WINNING THE FIGHT AGAINST TOBACCO
Lucille C. Perez, M.D. 

102nd President 

National Medical Association 

WINNING THE FIGHT AGAINST TOBACCO

The National Medical Association (NMA) supports the 

distribution of Pathways to Freedom to the African American 

‘‘

community. Tobacco use is a major cause of death and disease 

for Black people. Pathways to Freedom has been a tremendous 

blessing for Black smokers, their families and friends, and the 

greater community. The NMA endorses Pathways to Freedom 

and urges all persons concerned with the well-being of Black 

people to use these materials, support their distribution, and 

make them part of all health programs and services intended 

for the African American community. ‘
 ‘

Authors
 

Robert G. Robinson, Dr.P.H.
 

Charyn D. Sutton, B.A.
 

Denise A. James, B.S., M.Ed., CHES
 

Carole Tracy Orleans, Ph.D.
 

Pathways to Freedom
 

The freedom we are talking about is freedom from tobacco. Freeing ourselves 

from the need for cigarettes is a step on the path to taking more control over our 

lives. The Pathways to Freedom guide is one answer to the major problem of 

smoking for Blacks in America. For smokers, it provides a place to start. It helps 

friends and families be part of the solution and provides strategies for community 

members who want to educate people about the dangers of tobacco. This is your 

guide. It was put together with the help of Black churches, tenant groups, the 

Prince Hall Shriners, Daughters of Isis, and other members of the community. 

The Guide Has Three Parts 

■ Education—Informs you of how tobacco use affects 

the Black community. 

■ How to Quit—Tells you and those around you how 

you can quit smoking. 

■ Community Organization—Shows you how 

communities can work together to fight against the 

tobacco industry. 

Freeing ourselves 

from the need 

for a drug like 

nicotine in 

cigarettes is a 

step on the path 

to taking more 

control over our 

lives. 

Highlights 

What Smoking Cigarettes Does to Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 

Tobacco Products: They Sell, We Buy . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 

Fight the Smoking Triggers: You Can Quit! . . . . . . . . . . . . . . . . . . . . . . . 16 

Ending the Tobacco Addiction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 

Keeping the Weight Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 

If You Start Smoking Again . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 

Fighting Back and Winning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 

The Power to Make a Difference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 

3
Education 
Meet the 

Freeman Family 

Finding the path that takes us away from tobacco isn’t easy. No one way works 

for everybody. That is why we asked the Freeman family to help. 

The Freeman family lives in Anytown, USA. The family has a father, a mother, 

and three children. The grandparents and Aunt Noreen (the father’s sister and 

mother’s best friend) are also part of the family. Granddaddy’s great-grandfather 

took the last name “Freeman” in the mid-1800s when slavery ended. 

The Freemans are a lot 

like many Black people 

you know. Some of them 

are smokers, and some 

are not. 

EDUCATION
 

The Freeman family...Top row, from the left: father Sam, mother Dot, older son Tyrone, and Aunt 

Noreen (father’s sister and mother’s best friend). Bottom row, from the left: younger son M.J., 

daughter Nia, Granddaddy, and Grandma. Granddaddy, father Sam, and Aunt Noreen are smokers. 

5
EDUCATION
 

What Smoking 

Cigarettes Does to Us 

“He who 

conceals his 

disease cannot 

expect to be 

cured.” 

– Ethiopian proverb 

Smoking causes 1 out of every 5 deaths in the United States. The average 

smoker dies 7–8 years too early. Smokers are also more likely to get diseases 

that make it hard to lead an active life. 

Before the 1950s, smoking was far less common among Blacks than Whites. 

This is not true anymore. There are now more than 8 million African Americans 

who smoke. Because more Blacks are smoking, deaths of Black people who 

smoke have gone way up. 

Each year, more than 47,000 Black people in the United States die from 

diseases they get just because they smoke. That includes African Americans and 

also Black people who have come to the United States from other parts of the 

world. Tobacco-related diseases kill more Black Americans each year than car 

crashes, AIDS, murders, and drug and alcohol abuse put together. 

Sickness caused by smoking puts people in the hospital every day. 

6
Leading Causes of Death for African Americans 

Each year, more Black Americans die from diseases caused by smoking than from 

murders, AIDS, drug and alcohol abuse, and car crashes put together. 

Number of Deaths 

47,300 

5,000 6,000 

8,000 8,000

Smoking- Murder Car Drug and AIDS 

Related Crashes Alcohol 

Diseases Abuse 

Some Other Problems That Come From Smoking 

Smoking even a few cigarettes a day does damage. Cigarettes are a major cause 

of heart attacks, and they can also damage the blood vessels. Smoking can lead 

to strokes and emphysema. Smoking can cause cancers of the lungs, throat, 

mouth, bladder, cervix, stomach, and kidney. 

Women face special risks from smoking. More Black women today get lung 

cancer than get breast cancer. Smoking causes problems during pregnancy. A 

baby that is born to a smoker may be sickly or even die. Black men are 50% 

more likely to get lung cancer than White men. Baby’s Healthy Lungs 

Mildly Diseased 

Adult Lungs 

Severely Diseased
 

Adult Lungs
 

EDUCATION 

7
 
EDUCATION
 

Breathing Someone 

Else’s Smoke 

“Nothing can 

be changed 

until it is 

faced.” 

– James Baldwin 

Secondhand smoke is the smoke that is exhaled or that comes from the burning 

end of a cigarette, pipe, or cigar. Secondhand smoke can come in through 

cracks in the walls. It can hang around in hallways and doorways where people 

have been smoking. 

