When Steve Bates chose Sept. 11 as the day to quit his 50-year smoking habit, he did it for a profound reason.

It was a heartfelt gift for his parents, both deceased, whose wedding anniversary would have been the next day. While his mom died from cancer years earlier, his dad’s death was especially significant because, like Steve, he had been a lifelong smoker.

By giving up cigarettes, Steve hoped to break the nicotine cycle and avoid his dad’s fate.

“My dad was a World War II vet who smoked Lucky Strikes and died of heart disease at 69,” Steve said.

While the date Steve quit is an homage to his parents’ anniversary from long ago, the motivation to stop smoking came to him more recently and under more serious and sober circumstances.

According to the American Cancer Society, being a smoker makes you three times more likely to get bladder cancer compared to nonsmokers, and smoking can be blamed for as many as half of all bladder cancers in the U.S. In fact, smoking is the No. 1 risk factor for the disease.

Steve, unfortunately, experienced what researchers have long known – the direct correlation between smoking and bladder cancer.

Last January, he underwent a biopsy after he noticed blood in his urine. Results showed an aggressive form of cancer in the muscle of his bladder wall. He underwent three months of chemotherapy at UCHealth Highlands Ranch and then had surgery in July to remove his bladder and prostate to stem the cancer’s spread.

“The chemo was a walk in the park compared to the operation and my recovery,” said the 76-year-old Highlands Ranch resident. “My doctors kept reminding me that I needed to consider quitting smoking. I realized they were right – I don’t want to face surgery again. I don’t want to face cancer again. I don’t want to face the fear of cancer again.”

Smoking: an addictive habit learned early in life

A South Dakota native, Steve began smoking as a young man while stationed in Germany after enlisting in the U.S. Air Force during the Vietnam War. There, he met his wife Mary, who was visiting her brother, also an Air Force enlistee. After Steve’s discharge, he and Mary traveled Europe, then returned home to live in Minnesota and Wyoming before permanently settling in Metro Denver nearly 50 years ago.

Through the moves, raising two daughters and a successful career in advertising and marketing, smoking a pack a day was a constant for Steve.

While he tried quitting six times, he now realizes he “wasn’t all in” during those previous attempts. After his bout with cancer and spending months recuperating, regaining his strength and managing the complications that come with his medical condition, it became clear to him that he finally had to stop smoking.

“If I take care of myself today, I have a decent chance of saving myself for tomorrow.”

For Steve, that tomorrow began on Sept. 11.

He did it cold turkey, without nicotine gum, patches, or medication that many people use to wean themselves off tobacco.

Help from a free tobacco cessation program 

He wasn’t alone. He had the assistance of a free UCHealth tobacco cessation program and a valuable resource: Collene Curran, certified tobacco and nicotine addiction treatment specialist at UCHealth University of Colorado Hospital on the Anschutz Medical Campus.

The program works with people who have been referred by physicians, specialty clinics or those who want help for themselves or family members.

A former smoker, Curran understands the tenacious hold cigarettes have, as she began smoking at 16 to be “cool and rebellious” and finally stopped when she was 44. She approaches her job with empathy not judgment, and sees herself as part mentor, part coach and part educator.

“When I quit smoking, I realized that cigarettes don’t do any of the things we give them credit for. People tend to smoke to deal with stress, to relieve boredom, to relax, to help them concentrate, but cigarettes don’t actually provide any of those benefits.

“And the moment you get addicted you start making connections between smoking and those feelings – relaxing after a meal, having a cigarette when you’re angry, anxious, or enjoying something. Then you begin to feel as if you need a cigarette to help you experience those things, and you’re hooked.”

Curran builds a rapport and relationship with her patients by talking with them regularly on the phone and helping them better understand the reasons they smoke, their triggers, as well as tips to help them overcome their nicotine craving.

For Steve, that includes a few techniques he uses when he gets the urge to smoke.

What worked for Steve as he tried to quit cigarettes

One is called HALT – recognizing if he was feeling Hungry, Angry, Lonely or Tired – and dealing with those emotions instead of reaching for a smoke like he once did.

Another exercise is “square breathing” where he envisions a square or box, and works his way around it, with each side containing its own mantra: inhaling for four seconds, holding for four seconds, exhaling for four seconds, and repeating.

“It buys me time to calm myself down,” he said. “The urges are still there, but they’re diminished. I am working to the point where they’re less frequent, and I don’t have that compulsion to smoke. It’s not like I don’t have urges because I do, but I’m able to work through it.”

Many patients like Steve in the UCHealth tobacco cessation program began smoking in a different era, before conclusive medical research showed how dangerous, damaging and addictive tobacco is to the human body.

Along with this knowledge, there has also been a backlash against smokers who are often blamed for their illness without recognizing the addictive nature of tobacco – a stigma that doesn’t help patients in their struggle to give up cigarettes, and now vaping for younger patients, experts say.

“To help patients quit, it needs to be a collaboration. We are not here to scold our patients, but partner with them,” said Dr. Nina Thomas, a pulmonologist who specializes in pulmonary diseases at the UCHealth Pulmonary Nodule Clinic – Anschutz Medical Campus.

Education is a big part of the program, as counselors try to demystify the power of nicotine. For instance, many smokers see their habit as a stress reliever, while it actually does the opposite as it chronically increases heart rate and blood pressure, said Thomas, who is also an assistant professor of medicine-pulmonary sciences and critical care at the University of Colorado School of Medicine.

A brighter future without cigarettes: easier breathing, more cash in his pocket

For those who do give up smoking, the payoff is big, she says, as the longer you go without smoking the more your risk of developing lung cancer declines. After 15 years, your risk of cancer approaches the level of someone who has never smoked, she said.

“No matter where you’re at in the spectrum, or how long you’ve smoked, it can only help if you stop smoking,” Thomas said.

That is heartening for Steve, a firm believer in living for today, and hopefully, many more tomorrows. That includes reading, keeping up with current events, lots of gardening, perhaps some traveling, and spending time with his family, who are very proud of his commitment to quit.

“I don’t know of anyone stronger when it comes to making a choice and sticking to it,” said his daughter Erica. “His work in the cessation program only demonstrates his dedication to his present and future.”

And if all of that wasn’t reason enough to bolster his resolve, he has a handy list to remind himself that he is happy to pull out of his shirt pocket and read aloud:

• I’m more relaxed
• My lungs are healthier
• I smell better
• I breathe easier
• My fingers aren’t stained
• I’m saving money. Every cigarette I don’t smoke is 40 cents I don’t spend.

“In the end, you just need to come to grips with your life. This is a powerful, addictive drug. Do you want your life to be controlled by it? I don’t.”