BY SUSAN STEVENS
Daily Herald Health Writer

Fred Coombs’ former smoking buddies miss him.

Coombs hasn’t smoked a cigarette since Feb. 8, his quit day.

That means he’s already surpassed his previous record of five weeks without a cigarette. “I’m surprised how easy this has been,” Coombs said. “Maybe the 19th time is the charm.”

Coombs, a 63-year-old computer programmer from Wheeling, smoked for 50 years. He has spent hundreds of dollars trying nearly every method to quit, from hypnosis to laser therapy.

What’s different this time?

Coombs thinks it’s his attitude. This time, he really means it. He also met one-on-one with a smoking counselor, and he’s using a nicotine replacement patch for the first time. (He tried the patch before, but threw the box out after the first one irritated his skin).

Figuring out how much nicotine your system needs to avoid withdrawal plays a key part in successfully quitting smoking, said Lyn Tepper, a certified smoking cessation specialist and advanced practice pulmonary nurse at Northwest Community Hospital in Arlington Heights. “Most people do not use enough nicotine replacement, and that’s why they fail,” Tepper said.

At her meeting with Coombs, Tepper gave him a quiz to analyze his nicotine dependence. To his surprise, Coombs scored on the low end of the scale. That’s because he’d already begun to taper off his smoking by delaying his morning cigarette and waiting a while to smoke after meals.

“Because of that, you’ve really changed your focus on cigarettes,” Tepper said.

“If you do have a lapse, don’t beat yourself up about it,” she said. “Get off the pity pot and get back on the smoke-free lifestyle bandwagon. Use it as a lesson, but don’t beat yourself up about it. You’ve got the rest of your life to remain smoke-free.”

Because Coombs smoked up to 20 cigarettes a day, Tepper recommended a 21-milligram nicotine replacement patch to start.

Generally, smokers should count one milligram of nicotine replacement for every cigarette they smoke in a day, Tepper said. Three weeks after his quit day, Coombs stepped down to a 14- milligram patch, and he says he didn’t notice any difference. Eventually he’ll transition to a 7-milligrampatch.

Coombs is also using nicotine lozenges to curb short-term urges for cigarettes, though he says he doesn’t like them too much. Unfortunately, he bought a box of 192.

“I think I have a lifetime supply,” he said. The patches have an interesting side effect: vivid dreams. The first few days, Coombs dreamt he was smoking, and it horrified him.

“I’m amazed about how easily I eased into this,” Coombs said. “I think because my mind was made up and I was doing it for myself.”