Breathing someone else’s smoke can be deadly, especially if you live or work in 

a place where people smoke. That is why it is so important for smokers to go all 

the way outside if they want a cigarette. When one person smokes inside, it can 

cause problems for everyone else. 

Children who are around tobacco smoke in their homes have more health 

problems like asthma and ear infections. They are sicker and stay in bed more. 

They miss more school days than children whose homes are smoke-free. Babies 

who live in homes with secondhand smoke are more likely to die as infants than 

other babies. 

Grandma to Granddaddy: “I wish you wouldn’t smoke those cigarettes around your 

granddaughter Nia. It’s hard for her to breathe with all that smoke.” 

8
Smoke Hurts Those Around You
 

EDUCATION 

“We are happier when the people we love don’t smoke.” 

The number of Black children with asthma is 25% higher than the number of 

White children with asthma. These children can have attacks if they breathe 

cigarette smoke. African American adults are 2 to 3 times more likely than 

White adults to go to the hospital if they have an asthma attack. 

In many Black communities, people don’t say much about secondhand smoke. 

They don’t want to hurt a smoker’s feelings. It is often hard for younger Black 

people to say anything at all. To speak out would seem rude and disrespectful. 

Most smokers know that it is important for them to quit for their own health. 

What smokers need to understand is that their secondhand smoke can make 

people around them sick too. It can take as long as 2 weeks for the nicotine in 

tobacco smoke to clear out from a room where people have been smoking. 

If you smoke around 

your child, he inhales 

many of the same poisons 

that you do. 

9
 
EDUCATION
 

Tobacco Products: 


They Sell, We Buy
 

“All actions are 

judged by the 

motive 

prompting them.” 

– From the sayings of 

Muhammed (Hadith) 

Tobacco companies sell billions of cigarettes and cigars in Black communities. 

One reason is because of target marketing. That’s when a company picks out 

certain groups and uses ads to get their attention. Cigarette companies use target 

marketing all the time—not only to the Black community, but also to other 

groups like women, gays and lesbians, and blue-collar workers. 

A report by the tobacco company says it is the money: “Clearly, the sole 

reason for interest in ... black ... communities is the actual and potential 

sales of ... products within these communities ....” (Brown and Williamson 

Tobacco Corporation). 

NO community should ever be targeted with a product that kills. 

Tobacco companies reach the Black community with glitzy ads that give the 

wrong message—especially to children. Tobacco ads show only beautiful 

people. They never show people who become sick and die because they 

smoked. 

It is hard to miss all the cigarette ads in the community. 

10
EDUCATION
 

False Friends 

Over the years, tobacco companies have given money to support Black music, 

sports, theater, dance programs, and art shows. But the money that they give away 

is much less than the money they make from selling cigarettes to Black people. 

In fact, the money that African American smokers spend on cigarettes in a 

single day could send more than 2,500 Black students to college for an 

entire year. 

Your Cigarette Money Could Buy... 

“If we just count the 

number of people it kills, 

tobacco is the number 

one health problem facing 

the Black community.” 

11
EDUCATION
 

“My people 

are destroyed 

for lack of 

knowledge.” 

– Old Testament, KJV, 

Hosea 4:6 

Why Do Smokers 


Keep Smoking?
 

Some people think that smoking is just a bad habit. But smoking is more than 

a habit. Most smokers’ bodies need the nicotine in cigarettes or they go into 

withdrawal. Needing something that much is called addiction. That’s why most 

smokers keep smoking even when the cigarette prices go up. That’s why a 

smoker will go outside to smoke even if the weather is raining, cold, or blazing 

hot. 

Most smokers are addicted. If a person reaches for a cigarette within 30 minutes 

after waking up, that tells the tale. According to the U.S. Surgeon General, the 

nicotine in cigarettes can be as addictive as cocaine or heroin. 

Many people say they smoke cigarettes to unwind and to feel more relaxed. But 

studies show that smoking actually raises a person’s blood pressure and heart 

rate. 

You know you are hooked when you reach for a cigarette first thing in the morning. 

12
EDUCATION
 

“I want to quit, but the pressure 

at work really gets to me. 

Then there is the addiction. 

Sometimes I just crave a 

cigarette.” 

What’s Keeping You from Quitting? 

What’s in 

Cigarette Smoke? 

There are 4,700 chemicals in 

cigarette smoke, and at least 

60 are known to cause cancer 

in humans. Some of the 

chemicals in cigarette smoke 

are: 

Acetoneœfingernail polish 

remover 

Ammoniaœtoilet cleaner 

Arsenicœrat poison 

Butaneœcigarette lighter fluid 

Cadmiumœused in paint 

Carbon Monoxideœcar exhaust 

fumes 

Formaldehydeœused to preserve 

dead people 

Hexamineœbarbecue lighter 

Hydrogen Cyanideœgas 

chamber poison 

Methanolœrocket fuel 

Naphthaleneœmothballs 

The Dangers of Menthol Nicotineœinsecticide/

addictive drug 

Menthol cigarette brands have been the top sellers among African American Nitrobenzeneœgasoline additive 

smokers for many years. In fact, 3 out of 4 Black smokers buy menthols. Stearic Acidœcandle wax 

Chemicals are added to menthol cigarettes to give them a fresh, minty taste. 

This can make it easier for a smoker to inhale deeply, which may allow more 

chemicals to enter the lungs. 

Menthol in cigarettes does not make smoking safer. In fact, menthol may even 

make things worse. No one knows for sure. What we do know is that the only 

safe number of cigarettes to smoke is zero. 

