b'Smoking Cessation Success Rate Low,Even in Veterans With Lung CancerWith a range of smoking cessation programs, the VA is having some success reducing the percentage of veterans who use tobacco. Still, data show that veterans find it hard to quit, even when they have been diagnosed with lung cancer and continued smoking affects their overall survival.By Stephen SpotswoodWASHINGTON,DCItslongbeenrecognizedsuch as bupropion and varenicline can help patients thatservicemembersandveteransusetobaccoatmanage nicotine withdrawal. VA offers tobacco ces-higher rates than the general population. Accordingsation counseling, in person or over the phone, to to the most-recent statistics, 29.2% of veterans re- help patients cope with the tobacco-use triggers and portedtobaccousewith21.6%ofthemfavoringmakechangesintheirlifestyletohelpthemquit cigarettes. This number is even higher among veter- tobacco.ans who had been deployed. Every year, the depart- Over the years, technology has played an increas-ment spends tens of millions on smoking cessationinglyimportantroleincessationefforts.VAs programsa fraction of the estimated billions spentTobacco Cessation Quitline (1-855-QUIT-VET) puts treating tobacco-related illnesses. veterans in touch with counselors who can help them According to a 2021 survey, VA is having somedevelop a cessation plan. SmokefreeVET is a text-success with enrolled veterans. VA found that thebased service that provides daily advice and support rate of veterans enrolled in VA healthcare who iden- to veterans who are in the process of quitting. And tified as smokers dropped nearly 20% in 21 years,the Stay Quit Coach is a mobile app designed with from 33% in 1999 to 13.3% in 2020. By comparison,interactive tools to help veterans deal with urges.the smoking rate for the general population in 2021Howsuccessfulthesemobilehealthprograms was 14.2%. are in helping veterans is still being examined. A How much of that is due to VAs cessation effortsstudy published last year in Nicotine and Tobacco andhowmuchisduetosmokingbecominglessResearch found that, of a cohort of veterans sub-prevalent among the younger populations of veter- scribedtoSmokefreeVET,morethan40%quit ans is unknown. beforetheprogramscompletionandonly3.7% Regardless, helping a veteran quit smoking is neverself-reported30-dayabstinenceaftersixmonths. easy. Attempts to quit are more likely to fail thanThe vast majority of those who quit did so within the succeed.Studieshavefoundthatformersmokersfirst week. Those who completed the program were tried to quit an average of five to seven times beforemore likely to have also been using smoking cessa-finding success. In 2018, the FDA found that, of thetion medication.55% of adult smokers who tried to quit in the previ- Evenpatientswhohaveanimmediatemedical ous year, only 8% were successful. incentive to quit are more likely to fail than succeed. Consequently, VA has developed a large cadre ofIn fact, specialist care referrals are less likely to be smoking cessation programs over the years to givefollowed up on by the patient than those made by veterans as many paths to quitting as possible. their primary care doctor.There are the standards of medication and counsel- A study published last year in Tobacco Prevention ing. Nicotine replacement therapy, and medications&Cessationfoundthatofveteranswhoreceived 112'