The Loma Linda VA Medical Center knows that the addiction to smoking is at least as powerful as the addiction to heroin or cocaine. That’s why they developed a treatment program that’s comprehensive and powerful enough to beat anyone’s smoking addiction. It’s called “Break the Chains of Tobacco Addiction.”

For the best results, you should incorporate as many of the following activities and remedies as possible into your personal stop smoking plan. If necessary, educate your doctor as to the seriousness of your addiction and ask him or her to prescribe just the right kinds of nicotine replacement therapies and medications based on your particular health and needs:

    (helps to treat physical causes)
    (helps to treat psychological and other causes)
    (helps to treat habitual and other causes)


The education and skills training classes are the gateway into the VA’s smoking addiction treatment program. They are presented in the chapel area on the first floor of the main hospital over the course of 4 weekly classroom sessions, each lasting approximately 2 hours long. The sessions are offered twice each week, on two alternate days and times, in order to accommodate most veterans’ busy schedules. One session is presented at 1:00PM beginning on the first Tuesday of each month, while the other is presented at 8:00AM beginning on the first Wednesday of each month. The sessions are presented by trained doctors and other experienced staff members under the direction of Dr. Linda Hyder Ferry. Students are required to attend all four classes at either session, but if one of the four classes is missed during a particular month it can be made up the following month. From my own personal experience, I found it best to try to complete all four classes during the same month.

Among the many things we learned as part of the education and skills training are the dangers of smoking, the three main causes of addictive smoking (the physical, the psychological, and the habitual causes) and how each of those causes can affect us personally. More importantly, we were given information about the tools, techniques, and medications that are available to everyone within the VA healthcare system to eliminate the causes of addiction.

In addition to having the harmful effects of smoking explained to us in detail, we also had some of the effects demonstrated to us first-hand by getting our carbon monoxide levels tested prior to the start of each class. We quickly learned that the more we smoked just before coming to class, the higher the harmful carbon monoxide levels would be.

If you are part of the VA’s healthcare system anywhere, you can obtain a referral to your local VA’s stop smoking program by talking to your primary care physician or other staff member. Those veterans within the Loma Linda VA healthcare system can also call (909) 825-7084 ext 1869 for more information about signing up.

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During the education and skills training portion of the VA’s stop smoking program we learned all about the three main causes of addiction. They are the physical, the psychological, and the habitual causes. We also learned that each of our addictions is comprised of unique combinations of those causes. The types and amounts of treatment used to combat a smoker’s addiction are determined by the degree to which he or she is affected by each of the main causes.

For example, one veteran’s addiction might be due mostly to physical causes (such as nicotine dependence) and not as much to psychological and habitual causes. Another veteran’s addiction might be the result mainly of psychological or habitual causes, and less to physical causes. With this idea in mind, there are two important things to understand:

  1. All smokers are addicted due to some combination of all three of the main causes and
  2. Each smoker is addicted differently because of varying degrees of the three contributing causes.

The doctors and staff at the Loma Linda VA stop smoking program conduct “individual addiction assessments” of each veteran by reviewing patient history and collecting additional information through one-on-one interviews, surveys, and questionnaires. They then use this data to prescribe customized treatment plans designed to combat the unique causes of addiction for each veteran.

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Individual counseling starts immediately upon attending the first of the four education and skills training classes. At the start of every class, veterans meet with a medical professional who measures their carbon monoxide levels, records data pertaining to their most recent smoking experiences, and offers advice on selecting a quit date.

In addition to pre-class counseling, veterans are given the opportunity to make same-day appointments to see a doctor on a one-to-one basis immediately following each class. At these appointments, individualized treatment options are discussed based upon each veteran’s smoking experience and medical history. Those treatment options will include nicotine replacement therapies, medications, and a variety of other tools and techniques – all designed to address the physical, psychological, and habitual causes of a veteran’s smoking addiction.

Once enrolled in the VA’s stop smoking program, veterans can make appointments with doctors for prescription refills and otherwise to receive counseling whether he or she has attended a class that week or not. At the Loma Linda Medical Center, physician appointments can be made by calling (909) 825-7084 ext 5508 in advance for each Tuesday between 3:00PM and 5:00PM, Wednesday from 10:00AM until 11:30AM, and Thursday from 8:00AM until 11:30AM. For those who receive their health care at a facility other than the Loma Linda VA Medical Center, you should call your local center for specific information regarding appointments at your location.