“I used to think that cigarettes 

helped me cope. But the way I 

see it now, they just add to my 

problems.” 

13
How to Quit 
Where Are You in Your 

Plans to Quit? 

HOW TO QUIT
 

■ I’m not ready to quit smoking. 

Read this guide for reasons why you should quit. 

■ I’ll be ready to quit smoking soon. 

Don’t wait too long. This guide will give you ideas on how to get ready 

to quit. 

■ I’m ready to quit right now. 

Great! Read on for ideas that can help you to quit and stay quit. 

■ I used to smoke, but I’ve quit. 

Great! This guide can help you to stay quit. 

■ I quit before, but I’m smoking again. 

This guide is for you, too. People quitting cigarettes often try many times 

before they succeed. Read on for tips to help you to quit for good. 

A few people can stop smoking just by throwing away their cigarettes. But for 

most people, quitting smoking is not that easy. Quitting takes more than 

willpower. It takes a solid plan. 

Pathways to Freedom is a quit-smoking plan that has worked for many African 

Americans. It looks at ways to end the smoking addiction. This guide tells 

about choosing a Quit Day. You will learn about medicines and counseling to 

help you quit. There is advice on handling stress, fighting off the urge to smoke, 

and keeping extra pounds away. 

And If You Don’t Smoke . . . 

This guide is for you, too. Just look for 

advice from Nia, Grandma, and M.J. 

You’ll find ideas and hints to help 

people you love who are trying to quit 

smoking. Smokers with support from 

family and friends are more successful 

in quitting smoking. 

“I set a goal of quitting 

by my birthday. To get 

ready, I used the plan in 

the Pathways to Freedom 

guide and I did it.” 

15
HOW TO QUIT
 

Fight the Smoking 

Triggers: You Can Quit! 

“Little by little 

the bird builds 

its nest.” 

– Haitian proverb 

Most smokers like to smoke at special times. It may be right after a meal or 

when they are at a party with friends. Some people light up whenever they talk 

on the phone or get into a car. Other triggers for smoking can be watching 

television, playing cards, or reading a book. Drinking alcohol or a cup of coffee 

can make a person want a cigarette. 

Often the triggers for smoking are feelings. Smokers sometimes smoke more 

when they are upset, bothered, or stressed out. Lighting up is a way of shutting 

down. It is a way of coping with problems—like losing a job, breaking up with 

a loved one, or having someone crash into your car. 

Nicotine is an addiction, but quitting is possible. There are many ways a smoker 

can gain control over urges to smoke. Here are some ideas. 

Make a list of the times when you always reach for a cigarette. Pick one of 

those times. Then, do something else instead of smoking. For example, let’s say 

you always smoke when you are on the phone. Put some paper and color pens 

by the phone instead of cigarettes. To keep from being tempted, remove the 

ashtrays and matches from the telephone stand. When you’re on the telephone, 

try doodling instead of puffing. 

Alcohol can act as a trigger for smoking. While you are quitting smoking, try 

not to drink liquor, beer, or wine for 3 months. 

Sam: “I usually smoke when I play cards. I’m trying to break that 

habit.” 

16
Things to Do Instead of Smoking
 

If you always smoke in the car, take away the lighter. Put your cigarettes in the 

trunk while you are driving. Instead of smoking, listen to some soft music. 

Don’t try to do everything at once. Change one thing at a time. Stop smoking at 

one special time. It may not be easy, but stick to it until you succeed! Don’t 

give in. Then go on to the next thing you want to change. 

Keep going until you have checked off all the smoking triggers on your list. If 

you can stop smoking at your favorite times, you are well on your way to 

stopping all the time. These quit ideas are useful for the light smoker as well as 

for the heavy tobacco user. 

“Exercising is part of my 

life now. I try to work 

out almost every day.” 

“Now that I’ve stopped smoking, I feel I can be a much better role 

model for my granddaughter. That really makes me feel good.” 

If You Want to Help 

“Don’t ask to go places where people 

will be smoking. Suggest a movie or 

a smoke-free restaurant instead.” 

HOW TO QUIT 

17
 
HOW TO QUIT 

Ending the Tobacco 

Addiction 

“We must 

learn to respect 

ourselves.” 

– Audre Lorde 

Why do most smokers have trouble quitting? It is because they are addicted to 

the nicotine in their cigarettes. 

Smoking cigarettes gives a smoker regular jolts of nicotine. After a while, the 

body gets used to it. For an addicted smoker, being without nicotine brings on 

feelings of withdrawal. 

But the nicotine is NOT what causes the major health risks of smoking. 

Cigarettes are filled with thousands of other chemicals. Doctors believe the 

deadly chemicals in cigarettes and tobacco smoke cause the bad health effects 

of smoking. For example, most brands that Blacks smoke are high in tar. Tar in 

cigarettes causes lung cancer. Cigarettes also have carbon monoxide, which 

takes oxygen from the blood and can lead to strokes. 

Studies show that Black smokers actually want to quit more than most other 

groups. Hundreds of thousands of Black smokers have quit smoking already. 

More try and succeed every day. So can you. 

Sam’s doctor talks to him about using a nicotine patch. 

18
 
Ways to Fight Nicotine Addiction 

Using products that replace the nicotine in cigarettes and cigars for a short time 

can greatly increase the chances of a smoker quitting. These products have 

small amounts of nicotine without all the other chemicals. The nicotine 

products come as patches, gum, lozenges, inhalers, and sprays. The idea is to 

help the body get over its need for nicotine—little by little. 

