machine called a spyrometer to measure lung function and show the smoker's progress every month as the lungs get stronger. This kind of feedback can be very encouraging. Talk to your mother's doctor about getting a referral to a spyrometry program. (CT scans can also give your mother a visual picture of how her lungs have improved over time.)

The number one reason people continue to smoke is they think that if they have even one cigarette it constitutes a relapse so they should give up and go back to smoking as much as ever. But the spyrometer shows the improvement that can be had even by just reducing the number of cigarettes a person smokes each day.

Your mother can wean herself off cigarettes slowly and see the progress. If she used to have six cigarettes a day and is now down to one or two, the machine will register the improvement and give her something to celebrate and build on.

It's also a good idea to enroll your mother in a support group that will pair her up with a buddy. It'll be much easier for her to quit if she has someone who's in the same situation, who can understand and sympathize.

The buddy has to be someone you trust who's strongly motivated to quit, so he or she doesn't undermine your mother's efforts. Having a buddy will also help counter any tendency on your mom's part to feel sorry for herself or dismiss you by saying, "You don't understand how hard this is," because the buddy does know how hard it is and is still trying to quit.