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(Scroll down the page to watch a video about Nicotine Replacement Therapies and other medical treatments)

Nicotine is highly addictive and, as such, is one of the most heavily used addictive drugs in the world. Research has shown that nicotine, like cocaine, heroin, and marijuana, increases the level of the neurotransmitter dopamine which affects the brain pathways that control reward and pleasure. Therefore, once ingested it can serve as both a stimulant and sedative to the brain. With the regular use of tobacco, levels of nicotine accumulate in the body during the day and persist overnight exposing smokers to the effects of nicotine for 24 hours each day. Nicotine in and of itself is relatively harmless. For smokers, it’s the 81+ cancer causing chemicals, carbon monoxide and host of other toxins absorbed along with the nicotine through smoking that is the big problem. Nicotine is what causes most of the physical addiction to smoking.

Cutting off the regular supply of nicotine to the body is no different than suddenly stopping any addictive drug. When a seasoned smoker quits ingesting nicotine, he or she can suffer symptoms that include shakiness, irritability, high anxiety, trouble focusing, uncharacteristic depression, and difficulty sleeping at night. This is what’s known as “withdrawal.” While the actual length of withdrawal time may vary from person to person, most people get over the most intense effects of nicotine withdrawal within the first few days and continue to experience them to a milder degree for a month or so. It may take as long as two months before the symptoms completely fade for some people, but it usually shouldn’t take longer than sixty days.

Nicotine Replacement Therapies were developed in order to help combat the physical causes of smoking addiction (nicotine withdrawal). They’re initially taken in doses that correspond to the amount of nicotine a smoker was used to ingesting; then, after awhile, the dosage is gradually reduced to zero. The specific dosage should be determined by the veteran’s guiding physician and used as just one of several weapons to fight the overall addiction.

Veterans should always seek guidance from their health professionals when considering any of the following Nicotine Replacement Therapies:

  • Nicotine Patches
  • Nicotine Gum
  • Nicotine Lozenges
  • Nicotine Inhalers

Video: Nicotine Replacement Therapies, Bupropion, etc.

This movie requires Flash Player 9

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The VA Medical Center offers two prescription medications to help stop smoking: Bupropion(Zyban)® and Varenicline(Chantix)®. They are normally taken 1 to 2 weeks before stopping and are best used in combination with counseling support and other forms of treatment:


Initially researched and marketed as an antidepressant, Bupropion(Zyban)® was tested and proven to be an effective way for many to stop smoking by our own Dr. Linda Hyder Ferry at the Loma Linda VA Medical Center. In contrast to many other antidepressants, Bupropion does not normally cause weight gain and, in fact, groups in most studies showed mild to moderate weight loss. Bupropion(Zyban)® is now being used by millions around the world to help them stop smoking.


Varenicline(Chantix)® is another medication currently being used by the VA to curb tobacco cravings.

Note: Only your doctor can decide which medications, if any, are right for you. You should only take these medications as prescribed by your doctor after a careful examination and after having been advised of any potential side effects.

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In addition to teaching us all about the dangers of smoking and the treatments available, we were given several tips and techniques that we could use to ward off cravings. One very effective technique is to use one or more of what are known as “The 6 D’s” whenever we feel a craving coming on:

Delay: Take a two-minute time out. Watch the clock and let the craving pass on its own.
Discuss: Call a friend or some other loved one. Better yet, visit someone you can trust in person and talk it out.
Deep breathe: Close your eyes and take in a few deep, slow breaths.
Do something else: Take a walk or jog around the park. Seriously, go for a hike!
Drink water: Carry a bottle of water with you wherever you go – take a “swig” instead of a “drag.”
Divine power: Call upon your personal source of inner strength to see you through the moment.

Oh, and the VA doesn’t stop the support just yet: there are “Staying Clean from Nicotine” relapse prevention meetings, as well as “Clean and Lean” healthy eating meetings to help you keep your weight down while quitting. In Loma Linda, call (909) 825-7084 ext 1869 (or your local VA Medical Center) for more information on these group meetings.

Finally, do you need additional help getting through a craving? QuitNet.com® is a web site where you can register for free and chat live with others just like yourself who are about to, or already have, quit smoking. In addition, the site is chock full of supportive information that will help you attain and maintain your quitting goals:

QuitNet.com: Quit All Together

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