There are also pills to help smokers quit. A smoker usually begins taking the 

pills a week or two before the Quit Day. They also reduce feelings of not 

having nicotine. However, they do not have nicotine in them. The first nicotinefree quit-smoking pill—Zyban®

—was approved for use in the United States in 

1997. Other products are in the planning stage. 

Medicines that help smokers quit can be bought over-the-counter and by 

prescription. Your doctor or pharmacist may be helpful in figuring out which 

medicine is best for you. 

Quit Smoking Medicines Work Best With: 

■ Help from your doctor 

■ One-on-one counseling 

■ Call-in telephone quitlines 

■ Quit smoking classes or support groups 

If You Want to Help 

“People can get very edgy when they are 

trying to quit smoking. Be understanding. 

Their grumpiness will pass with time.” 

HOW TO QUIT
 

“Patience and strong 

support from my friend 

helped me quit. He really 

understood what I was 

up against.” 

19
HOW TO QUIT
 

“Take the first 

step in faith.” 

– Dr. Martin Luther 

King, Jr. 

Set a Quit Day: 

Take the First Step 

Doctors say you should choose a specific Quit Day. Having a Quit Day gives 

you a goal to reach. It is a promise to keep to yourself and your loved ones. 

Setting a Quit Day 2 to 3 weeks in advance gives you time to get ready. 

There is no “perfect” time to quit. But some times are better than others. It is 

much harder to quit when you face a family crisis or a big problem at work. 

Pick a time when things are going well. You may pick a day that is celebrated 

by the community, such as Dr. Martin Luther King, Jr., Day. 

Circle your Quit Day on the calendar. Write it down. Carry it with you. Tell 

your family and friends. Share the Pathways to Freedom guide with them so 

they can help you succeed. Check to see if your doctor can tell you about any 

medicines that can help you quit. 

If you know people who used to smoke, ask them how they quit. If you live or 

work with other smokers, ask them not to offer you a cigarette, even if you ask. 

And don’t be surprised if a friend or family member wants to quit smoking 

along with you. 

Sam: “I’m ready to quit. Setting a Quit Day is my first step.” 

20
It Can Be Done
 

“My best friend and I 

picked the same Quit 

Day. That way, there 

were two of us going 

through the tough times 

together.” 

Your Quit Day is very important. Ask anyone you know who used to smoke. 

Twenty years from now, the day you gave up cigarettes for good will be a day 

that you remember. 

Think positive thoughts. Say to yourself, “I can do it this time!” even if you have 

tried before. Think about how much better you will feel after you quit for good. 

The Night Before 

■ 	 Throw out all your cigarettes, every last one! Get them out of hiding places, 

like pockets, handbags, and glove compartments. 

■ 	 Get rid of lighters, matches, and ashtrays. Make sure there is nothing 

around that reminds you of cigarettes. 

■ 	 If you plan to use medicines to help you quit, make sure you know how to 

use them. Ask your doctor or pharmacist if you have questions. 

■ 	 Stock up on sugar-free gum and mints, carrots, celery, or cloves, so you 

always have something to reach for instead of a cigarette. 

If You Want to Help 

“If you have a friend who’s trying to quit, 

be there for them. They need someone to 

tell them it’s going to be all right.” 

HOW TO QUIT
 

21
HOW TO QUIT
 

Don’t Get Side-tracked: 

You Are Not Alone 

“Make no promise 

for tomorrow if 

you are able to 

keep it today.” 

– Iyanla Vanzant 

One of the problems some smokers face when they try to quit is that other 

people around them are still smoking. They see people with cigarettes 

everywhere they look—on street corners, on posters, on TV, in movies. 

That can make quitting harder but not impossible. Smokers don’t have to battle 

smoking on their own. Quit-smoking materials, medicines, and program 

information are given out by doctors, local hospitals, health care centers, 

churches, and community organizations. Some are free, some are low cost, and 

some can be purchased without a prescription. 

Some people use prayer as part of their personal approach to quitting. Others 

chant or think quiet thoughts. Faith communities often sponsor quit-smoking 

classes and call-in prayer lines. Some hold special Smoke-free Sabbath services 

to help smokers quit. Drawing on spiritual support and a person’s belief in God 

or a “higher power” can lessen the stress of quitting smoking. 

Smoking can look great when celebrities do it, but it isn’t so great in real life. 

22
Quit Smoking Programs Can Help
 

“Quitting is hard work. 

But I did it for myself 

and for my children. I 

knew that they would be 

proud of me for doing 

my best to quit.” 

Many state health agencies and private groups have programs to help smokers 

quit. There are classes in the community, and some government and private 

groups offer free telephone quitlines. Doctors, local hospitals, and health plans 

also have resources. Some are free and others are low cost. 

However, not all quit-smoking programs are worth your time. Do not be fooled 

by programs that promise great success in quitting without any work on your 

part. They are probably just trying to take your money. If you have questions 

about a quit-smoking program, just ask your doctor or pharmacist. 

Switching to a so-called “light” cigarette is not a good idea either. Studies show 

that “light” cigarettes have just as many harmful chemicals as regular cigarettes. 

There is no such thing as a safe cigarette. 

If You Want to Help 

“If family members want to know more 

about quitting smoking, tell them you’ll 

look up stuff on the computer. If there is 

no computer at home, try the library.” 

HOW TO QUIT
 

23
The First Few Days 

Can Be Tough 

HOW TO QUIT 

“Though a 

righteous man falls 

seven times, he 

rises again.” 

