Every night before bed, Peggy Torres takes a black marker and makes an X on her calendar, crossing off the day.

It’s a visual reinforcement of her success.

“I started with a brand-new Sharpie, brand-new calendar. I started marking down the days that I didn’t smoke,” she said.

“Every time I looked at that, it was an achievement. It was like a pat on the back. It was like, ‘You did it.’”

Safer than a classroom

In May, Torres completed Quit 101, a free, four-week tobacco and nicotine cessation class from Spectrum Health Lifestyle Medicine. A resident of Grand Rapids, Michigan, she was part of the first group to take the class via videoconference after COVID-19 shut down in-person programs.

Though online meetings can sometimes feel less engaging for participants, Torres, 55, found the virtual class to be just what she needed.

“I think that it’s better,” she said. “You can literally be in your home and you have no excuse not to connect.”

For Torres, meeting online is safer than gathering in a classroom, especially during a pandemic. Torres has an autoimmune disorder called alopecia universalis, a condition that causes complete hair loss on the head and body.

Given her compromised immune system, Torres went on furlough from her grocery store job when the pandemic hit in March.

The financial stress that added to her life intensified her smoking habit. Being home all the time also gave her more opportunities to light up.

She jumped from half a pack to almost a full pack a day.

“I felt myself (getting) out of control,” she said.

“My designated place to smoke was the basement. And every time I’d go to the basement to put a load of laundry in … I just instantly took a cigarette. When I’d get a phone call, I’d go downstairs to smoke.”

Still, she knew the coronavirus put her health at increased risk. Her family knew it, too, and encouraged her to quit.

Strategies and support

Torres turned to the internet and found Quit 101.

“I thought, ‘You know what? This is something that I need. I need the support.’ So I connected with Libby—and I’m so grateful,” she said. “This program has changed my life.”

Libby Stern, NCTTP, a certified tobacco treatment specialist who designed Quit 101, leads the program in Grand Rapids.

When the pandemic struck, Stern made plans to move the class online. When the virtual class launched in May she had participants from outside Michigan for the first time.

In addition to teaching the class on Tuesday evenings, Stern communicates one-on-one with each of the participants between class sessions and leads a free support group for Quit 101 alumni.

“We really focus on the evidence-based cessation tools and strategies that are effective for people when they’re trying to quit smoking or vaping,” Stern said.

“We also talk about how complex nicotine addiction is and how it impacts the brain. We focus on the relationship between thoughts and feelings and behaviors, and how they interact to trigger smoking or vaping.”

For Torres, who quit smoking on her own several years ago but relapsed after three years, the class provided a level of support and encouragement she hadn’t had before.

“One of my biggest helps for quitting was the support—meeting people that struggled with the same addiction, hearing their stories and being able to voice mine,” she said.

“Even after I stopped smoking, I have communication with Libby every two weeks. … She continues to encourage me.”

Of the many practical strategies Stern presented, Torres found three particularly helpful:

  • Using medication to curb her nicotine cravings
  • Showing off her progress on a daily calendar
  • Identifying her triggers and learning how to avoid them

Her two biggest triggers? Her car and the basement of her home.

To avoid wanting to smoke in her car, Torres and her teenage son cleaned its interior, top to bottom, and stocked the console with chewing gum to use as a distraction.

To keep from smoking in the basement, Torres would ask her husband or son to go downstairs with her whenever she needed to throw in a load of laundry or get something from the pantry.

“(Then I would) run out of there as fast as I could,” she said, laughing. “It was so funny because I was scared to go downstairs.”

Over time, it got easier. Now she can go to the basement without feeling the need to smoke.

Picking a quit date

Stern usually advises class participants to set a quit date two to six weeks out.

But Torres ended up skipping this step. Before she’d had a chance to set a date, she had a distressing experience that caused her to quit on the spot.

It was mid-May and Torres had waited weeks for the state to process her unemployment claims.

She felt anxious about how the family would pay their bills. As the stress mounted, her phone began to glitch—all of her photos and contacts vanished.

That was the last straw, Torres said. She had a breakdown, right there in her home. Her blood pressure spiked. She could barely breathe. Her adult daughter, who had come to help with her phone, called 911.

Because Torres wouldn’t consider going to the hospital, the paramedics helped her relax and take deep breaths. She gradually calmed down—but the tightness in her chest frightened her.

“Feeling the way that I did at that moment—that’s when I decided, ‘No, I have to stop smoking.’

“And I did,” she said. “I didn’t pick this quit date. The date picked me.”

‘I can breathe’

Torres’s past experience with quitting has fueled her success this time around, Stern said.

“She’d had a substantial experience with quitting successfully, and that can be really useful, because you reflect back on ‘When I did that, what made that work, how did I do it and then what happened—why did I relapse?’”

Her ability to reflect on the past gave Torres a real readiness to quit, Stern said.

“She knew what to expect, and I think that helped her. She’s a very open and very genuine person as well, so she has … a balanced perspective.”

Over time, Torres, working with her primary care provider, will taper off of the medications she takes to curb her nicotine cravings and manage her anxiety. For now, though, she’s pleased to have found the strength to achieve her goal.

“I’m smoke-free, I’m happy, I’m doing exercises now on the treadmill because I can breathe—and I can’t emphasize enough how 101 saved my life,” she said.

“It makes me so emotional to know that people out there care for people like me that don’t have the willpower, that don’t think they can do it.”