Tobacco almost a 'dead' issue in United States?
The Seventh-day Adventist Church might be losing a piece of its image as a leader against tobacco in some parts of the world. And Stoy Proctor, MPH, is OK with that.
Proctor, an associate Health Ministries director for the Adventist world church, still promotes the church’s anti-smoking campaign. It was initiated by church co-founder Ellen White in 1848, about 15 years before the denomination was established. But in promoting healthful living to celebrate God’s gift of life, Proctor says the church, at least in the United States, isn’t alone on the anti-tobacco front anymore.
Tobacco companies have headed for potentially larger markets and Proctor travels the globe teaching the church’s stop-smoking program, which he helped write. Sometimes he’s an official guest of a government, and frequently he’s brought in to instruct the nation’s smoking cessation trainers on behalf of the Adventist Development and Relief Agency.
Just back from such training in Armenia, Proctor this week discussed what the church is now doing to combat smoking and the best weapons to use in the fight. Though the Texan might stall when asked his age, Proctor has reached the age he is, perhaps, because he practices what he preaches. Interview excerpts follow:
Adventist News Network: Adventists used to speak more openly about tobacco and lobby Congress. You don’t hear about it much today. Is that because Adventists are working through coalitions?
Stoy Proctor: “We have worked through coalitions, but in the U.S. we’re not unique in that anymore. We’ve said smoking is addictive from the beginning and we were one of the first to have a stop-smoking plan. But those days are virtually gone. People know it’s harmful. We’re unique in that we had a [stop-smoking] program early on, and we still run it in different places, but our pastors and doctors have led the fight and the rest of the public is on board.”
ANN: What about in other countries?
Proctor: “Overseas it’s a different situation. Tobacco company sales here [in the U.S.] have gone down, down, down. So they’ve gone overseas, particularly to developing countries. In the Philippines people are forming coalitions like we did 30 years ago. But smoking is almost a dead issue in America. About 24 percent of the adult population smokes now and many of them are the hardcore smokers who don’t want to quit. In some other countries they’ve got 45 to 50 of the population smoking and there isn’t as much help available.”
ANN: How long has the church had a stop-smoking program?
Proctor: “Dr. Wayne McFarland launched what was known as the Five-Day Plan in 1959.”
ANN: How has it evolved?
Proctor: “Well it’s longer now. That program was successful for many years, but when I came here [to the Adventist Church headquarters] in 1984 I was asked to revise it. My wife Leilani and I spent almost two years researching. It’s had some revisions since then, too. It’s now nine sessions covering four weeks. Before, they would help people stop smoking and about the time it ended that’s when withdrawal symptoms set in and they’d start smoking again a week or two later. Now in the program we sit with these people for three weeks after they’ve stopped smoking. It takes about a month to kick a habit.”
ANN: What’s the program’s success rate?
Proctor: “About two or three times what it used to be. The Five-Day Plan was about 20 percent successful. The Breathe-Free success rate is now about 60 percent. [Church-owned Loma Linda University] has worked with us and we feel we have good data of what works and what doesn’t.”
ANN: Is it true that Breath-Free is the official stop-smoking plan in the Philippines?
Proctor: “It is. It’s number one. We’ve done training with the Philippine government. Today, Adventist pastors are accredited representatives of the health department in health education. They have their cards and they can go anywhere in a city or in the country and represent the government to do a stop smoking-program.”
ANN: Where else is the church’s program used?
Proctor: “It is the official program for Taiwan…. I don’t know about now, but it has been in China…. It’s the official program for Poland. It’s been translated into about 15 different languages. We’ve done the training program in many more countries. But we haven’t done it on behalf of the government’s health services like we have in these countries where we were official invitees.”
ANN: What was unique about your trip to Armenia?
Proctor: “We were able to have our Adventist pastors take the training program along with about 30 of the country’s physicians. We hope they’ll work together to do public training in their own cities. They tell me about 70 percent of the adult male population smokes there. That’s very, very high. They liked our program because several years ago an anti-depressant company came in and spent several million dollars promoting their product. But has since pulled out. So the people there say, ‘We’re tired of all the nicotine replacement patches and all this stuff. We need the one-to-one help. We’d rather work in groups.’”
ANN: What are your thoughts about incorporating medication with group therapy?
Proctor: “We think it helps. Both the anti-depressants and the nicotine replacement. Here’s why—smoking is a chemical addiction, but it’s an even stronger psychological addiction. And so by using a nicotine replacement, then they’re able to sort of pacify their chemical addiction while they work on their behavioral addiction. When they get some replacement habits in place, then they can cut down on the patches or the gum so they don’t have to work on two fronts at one time. But the patches, the gum, the [inhaler], Zyban, they all say it works best with behavioral therapy. I’m just reading here in [a national business magazine] a health report on new medications—‘Behavioral therapy still is required for any smoking treatment.’”
ANN: Will some people be concerned that you advocate including medication?
Proctor: “Anything you can do, there’s no wrong way to stop smoking. What we don’t support is hypnotism, as well as aversion therapy. The medication is expensive, and for the most part you still go through withdrawal symptoms, and you can’t do it alone.”
ANN: Is there anything else Adventists could be doing?
Proctor: “There are still 45 to 50 million smokers in America. I think something we can do is help friends, neighbors, colleagues, and occasionally church members, on a one-to-one basis. The medical community can do more, but a physician spends just a few minutes with you. A smoker needs to spend more time. We’ve developed a Breathe-Free for one-to-one. People can e-mail us a request for it (SanchezL(at)gc.adventist.org). Also, [associate Health Ministries director Dr. Peter] Landless is chairing a new world church commission on tobacco and health. Hopefully this will re-energize our public service, particularly in some countries that don’t have as much help.”
ANN: What factors most discourage smoking?
Proctor: “Never scare tactics. It’s a combination of three things that governments can do. Raising taxes on tobacco will discourage young people from starting. If a person doesn’t start smoking before they’re 21, they’re not likely to start. Second, legislating smoke-free places like government and public buildings, like theaters. And then limiting convenience—not displaying cigarette vending machines everywhere.”
ANN: Have you ever smoked?
Proctor: “No. And that’s a good question. It’s been asked of me before. I know what they’re getting at—‘if I’ve never smoked then how can I help people?’ I know what cigarettes taste like because I took a couple of puffs as a kid. But the reason I can help people is because I can teach them how to say ‘no’ once they’ve stopped. Mark Twain said ‘It’s easy to quit smoking. I’ve done it hundreds of times.’ I can teach people how to say ‘no’ after they quit. I remember the first time I went to China they said, ‘This won’t work in China because we can’t do business without offering our client a cigarette.’ I said ‘Yes you can because you knew how to do business before cigarettes came to China.’ Many places in China have cut smoking drastically. So you can teach people in any culture how to choose better habits.”