– Old Testament, NIV, 

Proverbs 24:16a 

Things will get better soon. The “quitting blues” do not last forever. The pangs 

of giving up cigarettes tend to be strongest during the first week. You may not feel 

like yourself or may cough more at first. The worst part will be over soon—2 to 3 

weeks after you smoke your last cigarette. After a month, you will feel better 

than you felt when you smoked. So, be patient. Take it one day at a time. 

If You Have 

Urges to smoke 

What to Try 

Wait it out—whether you smoke or not, the 

strong urge to smoke will pass in a few minutes. 

Remind yourself of all the reasons why you want 

to stop smoking. Say a prayer. Do a brief 

meditation. Repeat a favorite poem or verse. 

Trouble paying attention Go easy on yourself. You’ll get your focus 

back soon enough. Break big jobs into small 

parts. Take a break and come back to the task a 

little later. 

Tense, restless feelings Take a quiet walk. Work in the garden. Listen to 

some soothing music. Take a shower or bath if 

possible. Arrange some flowers. 

Frustration and anger Get away from the problem. Exercise to blow 

off steam. Close your eyes and imagine 

something soothing and pleasant. Escape for a 

moment. Think about that peaceful image and 

nothing else. 

Trouble sleeping Try deep breathing to relax at bedtime. Drink 

something warm and tasty (but without 

caffeine!). Take a bath. 

Trouble with bowels Add some fiber to your diet—whole grain 

breads, cereals, fresh fruits, and vegetables. Don’t 

forget to drink lots of water! 

Hunger, especially 

for sweets 

Drink fruit juice. Eat low-calorie sweets and 

fruits. Chew some sugar-free gum. Try some 

licorice or peppermints. 

24
HOW TO QUIT
 

The 5 Ds Can Help You Cope 

■ Drink Water 

Slowly sip clear water—up to 8 glasses a day. The water helps flush
 

nicotine out of your body. 


■ Deep Breathe 

Take 10 slow, deep breaths—in through your nose and out ever so slowly 

through your mouth. Deep breathing will help you feel relaxed and in 

control. 

■ Do Something Else 

Focus on being busy doing something you like besides smoking. The idea is 

to keep from thinking about cigarettes at all. 

■ Discuss 

Talk with a friend or family member about what’s happening to you. Tell 

them how you are feeling. Sharing your thoughts will help a lot. 

■ Delay 

Allow some time. Don’t reach for that cigarette right away. Count to 200 

and then to 250. Urges to smoke pass in about 3 to 5 minutes. 

If You Want to Help 

“Parents who are trying to quit smoking can 

be very stressed out. We kids should be on 

our best behavior and stay out of trouble.” 

“Just called to say hi and 

see how you are doing.” 

“I am hanging in there. 

It’s hard, but I really 

want to make it this 

time.” 

25
Keeping the 


Weight Off
 

HOW TO QUIT
 

“Success doesn’t 

come to you— 

you go to it.” 

– Marva Collins 

Many people worry about gaining weight if they stop smoking. In fact, many 

women who don’t want to get fat choose “slim” and “ultra-slim” cigarettes. 

Fear of gaining weight is never a good reason to keep smoking. By watching 

what you eat and getting more exercise, it is possible to quit smoking without 

gaining much or any weight at all. 

You should wait until you have kicked smoking for good before starting on a 

diet. But it makes sense to avoid extra snacking and to do more exercise like 

walking. 

Drinking water is necessary for good health. It is even more important for 

people who quit smoking. Water helps the body get rid of leftover nicotine. Try 

to drink at least 8 glasses of water each day, especially right after your Quit 

Day. Stay away from caffeinated coffee, tea, and colas. 

Some People Do Gain Weight When They 

Stop Smoking—Here’s Why... 

■ Your sense of taste and smell improves. Foods taste better. 

■ You may start to crave sweets with lots of calories. 

■ Your body needs 100 to 200 calories fewer a day when you quit smoking. 

■ You may start putting food in your mouth instead of a cigarette. 

“After I quit smoking, I 

watched what I ate. Mostly, 

I tried to cut back on fatty 

and fried foods. I only gained 

3 or 4 pounds. It really 

didn’t bother me.” 

26
Watching What You Eat Is Only Half of It— 

The Other Half Is Exercise 

Keeping extra pounds off is easier if you exercise. Staying active also helps you 

quit smoking. 

Exercise does not have to be a big deal. Just do more than you were doing 

before. Walking is always a good idea. It gives you the chance to be alone—or 

to be with someone. It gives you time to think things over or to think about 

nothing at all. All you need are good walking shoes and a place to walk where 

you feel safe. 

Here Are Some Ways to Cut Down on Calories 

■ Broil or bake foods when possible. 

■ Drain extra fat from foods that are fried. 

■ Cut excess fat from meat before cooking. 

■ Ask for sauces, gravies, and salad dressings “on the side.” Walking with a friend 

is fun and a good way ■ Go easy on biscuits, rolls, and breads. to stay in shape. 

■ Boil or steam vegetables, and eat lots of them. 

■ Try not to use margarine or butter. 

■ Avoid meals that are full of sugars and starches. 

■ Switch to sherbet or frozen yogurt instead of ice cream. 

■ Use mustard in place of mayonnaise or sandwich spread. 

■ Buy tuna packed in water, not oil. 

If You Want to Help 

“Don’t go on a cake and pie baking spree 

when someone is trying to quit smoking.” 

HOW TO QUIT 

27
 
HOW TO QUIT
 

How to Stay Quit When 

You Want to Smoke 

“If there is no 

struggle, there is 

no progress.” 

– Frederick Douglass 

It takes time to get over the urge to smoke. The urges will be strongest in the 

places where you smoked the most. In the beginning, you may want to avoid 

places where you used to smoke. After a while, the urges will get a lot weaker. 

Avoid smoking even one cigarette. While a single cigarette may not doom your 

efforts to quit, any smoking makes it easier to backslide into addiction. It is not 

worth the risk. 

If you do get the urge to smoke, don’t act on it. Instead, write down what you 

will do instead of smoking. It may be as simple as reaching for a toothpick 

instead of a cigarette. You could say a prayer or go outside for a short walk. 

Some people who are still smoking may try to get you smoking again. Be ready 

to keep saying NO. Your life and your health are at stake. And no matter how 

much you miss your cigarettes, don’t start smoking cigars or “light” cigarettes. 

And don’t start using spit tobacco. All tobacco is bad. 

Praying helps some people meet difficult challenges, like ending addiction to tobacco. 

28
Making It to 2 Weeks 

If you have stopped smoking for 2 weeks, congratulations! You have made it 

through the hardest part. To stay smoke-free, stick to what got you this far. By 

now you should be enjoying some of the good things that come from quitting. 

You may already have noticed that you are coughing less and have more lung 

power. You should have more energy and a new sense of freedom and pride. 

If you have been taking medication to help you quit, continue for at least 6 to 8 

weeks—that’s the time needed for the medicine to help you stay tobacco-free. 

What if you slip? Try not to—not even once. But if you do smoke a cigarette or 

two, catch yourself and get right back on track. Don’t let guilt lead you back to 

regular smoking. Be patient with yourself. One or more slips do not mean failure. 

■ Think about why you slipped and how to avoid it next time. 

■ Get rid of any leftover cigarettes. 

■ Try to spend time away from people who are still smoking. 

■ Call a quitline for help. 

Just don’t give up. Quitting takes practice. Smoking is tough to beat. Many 

people do not quit for good on the first try, but each try is another step toward 

success. You can quit. Hundreds of thousands of African American men and 

women already have. 

HOW TO QUIT
 

“I did OK until I was 

laid off. I felt like I 

needed my old crutch— 

cigarettes. Then I 

remembered how far I’d 

come. I made up my 

mind to stay quit.” 

“No question about it—we wanted to give up trying. We thought 

about our family. We prayed about it. In 2 weeks, we felt fine.” 

29
HOW TO QUIT 

If You Start 

Smoking Again 

“The most 

important 

requirement 

in success is 

learning to 

overcome 

Black people quit smoking every day. But not everyone stays quit. Some return 

to smoking. In fact, African Americans have a harder time staying quit than 

other groups. No one knows why. It may simply be the stresses of everyday 

life...like keeping a job, juggling family demands, and dealing with race 

discrimination. 

The medical term for going back to an addictive behavior is “relapse.” It is 

similar for all kinds of addictive drugs—from cocaine to cigarettes. For some 

people, going back to smoking happens because they just can’t get over 

wanting a cigarette. Often that happens in the first 2 weeks. For others, going 

back to smoking can happen months or even years after they have quit. 

failure.” 

– Reggie Jackson 

How Your Body Changes When You Quit Smoking 

Within 20 minutes: • Blood pressure and pulse rate decrease 

• Body temperature of hands and feet increases 

Within 24 to 48 hours: • Chance of a heart attack decreases 

• Ability to smell and taste improves 

Within 2 weeks to 3 months: • Circulation improves 

• Walking becomes easier 

Within 1 to 9 months: • Coughing decreases in most people 

• Sinus congestion, fatigue, and shortness of 

breath decrease 

Within 1 year: • Added risk of heart disease drops by half 

Within 5 to 15 years: • Risk of stroke drops to that of people who have 

never smoked 

Within 10 years: • The risk of cancer of the lung, mouth, throat, 

esophagus, bladder, kidney, and pancreas also 

decreases 

30

Within 15 years: • Risk of coronary heart disease is now similar to 

that of people who have never smoked 

• Risk of death returns to nearly the level of 

people who have never smoked 
Learn to Deal With Stress 

When a former smoker goes back to 

smoking, it is often because of a stressful 

event. That is why it is so important to learn 

how to manage stress as a part of quitting 

smoking and staying quit. When life takes a 

turn for the worse, smoking a cigarette may 

seem to relieve the stress. The truth is that 

smoking actually keeps the body in a 

stressed state and causes more problems than 

it solves. Deep breathing and exercise are 

much better ways to reduce stress than 

cigarettes. 

Stress isn’t the only reason why people 

return to smoking after being quit. Happiness, boredom, loneliness, and even 

being around people who are smoking and drinking at a party can trigger a 

return to cigarettes. 

What to Do 

If you have been quit for a while but find yourself smoking again, act quickly: 

■ If you have smoked only a few cigarettes, quit again right away. 

■ If you are smoking at your old level, set a new Quit Day within a month or so. 

■ Think about what worked before, and try to figure out what you could do better. 

■ Ask your doctor or pharmacist if there are any other products to help smokers quit. 

■ Talk with a pastor or counselor. 

■ Read Pathways to Freedom again to see if there is anything you missed. 

Remember, if you quit once, then you can quit again—but for good this time. 

If You Want to Help 

“An ex-smoker who starts smoking again 

needs encouragement to try again—not 

your criticism.” 

“I started smoking again 

right after my accident. 

But I didn’t let that slip 

defeat me. I quit again. I 

haven’t smoked for 10 

years.” 

HOW TO QUIT 

31
 
Community Organization 
We Must Teach, Organize, 

and Take Action! 

“Educating the 

community about the 

dangers of tobacco is as 

easy as talking to your 

neighbors and friends.” 

“Harambee” is a Swahili word from Africa that means “We must pull together.” 

That is what we have to do to solve the tobacco problem. 

Most African Americans do not smoke. Yet all of us are affected in some way 

by tobacco. Tobacco is part of our history. It was a major crop in the South 

during slavery. Tobacco companies hired Black people in good jobs. Over the 

years, many African Americans have worked for tobacco companies or on 

tobacco farms. Tobacco paid our bills. 

For decades, we accepted the tobacco companies. These companies gave 

hundreds of thousands of dollars to Black cultural and educational programs. 

We really thought the tobacco companies were our friends. We did not realize 

their products caused disease and death. 

Fighting the Tobacco Companies Is Not Easy 

It is hard to fight an industry that gives us money and jobs—because the Black 

community needs money and jobs. But times are changing. 

We can break the hold that tobacco has on our loved ones and on our 

community. Following are some strategies that have worked. 

COMMUNITY ORGANIZATION
 

33
COMMUNITY ORGANIZATION
 

Fighting Back 


and Winning
 

“No matter how 

long the night, 

the day is sure 

to come.” 

– Congolese proverb 

All around the nation, Black people are fighting back against the companies that 

sell cigarettes—and winning. 

The first major victory was in 1990 with Uptown cigarettes. Uptown was a 

high-tar, menthol cigarette brand advertised for African Americans. It was going 

to be sold in Philadelphia. But the Black community fought back. As a result, 

not a single Uptown cigarette was ever sold in Philadelphia, or anywhere else. 

Success happened in other cities. In Boston, Chicago, Los Angeles, and Atlanta, 

new menthol cigarettes for Blacks were introduced. They had names like X 

cigarettes and Camel Menthols. The people fought back against those brands, 

too. 

Black people held sit-ins to protest cigarette ads. They took part in letter-writing 

campaigns against new menthol brands. Black churches held Smoke-free 

Sabbaths. They asked people to make their homes smoke-free. There were 

church services to remember loved ones who had died from tobacco. Some 

pastors and community leaders even whitewashed tobacco billboards. 

34
Communities Organized and Became 

More Powerful 

Organizing to promote a tobacco-free world. 

■ 	 Black pastors preached from their pulpits about the dangers of tobacco. 

■ 	 Black leaders said NO to money from tobacco companies. 

■ 	 Black parents joined in protest marches against new cigarette brands and 

cigarette ads. 

■ 	 Black children made their own ads about the lies tobacco companies tell. 

Black people said NO to the tobacco companies. With each success, Black 

communities got stronger and healthier. 

“Health is a more active concern among Blacks 

than Whites.... Fortunately, for this industry, 

this health concern does not translate strongly to 

anti-smoking attitudes....” 

– R. J. Reynolds Tobacco Company 

COMMUNITY ORGANIZATION
 

35
COMMUNITY ORGANIZATION
 

The Power to Make 

a Difference 

“The need for 

change bulldozed 

a road down the 

center of my 

mind.” 

– Maya Angelou 

In our communities, smoking is just one of the problems we face every day. We 

worry about many things—lack of jobs, poor housing, schools that don’t teach 

our children, racism, drugs, and crime. All these problems need our time and 

energy. 

But fighting against tobacco is something we can do right now. Why? Because 

smoking is a problem we can solve. Because smoking kills more of our people 

than anything else. 

We can end deaths and diseases from tobacco if we all work together. Then, we 

can use these skills to fight other problems that our community faces. As our 

people become healthier, we can do great things. 

Here are some ways that you and your friends can join the fight against 

tobacco. No one expects you to do everything on the list. Just pick one or two 

things to start. 

Places of worship and community centers are places where people can come together to make their 

neighborhoods stronger and healthier. 

36
Things We Can Do to Help
 

1
 

2 

3 

4 

5 

6 

7 

8
 

9
 

10
 

JOIN with others to stop the sale of cigarettes to children and teenagers in stores and 

through vending machines. In every state, selling cigarettes to anyone under 18 is against 

the law. 

MEET with store owners and ask them to remove tobacco ads that young people can see. 

MAKE SURE schools teach the dangers of using tobacco. Our children need the facts so 

they can live healthy and tobacco-free lives. 

HOLD programs for churches and mosques, fraternities and sororities, civic leagues, clubs, 

and community groups on the dangers of tobacco and what communities can do. 

WORK with union leaders and company bosses to have smoke-free rules and quit-smoking 

programs on the job. Get health plans to cover quit-smoking medicines and classes. 

ASK health clinics, doctors, and local hospitals to hold low-cost or free clinics for people 

who want to quit smoking. 

HELP groups in the community say no to “gifts” from tobacco companies. Look for other 

ways to get money for youth programs, reading tutors, scholarships, and other things the 

community needs. 

SUPPORT efforts to increase taxes on tobacco. Make sure that money is spent in Black 

communities to end smoking and to help the community in other ways. 

URGE elected officials to pass strong laws to protect communities from the dangers of 

secondhand smoke and support state telephone quitlines. 

SHARE copies of the Pathways to Freedom guide. Give them to friends, neighbors, and 

family members. 

COMMUNITY ORGANIZATION
 

37
COMMUNITY ORGANIZATION
 

Following the 

Pathways to Freedom 

“Freedom is 

never given, 

it is won.” 

– A. Philip Randolph 

At the beginning of this guide, three members of our family were smokers— 

Granddaddy, Sam, and Noreen. 

Our children—Nia, M.J., and Tyrone—were all at risk for illnesses from 

secondhand smoke. They also were in danger of becoming smokers themselves 

because adults around them smoked. That has all changed. 

With love and support, the smokers in our family kicked their addiction to 

cigarettes. Our entire family also joined with others to help make our 

community as tobacco-free as possible. We helped pass clean indoor air laws 

and higher tobacco taxes... which give us healthy air and keep more children 

from starting to smoke. 

You and your family can do the same thing. Whoever you are, wherever you 

live, there is a way for you to join the fight against tobacco. 

One year later, everyone in the Freeman family is healthier, happier, and smoke-free. 

38
Respect Your Community, Keep It Tobacco-Free
 

There are many paths that each of us can take to a smoke-free future. 

If you are a smoker, quit as soon as possible. Check with your state or city 

health department about whether your state has a free telephone quitline or 

other programs. Ask your doctor or a local health center if medicine and 

counseling are available. 

If you don’t smoke, help someone who is trying to quit. A survey of smokers in 

2001 showed that more than 3 out of every 4 smokers in the Black community 

want to quit. Let’s help them succeed. 

Whether you are a smoker or not, get involved. There is a lot to do. Join a 

tobacco control group that needs your help. Get your club or neighborhood 

group to take a stand against tobacco in the Black community. By pulling 

together, we can build a healthier community where people don’t have to die 

years before their time because of cigarettes. 

“I decided to get 

involved for him. We 

need strong healthy 

communities for our 

children.” 

COMMUNITY ORGANIZATION
 

39
Help Yourself and Others 

Quit Smoking 

“I am glad I called. I 

was not sure what to 

expect. I got some good 

advice from a person 

who really knew what I 

was going through.” 

“As a quitline 

counselor, I’m happy 

that I can help others 

over the rough spots. 

I’m an ex-smoker 

myself. I know it’s 

hard to quit.” 

40
Here Are Some Resources 

to Help You Quit 

Call Toll-Free Numbers... 

American Cancer Society 

1-800-227-2345
 

http://www.cancer.org
 

Or Visit These Web Sites 

Agency for Healthcare 

Research and Quality (AHRQ) 

http://www.ahrq.gov 

Centers for Disease Control and 

Prevention (CDC) 

http://www.cdc.gov/tobacco 

National Cancer Institute 

1-877-448-7848 

http://www.smokefree.gov 

American Lung Association 

Freedom From Smoking Online 

http://www.ffsonline.org 

American Legacy Foundation 

http://www.americanlegacy.org 

American Heart Association 

http://www.americanheart.org 

41
Acknowledgments 

We are especially indebted to members of the Pathways to Freedom Advisory Committee. First 

Edition: James Barnes, Jr., Rita Butler, Russell Fletcher, Jr., Sister Patricia Haley, Vivian Hughes, 

Ulysses Jones, Howard T. Mallard, Jr., Ruby J. Ruffin, Regina Sidney, Wallace Stevenson, Jr., and 

Lillian Trump. Second Edition: Bishop S.C. Carthen, Sandra Headen, Denise A. James, Yvonne 

Lewis, Jeanne Robinson, Sylvia Rosas, Abby C. Rosenthal, Peggy Toy, and Janice R. Love. 

In addition we would like to thank David Graham, Dr. Gary King, Dr. Sharon Marable, and Dr. 

Valerie Yerger for consultation on this publication; Cal Massey for his illustrations; and Eloisa 

Montes for her management and coordination of this initiative. 

CREDITS 

Page 7: The first two lung photographs were provided by the Medical Examiner’s Office, City of Philadelphia. The third lung photograph was
 

provided by Stephen M. Keller, M.D., Fox Chase Cancer Center. Note: The lungs are not shown true to scale; Data source: Centers for Disease
 

Control and Prevention. Smoking-attributable Mortality, Morbidity, and Economic Costs (SAMMEC): Adult SAMMEC software, 2002. Available
 

at http://www.cdc.gov/tobacco/sammec.htm; Hyert DL, et al. Deaths: Final Data for 1999. National Vital Statistics Report; Vol 49 No 8.
 

Hyattsville, Maryland: National Center for Health Statistics. 2001; Anderson, RN. Deaths: Leading Causes for 1999. National Vital Statistics
 

Reports; Vol 49 No 11. Hyattsville, Maryland: National Center for Health Statistics, 2001.
 

Page 9: Ashtray lungs photo courtesy of Minnesota Partnership for Action Against Tobacco.
 

Page 10: Quote Source: Brown and Williamson Tobacco Corporation (1984). Bateman M., Total Minority Marketing Plan. Bates Number:
 

531000141-0144. Retrieved on February 28, 2002 from: http://legacy.library.ucsf.edu/tid/eph40f00.
 

Page 29: Family photo courtesy of South Carolina African American Tobacco Control Network.
 

Page 35: Photograph courtesy of National Association of African Americans for Positive Imagery.
 

Quote Source: R.J. Reynolds Tobacco Company (1985). Black Opportunity Analysis. Bates Number: 505368425-505368482. Retrieved on January
 

14, 2002, from http//tobaccodocuments.org/rjr/505368425-8482.html.
 

Additional photography services were provided by Randy Santos, Randolph Photography. 


Cartoon concept created by Charyn Sutton; illustrated by Jay Scruggs, Comics Collaborative.